Somewhere and I dont remember the source but I remember seeing 20k/DPM in the community is the recommended saturation level.
Anyone else heard this?
This is commonly passed around, but a lot depends on payers and if the DPMs are part or full-time, offering all services, etc.
In actuality, I've never seen a city, especially a metro, with less than 1 DPM per 20k population... it's typically much higher. For example, if you look at the USA with 300M ppl and 20k DPMs (not exact numbers but for easy math), that's only 15k :1 ratio. Sure, some DPMs are part-time, but some people never go to doctors also. I'm sure the 'underserved' cities and towns exist, but personally, I have never found one. Ever. I would guess most of FL probably has a terrible ratio, but it works with all the DPM geriatric care. Most of the underserved highly rural areas are tiny and nowhere near 20k (like the one OP is looking at). Some areas are absolutely better to practice than others, but the 20k+ ppl to one DPM seems enigmatic just based on the hard population and DPM stats.
Also, for demographics, I would also count each area F&A ortho as 2 or 3 if you want to do surgery... so 100k city can support maybe 5-8 DPMs... or 3-4 DPMs and a F&A ortho (although they'd typically be in bigger metro than that, but you get the idea). If a DPM just wants to do PPMR stuff with derm and nail, wound, etc... then the F&A orthos or other orthos who do a lot of F&A work don't matter so much - but other DPMs matter even more to those non-op DPMs.
I think my currency city has 15k ppl, and there are 3 DPMs (all part time here... I'm busiest at 3d/wk), but there is also a sizable surrounding catch area of other towns and a bit from the nearest metro. The small metro of my other office nearby is maybe 125k, but it has probably close to 12-15+ DPMs (some part time there, including me)... but although it's technically way over-saturated by the numbers, it is nowhere near as bad as other places I've worked or looked at.
Personally, I think that you can compete anywhere if you have the offerings and are willing to go meet some PCPs. I wouldn't start up in a city of less than 10k or without reasonable catch area (so there's still plenty if a strong competitor moved in). It's a different story if a hospital wants to pay a DPM there and take all of the risk, though. It's sure easier with better payers, with less other DPMs, and once you get the referral patterns established.
The metros are really hard to get going in unless you want to see a lot of the crap payers to get up and running (and personally, I just dislike big cities, haha). The best locations, in my eyes, are usually the suburb cities maybe 30-60mins from the metro where you have growth of the suburb itself, growth of the associated metro, and good payers... but the groups from the metros haven't expanded there yet or only have a weak part-time presence since their providers and/or staff who live in the metro don't want to drive there. Those can work well (and can probably effectively give you a 20k+ ratio, especially if you draw a bit from the metro or other towns that are nearby to your suburb... but any growth area will attract competition eventually).
I don't mind the other DPMs, though... it tends to help you if they send you surgery or it will make you look good if you fix stuff they were bumbling with. I treat all of them good unless they give me a reason not to, and it works. I get second opinions from most in my area (either DPMs send to me, their PCP steers frustrated pts to me, or pts of other DPMs find me if they're not getting better)... and I'm sure it works the other way a bit also. In general, the competition usually limits itself since docs/groups who come in part-time can never make full-time if they're not doing good care and good networking.
If somebody has that 30k or 40k ppl per DPM place and it's not in Canada or some place with helligh weather or all medicaid, that's a unicorn!
