Forum Members Official: Job Offer Thread

[LossToFollowUp]

Question about offers like this for both OP and the general readers.

There are variable bases and percentages but in this scenario when it says 25% after 250k collections, does that mean a 1 time 250k threshold that you only need to pass once in your career there? Or does it renew every year? Strictly asking about bonus, I know base is the same.

For instance. Year 1 collect $300,000 then bonus 25% of remaining $50,000. Then year 2 collect $300,000 again and bonus 25% of remaining $50,000.

Or it is year 1 collect $300,000 then bonus 25% of remaining $50,000. Then year 2 collect $300,000 keep 25% of full $300,000?

Which scenario is correct? To be clear I think both are unethical. Just trying to understand how these contracts work.

Depends on specifics of contract but typically it resets each year. So in your examples, you would have to newly obtain the 250k threshold every year before the 25% kicks in. Like many before mentioned, not really sure where this "next level" accounting came from but it sure has become the standard.

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[eyeeye_captain]

Ouch, 4-5 hospitals? That alone should be an automatic non-starter. Even if you’re paid for call, it’s nowhere near covering mental health.

On the practice end of things, the numbers also don't really add up. So they think it will take 2 years to start reaching a painfully low bonus. So, 250k divided by 48 weeks of 5 full days. Depending on what your average collections per patient are, let's say $100 for reference (though I'm sure the attendings here can give you a real number) - that comes out to needing to see 10.4 patients per day. If it really takes 2 years to build up to 10 patients a day, then you have a pretty rough combination of varying degrees of saturation, practice management, and referral patterns. That practice clearly doesn't need an associate, you're just there to carry the pager.

 

[GreenHousePub]

I'm gonna make a top 10 worst job postings list, anyone feel free to add on

1) The Utah 85k associate gig
2) Nursing home million dollar buyout
3) NYC 125k two year contract, benefits are you don't get unemployment

 

[air bud]

I'm gonna make a top 10 worst job postings list, anyone feel free to add on

1) The Utah 85k associate gig
2) Nursing home million dollar buyout
3) NYC 125k two year contract, benefits are you don't get unemployment

This is good

 

[JustAPedicurist]

The job market is awful. Been at it for 6 months or so. Graduate in July.

 

[Feli]

The job market is awful. Been at it for 6 months or so. Graduate in July.

Time to look at fellowships?
I mean sure, they pay you $100k under what you should make for your first year out of residency... but they might hire you after that.

Fellowship spots (well, at least 92%-94% of them) need to go on the top 10 most pathetic podiatry job offers list.

...in all seriousness, did you talk to banks and hospitals in your target area(s) about helping you $tart up? You don't need as much as you think.

 

[Boba Foot]

If it really takes 2 years to build up to 10 patients a day, then you have a pretty rough combination of varying degrees of saturation, practice management, and referral patterns. That practice clearly doesn't need an associate, you're just there to carry the pager.

Bingo.

 

[icebreaker32]

I'm gonna make a top 10 worst job postings list, anyone feel free to add on

1) The Utah 85k associate gig
2) Nursing home million dollar buyout
3) NYC 125k two year contract, benefits are you don't get unemployment

Top 10 potential

$350 per day, multiple locations, rearfoot surgery and weekends in NYC


STARRETT PODIATRY, LLC
New York, NY

Pay​

$350 - $600 a day

Full job description​

PODIATRIST - ASSOCIATE POSITION
Busy multi-doctor podiatry practice with 5 locations across 3 boroughs looking for a ready to work, surgically trained associate to join our team. Part time and full time available. Candidates should be personable, driven and hard working. All phases of podiatry including forefoot and rearfoot surgery. Generous salary, malpractice, 401k, and scrubs included.

• 401(k) matching
• Health insurance
• Paid time off
• Retirement plan

Schedule:

• Day shift
• Monday to Friday
• Weekends as needed

Supplemental pay types:

• Bonus opportunities

Work Location: Multiple locations

 

[eyeeye_captain]

Top 10 potential

$350 per day, multiple locations, rearfoot surgery and weekends in NYC


STARRETT PODIATRY, LLC
New York, NY

Pay​

$350 - $600 a day

Full job description​

PODIATRIST - ASSOCIATE POSITION
Busy multi-doctor podiatry practice with 5 locations across 3 boroughs looking for a ready to work, surgically trained associate to join our team. Part time and full time available. Candidates should be personable, driven and hard working. All phases of podiatry including forefoot and rearfoot surgery. Generous salary, malpractice, 401k, and scrubs included.

• 401(k) matching
• Health insurance
• Paid time off
• Retirement plan

Schedule:

• Day shift
• Monday to Friday
• Weekends as needed

Supplemental pay types:

• Bonus opportunities

Work Location: Multiple locations

Nice that they include scrubs, just to remind you that you are a scrub if you take that gig #benefits

 

[air bud]

Nice that they include scrubs, just to remind you that you are a scrub if you take that gig #benefits

I am sure these are Dickies or something like that. For sure not figs and no way personalized. Probably just say Dr. Podiatrist Associate DPM.

 

[Shiyuan]

Weekends as needed = every weekend.

 

[eyeeye_captain]

I am sure these are Dickies or something like that. For sure not figs and no way personalized. Probably just say Dr. Podiatrist Associate DPM.

At least they would say Dr. Most of my scrubs declare me the property of hospitals I haven’t worked at in years.

 

[GreenHousePub]

Top 10 potential

$350 per day, multiple locations, rearfoot surgery and weekends in NYC


STARRETT PODIATRY, LLC
New York, NY

Pay​

$350 - $600 a day

Full job description​

PODIATRIST - ASSOCIATE POSITION
Busy multi-doctor podiatry practice with 5 locations across 3 boroughs looking for a ready to work, surgically trained associate to join our team. Part time and full time available. Candidates should be personable, driven and hard working. All phases of podiatry including forefoot and rearfoot surgery. Generous salary, malpractice, 401k, and scrubs included.

• 401(k) matching
• Health insurance
• Paid time off
• Retirement plan

Schedule:

• Day shift
• Monday to Friday
• Weekends as needed

Supplemental pay types:

• Bonus opportunities

Work Location: Multiple locations

They're saving that 600 a day for a very qualified candidate with decades of experience. Most new entrys will be at that 45$ an hour marker.

Also almost all NYC jobs (and residencies) are cheating and should all be lumped into the same number on my list.

 

[619]

Podiatrist​

Durango, Cortez & Pagosa, CO

401(k)
Dental Insurance
Disability Insurance
Employee Discount
Employer-matched 401(k) Plan
Flexible Spending Account
Health Insurance
Health Savings Account
License Reimbursement
Life Insurance
Malpractice Insurance
Mileage Reimbursement
Opportunities for Advancement
Paid Time Off
Support for Community Involvement
Travel Reimbursement
Vision Insurance
Professional Growth
Supportive Leadership
Work Life Balance
Private Practice
Contract
Full Time
Call-in/On-Call
Monday to Friday
Location: Durango, Cortez, Pagosa

As a skilled and motivated Podiatrist at Innovation Medical Group, you will be a vital part of our dynamic healthcare team. Your role involves diagnosing, treating, and preventing a wide range of foot and ankle conditions. With a patient-centered approach, you will provide comprehensive care that extends beyond symptom management, addressing the underlying causes of discomfort and pain.
Job Details:
• Provide services to home-bound patients at homes and Group Setting Facilities as well as in office hours.
• Full-time position salary- Depending on Experience
• Paid time off, Health Insurance/Mileage Allowance /Malpractice compensation and administrative support.

Requirements:
• Doctoral degree in podiatric medicine.
• Practical experience in a hospital or clinic.
• In-depth knowledge of modern surgical and therapeutic treatments.
• Knowledge of related medicines and topical treatments.
• Familiarity with foot abnormalities.
• Wound Care knowledge
Contact Information
To apply, please submit your resume detailing your relevant experience and passion for podiatric care. To [email protected]
We look forward to reviewing your application and potentially welcoming you to our team of healthcare.
Compensation: $200,000 - $300,000, Annually
Compensation Details:
Mileage allowance to facilitate travel between multiple locations.

 

[air bud]

Podiatrist​

Durango, Cortez & Pagosa, CO

401(k)
Dental Insurance
Disability Insurance
Employee Discount
Employer-matched 401(k) Plan
Flexible Spending Account
Health Insurance
Health Savings Account
License Reimbursement
Life Insurance
Malpractice Insurance
Mileage Reimbursement
Opportunities for Advancement
Paid Time Off
Support for Community Involvement
Travel Reimbursement
Vision Insurance
Professional Growth
Supportive Leadership
Work Life Balance
Private Practice
Contract
Full Time
Call-in/On-Call
Monday to Friday
Location: Durango, Cortez, Pagosa

As a skilled and motivated Podiatrist at Innovation Medical Group, you will be a vital part of our dynamic healthcare team. Your role involves diagnosing, treating, and preventing a wide range of foot and ankle conditions. With a patient-centered approach, you will provide comprehensive care that extends beyond symptom management, addressing the underlying causes of discomfort and pain.
Job Details:
• Provide services to home-bound patients at homes and Group Setting Facilities as well as in office hours.
• Full-time position salary- Depending on Experience
• Paid time off, Health Insurance/Mileage Allowance /Malpractice compensation and administrative support.

Requirements:
• Doctoral degree in podiatric medicine.
• Practical experience in a hospital or clinic.
• In-depth knowledge of modern surgical and therapeutic treatments.
• Knowledge of related medicines and topical treatments.
• Familiarity with foot abnormalities.
• Wound Care knowledge
Contact Information
To apply, please submit your resume detailing your relevant experience and passion for podiatric care. To [email protected]
We look forward to reviewing your application and potentially welcoming you to our team of healthcare.
Compensation: $200,000 - $300,000, Annually
Compensation Details:
Mileage allowance to facilitate travel between multiple locations.

Lol these innovation group jobs are all over the mountain west.

 

[Adam Smasher]

With a convenient 104 mile stretch for commuting

 

[Feli]

Lol these innovation group jobs are all over the mountain west.

This Innovation one in Durango etc is basically what's left of the podiatry group that went bankrupt...

Most of the usable pieces of it ended up in other groups, moving to other areas, going solo, or now getting acquired by Innovation.

With a convenient 104 mile stretch for commuting

It's a cool area (expensive tho)... just not sure how awesome job security would be working for a group with that much insolvency, breakup, restructure, layoffs, sell to MSG in the recent history.

If anyone takes it, get the lay of the land awhile before laying down roots?

 

[Shiyuan]

This Innovation one in Durango etc is basically what's left of the podiatry group that went bankrupt...

Most of the usable pieces of it ended up in other groups, moving to other areas, going solo, or now getting acquired by Innovation.


It's a cool area (expensive tho)... just not sure how awesome job security would be working for a group with that much insolvency, breakup, restructure, layoffs, sell to MSG in the recent history.

If anyone takes it, get the lay of the land awhile before laying down roots?

If youre THAT rural, may as well look for critical access hospitals looking for a DPM 🤷🏻‍♂️

 

[Feli]

If youre THAT rural, may as well look for critical access hospitals looking for a DPM 🤷🏻‍♂️

That's a decent idea, but it's not rural... those (Durango, Pagosa, Cortez) are tourist towns, ski towns, party towns.
They are 10k-25k population on paper but function well over double that due to the significant tourism.

...Colorado, like most places, is pretty tapped out for DPM jobs at small hospitals; it's a real popular place to live - even many of the smaller cities are getting expensive. Ortho is also real dense and powerful in most of the state (although more cooperative with DPMs than in most places); you have some of the best trauma and sports and other orthos in the world in Colo. You won't just dial up some random Denver or Colo Springs or Aurora outskirts hospital and set up an interview... they've probably already seen that movie quite a few times.

 

[iridocyclitiss]

Time to look at fellowships?
I mean sure, they pay you $100k under what you should make for your first year out of residency... but they might hire you after that.

Fellowship spots (well, at least 92%-94% of them) need to go on the top 10 most pathetic podiatry job offers list.

...in all seriousness, did you talk to banks and hospitals in your target area(s) about helping you $tart up? You don't need as much as you think.

Most of the fellowships pay around 58-65k a year (some outliers higher and lower for sure)

My contract this year was significantly higher than this as an INTERN.

Taking a fellowship year seems like its a huge ROI risk your first year out...

 

[GreenHousePub]

Most of the fellowships pay around 58-65k a year (some outliers higher and lower for sure)

My contract this year was significantly higher than this as an INTERN.

Taking a fellowship year seems like its a huge ROI risk your first year out...

Also look at how many "fellowship trained" DPMs end up working for the same associate mills.

 

[Retrograde_Nail]

If anyone has any free time I’d love to know how many total jobs have been posted in this thread. That will further magnify how terrible the market is.

 

[HeySister]

Also look at how many "fellowship trained" DPMs end up working for the same associate mills.

Would be curious to know this as well. If you look at some of the bigger mills there are usually fellowship trained docs there.

 

[heybrother]

This Innovation one in Durango etc is basically what's left of the podiatry group that went bankrupt...

Most of the usable pieces of it ended up in other groups, moving to other areas, going solo, or now getting acquired by Innovation.


It's a cool area (expensive tho)... just not sure how awesome job security would be working for a group with that much insolvency, breakup, restructure, layoffs, sell to MSG in the recent history.

If anyone takes it, get the lay of the land awhile before laying down roots?

Strange reading someone else's expenses. There they are paying $3K a month for MLS lasers and my office has one sitting in a corner doing f-all.

 

[Weirdy]

If anyone has any free time I’d love to know how many total jobs have been posted in this thread. That will further magnify how terrible the market is.

57 actual including poor offers to comment on. 9 posted for opinions/discussion.
As of page 26.

Will continue later.

 

[Hybrocure]

That's a decent idea, but it's not rural... those (Durango, Pagosa, Cortez) are tourist towns, ski towns, party towns.
They are 10k-25k population on paper but function well over double that due to the significant tourism.

...Colorado, like most places, is pretty tapped out for DPM jobs at small hospitals; it's a real popular place to live - even many of the smaller cities are getting expensive. Ortho is also real dense and powerful in most of the state (although more cooperative with DPMs than in most places); you have some of the best trauma and sports and other orthos in the world in Colo. You won't just dial up some random Denver or Colo Springs or Aurora outskirts hospital and set up an interview... they've probably already seen that movie quite a few times.

Can confirm. The only jobs you’ll find in Colorado somewhere relatively livable is going to be as an associate PP

 

[Weirdy]

If anyone has any free time I’d love to know how many total jobs have been posted in this thread. That will further magnify how terrible the market is.

Year 2020 to current:
-109 job listings (identical postings combined)
-15 separate listed for second opinion

 

[air bud]

57 actual including poor offers to comment on. 9 posted for opinions/discussion.
As of page 26.

Will continue later.

Sounds like you are at a weak program with too much time on your hands.

 

[Weirdy]

Sounds like you are at a weak program with too much time on your hands.

There was too much lobstering to be done.

 

[Retrograde_Nail]

Year 2020 to current:
-109 job listings (identical postings combined)
-15 separate listed for second opinion

Wow that's depressing

 

[jedimuscle023]

Can confirm. The only jobs you’ll find in Colorado somewhere relatively livable is going to be as an associate PP

I've been wanting to move back to Colorado. Does anyone know what an decent expected salary would be there? Would it even be worth the HCOL?

 

[Hybrocure]

I've been wanting to move back to Colorado. Does anyone know what an decent expected salary would be there? Would it even be worth the HCOL?

I would say 120-170. Doable if it’s just you if you had a family it would be tough. At the end of the day it’s still cheaper than getting paid that and living in New York lol

 

[air bud]

I've been wanting to move back to Colorado. Does anyone know what an decent expected salary would be there? Would it even be worth the HCOL?

No

 

[icebreaker32]

Physician Assistant - Outpatient Podiatry/Vascular Surgery​

UW Health
20 South Park Street, Madison, WI

Job details​

Should have good benefits also and be eligible for PSLF

Pay
$111,200 - $155,600 a year

Location
20 South Park Street, Madison, WI

Full job description​

Work Schedule :
100% FTE, Monday – Friday, between the hours of 8:00 am - 5:00 pm.

Be part of something remarkable
As an Advanced Practice Provider, you'll play an integral role in our care teams by providing high-quality, cost-effective care to patients.
We are seeking a Physician Assistant to :

• Provide comprehensive care to both well and ill patients in an outpatient podiatry and vascular surgery patients
• Work collaboratively within a pod model consisting of a physician, medical assistant, and RN.
• Perform history and physical, post-operative evaluations,develop, manage and modify treatment plans.
• Serve patient populations of pathologic bunions, hammer toes, ingrown nails, heel pain, surgical patients and work collaboratively with Vascular Surgery and Wound Team in caring for wound patients.
• Perform procedures such as; suture removal, cortisone injections, splint removal.
• See patients in follow-up for routine post-op care and manage complications related to surgery.

 

[Retrograde_Nail]

Physician Assistant - Outpatient Podiatry/Vascular Surgery​

UW Health
20 South Park Street, Madison, WI

Job details​

Should have good benefits also and be eligible for PSLF

Pay
$111,200 - $155,600 a year

Location
20 South Park Street, Madison, WI

Full job description​

Work Schedule :
100% FTE, Monday – Friday, between the hours of 8:00 am - 5:00 pm.

Be part of something remarkable
As an Advanced Practice Provider, you'll play an integral role in our care teams by providing high-quality, cost-effective care to patients.
We are seeking a Physician Assistant to :

• Provide comprehensive care to both well and ill patients in an outpatient podiatry and vascular surgery patients
• Work collaboratively within a pod model consisting of a physician, medical assistant, and RN.
• Perform history and physical, post-operative evaluations,develop, manage and modify treatment plans.
• Serve patient populations of pathologic bunions, hammer toes, ingrown nails, heel pain, surgical patients and work collaboratively with Vascular Surgery and Wound Team in caring for wound patients.
• Perform procedures such as; suture removal, cortisone injections, splint removal.
• See patients in follow-up for routine post-op care and manage complications related to surgery.

This would be a top tier private practice podiatry associate job coming out of residency. This profession is a disgrace.

 

[icebreaker32]

CompHealth | Find your just right job.

comphealth.com

 

[DYK343]

This would be a top tier private practice podiatry associate job coming out of residency. This profession is a disgrace.

U of W will pay a DPM 300+

Cheaper for them to hire a NP/PA

We are probably going to hire a midlevel next year to help w post ops and take the pressure away from preventative/chronic care.

 

[icebreaker32]

U of W will pay a DPM 300+

Cheaper for them to hire a NP/PA

We are probably going to hire a midlevel next year to help w post ops and take the pressure away from preventative/chronic care.

True but yet it is often cheaper for a mustache to hire a DPM than a NP/PA

 

[Feli]

True but yet it is often cheaper for a mustache to hire a DPM than a NP/PA

It is cheaper for anyone to hire a DPM versus NP/PA... private practice, ortho group, MSG, hospital.

One of my attendings told me that in residency... and it's absolutely true.
He actually laughed loudly at me (I had asked "have you ever considered a PA to round and see the easier clinic patients"). He told me that 99% of podiatry groups or hospitals that have podiatry would be better just hiring an associate DPM, because there is such high supply of them.

A podiatry associate and a PA are roughly equal cost in terms of salary, but the PA/NP will want costly fringe benefits (since most of their other job options have them). They also won't take call and will typically require at least some training. And it's not like you're going to get the best and brightest of PA/NPs who want to do podiatry versus the numerous other specialties they can apply for (derm, ortho, cardio, urgent care, OB, etc etc).

The podiatry DPM associate or new grad ("non-op" DPM) can do all of the potential longevity, cost savings, expedite the surgical docs in the practice... typically cheaper than PA/NP when you include benefits and cost of training/turnover. There are 600+ coming out each year now; plenty will do non-op if the money is ok. Podiatrists also won't (can't) leave for a different specialty or have as many other job options overall - or especially in the city/area as PA/NP have. Pods applying for non-op jobs typically won't have great training or a ton of job options overall.

Many savvy ortho groups and MSGs have known this for years. They use DPMs for non-op or minimal surgery cares, orthotics, injects, whatever. Can't blame them... many pods line up for those spots, and they will continue to do so.

I think hospitals would - and will - absolutely do the same (hire DPM and not PA/NP), but the already podiatrists working there would be threatened by posting another DPM job (or the hospital would see how overpaid the current DPM is), and they typically tell HR and their supervisor that hiring podiatry PA/NP, or maybe wound/nails RN, is the way to go. It is hard enough to get decent hospital DPM jobs; then, you need to convince them all of the apps and cold calls they get and all of the low DPM salaries they see are to be ignored.

 

[DYK343]

I think hospitals would - and will - absolutely do the same (hire DPM and not PA/NP), but the already podiatrists working there would be threatened by posting another DPM job (or the hospital would see how overpaid the current DPM is), and they typically tell HR and their supervisor that hiring podiatry PA/NP, or maybe wound/nails RN, is the way to go. It is hard enough to get decent hospital DPM jobs; then, you need to convince them all of the apps and cold calls they get and all of the low DPM salaries they see are to be ignored.

Assuming a lot here (me being afraid/screwing my fellow DPM).

I work for a medium/large hospital system. Multi state. They pay providers based on MGMA and state averages.

We need a non op provider. Our surgery #'s are stable and we currently dont need another surgeon.
We do need someone to round on inpatients, assist in OR, and do diabetic foot exams/post ops.

Our admin does not want to pay someone a Dr's salary to do that.
Our admin wants to hire a NP/PA just like the MD/DOs in most subspecialties have.

If they hire a DPM they will have to pay them 300-325k a year starting guarenteed for x amount of years and then straight production.

A NP/PA is 120k a year and thats pretty much max out with only small increases over time.

 

[Retrograde_Nail]

Assuming a lot here (me being afraid/screwing my fellow DPM).

I work for a medium/large hospital system. Multi state. They pay providers based on MGMA and state averages.

We need a non op provider. Our surgery #'s are stable and we currently dont need another surgeon.
We do need someone to round on inpatients, assist in OR, and do diabetic foot exams/post ops.

Our admin does not want to pay someone a Dr's salary to do that.
Our admin wants to hire a NP/PA just like the MD/DOs in most subspecialties have.

If they hire a DPM they will have to pay them 300-325k a year starting guarenteed for x amount of years and then straight production.

A NP/PA is 120k a year and thats pretty much max out with only small increases over time.

At my hospital we have non op and surgical DPMs. Non op only do nail care and basic procedures for toenails, injections, warts etc.

Surgical DPMs do everything.

Our non op DPMs dont round for us or do any inpatient work.

There is a significant discrepancy in pay though between non op and surgical DPM. Almost a 100-125k salary difference.

So yeah there are hospitals out there who will pay different salaries for different skill sets.

I think hiring a NP/PA non op provider is stupid when you can get a trained DPM to do that who will be way better and will pump out more procedures in the clinic because they actually know what they are doing and how to bill.

Lastly we have an NP who does all our rounding for us. We share the NP with other ortho specialties. That’s how we work around the the typical “podiatry can’t oversee NP/PA” rule in our particular state. It’s awesome. I never see the patient and only show up for the surgery then never round on them afterwards.

 

[Boba Foot]

It’s awesome. I never see the patient and only show up for the surgery then never round on them afterwards.

Is that awesome though? Call me old fashioned, but even before I entered a healthcare specialty, if a doctor was a ghost I'd drop them real quick. That's pretty ****ty patient care.

 

[Adam Smasher]

Is that awesome though? Call me old fashioned, but even before I entered a healthcare specialty, if a doctor was a ghost I'd drop them real quick. That's pretty ****ty patient care.

Like it or not, this is the way of the future for a lot of surgical specialties. My aunt broke her wrist a few years back and she never saw her surgeon again after the ORIF, just his PA. This is the endpoint for when the opportunity cost of a surgeon's time is too great: you can't waste your time on patient care when it's more profitable to be operating.

In fairness to DYK and Retrograde, it's probably better in the big picture that they not get bogged down with routine postoperative care, so they can maximize their availability to other surgical candidates and a greater number of patients receive treatment from them.

In a perfect world, instead of adding schools, we'd change the laws to have the podiatry versions of dental hygienists to be our extenders, take xr, debride nails, and so on. This is why podiatry is so behind.

 

[Retrograde_Nail]

Is that awesome though? Call me old fashioned, but even before I entered a healthcare specialty, if a doctor was a ghost I'd drop them real quick. That's pretty ****ty patient care.

Considering every orthopedist in the USA functions like this it is not too crazy. Maybe work in a hospital and see how real doctors run their practices. It is called efficiency. The hospital wants it this way. So their docs can do more cases and not get bogged down with aftercare.

 

[Retrograde_Nail]

Is that awesome though? Call me old fashioned, but even before I entered a healthcare specialty, if a doctor was a ghost I'd drop them real quick. That's pretty ****ty patient care.

You want to know what’s bad care?

Having an attending, their 3 residents and 3 extern students rounding on a diabetic toe at 6:00am.

You want to know why other specialties don’t take us seriously? Because we don’t do anything like they do. Podiatry just designs ways to waste time in attempt to look busy. When everyone could be doing something more productive.

 

[HeySister]

You want to know what’s bad care?

Having an attending, their 3 residents and 3 extern students rounding on a diabetic toe at 6:00am.

You want to know why other specialties don’t take us seriously? Because we don’t do anything like they do. Podiatry just designs ways to waste time in attempt to look busy. When everyone could be doing something more productive.

I agree anything that is unpaid is a waste of your time. CMS decided that when they made global. If they don't care enough to pay you then find a way to offload it. For podiatry that means resident labor more than anything else

 

[DYK343]

At my hospital we have non op and surgical DPMs. Non op only do nail care and basic procedures for toenails, injections, warts etc.

Surgical DPMs do everything.

Our non op DPMs dont round for us or do any inpatient work.

There is a significant discrepancy in pay though between non op and surgical DPM. Almost a 100-125k salary difference.

So yeah there are hospitals out there who will pay different salaries for different skill sets.

I think hiring a NP/PA non op provider is stupid when you can get a trained DPM to do that who will be way better and will pump out more procedures in the clinic because they actually know what they are doing and how to bill.

Lastly we have an NP who does all our rounding for us. We share the NP with other ortho specialties. That’s how we work around the the typical “podiatry can’t oversee NP/PA” rule in our particular state. It’s awesome. I never see the patient and only show up for the surgery then never round on them afterwards.

Depending on volume NP/PA is not dumb.

If we hired a non op DPM to do plantar fasciitis evals, injections, etc would take away from my current clinic volume. Im sitting around 800wRVUs a month but if we hired someone else that would drop considerably.

We have about 25 people a day calling asking to get their toenails clipped.

Currently denying them but I suspect it is hurting referral sources as we are not a "one stop shop" for patient care.

Dont need a doctoral level to clip toenails (or see post ops/round on the never ending inpatient pus referral).

 

[Retrograde_Nail]

Depending on volume NP/PA is not dumb.

If we hired a non op DPM to do plantar fasciitis evals, injections, etc would take away from my current clinic volume. Im sitting around 800wRVUs a month but if we hired someone else that would drop considerably.

We have about 25 people a day calling asking to get their toenails clipped.

Currently denying them but I suspect it is hurting referral sources as we are not a "one stop shop" for patient care.

Dont need a doctoral level to clip toenails (or see post ops/round on the never ending inpatient pus referral).

Do you honestly think you are going to find a quality NP/PA to cut toenails? Even if you do there is no way they stay long term. You are kidding yourself.

And if you are threatened that the new non op DPM is going to hinder your productivity by taking away a few injections here and there then you need to take a step back and think about how you want your practice to be. You would be way more productive billing out in the OR and in wound care clinic then seeing patients in regular clinic. So what the non op treats PF and does an injection here and there. They will refer it to you when it fails and you get to do the surgery.

You should also negotiate with your hospital or chief of ortho to convince them to let you borrow their PA for rounding. It would save everyone money if you are sharing a PA/ NP rather than getting one for yourself.

 

[Feli]

...

If they hire a DPM they will have to pay them 300-325k a year starting guarenteed for x amount of years and then straight production.

A NP/PA is 120k a year and thats pretty much max out with only small increases over time.

It does NOT have to be that way. Not even close.
Numerous ortho, MSG, podiatry, and various other hospitals have figured it out. The key is what @Retrograde_Nail said: different job descriptions, different pay scale.

With regard to private hospitals being slow to adapt to minimal/non op DPM being more economical than PA/NP (for podiatry clinic), I was not saying you personally, but that's the snafu that a lot of private hospitals run into:

Hire a non-op DPM is the way to go, but they make muuuuuch less than MGMA (and will be happy to).
A lot of current hospital DPMs are very scared of that. Many of them created a job for themselves and don't want to open that can of worms (potentially lose surgical volume or open the floodgate of many DPM applicants who are giddy to work for less salary). They are petrified that their $300k+ would be jeopardized if some DPM applicants are chomping at the bit to sign for $200k or even less. The key is just communication; tell them that podiatry training varies widely and that podiatrist is not equal to podiatrist. Many govt and private hospitals and PP groups of all kinds have figured this out (non-op DPM >>> podiatry PA/NP).

Also, agree 100% that the PA won't stick for nail/wound. The DPM is more likely to stick. The podiatry job market is so horrible that plenty will trade decent stable income for not using all skills (look at VA job apps for podiatrists). So: the DPMs get paid same/less than PA, they're better at it, and they're more likely to stay awhile (less job options and happier with pay+benefits). The non-op or primary care type of DPM hire is a win all around, but it's a communication hurdle if that's not the facility or group norm.

At my hospital we have non op and surgical DPMs. Non op only do nail care and basic procedures for toenails, injections, warts etc.

Surgical DPMs do everything.

Our non op DPMs dont round for us or do any inpatient work.

There is a significant discrepancy in pay though between non op and surgical DPM. Almost a 100-125k salary difference.

So yeah there are hospitals out there who will pay different salaries for different skill sets.

I think hiring a NP/PA non op provider is stupid when you can get a trained DPM to do that who will be way better and will pump out more procedures in the clinic because they actually know what they are doing and how to bill.

Lastly we have an NP who does all our rounding for us. We share the NP with other ortho specialties. That’s how we work around the the typical “podiatry can’t oversee NP/PA” rule in our particular state. It’s awesome. I never see the patient and only show up for the surgery then never round on them afterwards.

Yes, for sure.

That's the norm for govt VA/IHS also...
Hugely different salaries for surg vs non-surg DPMs. There are a few old geezers who get by on seniority and have high pay, but the ABFAS ones who take call generally get much more than the minimal/non op ones who do wound and nail care. The VA/IHS hires tons of midlevels also, but very few that I know of work podiatry; they just do surgical DPMs and what basically amount to primary care pods. The surgical are much higher paid due to taking call and wider skillset, with rare exception to a few grandfathered in and pretenting to take call and do surgery or do admin stuff.

 

[DYK343]

Do you honestly think you are going to find a quality NP/PA to cut toenails? Even if you do there is no way they stay long term. You are kidding yourself.

Yes, I do. In fact the PA who is in the next department over said she was interested.

And if you are threatened that the new non op DPM is going to hinder your productivity by taking away a few injections here and there then you need to take a step back and think about how you want your practice to be. You would be way more productive billing out in the OR and in wound care clinic then seeing patients in regular clinic. So what the non op treats PF and does an injection here and there. They will refer it to you when it fails and you get to do the surgery.

You should also negotiate with your hospital or chief of ortho to convince them to let you borrow their PA for rounding. It would save everyone money if you are sharing a PA/ NP rather than getting one for yourself.

Not everyone has a clinic volume to reach 1000+ wRVUs a month like you do. I currently handle everything that is given to me except nail care.

We are the only clinic around that takes medicaid. We get soooo many medicaid nail referrals its ridiculous.

If I hire someone else that will hurt my volume. I am going straight production. I need to stay at 800wRVUs.