As my late residency director would say:
"If you are just after the money, drop out after your first year of residency, take your certificate, and go cut toenails at nursing homes."
If you want to do rewarding work, work hard and pay attention to get a lot of skills to help your patients. In practice, you will always see or read or hear of DPMs who make more than you. You will have many chances to do services or dispense stuff that patients don't need... or to "up-code" or choose the blacker side of gray areas every day also. Life is full of choices.
...as for the ortho groups, it is all situational. There is the whole spectrum in terms of scope, pay, respect, etc. There are two main types, though:
1 - A lot of ortho groups or hospitals like having a DPM to do just injects and orthotics/DME and various derm/nail/wound non-op stuff. They may or may not have them doing forefoot surgery or I&D/amp stuff, but they will tend to advertise what they expect. They don't lie, and they have no shortage of applicants (even many fellowship-trained, lol). A lot of those minimal/no surgery pods in these ortho situations are still very high earners (for the group or hospital, not necessarily for their own W2) since they generate a lot of RVUs while also funneling a lot of surgery to the F&A ortho or other group orthos. They function somewhat similar to PM&R docs, sports med FP docs, PAs, or PTs, etc in the ortho group or hospital employ... basically funnel cases to the orthos and make the orthos able to do more operating by taking care of many of the non-op and pre/post-op visits.
2 - Other ortho groups (large or very small, rural or uban) have the DPM function as basically F&A ortho if they have the training - except not able to take gen ortho call, of course... and probably still doing at least a bit of derm/nail/wound stuff that real F&A orthos tend to duck and dodge. This DPM as big shot ortho group surgeon can even happen in a big metro, but those groups tend to have ortho F&A(s) and no DPM - or just the former minimal/non op type. The" super surgeon" DPM hospital or ortho group setup can be fair to good for the DPM, depending on how much volume the group can get the DPM and how the contract is structured, if partner in group/rad/surg/etc centers is offered, etc. Those are generally good job quality and the most competitive DPM jobs since they have good variety, typically quality staffing/office, prestige, many cases to at least good to get board cert and pay some loans out of training.
Some have high burnout or I suppose a few DPMs might feel like the "low man on the totem pole" since they're not MD/DO even if they are doing a lot of cases and making good money... but the doc can always go solo or to another job later on if the compensation isn't very good or the hours are too rough. As waka said above, you typically won't hear the horror stories as you will from DPM grads who sign a $100k or lower podiatry PP job contract.
^^A fair amount of alumuni from my program and ones I've worked with do this (be the F&A surgeon for ortho group or function as big F&A surgeon for hospital, sometimes replacing an outgoing F&A ortho). I notice it tends to work and last awhile for the more rural and suburban setups (usually small/medium size group/hospital)... bigger urban and metro ones seem to have less longevity for the DPM being there if you check back after awhile. I would imagine the politics and the hours grind you down even in some "dream" jobs. Dunno.
