LECOM 2023

[heybrother]

None of the above will ever happen and any discussion of hypotheticals will just show a lack of understanding of MD/DO schooling, IM training, how residencies are created/certified etc, and how the hospitalist job market works.

There's a whole bunch of funny additional things though.

Like that no DPM who went back to MD/DO school ever practiced as a podiatrist. (Don't waste your time trying to find an exception)
Or that most podiatrists couldn't pass the USMLE (I had classmates who could barely pass "Podiatry Infectious Disease" after somehow passing Pharm)
Or that a lot of people go into IM to avoid procedures/surgery ie. they already suffered through general surgery. They just really love potassium.
Or that the hospital needs hospitalists to work 7/7 off shifts for $300K but that some local dumb PP pod will see the pus for free.

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[CutsWithFury]

Point is to graduate hospitalist podiatrist that will management diabetic patient with foot infections. Imagine if every hospital decides to hire a dedicated hospitalist podiatrist to manage this inpatients. The demand for pods will sky rocket.

You must be a boomer ABPM or grandfathered in ABFAS podiatrist.

This would never be allowed. It’s also so unnecessary. Hospitalists, MD/DO internal med, MD/DO family med would block this so hard.

Really????

A hospitalist podiatrist to ONLY medically manage diabetic foot inpatients?

I want the drugs you are smoking

 

[Shiyuan]

You must be a boomer ABPM or grandfathered in ABFAS podiatrist.

This would never be allowed. It’s also so unnecessary. Hospitalists, MD/DO internal med, MD/DO family med would block this so hard.

Really????

A hospitalist podiatrist to ONLY medically manage diabetic foot inpatients?

I want the drugs you are smoking

There is a large group in Orlando not far for me that does have a couple “hospitalist podiatrists”.

 

[PeaJay]

You must be a boomer ABPM or grandfathered in ABFAS podiatrist.

This would never be allowed. It’s also so unnecessary. Hospitalists, MD/DO internal med, MD/DO family med would block this so hard.

Really????

A hospitalist podiatrist to ONLY medically manage diabetic foot inpatients?

I want the drugs you are smoking

I know it is not the same, but I have heard talks of hiring a NP or MD/DO to medically manage patients for podiatry services (part of pod/ortho department not a hospitalist). This is a way of circumventing all the hospitalist moaning and groaning about podiatry train wrecks.

 

[Pronation]

I know it is not the same, but I have heard talks of hiring a NP or MD/DO to medically manage patients for podiatry services (part of pod/ortho department not a hospitalist). This is a way of circumventing all the hospitalist moaning and groaning about podiatry train wrecks.

These aren’t podiatry train wrecks. These are medical train wrecks with lower extremity issues on top of it. Ortho doesn’t want to be primary on geriatric hip fractures either and appropriately so.

 

[deleted1093615]

View attachment 362761

This was an awesome reply that got deleted by the podmed Instagram page. This must be an SDN member.

They disabled comments on the instagram because more people were commenting similar things hahaha

 

[CutsWithFury]

There is a large group in Orlando not far for me that does have a couple “hospitalist podiatrists”.

It’s not the same thing as described above. No way these podiatrists are doing medical management.

Hospitalist podiatrist is a podiatrist that takes care of all the inpatient consults and deals with all the inpatient cases. Little to no outpatient work.

There were hospitals in Minnesota that were hiring for these types of positions a couple years ago.

 

[msion]

This hospitalist podiatrist thing aside...I do want to emphasize that podiatry make hospitals good money on some of these I&D and amp procedures. Not the surgeon fee of course, but those facility fees add up.

There were couple times the OR just opened up a room for me on a weekend for these cases. I always wonder how the financials work out for our cases, until I learned about the facility fees. You are looking at around $3k for a toe amp/I&D/TMA. They all reimburse pretty much the same for the hospitals. A toe amp is of course much faster to do than a TMA. Depends on the insurances they can be a bit more or less. But in general not bad as you are just using a blade and no fancy hardware. A femur ORIF may have over $10k in facility fees, but these cases also take much longer.
Over the years I learned that OR doesn't really care much about the specialties. They just want quick cases with a high turnover rate. For anesthesia it's a different story. Surgery length matters more than the CPT codes. Ankle cases and toe amp mean the same to them. It's only when it gets to the leg that it will reimburse more for anesthesia. So a gastroc or some leg grafting work will pay more for the anesthesiologist than the ankle ORIF or triple arthrodesis. But they will definitely get more for that 4 hr 1st MTPJ fusion like someone mentioned in another post, though OR will get mad at you.

 

[deleted1138023]

Only positive I can think of is if in the future there is a possibility of a DPM/DO dual degree then LECOM will be the one to make it happen. Then other schools affiliated with a medical school and follow suit. A hospitalist podiatrist managing all the diabetic inpatient and also doing surgery will help increase pay and demand for "hospitalist podiatrist'. The "hospitalist podiatrist" can work under an MD/DO but still be somehow independent. Just like PA/NP who work on the hospital floor side by side with MD/DO and help manage inpatients.

We already do this in residency when we primarily admit our patients and manage them with appropriate consults.

yeah let's add even more confusion.

 

[619]

You must be a boomer ABPM or grandfathered in ABFAS podiatrist.

I wish I was a boomer so I am close to retiring after screwing tens of associates over the years

I want the drugs you are smoking

I only smoke Hookah haha

 

[Housewifey]

The administrators in the podiatry schools make more, lady at NYCPM got fired for selling test questions to students a few years ago. Thats where the real money is.

 

[deleted1138023]

The administrators in the podiatry schools make more, lady at NYCPM got fired for selling test questions to students a few years ago. Thats where the real money is.

not surprised rampant cheating goes on at most pod schools. something else that's never addressed.

 

[Housewifey]

not surprised rampant cheating goes on at most pod schools. something else that's never addressed.

I've heard other stories from TUSPM and Kent, don't know 100%, but don't doubt it. You also have to realize, these issues are prevalent in any school; MD, DO etc... I just feel like my education was devalued.

 

[AttackNME]

Just not a good idea for podiatrists to be medically managing patients. If the hospital is short they can find NP and PAs to help with that stuff. Where do we draw the line where it’s too medically complex to handle? Most states we can’t have NP/PAs working for us, so we would be on our own. What if someone needs urgent medical attention, do you cancel clinic? What if you’re in the middle of surgery? Why not at that point offer a podiatry residency for MD/DO candidates? That doesn’t even make sense but it makes more sense than podiatrists managing medical problems

 

[PeaJay]

What if someone needs urgent medical attention, do you cancel clinic? What if you’re in the middle of surgery? Why not at that point offer a podiatry residency for MD/DO candidates?

Why is this always the argument. What kinda of hospitals do people work at…there are code teams for acute problems.

 

[Boba Foot]

Point is to graduate hospitalist podiatrist that will management diabetic patient with foot infections. Imagine if every hospital decides to hire a dedicated hospitalist podiatrist to manage this inpatients. The demand for pods will sky rocket.

Some residency programs already have pod services that can primarily admit their own patients. I went to one of them. The problem is that it’s a “fake” admission in that yes the patient is technically admitted to podiatry but we consult every service under the sun because we don’t know how/are covering our ass to manage every comorbidity. Sure you can add some DO title next to DPM but at the end of the day you’re still a podiatrist and you don’t want to manage thyroid and cardiac **** because you’re just a podiatrist. You don’t see ortho tripping over their own dick to manage all this stuff because they know that’s ridiculous. Podiatrists are specialists and need to act like one instead of trying to be something they’re not.

 

[icebreaker32]

Admitting for podiatry is nothing new. I could admit at one hospital a long time ago and co-admit at another. The problem was I needed an H&P from a PCP prior to surgery anyways, so it really did no good 99 percent of the time. Only a few times did I admit, manage and discharge a patient without doing surgery or consulting another doctor. It just caused me to have to do discharge summaries and get even more calls than usual from nurses on the floor. Another thing is most hospitals have a rule at least one provider must round daily on a patient....if you admit that would be you. Even if you consult the hospitalist they may not round daily if they are not the admitting physician. It caused me to have to round daily.

It was easier when hospitalists took over and I just let them admit. I would still send the patients over to the hospital with my orders. They still sensed I had a decent understanding of medicine for a podiatrist, of course. They would sometimes basically switch care and consult general surgery or ortho on other podiatrists without their permission, but never on me.

 

[AttackNME]

Why is this always the argument. What kinda of hospitals do people work at…there are code teams for acute problems.

As you know there are plenty of issues that require medical attention that is not appropriate for a code