Several Negative Comments on Podiatry Career/Outlook

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k69143

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Hello everyone,

First time poster (and pre-pod undergrad), so I apologize if there was a similar thread that I hadn't come across. I Google'd "future of podiatry" and came across an entry on The Podiatry Post's website. The post itself was titled, "Is the future of Podiatry bleak?" - but that wasn't my concern (considering that it was just one person's opinion). What DID concern me were the 72 comments following the thread, seemingly all very negative when speaking on the podiatry career path. Attached is a link for you guys to check out. Not that I necessarily turn my back on the profession and intentions of pursuing it, I was just surprised to see so many comments that are vastly different from what I've read on SDN. Thanks in advance!

http://podpost.us/issue/september-2015/article/is-the-future-of-podiatry-bleak

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This website keeps coming up. Mostly because of new prospective students finding it. This is really just one odd ball's personal quest to defame the profession. It is very bizarre. He used to come on here and create different names but his identity was revealed and he has stopped. Plus the moderators came down hard on him and banned all his different accounts.

The podiatry profession has its pros and cons. Cons are mostly related to the political agenda of other MD/DO organizations to try and keep podiatry from progressing. Mainly the AOFAS. Podiatrists continue to move forward and have successful careers despite this but our profession still has a lot of fighting to do to continue to progress towards parity.

If you pursue this profession you will be fighting for your training rights for the rest of your career. That is my only caution.

Thank you for the quick response! I had my doubts regarding the legitimacy of the comments, especially because a majority of the comments were all within a few days of each other.
 
Yeah I remember that person. Every week he/she made a new account ripping on the profession. I know they run that site, and probably make up most of the comments too. Never understood the reasoning behind the solo-witch hunt
 
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The guy who runs that site is unfortunately a very sad story. He had a mental breakdown (or is schizophrenic or something). If you know his name you can read about how he lost his podiatric medical license in West Virginia. I wouldn't put much faith in his posts (and I'm pretty confident all the replies are from him). He has historically been terribly aggressive, dishonest, and unpleasant on this website, but thankfully the moderators have done a better job dealing with his posts (by deleting them rather than allowing them to remain part of the record).

I haven't read his website in a long time (its mostly junk), but he HATES the podiatric leadership and he does do an adequate job findings stories of the scumbag fraudsters in this profession getting prosecuted. If some APMA "Practice Management Guru" gets arrested for false billing there's probably a link to it on his website.
 
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The site has some unnecessary attacks on individuals, underestimates the training and education of podiatry but there is a different tone in myself and my colleagues practicing for 1-3 decades. I truly enjoy what I do. The dynamics have changed in the past decade adding severe challenges to making an honest living. Most people I know are still paying off loans from when tuitions were 10-20K/year. Not sure how that works out when the younger group is doubling that with challenges continuing to add up.

There are more problems than just one guy, that fraudulently billed a couple mil. There are students with 300K in debt and good grades that have to take a year or more off because of a weak residency supply. There is a false expectation that you don't have to cut toenails to make a living. Medicare released coding data and 11721, 11719 were the most commonly used codes for an overwhelming majority of podiatrist (many of which will tell you they don't or rarely cut toenails). Most of us that have applied and or been hired as an associate have discussed quotas for DM shoes, orthotics, topical OTC nail products and other items that are partly or entirely unnecessary to good patient care and have no place in an employment contract. Yet this is how many DPMs make a living. But ,students feel they can ignore these realities and bank on a mythical training gap to propel them above what has been in the past.

It is similar to hearing 50 year olds talk about todays college grads thinking they won't have to get their hands dirty or avoid anything boring or unpleasant to make a living.

Private practice has been the most utilized option for podiatrist. But new legislation makes private practice and solo practice in particular very difficult to maintain and make a living. Other specialties have found more leverage and had an easier time incorporating into multispecialty and hospital run medical groups than podiatry. This is where negative sentiments come in to play.

According to articles I have read and orthos I have spoken with, Ortho is moving away from hiring general orthos and there is pressure to have a fellowship going forward. As of a few years ago foot an ankle fellow ships almost doubled from 40 -70 over short time from of about 5-10 years. This has put further pressure on DPMs to split the pie with occasional degree bias by referring doctors.

There are plenty of people adapting to the legislative changes and other dynamics and doing well in podiatry and will continue to do so in the future. There will always be feet to fix. It's hardly hopeless. But there are hills to climb that can make talented doctors unable to utilize their training and that is another source of frustration.
 
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Based on my shadowing experiences and digging around online, it sounds like podiatry has massive amounts of potential as the Baby Boomers age and the diabetic population broadens. I'm really interested in the complications of the diabetic foot, and podiatry fits that niche to a T. As far as legislation and its role in the profession's ability to succeed is concerned, I just hope current DPMs select influential representatives and continue to provide the awesome care I've been lucky enough to witness.

I'm only a junior in college, but I know this is what I want to pursue. Thanks again to you guys for addressing the post, I'll steer clear of that guy's site from here on out.


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Based on my shadowing experiences and digging around online, it sounds like podiatry has massive amounts of potential as the Baby Boomers age and the diabetic population broadens. I'm really interested in the complications of the diabetic foot, and podiatry fits that niche to a T.

The argument for a long time has been "the population is getting older, diabetes is increasing in prevalence, old people and diabetics both develop foot problems, podiatrists address foot problems, therefore podiatrists are needed." The devil in the details is that "foot problems" often equates to calluses, dry skin, and long toenails. Which isn't so interesting, but it's fine and dandy with me. A plastic surgeon once told me that after 3 years in practice, there are no more "interesting cases." You get into a rhythm and do what you're good at and it's just work.

The question we need to answer as a profession, to paraphrase Dave Chappelle, is how many years of training does it take to treat "foot problems" really?
 
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The devil in the details is that "foot problems" often equates to calluses, dry skin, and long toenails.

The question we need to answer as a profession, to paraphrase Dave Chappelle, is how many years of training does it take to treat "foot problems" really?
To treat calluses, dry skin, and long toenails obviously wouldn't take much time at all. But being trained to the extent of the current scope of practice is what takes a lot longer. Most podiatrists, even in general practice, aren't treating just calluses, dry skin, and long toenails all day. They still need to be trained to spot and/or treat foot problems that are seen less frequently. For all of that, including the emphasis on foot and ankle in podiatry school, a 3 year residency is probably about right.


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You are correct, the podiatrists who operate under the full extent of today's scope of practice benefit the most from the 3 year post graduate training. But some podiatrists continue to earn a comfortable living doing plain chiropody. It's a continuum really. The closer you are to the chiropody side, the less you really needed to do a 3 year training program. By the way, when we talk about serving the needs of the elderly and the diabetics, and that's why we need to train more podiatrists, we're talking largely about chiropody.

The reason I bring it up here is that the pre-health student is going to be looking at our 7-year track and will obviously be wondering what's at the end of the rainbow. Think about that next time you hear about the size of the applicant pool to podiatry school.
 
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If you pursue this profession you will be fighting for your training rights for the rest of your career. That is my only caution.

Just how bad is this? It does worry me as a hopeful pod student
 
If you shadow and look at the need and importance of podiatry today it's laughable how dumb that thread is. Just some people with a sadistic life and bias towards podiatry for whatever anecdotal experience they have. You can find stuff like this about absolutely any profession on the internet. Don't take it with a grain of salt just ignore it.
 
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dont worry, pods will get there. The same thing happened to DOs and there is even still a stigma attactched to them. There are DO surgeons in the country that never took the USMLE, instead took the COMLEX. It's well known that DOs take lower stats too. MD is top dog, I think everyone knows that.


The amount of discrimination you will face from other health care providers is geographically dependent as podiatry is more "welcomed and admired" in certain parts of the country but universally MD/DO do not and will never respect your education.

Doesn't matter if you did a residency in "reconstructive rearfoot surgery/ RRA" or you're a fellow of the american college of foot and ankle surgery. You. Are. A. PODIATRIST.

You didn't go to medical school. You didn't take USMLE. You don't sit for surgical boards governed by the American Board of Medical Specialties. It is really that simple.

Just own this information so you can fully understand why MD/DO ortho doesn't treat you equally. Doesn't mean they are better foot and ankle surgeons than you but in the court of law and the eye of public opinion their academic credentials will always hold more weight.

Again this means nothing about them being better surgeons than you or understanding the foot and ankle better than you. Trust me. I fully believe well trained surgically based podiatrists appreciate and understand the nuances of surgery involving the foot and ankle BETTER than any foot and ankle fellowship trained orthopedist with exception to Coughlin, Mann, Myerson, any of the Duke ortho F/A guys, Harborview F/A guys, etc.

The common foot and ankle fellowship trained ortho has one year of specialized training in foot and ankle compared to your three. Whether or not they got significant exposure to foot and ankle surgery in their ortho residency really depends on where they did their ortho residency and whether they had attendings who specialized in foot and ankle surgery
 
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The amount of discrimination you will face from other health care providers is geographically dependent as podiatry is more "welcomed and admired" in certain parts of the country but universally MD/DO do not and will never respect your education.

Doesn't matter if you did a residency in "reconstructive rearfoot surgery/ RRA" or you're a fellow of the american college of foot and ankle surgery. You. Are. A. PODIATRIST.

You didn't go to medical school. You didn't take USMLE. You don't sit for surgical boards governed by the American Board of Medical Specialties. It is really that simple.

Just own this information so you can fully understand why MD/DO ortho doesn't treat you equally. Doesn't mean they are better foot and ankle surgeons than you but in the court of law and the eye of public opinion their academic credentials will always hold more weight.

Again this means nothing about them being better surgeons than you or understanding the foot and ankle better than you. Trust me. I fully believe well trained surgically based podiatrists appreciate and understand the nuances of surgery involving the foot and ankle BETTER than any foot and ankle fellowship trained orthopedist with exception to Coughlin, Mann, Myerson, any of the Duke ortho F/A guys, Harborview F/A guys, etc.

The common foot and ankle fellowship trained ortho has one year of specialized training in foot and ankle compared to your three. Whether or not they got significant exposure to foot and ankle surgery in their ortho residency really depends on where they did their ortho residency and whether they had attendings who specialized in foot and ankle surgery

Wow, that is sad. What have you specifically experienced?
 
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The podiatry profession has its pros and cons. Cons are mostly related to the political agenda of other MD/DO organizations to try and keep podiatry from progressing. Mainly the AOFAS. Podiatrists continue to move forward and have successful careers despite this but our profession still has a lot of fighting to do to continue to progress towards parity.

If you pursue this profession you will be fighting for your training rights for the rest of your career. That is my only caution.

The amount of discrimination you will face from other health care providers is geographically dependent as podiatry is more "welcomed and admired" in certain parts of the country but universally MD/DO do not and will never respect your education.

Doesn't matter if you did a residency in "reconstructive rearfoot surgery/ RRA" or you're a fellow of the american college of foot and ankle surgery. You. Are. A. PODIATRIST.

You didn't go to medical school. You didn't take USMLE. You don't sit for surgical boards governed by the American Board of Medical Specialties. It is really that simple.

Just own this information so you can fully understand why MD/DO ortho doesn't treat you equally. Doesn't mean they are better foot and ankle surgeons than you but in the court of law and the eye of public opinion their academic credentials will always hold more weight.

I think this is really it, especially during your training and early years of practice. The second class status can be a real bummer some places. That said, it is nearly non-existent in others. I happen to be training in a place where there has historically been a strong political bias against podiatrists, for reasons both good and petty. The "uphill battle" can sometimes be a great opportunity because the bar is already set so low. Other times it is just disheartening.

From what I have seen, it seems to matter less once you move on and become established in your practice. At the end of the day, we are all just doing a job to pay the bills. If you realize what you have chosen as a profession and appreciate it for what it is, you will likely be happy.
 
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What areas of the country are more “pro” prodiatry vs more against it? Is it more pro where podiatry schools exist?
 
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New York/Tri-state area can be tricky. Massachusetts also. Seems like there can be some issues in the immediate Seattle area, but others would know better than I.

Elsewhere, especially in rural areas, you're golden. I'm sure there are exceptions.

You might not have the same headwinds, but not being an MD makes it so you might not be immediately part of the same club. Being in the middle of the job hunt right now, I can tell you that how you are initially received by your medical colleagues can be variable even in the same region. The variation probably depends on a lot of factors...local need, education as to how much money you can make the group/hospital, how sick the local docs are of dealing with diabetic feet, etc.... As with most people, most docs just want to make more money and have less headaches. You are well received when they see you will help them in that goal, and poorly received when seen as a threat.
 
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New York/Tri-state area can be tricky. Massachusetts also. Seems like there can be some issues in the immediate Seattle area, but others would know better than I.

Elsewhere, especially in rural areas, you're golden. I'm sure there are exceptions.

You might not have the same headwinds, but not being an MD makes it so you might not be immediately part of the same club. Being in the middle of the job hunt right now, I can tell you that how you are initially received by your medical colleagues can be variable even in the same region. The variation probably depends on a lot of factors...local need, education as to how much money you can make the group/hospital, how sick the local docs are of dealing with diabetic feet, etc.... As with most people, most docs just want to make more money and have less headaches. You are well received when they see you will help them in that goal, and poorly received when seen as a threat.

Thanks for the insights! I'm interested in practicing in Washington state. I'm not necessarily interested in working in the "immediate Seattle area" but I'd like to work in Western Washington. Do you think that other areas in Western Washington are more pro podiatry than Seattle?
 
New York/Tri-state area can be tricky. Massachusetts also. Seems like there can be some issues in the immediate Seattle area, but others would know better than I.

That's disappointing, because I will be going to NYCPM and will therefore likely practice in the tri-state area
 
Is finding a job really that difficult that you have to "hunt" for one? Lets be honest, jobs fall in MD/DO laps most of the time. Just doing a quick search on indeed can show you how many med jobs there are, and how little pod jobs there are.
That's something that is concerning to me as an applicant for pod right now.
There are not many jobs of F/A orthopedist either.

In my local health system, I can see 6-7 pods employed and 1-2 orthopedic docs.
 
Is finding a job really that difficult that you have to "hunt" for one? Lets be honest, jobs fall in MD/DO laps most of the time. Just doing a quick search on indeed can show you how many med jobs there are, and how little pod jobs there are.
That's something that is concerning to me as an applicant for pod right now.

It depends. If I wanted to stay in my current area and join a practice, I would probably already have a contract signed and it would not have taken much effort. Being that I am trying to head back to the other side of the country, it’s a little more challenging.
 
Yeah but they can just be general ortho surgeons then if there aren't any F/A specific jobs. We don't have that option. And I wasn't talking about F/A specifically. I meant in general, there's more jobs out there for do/md, regardless of specialty.
You can't compare specialty to a general degree type.

Compare apples with apples and oranges with oranges.

If you are MD neurologist, it wont help you that there are a ton of FM, IM or Peds positions available.
 
Yes it is. It’s far easier to land jobs as a MD/DO.

If you are open to looking for jobs across the US then you will have a far easier job of landing a position.

If you are a podiatrist just targeting one state or region then, based on my personal experience, looking for jobs will be very cumbersome.
again, you are saying that there are a ton of MD jobs. But these includes various specialties. It wont help you if there are ton of other specialties open but less of your specialty.
 
Yes it is. It’s far easier to land jobs as a MD/DO.

If you are open to looking for jobs across the US then you will have a far easier job of landing a position.

If you are a podiatrist just targeting one state or region then, based on my personal experience, looking for jobs will be very cumbersome.
Show me neurosurgeon or cardiology surgeon in town with less than 70-100k population. Same thing. With highly specialized positions, it is hard to find a job especially anywhere away from large or metropolitan areas.

In my hometown, of 30K people, the hospital doesn't even have pediatrician on staff. For any special or complicated care regarding birth or child care patients have to go 80-100 miles away. So, if I specialize most likely I won't find a job there anyways. I will be restricted to highly populated areas.
 
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Show me neurosurgeon or cardiology surgeon in town with less than 70-100k population. Same thing. With highly specialized positions, it is hard to find a job especially anywhere away from large or metropolitan areas.

In my hometown, of 30K people, the hospital doesn't even have pediatrician on staff. For any special or complicated care regarding birth or child care patients have to go 80-100 miles away. So, if I specialize most likely I won't find a job there anyways. I will be restricted to highly populated areas.
This is not true. I have a friend in Midwest state with population 4k, pulls from 12 k and he is in large multiple state hospital system making 250k base. These jobs are out there. Rural especially. Being a podiatrist with 300k debt and wanting to live in high cost of living centers that is saturated with pods is literally the stupidest thing you could do
 
This is not true. I have a friend in Midwest state with population 4k, pulls from 12 k and he is in large multiple state hospital system making 250k base. These jobs are out there. Rural especially. Being a podiatrist with 300k debt and wanting to live in high cost of living centers that is saturated with pods is literally the stupidest thing you could do
What specialty is your friend in? and how far is it from large city?
 
I am.in a town of 40k. We are 50 miles from a city of 400k with farmland in between. We have 4 cardiologists including vascular. There is a spine surgeon. There are open hearts done here. There are 2 podiatrists. There are specialists in smaller cities. Get out of the city and take a drive.
 
A foot and ankle Ortho is not highly specialized. A cardiologist is not highly specialized. A pediatric oncologist is highly specialized. A pediatric infectious disease is highly specialized. A pediatric orthopedist is highly specialized. They gets jobs in larger cities.
 
I am.in a town of 40k. We are 50 miles from a city of 400k with farmland in between. We have 4 cardiologists including vascular. There is a spine surgeon. There are open hearts done here. There are 2 podiatrists. There are specialists in smaller cities. Get out of the city and take a drive.
I have lived in many different states and various regions for the last 12 years. I have lived in 500ppl, 2k, 20k, 30K, 80k, 250K and 3.5 million areas
 
No I didn't miss your point. I am saying you as a "specialized" podiatrist will not need to go to a larger population center to find a good high paying job.
 
No I didn't miss your point. I am saying you as a "specialized" podiatrist will not need to go to a larger population center to find a good high paying job.
I wasn' saying that. I agree with that actually. In same hometown, we have podiatrist who also does surgery.

What I meant that you can't compare podiatrists to MD/DOs in general or to PCPs in terms of job availability. You have to compare specialties among each other.
 
A foot and ankle Ortho is not highly specialized. A cardiologist is not highly specialized. A pediatric oncologist is highly specialized. A pediatric infectious disease is highly specialized. A pediatric orthopedist is highly specialized. They gets jobs in larger cities.
you pretty much said what I said earlier that for any specialty care for peds, patients will have to go to a larger town.
 
So, if I specialize most likely I won't find a job there anyways. I will be restricted to highly populated areas.
Aren't you trying to be a podiatrist? This is a podiatry forum
 
Then you won't be restricted to highly populated areas. The end.
 
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Talk to me when you are looking for a QUALITY podiatrist position.

Seriously? Why don’t you try and graduate the top 10% of your class, pass all your boards, do a high powered residency....then talk to me

Hey champ, maybe sit this one out. You must be having too much fun on the left coast.
 
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Rual Podiatry is a thing? Is there a stigma to DPMs in this environment?

I am.in a town of 40k. We are 50 miles from a city of 400k with farmland in between. We have 4 cardiologists including vascular. There is a spine surgeon. There are open hearts done here. There are 2 podiatrists. There are specialists in smaller cities. Get out of the city and take a drive.
 
Rual Podiatry is a thing? Is there a stigma to DPMs in this environment?
You have no idea how good of a thing rural podiatry is....and no there is no stigma. Rural PCP/FM are much more attached to their patients IMO. These are their neighbors, their friends, etc. They want these people taken care of, and don't like having to tell the patient to drive 3 hours to the nearest big city. They don't care who you are or what your degree is, if you can do an ingrown nail, a bunion or even just and ankle injection, they are happy and grateful.
 
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Why couldn't the PCP/FM doc do all those things for the patient (with the exception of bunion surgery)

You have no idea how good of a thing rural podiatry is....and no there is no stigma. Rural PCP/FM are much more attached to their patients IMO. These are their neighbors, their friends, etc. They want these people taken care of, and don't like having to tell the patient to drive 3 hours to the nearest big city. They don't care who you are or what your degree is, if you can do an ingrown nail, a bunion or even just and ankle injection, they are happy and grateful.
 
Why couldn't the PCP/FM doc do all those things for the patient (with the exception of bunion surgery)
Because they don't, at least in my experience in residency and in practice. My group has around 10 PCP. 1 or 2 may do an ankle injection. None do ingrown nails, but they usually out then on AB. They generally don't even bother putting on lamisil for fungus. They have other patients with more pressing issues and once they know somebody else better trained and is willing to do it, they gladly send them your way.

In a bigger city where a PCP may be struggling for patients, that may be the case. In residency I don't remember seeing my attendings do so many ingrowns. Now in practice my partner and I do probably 20 or so a week, sometime more. We are the only ones in town who do them.
 
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