RVU Production for podiatrist?

[bloxxeeey]

What's the typical wRVU earned for a podiatrist yearly? I've seen all over from 5500-7200. I'm asking for both surgical and non-surgical podiatrist.

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[Feli]

There are a ton of factors... referrals, staff, what services office/clinic offers, DPM's ability and desire to see high vs avg volume, DPM's billing acumen, OR turnover times, if DPM gets credit for DME or rad or etc etc etc.

One of the biggest errors most new grads make is thinking they'll see 25, 30, 40+ per day consistently and right away.
That is almost always not possible as they won't get that pt volume, they won't be able to handle it (staffing, own ability, keep up on notes, etc), won't have clinic or schedule staff support for it, billers are below avg, whatever.

...The best thing to do is talk to current or recent past DPMs who work the job in question and see how it went for them in terms of pts/day or collections or RVU or whatever.

 

[RollingstonePod]

What's the typical wRVU earned for a podiatrist yearly? I've seen all over from 5500-7200. I'm asking for both surgical and non-surgical podiatrist.

Feli is correct, many factors will determine one’s ability to generate wRVUs. Numbers can be much higher than 7200/yr depending on the variables. I worked for a MSG for several years and it took me about 2 years upon starting to consistently generate my usual numbers. I saw on average about 120 patients per week (4 clinic days) and one full OR day averaging 6-8 cases per week. No RFC or wound care and we had physician extenders doing post op care. In that scenario I was able to consistently generated 750-1000 wRVUs/month. I know of colleagues that generate more.

 

[619]

One of the biggest errors most new grads make is thinking they'll see 25, 30, 40+ per day consistently and right away.

True. A lot of folks don't realize that high volume practices seeing 30 to 40+ patients a day are all saddled by mostly medicaid patients coming in for wounds, nails, itchy feet from poor hygiene etc. This could be profitable ONLY if you are RVU based but then it gets tiring and overwhelming and leads to burn out.

In residency, we all have that one "busy" clinic attending seeing 50+ patients but that is only possible because he/she has residents to see the patients and also do the notes. Honestly, you don't want to be out by yourself seeing that much volume in clinic. This is not even including surgery and inpatient consults.

 

[Retrograde_Nail]

What's the typical wRVU earned for a podiatrist yearly? I've seen all over from 5500-7200. I'm asking for both surgical and non-surgical podiatrist.

Too many factors. Depends on size of hospital and resources. Depends on size of community.

I've had two hospital gigs.

First one was an independent hospital in a town of 60,000. Not bad volume but terrible hospital support and resources. I still did close to 10,000 RVUs my last year there but I was absolutely killing myself

Second gig I am at a 600 bed tertiary referral center in a town of 200,000. Lots of wound care certified nurses to do my ex-fix dressings on the floor. I have two nurses in clinic. I have an APRN who does our inpatient rounding. This frees me up to do as many surgeries as I can. I am currently on pace for 12-13K RVUs this year and I am not nearly stressing out as much as I was when I was at a small community hospital.

Other factor is skill set. Potential productivity depends on skill set. I do everything from toenails to TARs. My practice is more wound care and limb salvage and trauma. I also do elective cases but majority is high risk limb salvage and wounds with trauma that nobody wants to do. Big RVU cases. If you aren't comfortable doing Charcot, ex-fix, muscle flaps, STSG, wounds then you are going to lose a lot of productivity.

RVU system is built for limb salvage. You can really take advantage of these cases and really rack up RVUs if you are willing to do it. Trying to make a killing in RVUs only doing elective cases is going to be a struggle because these elective cases you are fighting for with other podiatrists and even foot and ankle ortho if they are present in our community. But nobody wants to do wounds and diabetic offloading surgeries and charcot, etc

 

[Hybrocure]

Too many factors. Depends on size of hospital and resources. Depends on size of community.

I've had two hospital gigs.

First one was an independent hospital in a town of 60,000. Not bad volume but terrible hospital support and resources. I still did close to 10,000 RVUs my last year there but I was absolutely killing myself

Second gig I am at a 600 bed tertiary referral center in a town of 200,000. Lots of wound care certified nurses to do my ex-fix dressings on the floor. I have two nurses in clinic. I have an APRN who does our inpatient rounding. This frees me up to do as many surgeries as I can. I am currently on pace for 12-13K RVUs this year and I am not nearly stressing out as much as I was when I was at a small community hospital.

Other factor is skill set. Potential productivity depends on skill set. I do everything from toenails to TARs. My practice is more wound care and limb salvage and trauma. I also do elective cases but majority is high risk limb salvage and wounds with trauma that nobody wants to do. Big RVU cases. If you aren't comfortable doing Charcot, ex-fix, muscle flaps, STSG, wounds then you are going to lose a lot of productivity.

RVU system is built for limb salvage. You can really take advantage of these cases and really rack up RVUs if you are willing to do it. Trying to make a killing in RVUs only doing elective cases is going to be a struggle because these elective cases you are fighting for with other podiatrists and even foot and ankle ortho if they are present in our community. But nobody wants to do wounds and diabetic offloading surgeries and charcot, etc

This situation is a 1% podiatry experience for what it’s worth. It’s what schools hope everyone will do but only a very few motivated and smart individuals like retrograde actually end up in. That being said, most grads cant do what retrograde does.

 

[Jummy Biffett]

For the hospital pods out there, how feasible is it to earn ~350k salary in a wRVU based model? Does this require 'burnout' level of hours/work? Specifically in a limb salvage/inpatient wound care focused practice. Assuming good midlevel/admin support and other foot & ankle surgeons to help with call etc.

 

[LossToFollowUp]

It's very dependent on what the $ to wRVU rate is and what base you start with BUT 350K should be very reasonable. Assuming full-time and 15-20ish patients a day, with or without surgery, you should exceed 350K.

 

[Jummy Biffett]

It's very dependent on what the $ to wRVU rate is and what base you start with BUT 350K should be very reasonable. Assuming full-time and 15-20ish patients a day, with or without surgery, you should exceed 350K.

What would be a good dollar amount per wRVU? Assuming the base is 250k for first couple years

 

[LossToFollowUp]

Last facility I was at, the rate was 38 but then it got negotiated to 45. I think there are pods getting 60s and even 80s but I'm not sure how true that is.

 

[Feli]

It's very dependent on what the $ to wRVU rate is and what base you start with BUT 350K should be very reasonable. Assuming full-time and 15-20ish patients a day, with or without surgery, you should exceed 350K.

For the hospital pods out there, how feasible is it to earn ~350k salary in a wRVU based model? ...

The majority of hospital-employed (DPMs, not MD/DOs) are VA and IHS... so they don't have a bonus. $350k is basically impossible for them.

Hospital jobs (non govt) are under 10%, prob under 5%, of DPMs overall.
It's a noble goal, but the majority of those jobs are flooded with apps and go to someone with a connection.

 

[Jummy Biffett]

The majority of hospital-employed (DPMs, not MD/DOs) are VA and IHS... so they don't have a bonus. $350k is basically impossible for them.

Hospital jobs (non govt) are under 10%, prob under 5%, of DPMs overall.
It's a noble goal, but the majority of those jobs are flooded with apps and go to someone with a connection.

At the risk of sounding like an a**hole, the offer is in hand. But in high cost of living area, hence the specific question about 350k potential, which is what I would anticipate needing for family to be comfortable.

 

[dtrack22]

Last facility I was at, the rate was 38 but then it got negotiated to 45. I think there are pods getting 60s and even 80s but I'm not sure how true that is.

$60’s exists. $80’s may but that’s more than some ortho get so it’s a pipe dream. $40’s is criminal but in some regions it’s unfortunately standard.

$350k in an employed production model isn’t hard unless you’re $40 per wRVU, then it takes around 9,000 wRVU which is top 10-25th percentile production.

 

[billBOB213]

What is MGMA data saying now about it? A few years back $53 was average for surgical pods but I don’t have access to that info now, but it might be good to get my our hands on it and use that in your negotiations. Remember, that’s the average, so I would start higher than that and bring up your cost of living etc.

 

[AttackNME]

I have ortho colleagues at $50. Speaking of production, I recently heard of a few hospitals get rid of their podiatry departments and all of a sudden these pods are scrambling to find jobs as associates in our community. Somehow they never did take call or do inpatient work, and had average surgical volume. I don’t know the details of why the hospitals decided to let them go but it’s scary that they would do that apparently out of nowhere

 

[Hybrocure]

I have ortho colleagues at $50. Speaking of production, I recently heard of a few hospitals get rid of their podiatry departments and all of a sudden these pods are scrambling to find jobs as associates in our community. Somehow they never did take call or do inpatient work, and had average surgical volume. I don’t know the details of why the hospitals decided to let them go but it’s scary that they would do that apparently out of nowhere

Never taking call, or doing inpatient work, having average surgical volume. Sounds like they’re right at place in PP podiatry.

If a hospital employs a podiatrist who can’t see inpatients why are they even there? No outside independent practices should be doing call at a hospital for free when they aren’t employed. The only reason hospital employed podiatrists should exist are to deal with inpatients as needed.

To them I say good riddance. I’d rather have a doctor as my boss than an associate/bachelors grad bean counter who doesn’t know about medicine cutting losses.

 

[BubbaWub]

I have ortho colleagues at $50. Speaking of production, I recently heard of a few hospitals get rid of their podiatry departments and all of a sudden these pods are scrambling to find jobs as associates in our community. Somehow they never did take call or do inpatient work, and had average surgical volume. I don’t know the details of why the hospitals decided to let them go but it’s scary that they would do that apparently out of nowhere

In the end you are a just a cog in the wheel at these hospitals. If you do not meet up to certain metrics or standards they hold you to, it's an easy decision for them.

A lot of these hospitals will often subsidize the clinics for their specialists, meaning some of the outpatient clinics will have a net operating loss with staffing, overhead, etc. but the surgeon itself will bring volume/coverage to the hospital.

I feel like podiatry would be one of the easiest things to remove due to it being an ancillary service, and maybe their volume wasn't justifying keeping the clinic running.

 

[BubbaWub]

Never taking call, or doing inpatient work, having average surgical volume. Sounds like they’re right at place in PP podiatry.

If a hospital employs a podiatrist who can’t see inpatients why are they even there? No outside independent practices should be doing call at a hospital for free when they aren’t employed. The only reason hospital employed podiatrists should exist are to deal with inpatients as needed.

To them I say good riddance. I’d rather have a doctor as my boss than an associate/bachelors grad bean counter who doesn’t know about medicine cutting losses.

Bring back baby billy avatar please. Thank you

 

[dtrack22]

I have ortho colleagues at $50.

That’s below 10th percentile for a general ortho. They aren’t “just” making $50 per wRVU. There’s more to their contract/compensation that they aren’t telling you or you aren’t telling us.

 

[Jummy Biffett]

What is MGMA data saying now about it? A few years back $53 was average for surgical pods but I don’t have access to that info now, but it might be good to get my our hands on it and use that in your negotiations. Remember, that’s the average, so I would start higher than that and bring up your cost of living etc.

Latest MGMA data on this would be super helpful. I've heard median total comp. was around $280k but not sure about the $ per wRVU breakdown

 

[Hybrocure]

Bring back baby billy avatar please. Thank you

Ask and you shall receive.

Praise be to he!

 

[BubbaWub]

Ask and you shall receive.

Praise be to he!

Finally, peace at last.

 

[Retrograde_Nail]

For the hospital pods out there, how feasible is it to earn ~350k salary in a wRVU based model? Does this require 'burnout' level of hours/work? Specifically in a limb salvage/inpatient wound care focused practice. Assuming good midlevel/admin support and other foot & ankle surgeons to help with call etc.

350K should be a certainty if you are the only DPM on staff. If not then it should be a certainty after 2 years. There are factors that influence this such starting base pay, dollar per RVU, size of hospital, etc.

First year out of residency at my first hospital job I did not bonus at all just had my base salary which was $240K at the time (7 years ago). Second year I had maybe 60-70K in bonuses. Third and fourth year I was getting 100-150K in bonus and also had my base salary bumped from 240K to 275K during that time. I was only making $45 per RVU at this hospital job which was normal for the region.

Then I got a job in a more favorable area for podiatry at a hospital 5x bigger than the community hospital I had worked at before. I have two other surgical podiatry partners at this new job. Still cranking 1000 RVUs out per month since I do mostly complicate limb salvage cases and trauma nobody wants to do along with some bread and butter podiatry cases. I also do a ton of outpatient wound care.

At this job my base is 325K and $53 per RVU.

It certainly can happen.

DPMs who take jobs at the Kaisers, VAs, or even some really dumpy independent community hospitals may not get there but I will say this. The more pathology you are willing to treat or have the skill set to treat will grossly increase your production potential. If you pick and choose pathology it will not happen. I came from a well known residency program. We never did complex limb salvage or wound care. It was frowned upon. We were "surgeons". Whatever. I jumped right into that stuff my first year out because that is the most common thing you will see and do and be given by ortho, medicine, general surgery, etc. You can't turn that stuff down. In an RVU system it is an absolute money maker. You would be a fool to turn it down but that would be podiatry for you.

 

[Shiyuan]

If you pick and choose pathology it will not happen. I came from a well known residency program. We never did complex limb salvage or wound care. It was frowned upon. We were "surgeons". Whatever.

So you're telling me you're not a "Foot and Ankle Surgeon" ... just a measly "podiatrist"?

 

[Retrograde_Nail]

So you're telling me you're not a "Foot and Ankle Surgeon" ... just a measly "podiatrist"?

I am a podiatrist. I say it proud. I know my role and have accepted it. I'll fix anything that is referred or dumped on me. All I do now is hunt RVUs.

 

[Hybrocure]

350K should be a certainty if you are the only DPM on staff. If not then it should be a certainty after 2 years. There are factors that influence this such starting base pay, dollar per RVU, size of hospital, etc.

First year out of residency at my first hospital job I did not bonus at all just had my base salary which was $240K at the time (7 years ago). Second year I had maybe 60-70K in bonuses. Third and fourth year I was getting 100-150K in bonus and also had my base salary bumped from 240K to 275K during that time. I was only making $45 per RVU at this hospital job which was normal for the region.

Then I got a job in a more favorable area for podiatry at a hospital 5x bigger than the community hospital I had worked at before. I have two other surgical podiatry partners at this new job. Still cranking 1000 RVUs out per month since I do mostly complicate limb salvage cases and trauma nobody wants to do along with some bread and butter podiatry cases. I also do a ton of outpatient wound care.

At this job my base is 325K and $53 per RVU.

It certainly can happen.

DPMs who take jobs at the Kaisers, VAs, or even some really dumpy independent community hospitals may not get there but I will say this. The more pathology you are willing to treat or have the skill set to treat will grossly increase your production potential. If you pick and choose pathology it will not happen. I came from a well known residency program. We never did complex limb salvage or wound care. It was frowned upon. We were "surgeons". Whatever. I jumped right into that stuff my first year out because that is the most common thing you will see and do and be given by ortho, medicine, general surgery, etc. You can't turn that stuff down. In an RVU system it is an absolute money maker. You would be a fool to turn it down but that would be podiatry for you.

Great post. I think there should be more residency emphasis and respect on complex limb salvage rather than frowning on it. It’s where the money is and our calling as a profession to fill an unmet need. And it’s truly the best way to gain respect with MDs and DOs, for those who even care about that stuff.

It’s much more rewarding to save a limb (and by extension possibly a life) than it is to make someone’s arthritis feel better.