Podiatry vs. Dentistry

[toothfetish]

I know this forum will be pretty biased, and I will ask this on the Dental thread as well.


But I'm currently in between both professions and I want to know what to do this cycle;

So let me hear the pro vs cons!

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[PADPM]

I know this forum will be pretty biased, and I will ask this on the Dental thread as well.


But I'm currently in between both professions and I want to know what to do this cycle;

So let me hear the pro vs cons!

I had wanted to be a dentist since I was a child, and was accepted at dental school and podiatric medical school. After shadowing I made my final decision. I just disliked looking into a mouth and listening to the saliva extractor. I was also probably biased toward podiatry since I was a very competitive Division 1 soccer player, and the only one able to figure out a problem I was having was a DPM.

Dentistry is a great profession, and some of the dental specialties such as orthodontics, periodontist and oral surgeons have some of the highest incomes of ANY medical professional.

However, you also must be prepared to spend your career practicing general dentistry, because obtaining a residency in one of the above specialties is extremely competitive.

I have many friends and neighbors who are dentists, and although I don't know the stream of their income (wealthy family, good investments, inheritance, etc., ) they all live an excellent lifestyle wth nice homes, nice cars, lots of travel,....... Of course these material things don't equate with happiness, but it is indicative of a good income.

Podiatry today is in an excellent place with unbelievable training. I know some recent residency grads who are making significant money.

No, there are presently no guarantees that you will obtain a podiatric surgical residency. Similarly,there is no guarantee you will obtain the specialty training you may be seeking in dentistry.

However, I believe you can still practice general dentistry with no additional training (I do know that there are general dentistry residencies) which will allow you to start earning income and paying back loans. In podiatry, with no residency the outlook is certainly not positive.

Just some of my thoughts.

 

[NatCh]

I'm pretty sure I'd be happy doing either one. For some reason I didn't even consider dental school when I was an undergrad but I wish I had at least looked into it back then.

I think the dental model of training is better than podiatry's current model. After finishing dental school you can go straight into practice or seek a residency if you want to do a specialty. In podiatry you more or less have to do a residency. Due to the current podiatry residency crisis some folks have suggested changing the podiatry model to mimic the dental model but at this point if you don't finish a podiatry residency then you won't become ABPS board certified, which means you won't get on a hospital staff, which means you won't get on insurance provider panels, which means you could end up clipping nails in nursing homes for medicare patients only. In that case I'd rather be cleaning teeth. Fortunately I'm already on the other side of that problem so I get to do a bunch of really cool stuff during my work day.

Dental office overhead expenses are much higher than podiatry's from what I've been told. It's more expensive to run a dental office.

There are more dentists against whom you'd have to compete. I think my city has about 25 dentists to every podiatrist, so you might have to work a bit harder at marketing to make yourself stand out. Maybe.

I'm not sure what's going to become of the practice climate with the Accountable Care Organization (ACO) changes coming down the pike. Dentists have less reliance on health insurance (I think), which sounds appealing to me but I've always wondered if that's a case of the grass being greener on the other side.

 

[CATSandKILOS]

Have you shadowed either profession, OP? Maybe you can show us your current pro/con list of each profession?

I think it might come down to... do you want to touch feet/ankles or teeth all day?

 

[toothfetish]

Have you shadowed either profession, OP? Maybe you can show us your current pro/con list of each profession?

I think it might come down to... do you want to touch feet/ankles or teeth all day?

Dental Pro:
- Independent
- Prestige
- More respected
- Higher income

Dental Con:
- Much more expensive schooling, nearly $400,000 at NYU
- Some people have nasty teeth



Pod Pro:
- Cheaper schooling
- Less overhead
- Good money

Pod Con:
- Not really respected
- Seen as a "backup" for DDS/DMD and MD
- Feet fetish anyone?




I'm surprised no one mentioned the HUGE price differential in attending dental vs. podiatry school.

 

[Mofti]

Dental Pro:
- Independent
- Prestige
- More respected
- Higher income

Dental Con:
- Much more expensive schooling, nearly $400,000 at NYU
- Some people have nasty teeth



Pod Pro:
- Cheaper schooling
- Less overhead
- Good money

Pod Con:
- Not really respected
- Seen as a "backup" for DDS/DMD and MD
- Feet fetish anyone?




I'm surprised no one mentioned the HUGE price differential in attending dental vs. podiatry school.

Here is how i look at the price difference... Pod students usually come out with 250k of loans, while dental students come out as much as 400k.

Now most states don't require a residency to practice for dentist, so they could make over 150k coming out right away. Where as pod grads have to complete a mandatory 3 year residency making anywhere from 40-60k a year.

When it all comes down, you pretty much are paying the same.

 

[rabbitears333]

I don't really see the difference of salary between dentists and podiatrists as that much different. For an average family or general dentist, the income is around 150K. In fact, some pods might make greater than what general family dentists make

 

[toothfetish]

Here is how i look at the price difference... Pod students usually come out with 250k of loans, while dental students come out as much as 400k.

Now most states don't require a residency to practice for dentist, so they could make over 150k coming out right away. Where as pod grads have to complete a mandatory 3 year residency making anywhere from 40-60k a year.

When it all comes down, you pretty much are paying the same.

Well only difference is you'd be paid for residency. How hardcore is residency? Like 80 hrs per week?

 

[ldsrmdude]

Well only difference is you'd be paid for residency. How hardcore is residency? Like 80 hrs per week?

Depends on the program. I'd say my program is probably average in terms of the number of hours worked, maybe high end of average, and I plan on 10-12 hrs/day and then add in how much call I have, so total is usually 60 or so, but I've had 100+ hr weeks as well.

 

[toothfetish]

Depends on the program. I'd say my program is probably average in terms of the number of hours worked, maybe high end of average, and I plan on 10-12 hrs/day and then add in how much call I have, so total is usually 60 or so, but I've had 100+ hr weeks as well.

Is Pod residency the same intensity as a dental specialty?

 

[cpinkows]

Dentistry depending on region is probably more at risk of over-saturation. Just one scenario from personal experience, so correct me if this is not often the case, but my dentist's salary has been hit by increased competition. Also salary for dentists is comparable to podiatrists, possibly even less for general dentistry?

 

[toothfetish]

Dentistry depending on region is probably more at risk of over-saturation. Just one scenario from personal experience, so correct me if this is not often the case, but my dentist's salary has been hit by increased competition. Also salary for dentists is comparable to podiatrists, possibly even less for general dentistry?

I don't know but the averages look the same but it is all about location, skill and other variables.

 

[PADPM]

The AMA has a rule that residents can not work more than 80 hours a week for AMA approved residencies ( please correct me if I'm wrong). As far as I know, podiatry/APMA/CPME/ABPS has no such rule.

However, I know many podiatric residency programs that follow the AMA rules and residents work hours are limited to 80 hours for the safety of the resident and patient.

In my opinion, any podiatric residency program that has residents working more than 80 hours a week is simply poorly managed/administered, abusive to the residents and placing patient care in jeopardy.

 

[jonod1107]

To me, the 2 biggest advantages of dentistry over podiatry is:

1. At the very least, you can be a general dentist after 4 years of dental school. But a Podiatrist has to do a 3 year residency and with the shortage, you can graduate with a DPM but not be a practicing pod at all if you can't get a residency.

2. A dentist, even a general dentist, has a higher ceiling of earning and opportunities than a Pod. I know several dentists who have expanded their general dentistry practice to include dental cleaning by a dental hygienist, laser treatments, etc. I don't really see a Pod office being able to expand like that. What else can they offer? A nail beauty salon in the office?

Some people mention the price of dental school but there are several state schools that are the same amount as Pod and are even lower than Pod. For example, Temple's tuition is 35K a year so Pod school isn't that cheap anyways.

The advantages of Pod is that if you can get a residency, you will be able to do surgery. Whereas, in dentistry, residencies are super hard to get, especially ones like orthodontics and oral surgery.

 

[NatCh]

2. A dentist, even a general dentist, has a higher ceiling of earning and opportunities than a Pod. I know several dentists who have expanded their general dentistry practice to include dental cleaning by a dental hygienist, laser treatments, etc. I don't really see a Pod office being able to expand like that. What else can they offer? A nail beauty salon in the office?

I don't know about that. There are avenue streams other than simply working harder. Ownership of surgery centers, HBOT, MRI, hiring of Associates, and leasing of office space are just a few examples.

 

[ldsrmdude]

The AMA has a rule that residents can not work more than 80 hours a week for AMA approved residencies ( please correct me if I'm wrong). As far as I know, podiatry/APMA/CPME/ABPS has no such rule.

However, I know many podiatric residency programs that follow the AMA rules and residents work hours are limited to 80 hours for the safety of the resident and patient.

In my opinion, any podiatric residency program that has residents working more than 80 hours a week is simply poorly managed/administered, abusive to the residents and placing patient care in jeopardy.

You're mostly right, I think. The 80-hour week is averaged over a 4 week period so going over 80 hours in a specific week isn't totally forbidden as long as the average is less than 80. And I don't think podiatry residencies have a specific limit, but most of the programs I visited follow what the MD/DO programs require just like you said.

 

[cpinkows]

2. A dentist, even a general dentist, has a higher ceiling of earning and opportunities than a Pod. I know several dentists who have expanded their general dentistry practice to include dental cleaning by a dental hygienist, laser treatments, etc. I don't really see a Pod office being able to expand like that. What else can they offer?.

I've heard some outrageous numbers for the high end of pod pay by very reputable sources.

 

[feet2017]

I've heard some outrageous numbers for the high end of pod pay by very reputable sources.

personally I feel this is more of the extreme than the norm. Also I think this has been the case because from what i know many orthopods choose to specialize in other parts besides the ankle. (i.e. the knees,hips, etc.). They do these because there is more money in the knees/hip than in ankles and so other orthopods hire pods to do the ankles. The Pods that are getting the large offers are from these multi specialty groups. The multispeciality groups general have other ways to earn extra income as stated above (mri, physical therapy, etc.)

This information is just from my personal research.

 

[cpinkows]

personally I feel this is more of the extreme than the norm. Also I think this has been the case because from what i know many orthopods choose to specialize in other parts besides the ankle. (i.e. the knees,hips, etc.). They do these because there is more money in the knees/hip than in ankles and so other orthopods hire pods to do the ankles. The Pods that are getting the large offers are from these multi specialty groups. The multispeciality groups general have other ways to earn extra income as stated above (mri, physical therapy, etc.)

This information is just from my personal research.

Well of course its the extreme. Thats basically what the high end of pod pay means. The individuals bussiness model was very unique. My point was theres no real "ceiling" to pod pay, but also dont expect it to just happen because it probably wont.

 

[MaxillofacialMN]

Look at my name! I was 100% set on dentistry all through high school and freshman year of college. I even did an SMDEP in dentistry at Columbia University. But I realized the majority of dental graduates are general dentists and while the lifestyle of a dentist is probably the best of any healthcare provider, their job sucks.

All they do is drill, fill, and bill all day long. GDs rarely do "complex" surgery (ie anything beyond MINOR tooth extraction).

Podiatrists range of care is incredible, indeed! And you have the prospect of musculoskeleton surgery without being in the top ten percent of your dental school class.

I don't know where you are in your education, (I've posted this on here before and it gets people excited, but it's true nonetheless) but podiatry school is significantly easier and less stressful to get into than dental school. I remember freshman year i was busting my butt in the library 6-7 days a week, I'd freak out of I got anything below a 90% on a calc test (I thought I would never be accepted to dental with a B in any class), and my social life wasn't all that great.

I found podiatry, realized I needed to study about 80% less to get "acceptable" grades (the amount of time required studying between getting Bs instead of As is extraordinary!) and I could actually enjoy my college experience all while having a 95% confidence in my ability to get into podiatry school.

When it was all said and done i had a 3.5 GPA, tons of leadership/extracurriculars (because I had the time), and a good MCAT (this part is irrelevant to my study habits, but I never pass up an opportunity to talk about my MCAT score! Haha jk jk).

Basically if you want to enjoy undergraduate, have a varied job, perform surgery, and not have patients that can't respond while you're working on them, go podiatry.

If you want a sucky undergrad experience, a plush lifestyle, but have a repetitive job, go dental.

 

[Dr Aboody]

If you're interested in the oral cavity, go to dental school.
If you're interested in the lower extremity, go to podiatry school.

They are both surgical medical specialties having similar lifestyles and pay grades.
It all comes down to what YOU want to do in YOUR life.
Best of luck in your decision.

 

[PatchAdamsFan]

If you want a sucky undergrad experience, a plush lifestyle, but have a repetitive job, go dental.

I don't know what skewed your views so much, but those are extremely subjective thoughts on dentistry. Every pre-med/dent I know had a very fulfilling college experience, including myself. Work hard, play hard. And let's be honest, all jobs are repetitive to a degree, and podiatry is no exception. Both careers are great opportunities.

 

[MaxillofacialMN]

I don't know what skewed your views so much, but those are extremely subjective thoughts on dentistry. Every pre-med/dent I know had a very fulfilling college experience, including myself. Work hard, play hard. And let's be honest, all jobs are repetitive to a degree, and podiatry is no exception. Both careers are great opportunities.

Did every premed you know get into medical school? I doubt it. I could be a "premed" and get wasted every night and you could say that I had a "fulfilling" experience but that isn't the point. You've got to get in too!

And how many general dentists have you shadowed?? Their job is literally 10x more repetitive than any podiatrist I shadowed. Do you disagree?

 

[NatCh]

personally I feel this is more of the extreme than the norm.

Yes that was the extreme but you were talking about ceilings. If you want to compare norms then we need to look at median incomes.

 

[PatchAdamsFan]

Did every premed you know get into medical school? I doubt it. I could be a "premed" and get wasted every night and you could say that I had a "fulfilling" experience but that isn't the point. You've got to get in too!

And how many general dentists have you shadowed?? Their job is literally 10x more repetitive than any podiatrist I shadowed. Do you disagree?

I've got to quote, since there are 3 discussions going on at once! Many of my peers were accepted, a few did not, and a many more are applying this year (now) with substantially higher stats than myself. What I meant to get across is that everyone was in multiple school clubs, extracurricular activities, sports, even fraternities (I'm guilty). All but a certain few had a great time in college (doesn't necessarily mean drinking) that I'm aware of. With respect to dentists, I actually did shadow a dentist (with no interest in dental school), and he was very busy. The work he did was hardly repetitive, but I can see that it might be. I have shadowed 3 podiatrists, one of which was casting and clipping all day. The other two did many procedures, so it comes down to personal experiences. Bottom line is there are extremely happy people in both professions doing a myriad of procedures, so the subjectivity is unwarranted.

 

[PADPM]

Dental students have to enter dental school understanding the reality that the odds of obtaining a prestigious residency such as oral surgery, orthodontics, perio, etc., are slim. Therefore they should all understand and be prepared to practice general dentistry.

However, podiatry has created a monster. They now REQUIRE a 3 year surgical residency and those who don't get placed are screwed.

As others in the past have stated, we need to follow the dental model and let pod students know there is a possibility they may not land a surgical residency and may have to practice general podiatry. I strongly believe not everyone is cut out to be a surgeon.

So pod students should proceed as dental students do, understanding that there are no guarantees and you may have to be a general provider. But this can't happen currently in podiatry since the 3 year residency is mandatory.

Yep, we created our own monster.

 

[Dr Aboody]

Dental students have to enter dental school understanding the reality that the odds of obtaining a prestigious residency such as oral surgery, orthodontics, perio, etc., are slim. Therefore they should all understand and be prepared to practice general dentistry.

However, podiatry has created a monster. They now REQUIRE a 3 year surgical residency and those who don't get placed are screwed.

As others in the past have stated, we need to follow the dental model and let pod students know there is a possibility they may not land a surgical residency and may have to practice general podiatry. I strongly believe not everyone is cut out to be a surgeon.

So pod students should proceed as dental students do, understanding that there are no guarantees and you may have to be a general provider. But this can't happen currently in podiatry since the 3 year residency is mandatory.

Yep, we created our own monster.

Well said. I am definitely in favor of having general podiatrists around, even if it requires a 1-2 year residency. To my knowledge, the federal funding for these programs is available... Unfortunately for us, politics are playing their role.

 

[toothfetish]

So then why would a patient visit a podiatrist over a orthopedic surgeon?

 

[PADPM]

So then why would a patient visit a podiatrist over a orthopedic surgeon?

It depends on whether they were visiting a general practitioner podiatrist or someone with significant surgical training. Dentist for general issues-----oral surgeon for surgical issues.

Podiatrist for general issues------podiatric foot/ankle surgeon or orthopedic foot/ankle surgeon for surgical issues.

Seems pretty simple to me.

 

[toothfetish]

It depends on whether they were visiting a general practitioner podiatrist or someone with significant surgical training. Dentist for general issues-----oral surgeon for surgical issues.

Podiatrist for general issues------podiatric foot/ankle surgeon or orthopedic foot/ankle surgeon for surgical issues.

Seems pretty simple to me.

Well I'm talking about podiatric foot/ankle surgery vs. orthopedic foot/ankle surgery.

 

[PADPM]

Well I'm talking about podiatric foot/ankle surgery vs. orthopedic foot/ankle surgery.

Anyone who denies the excellent training of today's podiatric residency grads, simply has his/her head in the sand. The argument that orthopods are more qualified is simply obsolete.

Even the head of the orthopedic group "admitted" this in a written statement.

Orthopedic foot and ankle surgeons are certainly well trained and should be highly respected. Their fellowship in foot and ankle is 1 year, and it's well documented that their foot and ankle exposure during residency is minimal. Today's podiatric residency grads spend 3 years (some 4), predominately on the foot and ankle, and some also do a fellowship in addition.

There is equality in foot and ankle training, whether some want to admit it or not.

 

[feet2017]

Well I'm talking about podiatric foot/ankle surgery vs. orthopedic foot/ankle surgery.

i believe it's based on preference, referrals, reputation, and just availability.

 

[toothfetish]

One thing that turns me off is that general dentists make their income right after 4 years (general) while a podiatrists has to go through 7 years of schooling just to match that dentist's income.

 

[cpinkows]

One thing that turns me off is that general dentists make their income right after 4 years (general) while a podiatrists has to go through 7 years of schooling just to match that dentist's income.

If you think your gunna make the big bucks right out of dental school, your going to be very disappointed.

 

[pod101]

http://benbrownmd.wordpress.com/

Reality that is hitting every medical profession. If you want money, don't pick a career in medicine.

 

[NatCh]

Well I'm talking about podiatric foot/ankle surgery vs. orthopedic foot/ankle surgery.

I think it might help to back up and look at the typical progression of how a person goes to a doctor. People generally don't wake up one morning and say, "Dang, my toe hurts. I need surgery." Nowadays they're likely to Google "big toe pain" then try self-treatment long before they go see any doctor. If or when they don't get better on their own and they decide they want to see a doctor they might start asking around, "Who should I go see?" They may ask their friends and their primary care doctor, so here is where reputation and referrals come into play. Once they've decided on whom to call they'll see if they can get in. If the doctor is booking too far out then they might call elsewhere to see if they can get in sooner, unless the first doc is the man (or woman) to see based on reputation. Here is where availability comes into play. So as another poster already said, a lot of it comes down to preference, referrals, reputation, and availability.

If you ever get to the point where you want or need surgery you should be looking for the person (more than his or her degree) that does a lot of whatever procedure you need, and you'll want to find out if his or her outcomes are good. Again, this goes back to reputation rather than credentials. Instead of asking, "Should I have surgery from an orthopedic surgeon or a podiatrist?" you should be asking, "Which person in town does the most bunionectomies and who has the best outcomes." The answer in your vicinity might be either type of doctor.

I'm getting off on a little tangent here, but with some exceptions, most people are looking for non-surgical treatments long before they want surgery. It took me awhile to clue into the following fact, but a lot of people just want some guidance rather than a fix, or simply to be told that they're okay. As much as we as surgeons want to "fix" things a lot of patients just want counseling. If one doctor is only going to be able to give you four minutes to discuss your problem versus another doctor who can spend more time, then patients will find that out.

It's not always about the nail.
http://vimeo.com/66753575

 

[toothfetish]

If you think your gunna make the big bucks right out of dental school, your going to be very disappointed.

Not 150,000 ish but certainly more than 110,000 with only 4 yrs training

 

[cpinkows]

Not 150,000 ish but certainly more than 110,000 with only 4 yrs training

Per my 4 cousins/uncles who are dentists, expect high 5 figures for recent grads for most cases when first starting. Simply what they told me. There all from the midwest.

 

[NatCh]

I spent some time thinking about this yesterday...

One aspect about podiatry is that there is nothing a podiatrist treats that someone else doesn't also treat. Can you name one thing? I can't.

This forum usually focuses at the surgical aspect of the profession and the pod v. ortho question often comes up, but what about the things that don't require an operating room?

- Ingrown nails? FP, urgent care, Derm all treat that.
- Plantar warts? FP and Derm treat that.
- Plantar fasciitis? FP, PT, chiropractic, and the entire internet treat that.

So in addition to competing against one another, we also compete against other professions and Dr. Google.

On the other hand, who competes against a dentist? If your dentist tells you that you need a root canal, do you get a second opinion from an orthopod? Do you go online to an internet forum and ask how to do your own root canal procedure? The dentist is the sole authority on oral care. That must be nice.

 

[pod101]

Usually people make life decisions based on personal experience. Something as simple as Dr. X was a really awesome person and I really enjoyed doing what he does or Dr Y is a terrible person and I hate what they were doing to their patients. This is why shadowing is essential before picking a direction.

You are right dentists and dental hygienists have really cornered the tooth market. Very few MDs will touch the mouth. Dentistry is more popular today than it has been in years in terms of money and "prestige". However, as the dental forums will tell you. Not everything is rosy on the dentist side of things (saturation, general vs. surgical - have to pick one or the other, compensation issues,...). I would be careful reading too many websites or comparing stats b/c stats can be very misleading and people usually use whatever statistic supports their case and dismiss stats that are inconvenient.

You might not have to worry about the MD/DO's just the 5,000+/yr dental graduates you have to compete against. Compare this to the 550 podiatrists. There are more dental surgeons than podiatric surgeons in the US). Also you are right a Family Doctor could address the nail infection and a surgeon could address a bone problem, but no hospital is going to let a family doctor operate, and no surgeon is about to prescribe foot cream any time soon. Podiatrist can bring the two together in a part of the body that generally none of the afore mentioned professions want to touch. When was the last time your primary care doctor looked at your foot? Even if your a diabetic I watched an endocrinologist completely ignore the foot during her 30 minute session, even though I could smell an odor. I asked what was that odor on the patients way out, they checked, OH surprise surprise she has gangreen her foot is rotting and she can't feel it. Podiatry, it's a nitch. A neglected part of the body that 1 MD recognized 110 years ago.

Prestige - A prestigious career in 2010 can be complete hog wash in 2020. Look at crime scene investigators 30 years ago, looking at mutilated corpses was not popular at all, 80+ episodes of CSI and a couple of hot chicks and dudes (if your into that) later now the market is flooded with CSI students.

Final food for thought, when I was shadowing doctors...

MD Family Med, god PA is pushing me out of a job, 2 yrs and they are equal to me, I might have to sign off for them but I have to report to my supervisor at the hospital who is a PA with an MHA, go be a PA ->

PA god I hate taking orders, working hourly and discovering ive been laid off for no reason go be an RN they are more established and people know what they are...

RN are you kidding me? I have the same problems as a PA, I have to take orders and clean bed pans and work in nursing homes to get my first job, and I may never even break out of nursing homes until i have 10 yrs under my belt, APRN is hard to achieve and its almost impossible to get into the lucrative jobs (Anesthesiologist..Emergency Room...) go be a DO they are just like MD doctors...

DO, OMM is not recognized by many insurance agencies AND 90% of my fellow DOs don't bother practicing it, I always have to explain what my degree is, its damn hard to get a surgical residency, you think we are all equal? Try telling that to the Match, god go be a dentist ->

Dentist -> You thought all dentists could get a surgical residency LOL! No I am a general dentist despite graduating in the top 20% of my class. Its not too bad except that I don't get the same respect and people still think I am not a "real doctor" and good luck trying to be the PI on a research paper the mighty Ph.D.'s will treat you like ****. Go be a podiatrist, the busiest physician in the state is a podiatrist you have to book months in advance to see him...

Podiatrist -> I am tired of defending/defining what DPM is for everyone, I am a real doctor too, some people think all I do is clip nails or day, I am trained in surgery but wish I could practice my full scope in every state and get equal reimbursement to an MD, sigh, if I could do things over...I would be an MD.

And the Cycle continues...

<P.S. I cut out
OD - over saturated, low compensation, and a feeling of being professional eye glass vendors
Pharm.D. - Wallgreens vs. Walmart anyone? I don't make 100k just starting but my school cost a ton? Why are there are a TON of Pharm. D. programs out there?
DPT - We were 2 yrs now we are turning into 4 year programs, but what did we gain? We are not MDs and most of us make <100k a year.
I will spare you the rants of Chiropractors (I could type here all day)

I could go on and on with other health care professions ranging from Radiation Therapists, Neutricianists, Genetic Councilers, Medical Technicians, Biomedical Technicians, CLS, Coders...

Point Is: NOBODY IS HAPPY. Not even the $400,000 Orthodpedic Suregon who took 8 years of 40-60k/yr being propped up by her/his hubby/wifes salary during that time trying to pay off the same $200k, 300k, or 400k debt we all have to pay.

You know maybe I missed my calling, maybe I should have been a career councilor...hmmmm

 

[NatCh]

^ LOL, ain't nobody happy! The grass is greener on the other -- oh wait, the grass is dead.

 

[Jacknife]

I spent some time thinking about this yesterday...

One aspect about podiatry is that there is nothing a podiatrist treats that someone else doesn't also treat. Can you name one thing? I can't.

This forum usually focuses at the surgical aspect of the profession and the pod v. ortho question often comes up, but what about the things that don't require an operating room?

- Ingrown nails? FP, urgent care, Derm all treat that.
- Plantar warts? FP and Derm treat that.
- Plantar fasciitis? FP, PT, chiropractic, and the entire internet treat that.

So in addition to competing against one another, we also compete against other professions and Dr. Google.

On the other hand, who competes against a dentist? If your dentist tells you that you need a root canal, do you get a second opinion from an orthopod? Do you go online to an internet forum and ask how to do your own root canal procedure? The dentist is the sole authority on oral care. That must be nice.

I posted this on another thread, and repost here because it seems applicable.

You seem like a well seasoned sort in the field. What do you think of putting some emphasis on office procedures, verrucae, clavi, HD5, simple enucleation of IPKs, and T and Cs for reducible contracted digits?¶Seems like there's too much emphasis on more complex procedures which I gather from you posts, present their share of aggravation. Let's face it, the art of reducing a callus, shaving a corn has been derided, dismissed, and largely ignored by younger podiatrists, but it DOES put podiatry in the unique position it was in before the boom of the 70s and 80s--Yes, chiropody procedures, a dying--in the US--healing art.¶Unfortunately podiatry hasn't broken into the mainstream of medical specialties (ABMS), and as someone mentioned doesn't do much that some other profession can do, i.e.., derm, ortho, etc.. Why not embrace the face-to-face human contact with basic in-office building relationships practice that will ultimately be the bread and butter of any podiatrist's career?¶I know the who are you, why, what, hazing, is forthcoming, but please, understand this: No matter what anyone says on these forums is suspect, no one IS truly who they say they are--or are they? And everyone's got an agenda, right? but to what ends? I've been around the field for over 30 years, and so far there hasn't been as much change in the state scope of practice laws--That's been a constant. So maybe we can dispense with the hazing. Huh?

I interact daily with MD specialists in an array of disciplines. Many of the orthopedic surgeons who ARE NOT foot and ankle fellowship trained do an average of 3 or 4 ankles a week. These are guys who've been in the field for over 25-30 years. I have a difficult time with the rhetoric from "Rearfoot Certified" podiatrists claiming to be "Just as good as," these docs.Not only do most states preclude this, it just doesn't make economic, or practical sense to spend 7 years training for something that will not ultimately be used routinely.¶I think it's time to reevaluate the objectives of a podiatric education, and how to make the graduates more of a part of the upcoming changes as opposed to feebly competing on an uneven playing field.¶There are things podiatrists can do that others cannot, yet those things are largely dismissed. The fact remains that there are in excess of 90 graduates who will not be trained, or have a path to pay off 250-300 thousand dollars in student loans. This is a serious issue transcending being called a troll, or banned because it is the 800 pound gorilla in the room--What do you do with a DPM degree if you can't get trained?

 

[PADPM]

Usually people make life decisions based on personal experience. Something as simple as Dr. X was a really awesome person and I really enjoyed doing what he does or Dr Y is a terrible person and I hate what they were doing to their patients. This is why shadowing is essential before picking a direction.

You are right dentists and dental hygienists have really cornered the tooth market. Very few MDs will touch the mouth. Dentistry is more popular today than it has been in years in terms of money and "prestige". However, as the dental forums will tell you. Not everything is rosy on the dentist side of things (saturation, general vs. surgical - have to pick one or the other, compensation issues,...). I would be careful reading too many websites or comparing stats b/c stats can be very misleading and people usually use whatever statistic supports their case and dismiss stats that are inconvenient.

You might not have to worry about the MD/DO's just the 5,000+/yr dental graduates you have to compete against. Compare this to the 550 podiatrists. There are more dental surgeons than podiatric surgeons in the US). Also you are right a Family Doctor could address the nail infection and a surgeon could address a bone problem, but no hospital is going to let a family doctor operate, and no surgeon is about to prescribe foot cream any time soon. Podiatrist can bring the two together in a part of the body that generally none of the afore mentioned professions want to touch. When was the last time your primary care doctor looked at your foot? Even if your a diabetic I watched an endocrinologist completely ignore the foot during her 30 minute session, even though I could smell an odor. I asked what was that odor on the patients way out, they checked, OH surprise surprise she has gangreen her foot is rotting and she can't feel it. Podiatry, it's a nitch. A neglected part of the body that 1 MD recognized 110 years ago.

Prestige - A prestigious career in 2010 can be complete hog wash in 2020. Look at crime scene investigators 30 years ago, looking at mutilated corpses was not popular at all, 80+ episodes of CSI and a couple of hot chicks and dudes (if your into that) later now the market is flooded with CSI students.

Final food for thought, when I was shadowing doctors...

MD Family Med, god PA is pushing me out of a job, 2 yrs and they are equal to me, I might have to sign off for them but I have to report to my supervisor at the hospital who is a PA with an MHA, go be a PA ->

PA god I hate taking orders, working hourly and discovering ive been laid off for no reason go be an RN they are more established and people know what they are...

RN are you kidding me? I have the same problems as a PA, I have to take orders and clean bed pans and work in nursing homes to get my first job, and I may never even break out of nursing homes until i have 10 yrs under my belt, APRN is hard to achieve and its almost impossible to get into the lucrative jobs (Anesthesiologist..Emergency Room...) go be a DO they are just like MD doctors...

DO, OMM is not recognized by many insurance agencies AND 90% of my fellow DOs don't bother practicing it, I always have to explain what my degree is, its damn hard to get a surgical residency, you think we are all equal? Try telling that to the Match, god go be a dentist ->

Dentist -> You thought all dentists could get a surgical residency LOL! No I am a general dentist despite graduating in the top 20% of my class. Its not too bad except that I don't get the same respect and people still think I am not a "real doctor" and good luck trying to be the PI on a research paper the mighty Ph.D.'s will treat you like ****. Go be a podiatrist, the busiest physician in the state is a podiatrist you have to book months in advance to see him...

Podiatrist -> I am tired of defending/defining what DPM is for everyone, I am a real doctor too, some people think all I do is clip nails or day, I am trained in surgery but wish I could practice my full scope in every state and get equal reimbursement to an MD, sigh, if I could do things over...I would be an MD.

And the Cycle continues...

<P.S. I cut out
OD - over saturated, low compensation, and a feeling of being professional eye glass vendors
Pharm.D. - Wallgreens vs. Walmart anyone? I don't make 100k just starting but my school cost a ton? Why are there are a TON of Pharm. D. programs out there?
DPT - We were 2 yrs now we are turning into 4 year programs, but what did we gain? We are not MDs and most of us make <100k a year.
I will spare you the rants of Chiropractors (I could type here all day)

I could go on and on with other health care professions ranging from Radiation Therapists, Neutricianists, Genetic Councilers, Medical Technicians, Biomedical Technicians, CLS, Coders...

Point Is: NOBODY IS HAPPY. Not even the $400,000 Orthodpedic Suregon who took 8 years of 40-60k/yr being propped up by her/his hubby/wifes salary during that time trying to pay off the same $200k, 300k, or 400k debt we all have to pay.

You know maybe I missed my calling, maybe I should have been a career councilor...hmmmm

Great post. However, in many states DPM reimbursement is already identical to MDs. So that's at least one item off the list!

 

[jonod1107]

Great post. However, in many states DPM reimbursement is already identical to MDs. So that's at least one item off the list!

A Pod I shadowed told me they are paid less than Orthos for same surgical procedure? Is that true? Or just with a specific agency (private insurance or Medicare, etc)?

 

[PADPM]

A Pod I shadowed told me they are paid less than Orthos for same surgical procedure? Is that true? Or just with a specific agency (private insurance or Medicare, etc)?

That is true for certain insurance carriers in certain states. I receive equal payment and personally would not practice in a state that had separate fee schedules for the same procedures.

 

[Jacknife]

A Pod I shadowed told me they are paid less than Orthos for same surgical procedure? Is that true? Or just with a specific agency (private insurance or Medicare, etc)?

The amount paid for specific procedures varies from payor to payor, and state to state. Medicare, Medicaid, private insurance companies, in-network, out-of-netork, and several variables including but not limited to specific procedures or providers. For instance, among the many third party payors there will be claims plucked out for review, and the individual carrier will "review" the claim. Many of the "reviewers," are nurses, some are "paid physicians," who dissect the claim for services, and decide on payment to the provider.¶This is not a binary answer where a blanket yes, or no regarding payments is adequate. However, insurance companies as a rule do whatever they can to frustrate benefits, stall payments, and collections for services rendered remains a task even the best and brightest have issues with.¶Nationwide there is considerable variability as to who gets paid how much for what, or why. Generally, podiatry claims that are not within certain parameters for the profession as a whole are kicked out for "special attention," and reviewed. Occasionally they are paid less than orthos.¶It would behoove you to understand early that the bulk of your income will NOT be derived from hospital procedures, routine office procedures tend to be the bulk of a podiatrists income. They fall into dermatological, (removal of lesions, nails, nail plates, verrucae, debridement of wounds, incision and drainage, etc.,) radiological, injections (neurological, rheumatologic, physicatric,, and other areas of general medical billing, coding protocols.¶Complex computer programs calculate usual and customary allocatable rates to pay various providers in thousands of geographic locations.¶There isn't a broad brush stroke answer to the: "Who gets paid more," question as it depends, as i said on the carrier, provider, provider's billing history, and documentation of procedures performed.¶In sum, it's best to be paid by the patient and let them fight with the insurance companies to collect. After all, the patient--the insured--has already paid you, and will be motivated to collect their money.

 

[toothfetish]

I'm liking this more and more.

 

[mees]

In my personal opinion, I would definitely chose podiatry over dentistry. I recently finished six months of employment as a dental assistant at a dental practice, I am taking time off to enjoy life before starting pod school in August. I was able to work for a general dentist, periodontist and an endodontist. The dentist I worked for expressed that she wishes she would have pursued a career in medicine over dentistry. The endodontist I worked for expressed how much she disliked her job, mostly because of colleagues. The periodontist seemed more satisfied with his job, although traveling from office to office was an annoyance.

Before applying, I shadowed three podiatrist. The first was a recent grad that had joined a private practice in a rural area. The second owned his own established practice and the third was part of a large orthopedic group. They all seemed pretty satisfied with their careers and were honest about both the pros and the cons. I will briefly mention that some of the cons were: dealing with insurance, lack of autonomy in certain cases, lots of paperwork (because of insurance). I feel like most of the cons on this list can be applied dentistry as well as other medical careers.

Here are a few big reasons I dislike dentistry as a career:
1.) There are many patients (more than you think) with a specific fear of the dentist. They will tell you to your face that they hate being there. This is not always the patient's fault -- for many it is the result of emotionally scarring previous experiences. I have not encountered too many people with a fear of going to the podiatrist (rather, they may generally dislike going to see any doctor).

2.) The patient has to physically keep their jaw wide open for you to be able to do any procedure on them. This includes children and the elderly. Instruments can be bulky, gag reflexes can be triggered, saliva must be suctioned away, vomiting may occur (rarely, but it has). Lots of nasty grossness comes out of a persons mouth, including but not limited to mucous and phlegm (that is difficult to get out of the spit bowl drains...yuck!!). With podiatry, the feet are out there for the whole world to see, no effort from the patient needed (other than to remove shoes).

3.) Did I mention that you have to constantly suction saliva away? Seriously, constantly. Any drill you use will shoot water out of it, this will obstruct the mirror and the mirror has to be wiped/air blasted constantly. Most procedures will require a completely dry tooth (in a wet environment). The tongue is a giant muscle that will want to constantly get in the way. Even when you retract the tongue, it will put up a fight. Your worst nightmare: small jaw, large tongue, lots of saliva. Good luck -- that is just about every adolescent. The foot does not salivate, 'nuff said.

4.) Dentistry requires a lot of different instruments, medications, impression materials, filling materials, cements, etc. Lots of small, expensive components that must be accounted for, and restocked constantly. I'm sure podiatrists require many instruments, but no where near as much (that I have seen).

5.) General dentistry is extremely repetitive. Most jobs are repetitive but multiply dentistry by 32... add in stinky open mouth breathing into your face and random splatters.

I hope this helps. Let me know if you have any questions.

 

[NatCh]

In my personal opinion, I would definitely chose podiatry over dentistry. I recently finished six months of employment as a dental assistant...

Thanks for giving your perspective. It's always helpful to hear from someone who has actually set foot on the other side of the fence.

I sometimes wonder if there is ANY job that is free from complaint. Movie star seems as if it would top the list but in one of the promo vids related to Man of Steel even megastar Russell Crowe said about acting, "The pay is good but they treat you like $#*!."

 

[toothfetish]

In my personal opinion, I would definitely chose podiatry over dentistry. I recently finished six months of employment as a dental assistant at a dental practice, I am taking time off to enjoy life before starting pod school in August. I was able to work for a general dentist, periodontist and an endodontist. The dentist I worked for expressed that she wishes she would have pursued a career in medicine over dentistry. The endodontist I worked for expressed how much she disliked her job, mostly because of colleagues. The periodontist seemed more satisfied with his job, although traveling from office to office was an annoyance.

Before applying, I shadowed three podiatrist. The first was a recent grad that had joined a private practice in a rural area. The second owned his own established practice and the third was part of a large orthopedic group. They all seemed pretty satisfied with their careers and were honest about both the pros and the cons. I will briefly mention that some of the cons were: dealing with insurance, lack of autonomy in certain cases, lots of paperwork (because of insurance). I feel like most of the cons on this list can be applied dentistry as well as other medical careers.

Here are a few big reasons I dislike dentistry as a career:
1.) There are many patients (more than you think) with a specific fear of the dentist. They will tell you to your face that they hate being there. This is not always the patient's fault -- for many it is the result of emotionally scarring previous experiences. I have not encountered too many people with a fear of going to the podiatrist (rather, they may generally dislike going to see any doctor).

2.) The patient has to physically keep their jaw wide open for you to be able to do any procedure on them. This includes children and the elderly. Instruments can be bulky, gag reflexes can be triggered, saliva must be suctioned away, vomiting may occur (rarely, but it has). Lots of nasty grossness comes out of a persons mouth, including but not limited to mucous and phlegm (that is difficult to get out of the spit bowl drains...yuck!!). With podiatry, the feet are out there for the whole world to see, no effort from the patient needed (other than to remove shoes).

3.) Did I mention that you have to constantly suction saliva away? Seriously, constantly. Any drill you use will shoot water out of it, this will obstruct the mirror and the mirror has to be wiped/air blasted constantly. Most procedures will require a completely dry tooth (in a wet environment). The tongue is a giant muscle that will want to constantly get in the way. Even when you retract the tongue, it will put up a fight. Your worst nightmare: small jaw, large tongue, lots of saliva. Good luck -- that is just about every adolescent. The foot does not salivate, 'nuff said.

4.) Dentistry requires a lot of different instruments, medications, impression materials, filling materials, cements, etc. Lots of small, expensive components that must be accounted for, and restocked constantly. I'm sure podiatrists require many instruments, but no where near as much (that I have seen).

5.) General dentistry is extremely repetitive. Most jobs are repetitive but multiply dentistry by 32... add in stinky open mouth breathing into your face and random splatters.

I hope this helps. Let me know if you have any questions.

The seven year path didn't bother you? I'll be 32 by then.