Tell me why again its so good to be in this profession

[bobtheweazel]

The PCPs who have these extenders keep podiatry in-house because it helps them with their expenses.

True perhaps, but misleading. PCPs may keep basic podiatry services in house but would they be doing a bunion surgery? No. PCPs also keep other specialty services in house, like basic cosmetic dermatologic care, physical therapy modalities, DME, lab testing. That doesn't just affect podiatry.

If you have these feelings now, I have a suggestion. Call ten different podiatry practices around the country that you don't know, and see what their take of the landscape is. Some may be different than me, but I'll bet there are a lot of similarities. Call ten different podiatry residents (not directors), and talk to them about their programs. Call ten different PCP offices, and get their opinion on Podiatry. With so many opinions you'll find a common thread. At that point, it's up to you to decide if you're going to stay where you are or pursue something else. By the way, while you're making your calls, you may also want to call ten different medical/PA/RN schools, and see if your credits from Pod school are transferable. If not, (and I understand they aren't) you'll be starting from square one.

This would only be fair if they also ask 10 different PCPs their opinion on being a PCP, or 10 different other MD/DO/PA/RNs their opinion on their own professions. Because probably just as many of them will not like their job as podiatrists that don't like podiatry. And I bet their complaints will be very similar. Most of the problems you cite with podiatry are really problems with medicine in general. Instead of jumping from one sinking ship onto another sinking ship, maybe we should just work harder to keep the ship from sinking. I'm willing to bet that the number of podiatrists that complain about podiatry is far greater than the number of podiatrists that regularly donate to the APMA PAC, contact their congressmen about things affecting podiatry, et cetera. Also, as a side note, the public at large as well as many medical professionals are largely uninformed about podiatry and I would give little weight to any non-podiatrist's opinion of podiatry.

Podiatry was built on fee for service, and this will change.

True, but misleading. All medicine was built on fee for service and the changes that are happening to the payment models will affect everyone that accepts insurance, not just podiatrists.

So, this is my reality. It's also every doc's reality...

I am only quoting this for emphasis, as I think this is the salient point here.

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[HappyHobPod]

Also, if you have a genuine interest here I would recommend giving this a listen:
http://www.podiatricsuccess.com/speaker/jeffrey-lehrman-dpm-pqrs-mu-expert-02-16-2016/

Thanks for the link, this definitely was a good listen that laid some things out pretty clearly.

 

[bobtheweazel]

Wounds are being managed by wound care nurses and even physical therapist; Nails can be managed by nursing; gout, heel pain and ingrown toenails can be addressed by Nurse practitioners and PAs. If surgery gets taken up by ortho, as reimbursements shift from RVU and CPT basis to "quality measures", then DPMs are in real trouble.

But it has always been the case that a general practitioner could do wound care or treat nails or gout or heel pain or ingrown toenails and yet the past generation of podiatrists had jobs and so did the one before that and the one before that. NP and PA admissions offices aren't being flooded by applicants hoping to get into NP or PA school so that they can work on feet. Do they work on these problems? Yes. Do they similarly perform basic services that fall within the realm of other specialists? Yes. They aren't out to wipe podiatrists off the face of the planet and there's no real evidence that they inadvertently will. Besides that, keep in mind that future payment models revolve around quality, not necessarily who can do it most conveniently or the cheapest. If you are confident that on average podiatrists treat these conditions better than any other provider, then I'm confident that you have nothing to worry about. Different medical professionals can get into pissing contests about who does what better, but the data won't lie. If podiatrists provide the best quality foot and ankle care then podiatrists have nothing to worry about and just need give the system time to figure that out. If podiatrists do not provide the best quality foot and ankle care, then they deserve to be wiped off the face of the planet.

If surgery gets taken up by ortho, as reimbursements shift from RVU and CPT basis to "quality measures", then DPMs are in real trouble. Ortho is presently restructuring to eliminate "General" orthopedists. They have to pick a subspecialty now, and the number of foot fellowships is increasing to accommodate this change.

This argument assumes that if orthopedics goes the way of everybody specializing that a sizable portion will choose foot and ankle over any other area of the body. If orthopedic foot and ankle fellowships up to now have always had a hard time filling all of their available positions, then why would a change like you're talking about push more orthopedists towards foot and ankle? Foot and ankle specialization has always been an option for them, and they simply don't choose it. And why not mention the fact that a change like this could be beneficial to podiatrists? General orthopedists currently perform a lot of foot and ankle care—not each orthopedist individually perhaps, but as a whole they perform a good amount. If general orthopedics is phased out and you take the foot and ankle problems currently performed by all general orthopedists in the US and redistribute that to all podiatrists and foot & ankle orthopedists then it would actually be quite a boon to podiatry.

Couple this with the oppressive overhead requirements for any private practice to comply with MACRA, PQRS, HIPAA and whatever new gems they come up with in the next few years. If you have not lived this, here is an example: You are responsible for making sure 50% of your patients access your patient portal to review their medical records, while assuring their privacy and confidentiality under HIPAA. This takes 20-50K/year in staff folks!! and it is just one of the requirements you have to contend with. Don't plan to comply? You will accept less money and be labeled a Low Quality provider by Medicare on an online list.

More than 50% of patients need to have access to the portal, but only one single patient needs to actually log in per year. And sure this is just one of the requirements, but if you do comply with all of the PQRS requirements then you get bonus money. And the costs of complying could be significant so for some physicians that bonus could be worth the effort and for others it could not be worth the effort. It just depends on each individual's circumstances, but it's not an across the board loser for everybody. And with MIPS, for every physician that gets a penalty another one will get a bonus and I believe some will get neither. So, on average, it will be a net zero penalty/reward system, certainly not a horrible-for-everyone system.

 

[bobtheweazel]

You are correct, I am in private practice. I started as an associate, then a partner with six full-time employees. As the years went on and costs to run a practice continued to climb as reimbursements leveled out then started to go down we reduced our staff to three when we out-sourced our billing. My partner and I split in 2000 but continue to share an office; I also have another one myself. I gave up my surgery practice in 2002 when reimbursements were such that I was getting more for a pair of prescription orthotics than a hammertoe (for those insurances that still paid for DME), and the malpractice "crises" struck in PA where my surgical rates would've gone up 300%, despite a history of no claims. It's kind of ironic because right before that went down I had just gotten on staff at an amb. sx. center and was just certified to use an Ossetron (Google that blast from the past). But in retrospect, for me it's best thing I ever did. I found out since that time over the years that a lot of my classmates have done the same thing.

That does suck. And those changes have affected all of medicine, not just podiatry.

The second part is not being part of mainstream medicine. And here’s what I mean: If you go to an allopathic med school, either in the states or abroad, it’s part of the LCME (look it up). The osteopathic schools have their counterpart. Here’s the rub- it’s standardized education, and the accrediting body is neutral. PAs and RNs follow the same model. Then there’s podiatry. Our schools aren’t part of this system, they have their own. They fall under the CPME (Council on Podiatric Medical Education- I gave you that one), and it’s not neutral. When you’re out in practice, you’ll be required to maintain CME credits to maintain your state license. In my state it’s 50 every two years. The vast majority of them have to be podiatry CMEs (CPME), and only a small part may be AMA Cat I credits. AMA credits I can get for free; podiatry CMEs I have to pay for. I’ll let you draw your own conclusions. The same goes for residencies. DO/MD are under ACGME (again, look it up). Podiatry, so sorry, no. Go on the ACGME website and type “podiatry” in their search box… so sorry, thanks for playing. I don’t know anything about current podiatry residencies, other than their case numbers are probably being affected by the changes in insurance (in other words, going down), and they don’t seem to be standardized programs. So, given if you go through an allopathic/osteopathic program, no matter where you go your training is essentially the same/along the same guidelines. You’ll fit right in with the system when you pop out.

College Accreditation
MD: LCME
DO: COCA
DPM: CPME
We all have separate accreditation bodies. So DOs can have a separate accrediting body than MDs and still be part of mainstream medicine, but the fact that podiatrists also have a separate accrediting body means that we are not a part of mainstream medicine? And of course we are not accredited by the body that accredits MD schools, podiatry schools are not MD schools. Nor are we DO schools. Nor are DO schools MD schools. The accrediting body doesn't matter.

Residency Accreditation
MD: ACGME
DO: AOA (past) or ACGME (future)
DPM: CPME
Once again, DOs also had separate residency accreditation, and then through their parity efforts they were eventually allowed to do ACGME residencies and now they are just going to combine into one residency system. That wasn't the case until just this past year. So for many years DOs also had separate residency accreditation body and yet were part of mainstream medicine yet somehow our separate residency accreditation body makes us not a part of mainstream medicine? And of course our residencies are not approved by the people that approve MD or DO residencies, as we are not MDs or DOs.

Also, for the record, MD school curriculums are far from standardized. You show me two medical school curriculums that are the exact same and I'll give you a gold star. From the 2015 LCME Standards Reformatting Project:

Standard 6: Competencies, Curricular Objectives, and Curricular Design
"The faculty of an institution that sponsors a medical education program defines the competencies to be achieved by its medical students with programmatic learning objectives and is responsible for the detailed design and implementation of the components of a curriculum that enables its medical students to achieve those competencies and objectives."

Standard 7: Curricular Content
"The faculty of an institution that sponsors a medical education program ensures that the program's curriculum provides content of sufficient breadth and depth to prepare medical students for residency education in every specialty and for the subsequent contemporary practice of medicine."

That's as detailed as LCME gets on standardizing what is taught in the MD schools. Although they do perform surveys to see what is taught by each school and what is not and compile this data for various reasons, they don't regulate the curriculum on the front end. I think if most of the students are passing the USMLE, then LCME is happy. But not everyone that passes the USMLE is equal and not every MD/DO school is equal.

https://www.etsu.edu/com/msec/documents/2015_LCME_Standards_Reformatting_Project-1.pdf

So let's look at one simple example. The number of course hours, not including exams, of gross anatomy in medical schools. A survey published in 2009 showed a range of 56-231 hours of gross anatomy and specifically lecture hours ranged from 0-78 hours whereas lab hours ranged from 20-160 hours. Standardized? OK. Maybe in this fictional "real world" you speak of, but not in the real "real world".

http://onlinelibrary.wiley.com/doi/10.1002/ase.117/epdf

Where’s the parity if podiatry is not part of the “system”? Then there’s the numbers: 854,000 doctors, over 100,000 PAs (as of 2014), 222,000 nurse practitioners (2014). Then there’s podiatry: 9,500 (2015- US Bureau of Labor Statistics). I think it’s a little more, maybe around 13,000. But really, does that matter in the overall picture? So, there’s all these large numbers in the system, along with the hospitals which are also on the same page, also regulated and accredited. And, then there’s podiatry.

You can't fairly compare the number of podiatrists to the number of all MDs and DOs. Podiatrists are specialists and so should be compared to other specialist groups. There are about 14,000 podiatrists practicing in the US. There are also about 14,000 dermatologists practicing in the US. Oh no, they've got us outnumbered 1 to 1. Oh, wait...

http://us.imshealth.com/Marketing/GTMN/Market-Profile-of-Dermatologists.pdf

 

[bobtheweazel]

So Dr. Phoot, I know what I would do if I were in your place, knowing what I now know. I would somehow parlay what I had now into the mainstream medicine tract in some capacity.

@dr.phoot the majority of the problems people have with podiatry are the same problems other medical professionals have. Mainly decreasing reimbursement and increasing paperwork. You would be jumping from one sinking ship to another. If you're genuinely interested in podiatry, then don't let those problems dissuade you. Go into podiatry and then fight to change the system á la my main man ZDoggMD.
http://www.forbes.com/…/doctors-declaration-of-independence/

Don’t take what I’m saying as 100% correct, either.

OK.

 

[bobtheweazel]

Quit being little bitches and complain on forums when somebody with more experience than you offers a dissenting opinon. You wouldn't do that to an attending in real life, so don't do it here.

However much experience someone might have, wrong is wrong. Some of what has been said here has truth to it but much of what has been said here is simply wrong or misleading, as I've already laid out in previous posts.

And even if someone on here were questioning or arguing the information being provided—and questioning information provided on any anonymous forum is prudent—and that stems from a genuine ignorance on certain topics rather than a willful ignorance or refusal to accept facts, shouldn't you cut them some slack? You yourself said that you just started learning about some of this stuff and you're through pod school already, but you won't cut any slack to prepods that have years less podiatry experience than you?

Certainly, at least, calling someone a little bitch in these circumstances is inappropriate? You wouldn't do it in real life, so don't do it here. Right?

Note: Unlike Air Bud, I don't think any of you are being little bitches. Always question the information being presented to you, especially on a forum. Personal opinions and anecdotes should hold little weight for any of you, only verifiable-evidence. And no matter how many people share misinformative anecdotes, the plural of anecdote is anecdotes, not verifiable-evidence. Believing somebody because of actual or perceived authority is a common fallacy, an appeal to authority. Experienced people can be wrong too. Nobody is immune to preconceived notions or personal bias clouding their judgment or perception of the world.

 

[738177]

That does suck. And those changes have affected all of medicine, not just podiatry.

Do Podiatrists uniformly start at ~150k? Most primary care MD/DO physicians at least make that as starting. I'm guessing lot of the concern stems from the fact that there isn't a concrete salary structure in Podiatry that pre-pods can refer to. I have next to nil knowledge on Podiatry so i could be completely wrong though.

 

[bobtheweazel]

Oh, also in response to people insinuating that only podiatrists are not satisfied with their job.

Only 29% of family medicine docs would choose the same specialty if they could do it all over again. But, hey, the grass is always greener, right?

http://www.medscape.com/features/slideshow/compensation/2016/familymedicine#page=12

 

[CardsFan92]

Do Podiatrists uniformly start at ~150k? Most primary care MD/DO physicians at least make that as starting. I'm guessing lot of the concern stems from the fact that there isn't a concrete salary structure in Podiatry that pre-pods can refer to. I have next to nil knowledge on Podiatry so i could be completely wrong though.

I'm not in the best position to answer this, but AFAIK salaries vary greatly post residency. I believe the BLS median salary is 113k or something close to that.

The high paying jobs are out there, as are the 80k a year jobs.


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[bobtheweazel]

Do Podiatrists uniformly start at ~150k? Most primary care MD/DO physicians at least make that as starting. I'm guessing lot of the concern stems from the fact that there isn't a concrete salary structure in Podiatry that pre-pods can refer to. I have next to nil knowledge on Podiatry so i could be completely wrong though.

According to the APMA 2015 Young Physician's Podiatric Practice Survey Findings Report, Table 83, in 2014 about 44% of podiatrists in practice for 1-5 years had a net income from 100,000-174,999 and about 38% of podiatrists in practice for 1-5 years had a net income of 175,000 or greater. The mean net income for podiatrists with 1-5 years work experience was 172,577. So, yes, I would say that podiatrists are in that ballpark.

The full report is behind the APMA paywall and you have to be an APMA member to access it. Another APMA member can verify this information.

 

[CardsFan92]

According to the APMA 2015 Young Physician's Podiatric Practice Survey Findings Report, Table 83, in 2014 about 44% of podiatrists in practice for 1-5 years had a net income from 100,000-174,999 and about 38% of podiatrists in practice for 1-5 years had a net income of 175,000 or greater. The mean net income for podiatrists with 1-5 years work experience was 172,577. So, yes, I would say that podiatrists are in that ballpark.

Bob, please. The data you have to back up your claims has no place in this thread. Where are the personal anecdotes?


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[bobtheweazel]

Bob, please. The data you have to back up your claims has no place in this thread. Where are the personal anecdotes?


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Oh, I like knew this one guy one time and he was like making money but then this stuff happened and he was like woah, I make a little less money but still kinda a lot. I was like, woah, dude...

And then I was having lunch next to this guy at McDonald's one time and he was all, dude world hunger is a myth. And I was like, dude, how do you know? And he was all like cause I just ate two Big Macs and I'm pretty full. And then I said but that's just how you feel subjectively, it's not objective data and anyway it doesn't actually represent a statistically significant portion of the world population. And then he was like, hey man, are you gonna finish that...

And then I knew this one guy that like got a flu shot and then like the next week he got a cold and then he was all like, hey man I got the flu from the flu shot. And then I was like, no man that's just coincidental and you don't even have the flu. And then he was all, but I feel like the shot gave me the flu, and I was like, oh why didn't you say that in the first place...

 

[ExperiencedDPM]

My personal opinion is that although podiatry does share in the woes of all of medicine, and basically all medical specialties are under the same gun, podiatry has one unique issue. Since it's a limited license, you can't make an about face and really use the degree for much outside of podiatry. Yes, there are always exceptions, but I'm referencing the majority of cases.

I've given this example before, and will use it again. All MDs and DOs are full scope. By theory, they can practice any branch of medicine with no limits. I'm not talking about the medical-legal issues or concerns with a gastroenterologist treating earaches. The fact is that by his degree, he can. As stated before, many GPs got tired of long hours for nominal pay. In my area, these GPs opened medical spas. They took a few weekend courses and now perform injectable cosmetic procedures with Botox, Restylene, Sculptra, etc. They offer laser weight reduction, laser lipo, etc., all for cash. With the DPM degree, we can't do that which is unfortunate.

My neighbor was an ER physician and got tired of the shift work and stress. He landed an amazing job as a consultant with a firm that plans health care needs for wealthy execs traveling overseas. So if the president of Acme explosive company is traveling to Botswana, he makes arrangements for medical care in the case of an emergency. He arranges doctors, hospitals, flights, medical evacuations, etc. At times he has to travel to check the facilities. It's a great gig that pays incredibly well. But a requirement was an MD/DO degree.

I'm not complaining. I've done pretty well, but after having been there and done that, about 2 years ago I explored other options (midlife crisis) and found that my DPM degree was not really recognized or appreciated for any positions in healthcare, outside of podiatry. So I happily continued to practice and have no regrets.

As long as your decision to obtain the DPM degree is truly an informed decision, than I would recommend plowing full steam ahead. And always maintain your ethics and integrity, even if those around you are making more money by compromising their ethics. Always do the right thing. Always.

 

[bobtheweazel]

My personal opinion is that although podiatry does share in the woes of all of medicine, and basically all medical specialties are under the same gun, podiatry has one unique issue. Since it's a limited license, you can't make an about face and really use the degree for much outside of podiatry. Yes, there are always exceptions, but I'm referencing the majority of cases.

I've given this example before, and will use it again. All MDs and DOs are full scope. By theory, they can practice any branch of medicine with no limits. I'm not talking about the medical-legal issues or concerns with a gastroenterologist treating earaches. The fact is that by his degree, he can. As stated before, many GPs got tired of long hours for nominal pay. In my area, these GPs opened medical spas. They took a few weekend courses and now perform injectable cosmetic procedures with Botox, Restylene, Sculptra, etc. They offer laser weight reduction, laser lipo, etc., all for cash. With the DPM degree, we can't do that which is unfortunate.

My neighbor was an ER physician and got tired of the shift work and stress. He landed an amazing job as a consultant with a firm that plans health care needs for wealthy execs traveling overseas. So if the president of Acme explosive company is traveling to Botswana, he makes arrangements for medical care in the case of an emergency. He arranges doctors, hospitals, flights, medical evacuations, etc. At times he has to travel to check the facilities. It's a great gig that pays incredibly well. But a requirement was an MD/DO degree.

I'm not complaining. I've done pretty well, but after having been there and done that, about 2 years ago I explored other options (midlife crisis) and found that my DPM degree was not really recognized or appreciated for any positions in healthcare, outside of podiatry. So I happily continued to practice and have no regrets.

As long as your decision to obtain the DPM degree is truly an informed decision, than I would recommend plowing full steam ahead. And always maintain your ethics and integrity, even if those around you are making more money by compromising their ethics. Always do the right thing. Always.

Good post. I agree that anybody considering applying to podiatry school or any medical school needs to inform themselves not only about the great parts of medicine, but the monotonous and annoying parts as well.

I can appreciate the difficulty podiatrists would face with trying to switch into another specialty or into some less clinical medical jobs. But that's something that we all face from day one and every day of every year along the way a podiatrist can make an about face and just cut their losses. I would think that someone who makes it through years of learning about feet and being exposed to feet and knowing that that will be the rest of their life probably doesn't really have a problem with podiatry. And in your case, it wasn't until you had your midlife crisis that you began really questioning podiatry. That whole situation surely had more to do with your age than it did with podiatry itself.

I get the limited license argument. I think that it's unfair though to speak in theoreticals. That's like talking about the freefall of an object without accounting for air friction. Yes, there is this great theoretical scope for all MDs and DOs but that's not how it is put into practice, when accounting for all factors. And besides that, DOs didn't used to have the full unrestricted license that they enjoy today. They had to work for it. Podiatry is the closest profession to MDs and DOs in terms of education and training and are therefore the closest to the same unlimited license as MDs and DOs, we just have to work for it. And we have been working for it, and we will continue working for it. The California Podiatric Medical Association is really making great strides towards parity, a full medical license that is only restricted by the licensee's education and training. And the fact that the California Medical Association and California Orthopedic Association are working with the podiatrists towards this goal and have been for years now is a great sign. The California Medical Associations represent a very large percentage of the total US physician population and so if the California Medical and Orthopedic Associations go along with this then the national Medical and Orthopedic Associations may be less willing to intervene in future scope battles. California is doing the hard work, but other states are going to need to start laying the groundwork soon for such future measures throughout the US. The proof of concept has been successful as far as I'm concerned. The DOs have done it in every state. DPMs are well on their way to doing it in California.So if you don't like the current status of podiatry in your state, then you can do like they're doing in California to try to make the changes that you want, get politically active with the Medical, Orthopedic, and Podiatric state Associations and start to make change, if not for current podiatrists then for future podiatrists.

 

[bobtheweazel]

Also, this is the most recent update that I could find on the Joint Task Force out in California and on the status of podiatry's progress towards achieving an unlimited medical license. Anyone interested in that, which should be all of you, should give this a listen.

http://www.podiatricsuccess.com/spe...sk-force-give-dpm-plenary-license-03-08-2016/

 

[bobtheweazel]

Do Podiatrists uniformly start at ~150k? Most primary care MD/DO physicians at least make that as starting. I'm guessing lot of the concern stems from the fact that there isn't a concrete salary structure in Podiatry that pre-pods can refer to. I have next to nil knowledge on Podiatry so i could be completely wrong though.

Oh, and furthermore, of the podiatrists with 1-5 years experience that participated in that survey, about 69% saw a net increase in income from 2013 to 2014 and only about 13% reported a net decrease in income from 2013 to 2014 with the rest having about the same income in 2013 and 2014.

That is from Table 84 if anyone wants to verify.

 

[SLCpod]

Good post. I agree that anybody considering applying to podiatry school or any medical school needs to inform themselves not only about the great parts of medicine, but the monotonous and annoying parts as well.

I can appreciate the difficulty podiatrists would face with trying to switch into another specialty or into some less clinical medical jobs. But that's something that we all face from day one and every day of every year along the way a podiatrist can make an about face and just take the loss. I would think that someone who makes it through years of learning about feet and being exposed to feet and knowing that that will be the rest of their life probably doesn't really have a problem with podiatry. And in your case, it wasn't until you had your midlife crisis that you began really questioning podiatry. That whole situation surely had more to do with your age than it did with podiatry itself.

I get the limited license argument. I think that it's unfair though to speak in theoreticals. That's like talking about the freefall of an object without accounting for air friction. Yes, there is this great theoretical scope for all MDs and DOs but that's not how it is put into practice, when accounting for all factors. And besides that, DOs didn't used to have the full unrestricted license that they enjoy today. They had to work for it. Podiatry is the closest profession to MDs and DOs in terms of education and training and are therefore the closest to the same unlimited license as MDs and DOs, we just have to work for it. And we have been working for it, and we will continue working for it. The California Podiatric Medical Association is really making great strides towards parity, a full medical license that is only restricted by the licensee's education and training. And the fact that the California Medical Association and California Orthopedic Association are working with the podiatrists towards this goal and have been for years now is a great sign. The California Medical Associations represent a very large percentage of the total US physician population and so if the California Medical and Orthopedic Associations go along with this then the national Medical and Orthopedic Associations may be less willing to intervene in future scope battles. California is doing the hard work, but other states are going to need to start laying the groundwork soon for such future measures throughout the US. The proof of concept has been successful as far as I'm concerned. The DOs have done it in every state. DPMs are well on their way to doing it in California.So if you don't like the current status of podiatry in your state, then you can do like they're doing in California to try to make the changes that you want, get politically active with the Medical, Orthopedic, and Podiatric state Associations and start to make change, if not for current podiatrists then for future podiatrists.

Just a friendly reminder to respect one another. I enjoy reading one's opinion about our profession but prefer it not to be peppered with degrading statements directed at one individual.

 

[ExperiencedDPM]

Good post. I agree that anybody considering applying to podiatry school or any medical school needs to inform themselves not only about the great parts of medicine, but the monotonous and annoying parts as well.

I can appreciate the difficulty podiatrists would face with trying to switch into another specialty or into some less clinical medical jobs. But that's something that we all face from day one and every day of every year along the way a podiatrist can make an about face and just cut their losses. I would think that someone who makes it through years of learning about feet and being exposed to feet and knowing that that will be the rest of their life probably doesn't really have a problem with podiatry. And in your case, it wasn't until you had your midlife crisis that you began really questioning podiatry. That whole situation surely had more to do with your age than it did with podiatry itself.

I get the limited license argument. I think that it's unfair though to speak in theoreticals. That's like talking about the freefall of an object without accounting for air friction. Yes, there is this great theoretical scope for all MDs and DOs but that's not how it is put into practice, when accounting for all factors. And besides that, DOs didn't used to have the full unrestricted license that they enjoy today. They had to work for it. Podiatry is the closest profession to MDs and DOs in terms of education and training and are therefore the closest to the same unlimited license as MDs and DOs, we just have to work for it. And we have been working for it, and we will continue working for it. The California Podiatric Medical Association is really making great strides towards parity, a full medical license that is only restricted by the licensee's education and training. And the fact that the California Medical Association and California Orthopedic Association are working with the podiatrists towards this goal and have been for years now is a great sign. The California Medical Associations represent a very large percentage of the total US physician population and so if the California Medical and Orthopedic Associations go along with this then the national Medical and Orthopedic Associations may be less willing to intervene in future scope battles. California is doing the hard work, but other states are going to need to start laying the groundwork soon for such future measures throughout the US. The proof of concept has been successful as far as I'm concerned. The DOs have done it in every state. DPMs are well on their way to doing it in California.So if you don't like the current status of podiatry in your state, then you can do like they're doing in California to try to make the changes that you want, get politically active with the Medical, Orthopedic, and Podiatric state Associations and start to make change, if not for current podiatrists then for future podiatrists.

I would appreciate if you'd refrain from commenting on why I decided to seek other opportunities during my "midlife crisis". You have no idea what I think. My decision wasn't based on my age. My decision was based on the fraud I saw around me daily. I was at the point where I felt the "bad guys" were winning. I didn't like the direction the APMA was headed. It was MY opinion that they put too much effort on collecting money for some crap product to obtain the APMA seal, than they did trying to guarantee residency positions for graduates. I got tired of listening to everyone talk about parity wirh MDs and then go to another seminar with the same lecturer (who gets paid by a pharma company) speaking about onychomycosis.

Do you really think that any DPM with any knowledge really has to hear another lecture on mycotic nails? Do we really need workshops at these seminars sponsored by practice management organizations telling us how to sell more and bill more (as previously stated, the biggest joke is that the current president of the practice mgmt organization filed bankruptcy in the past). PM me and I'll give the name of the organization and doctor. So I have to go to a seminar and listen to someone who filed bankruptcy tell me how to make money. That's like taking tooth brushing advice from someone who has no teeth.

Then there is a lecture for a self promoting doctor who tells us how much money we can make from Medicare if we make braces for them to prevent falls. There are two problems here. One is that Medicare does NOT pay for braces to prevent falls, so the doctor has to submit some other diagnosis. Read between the lines. The second problem is that there is NO legitimate literature to support the use of these braces. BUT you can make a boatload of money.

So my midlife crisis wasn't age dependent. I was disgusted with what I saw happening in the profession.

And the California thing is great. But the doctors still have to pass the USLME. Do some research regarding how well pod students did last time they were able to take the USMLE (or whatever the letters are).

There is a difference between the quality of students accepted to MD school vs DPM school. And just because DPMS may eventually be allowed to take the exam, I assure you that the pass rate will be embarrassing low until the schools tighten up their admission requirements.

And your comment that I should get involved is both disrespectful and inaccurate. I have served on the local and state level of the APMA. I have served on many committees to advance the profession. I have served on panels and have been active in resident training. I have been active on committees in the ACFAS and was involved for many years with the ABFAS. I've written text book chapters to advance the profession. So as a student, I really don't believe you should be giving me advice, without first knowing what I've already done in my career.

And I'm a little confused. Your avatar says "medical student"/accepted. So does that mean you are already in professional school or are still an undergrad? And is it medical school or podiatric medical school? Just trying to know where you are in your educational process.

 

[croak]

http://forums.studentdoctor.net/threads/need-advice-on-ortho.1211500/#post-17953934

 

[CardsFan92]

http://forums.studentdoctor.net/threads/need-advice-on-ortho.1211500/#post-17953934

No idea where you read on our forums that "general orthopedics is being phased out." (Unless it's somewhere in one of the huge posts in this thread that I missed)

Orthopedics isn't going anywhere. They've earned their place in medicine. Hopefully we can get somewhere close to that in the future.


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[bobtheweazel]

So my midlife crisis wasn't age dependent.

OK, I apologize for assuming that your midlife crisis was age dependent. It won't happen again. Should I go ahead and let Merriam-Webster know that midlife crises aren't age dependent as well?

And your comment that I should get involved is both disrespectful and inaccurate. I have served on the local and state level of the APMA. I have served on many committees to advance the profession. I have served on panels and have been active in resident training. I have been active on committees in the ACFAS and was involved for many years with the ABFAS. I've written text book chapters to advance the profession. So as a student, I really don't believe you should be giving me advice, without first knowing what I've already done in my career.

OK, for that one, I genuinely apologize. I shouldn't assume too much.

Do you really think that any DPM with any knowledge really has to hear another lecture on mycotic nails? Do we really need workshops at these seminars sponsored by practice management organizations telling us how to sell more and bill more (as previously stated, the biggest joke is that the current president of the practice mgmt organization filed bankruptcy in the past). PM me and I'll give the name of the organization and doctor. So I have to go to a seminar and listen to someone who filed bankruptcy tell me how to make money. That's like taking tooth brushing advice from someone who has no teeth.

Then there is a lecture for a self promoting doctor who tells us how much money we can make from Medicare if we make braces for them to prevent falls. There are two problems here. One is that Medicare does NOT pay for braces to prevent falls, so the doctor has to submit some other diagnosis. Read between the lines. The second problem is that there is NO legitimate literature to support the use of these braces. BUT you can make a boatload of money.

And I'm a little confused. Your avatar says "medical student"/accepted. So does that mean you are already in professional school or are still an undergrad? And is it medical school or podiatric medical school? Just trying to know where you are in your educational process.

There's no "Podiatry Student (Accepted)" option, so don't worry I'll be changing it to "Podiatry Student" in the next couple of weeks. So no, I haven't been through podiatry school, but that doesn't necessarily mean that I'm naive to all of the issues that face podiatry or healthcare in general.

For the past nine years or so I've been in orthotics and prosthetics. I was licensed and certified, eventually becoming Vice President of the practice I worked at. Also, we were an O&P residency site. I had my hand in every part of the company, I treated patients in clinic, had to deal with burdensome documentation requirements, insurance companies denying valid claims, ALJ hearing delays, decreasing reimbursements, et cetera. That's why I keep stressing for any prepods that might read this in the future that those problems affect all of medicine and aren't a reason to avoid podiatry specifically. I had also lectured at the Texas Association of Orthotists & Prosthetists meeting as well as the 2013 O&P World Congress and I've dabbled in orthotic research and have a utility patent for an orthotic device set to be issued in my and another orthotist's name within the next couple of months (Geez, is that a long process).

So coming from that, I can say that I'm at least on the same page as you when it comes to the meetings, because they're the same way in O&P. Practically everyone is sponsored and many of the presenters have no business presenting at all. We would sit through continuing education courses half awake and many people would sign in and then leave just to get the credit (Some conferences crack down on that more than others). I'd be lucky to glean one or two useful things from an entire meeting. Useless.

- Orthotists/prosthetists are reimbursed at lower rates by insurances, so doctors actually get paid more for doing orthotics than orthotists.
- Hospital and multispecialty group jobs are much rarer for orthotists/prosthetists than for podiatrists and even simple orthotic/prosthetic groups are a rare thing.
- Orthotists/prosthetists have very similar documentation requirements to everyone else, yet the their notes don't actually count. They are required to do the notes but only a physician's notes can medically justify an orthotic/prosthetic device.
- A residency is mandatory for orthotists/prosthetists but there is no fancy match system. There is pretty much just an outdated list of potential residency sites that you have to cold call. And on top of that they have a residency shortage. Good luck with that. http://www.ncope.org/programs/list/
- Physical therapists in many states can't directly see patients or if they can it likely isn't covered by insurance.
- Dentists and optometrists have pretty much zero chance of ever actually expanding their scope since everything surrounding the mouth/eyes gets different real quick.
- All of these fields have the similar limitations when it comes to non-clinical jobs. I don't think we're gonna see an optometrist as a surgeon general any time soon.

Compare podiatry to MDs and maybe it looks kinda sucky. Compare podiatry to everybody else and it's really not a bad deal.

 

[HappyHobPod]

http://forums.studentdoctor.net/threads/need-advice-on-ortho.1211500/#post-17953934

Who are these optometrists of the foot, and why don't they simply do what surgeons do - A residency.

Now that's just silly. It's Foot and ANKLE. By the way,

 

[ExperiencedDPM]

OK, I apologize for assuming that your midlife crisis was age dependent. It won't happen again. Should I go ahead and let Merriam-Webster know that midlife crises aren't age dependent as well?


OK, for that one, I genuinely apologize. I shouldn't assume too much.




There's no "Podiatry Student (Accepted)" option, so don't worry I'll be changing it to "Podiatry Student" in the next couple of weeks. So no, I haven't been through podiatry school, but that doesn't necessarily mean that I'm naive to all of the issues that face podiatry or healthcare in general.

For the past nine years or so I've been in orthotics and prosthetics. I was licensed and certified, eventually becoming Vice President of the practice I worked at. I had my hand in every part of the company, I treated patients in clinic, had to deal with burdensome documentation requirements, insurance companies denying valid claims, ALJ hearing delays, decreasing reimbursements, et cetera. That's why I keep stressing for any prepods that might read this in the future that those problems affect all of medicine and aren't a reason to avoid podiatry specifically. I had also lectured at the Texas Association of Orthotists & Prosthetists meeting as well as the 2013 O&P World Congress and I've dabbled in orthotic research and have a utility patent for an orthotic device set to be issued in my and another orthotist's name within the next couple of months (Geez, is that a long process).

So coming from that, I can say that I'm at least on the same page as you when it comes to the meetings, because they're the same way in O&P. Practically everyone is sponsored and many of the presenters have no business presenting at all. We would sit through continuing education courses half awake and many people would sign in and then leave just to get the credit (Some conferences crack down on that more than others). I'd be lucky to glean one or two useful things from an entire meeting. Useless.

- Orthotists/prosthetists are reimbursed at lower rates by insurances, so doctors actually get paid more for doing orthotics than orthotists.
- Hospital and multispecialty group jobs are much rarer for orthotists/prosthetists than for podiatrists and even simple orthotic/prosthetic groups are a rare thing.
- Orthotists/prosthetists have very similar documentation requirements to everyone else, yet the their notes don't actually count. They are required to do the notes but only a physician's notes can medically justify an orthotic/prosthetic device.
- A residency is mandatory for orthotists/prosthetists but there is no fancy match system. There is pretty much just an outdated list of potential residency sites that you have to cold call. And on top of that they have a residency shortage. Good luck with that. http://www.ncope.org/programs/list/
- Physical therapists in many states can't directly see patients or if they can it likely isn't covered by insurance.
- Dentists and optometrists have pretty much zero chance of ever actually expanding their scope since everything surrounding the mouth/eyes gets different real quick.
- All of these fields have the similar limitations when it comes to non-clinical jobs. I don't think we're gonna see an optometrist as a surgeon general any time soon.

Compare podiatry to MDs and maybe it looks kinda sucky. Compare podiatry to everybody else and it's really not a bad deal.

Your sarcasm and insults will certainly not move you far ahead in your career. You don't know when to quit. My "midlife crisis" wasn't BECAUSE of my age as you stated. My age had nothing to do with my actions at that time. Observations about the profession led to my actions. So twist words however you'd like, and look in any dictionary you'd like. Take anything out of context and it is easy to spin. If it wasn't a total waste of my time, I'd PM you to tell you my true thoughts.

I CAN assure you that as someone who hasn't even STARTED his first year of school, you're in for a very, very, rude awakening. Personalities like yours don't do well in a hierarchy system, and professional school and residency programs follow that model. Good luck with that one.

Are you really going to compare your experience as a Cped/orthotist with any branch of medicine? Are you serious? If I'm not mistaken aren't people eligible to obtain a Cped/orthotist degree right out of high school?? I utilize and respect Cpeds and orthotists, but your comparison is ridiculous. It's analogous to comparing a dental lab with a dentist.

I don't get your optometry and dental comparisons, so I'm not even going to try to figure out your thinking process, or lack thereof.

You've missed my points. I'm not here to complain about the profession that's put my kids through great universities, or the profession that's allowed me to have a beautiful home, etc. But I've observed a lot of changes taking place that concern me. Some are low salaries, non parity (DOs, MDs and dentists are on a different pay scale at the VA). Try going on some medical sites, sites for journals, sites for jobs, etc., and when you click on the drop down menu, you'll see every medical specialty, including allied health professions, but no podiatry. Click on some of these sites and enter your name and click the box for your suffix. You'll see MD, DO, RN, DDS, DMD, OD, DC, but often no DPM.

Until the APMA makes sure we are on the map, it's an uphill battle. And I also never advised anyone not to go into podiatry, I advise them to do their homework, and not simply listen to propaganda from the schools, etc.


I really have no desire to continue a conversation with you on this forum, because I've dealt with too many with your demeanor in the past, and know it'll never go anywhere good. And I don't want to bore those on this site who want information, not arguments.

In 7-10 years when you're done your education, completed your residency and have actually worked in the profession, I'll be happy to continue this conversation. Until that time, I assure you that you've got a lot to learn.

If you want to discuss this further, PM me so no one has to be subject to this anymore.

 

[bobtheweazel]

Are you really going to compare your experience as a Cped/orthotist with any branch of medicine? Are you serious? If I'm not mistaken aren't people eligible to obtain a Cped/orthotist degree right out of high school?? I utilize and respect Cpeds and orthotists, but your comparison is ridiculous. It's analogous to comparing a dental lab with a dentist.

I don't get your optometry and dental comparisons, so I'm not even going to try to figure out your thinking process, or lack thereof.

For full O&P licensure/certification it's a Master's Degree, + 1.5-2 year residency, on everything else we'll agree to disagree.


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[dyk343]

Please dont respond to the troll comments regarding ortho being phased out. Also wouldnt recommend going to their thread to spread your opinion as it will go nowhere for anyone. Flagging ldsdude for review.

 

[ExperiencedDPM]

For full O&P licensure/certification it's a Master's Degree, + 1.5-2 year residency, on everything else we'll agree to disagree.


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For full O&P licensure/certification it's a Master's Degree, + 1.5-2 year residency, on everything else we'll agree to disagree.


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On the ABCOP website it does not state a master's degree is needed for O&P certification. . It states bachelors or higher. And a Cped does not need a college degree.

 

[ldsrmdude]

No idea where you read on our forums that "general orthopedics is being phased out." (Unless it's somewhere in one of the huge posts in this thread that I missed)

Orthopedics isn't going anywhere. They've earned their place in medicine. Hopefully we can get somewhere close to that in the future.

Look at post #8 in this thread.

 

[bobtheweazel]

On the ABCOP website it does not state a master's degree is needed for O&P certification. . It states bachelors or higher. And a Cped does not need a college degree.

Used to be a Bachelor's. Either ABC lists that so that those people can be grandfathered in or because the ABC website is outdated (I wouldn't be surprised). And I wasn't talking about pedorthics, which you are correct only requires a college certificate and can be completed in about a semester's worth of work + 1,000 hours (6 months) clinical training. NCOPE approves the schools and a list of all of the full O&P programs is on their website, the current standard is the Master's Degree.
http://www.ncope.org/students/schools/

 

[CardsFan92]

Look at post #8 in this thread.

Are you able to remove those posts? I know it's like playing whac-a-mole with him and all the accounts he creates, but it couldn't hurt.


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[ldsrmdude]

Are you able to remove those posts? I know it's like playing whac-a-mole with him and all the accounts he creates, but it couldn't hurt.

Am I able to? Yes, I do have that capability

 

[deleted585480]

This thread was depressing to read through.

 

[mrjbb]

This thread was depressing to read through.

Very much so. Many of the facts and speculation on the future of Podiatry is one of the reasons I've leaned more towards the MD/DO route. I like Podiatry and although there's going to be changes that take place all across the board in all medical sub-specialties, with the median pay being what it currently is, it could be safe to say that the salary of newly minted Pods will begin to drop.

May possibly shadow a pod to gain better exposure. But lower reimbursements, scope of practice and limited ability to use the degree to pursue a different path (in the future) is a pretty scary reality. I don't think Podiatry is going anywhere. But it faces various challenges.

 

[mrjbb]

You're a pre-med...enough said.

I stumbled across jobs where hospitals are offering DPMs 225-250k salary with RVU bonus, full benefits, student loan reimbursement, CME, etc

All specialties are seeing decreased reimbursements across the board


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Yes, I'm a non trad pre-med. I never claimed to know everything that entails Podiatry. Nor did I mean to offend any of the practicing Pods in this forum. I can only comment from what I've read and heard. I'm not in the field, so my opinion isn't based on a first account.

But I've always had an interest in Podiatry ever since I found out about it several years ago. I have an immense respect for the field as a whole. And if I were to choose this route, I'd like to understand where the field is headed. That's all.

I've read that due to decreases in reimbursement and future policy changes Newly minted Pods may start anywhere between 80k-120k...that seems low to me. Especially given the amount of debt one would have amassed by the time they enter residency. Above six figure starting is fine, anything below that is just crazy.

I did state I may shadow a Pod to gain further exposure to your field and it would allow me to make an educated decision.

 

[mrjbb]

Until you start talking to physician recruiters and then to hospitals, ortho groups, podiatry groups, etc (any future employer) and start spit balling contracts over the phone you don't know know what people are willing to pay DPMs...period


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Thank you for the insight. My apologies if I've offended anyone here.

 

[Weirdy]

I get salty when people come here and start talking about the profession when they have zero life experience and aren't even remotely associated with podiatry. Especially when they are not even negotiating contracts right now like I am.


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For negotiations- is that something you just had to pick up yourself? Or did you have other DPMs help you in the process and drop some advice?

Asking cause I have a feeling students coming straight out are woefully under-prepared in the business aspects.

 

[mrjbb]

I get salty when people come here and start talking about the profession when they have zero life experience and aren't even remotely associated with podiatry. Especially when they are not even negotiating contracts right now like I am.


Sent from my iPhone using SDN mobile

That's understandable. Your hostility was duly noted in your responses.

None of what I said I claimed to be fact. In fact I said it was speculative. And although this is an online forum, all of what I said was first quoted or commented on multiple times by pod students or (according to them) practicing Podiatrists here.

Clearly you feel as though I've offended you, hence my apology. It's obvious I didn't comment on this thread to troll, but to gain better insight on the future of the profession from those of you that are currently in Pod school and those who are practicing.

 

[dr.phoot]

Something (very) interesting I came across today; might not be news to some people though:
http://osteopathic.nova.edu/dodpm/


Nova Southeastern University (NSU) has established a program leading to the Doctor of Osteopathic Medicine (D.O.) degree for doctors of podiatric medicine (D.P.M.) who are graduates of U.S. accredited colleges of podiatric medicine. Interested D.P.M. graduates must provide evidence of being accepted by or enrolled in the Council on Podiatric Medical Education. The D.O. program for D.P.M. graduates provide the opportunity for a limited number of D.P.M.s each year to complete the requirements of the D.O. degree in a three- year period. NSU's College of Osteopathic Medicine will determine on a yearly basis the number of D.P.M.s that may be accepted and enrolled.

After completing the requirements for the D.O. degree and a one-year osteopathic medical internship, the educational requirements will have been met for eligibility to obtain a license to practice osteopathic medicine in states requiring one year of graduate medical education. The program is designed for doctors of podiatric medicine who wish to obtain full medical licenses (i.e., osteopathic medicine) to provide added value to podiatric practice.


-------------------

Doesn't this solve the problem / issue that one poster brought up?

 

[bobtheweazel]

Something (very) interesting I came across today; might not be news to some people though:
http://osteopathic.nova.edu/dodpm/


Nova Southeastern University (NSU) has established a program leading to the Doctor of Osteopathic Medicine (D.O.) degree for doctors of podiatric medicine (D.P.M.) who are graduates of U.S. accredited colleges of podiatric medicine. Interested D.P.M. graduates must provide evidence of being accepted by or enrolled in the Council on Podiatric Medical Education. The D.O. program for D.P.M. graduates provide the opportunity for a limited number of D.P.M.s each year to complete the requirements of the D.O. degree in a three- year period. NSU's College of Osteopathic Medicine will determine on a yearly basis the number of D.P.M.s that may be accepted and enrolled.

After completing the requirements for the D.O. degree and a one-year osteopathic medical internship, the educational requirements will have been met for eligibility to obtain a license to practice osteopathic medicine in states requiring one year of graduate medical education. The program is designed for doctors of podiatric medicine who wish to obtain full medical licenses (i.e., osteopathic medicine) to provide added value to podiatric practice.


-------------------

Doesn't this solve the problem / issue that one poster brought up?

Adding an MD or DO behind your name doesn't change anything for the DPM. Might as well just go to DO school in the first place if that's what someone wants.

It all depends on where and how you wanna practice. Some states won't license DOs with only the one year internship. And if you do get licensed as a DO, how much would it change the way you practice? Would those changes be worth spending an extra $200,000 or however much to go through the Nova program plus the years worth of income you would be sacrificing to go that route? And don't forget you'll still have $200,000 to pay back from podiatry school.

There's some guy trying to start a new school that would give out a DPM/MD dual degree, which would work around the having to go to two separate schools and pay two separate tuitions, but again, if that's what someone wants they shouldn't go to podiatry school in the first place. If there are any problems to address, tacking on a second degree won't do that, it will simply circumvent them. Also, there's about a gazillion reasons why that DPM/MD school isn't gonna happen anyway.

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[mrjbb]

Have decided to shadow a Podiatrist. This may not be the right thread for this, but I'm going to go ahead and ask, given a majority of you have successfully matriculated. I've searched on the forum and found various answers but mostly directed towards the MD/DO cycle.

Would taking the September mcat put me at a disadvantage when applying in the 2017 cycle to matriculate in fall 2018?

I may be able to take it sooner but I should be done with all the prereqs including Biochem by the spring 2017 and I want to give myself ample time to study.

 

[HappyHobPod]

Have decided to shadow a Podiatrist. This may not be the right thread for this, but I'm going to go ahead and ask, given a majority of you have successfully matriculated. I've searched on the forum and found various answers but mostly directed towards the MD/DO cycle.

Would taking the September mcat put me at a disadvantage when applying in the 2017 cycle to matriculate in fall 2018?

I may be able to take it sooner but I should be done with all the prereqs including Biochem by the spring 2017 and I want to give myself ample time to study.

For Podiatry School, not at all. I took my MCAT in September, received/processed scores in October, and had interviews/acceptances by the end of the same month.


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[mrjbb]

For Podiatry School, not at all. I took my MCAT in September, received/processed scores in October, and had interviews/acceptances by the end of the same month.


Sent from my iPhone using SDN mobile

Great to know, thank you for your response.

 

[GypsyHummus]

I have minimal to no regrets with my career choice. However, if I had to choose today I would likely not choose the DPM degree. Medicine is much different and changing daily. I'm afraid of the roadblocks that may be ahead with a limited license.

NPs and PAs are infiltrating all aspects of care. And in some areas they are already performing palliative foot care, wound care and other foot/ankle care.

I did pretty well in my career professionally and financially. But that doesn't mean it was always smooth sailing. There are just to many unknowns at this time with the health care system.

Until DPMs TRULY provide a unique service, I think there may be issues. Orthopods can competently perform foot and a ol surgery, so don't think they can't. Wound care nurses can treat wounds. PAs and NPs are already doing palliative care. Dermatologists treat skin and nail disorders. Cpeds and orthotists make orthoses and sell/dispense shoes. And the list goes on.

All I ask is that you go in with eyes wide open and as an educated consumer.

What would you recommend for a unique service then?

 

[ExperiencedDPM]

What would you recommend for a unique service then?

I'm not sure podiatry has the ability to offer a truly unique service. Palliative care can be performed by nurses, PAs , etc. Conservative care for foot and ankle ailments can be performed by NPs , PAs, orthopedists, physical therapists, physiatrists and sometimes GPs. Surgical care of the foot and ankle can be performed by orthopedists and amps can be performed by general or vascular surgeons. Derm issues can obviously be taken care of by dermatologists. And of course there is overlap with what we do and rheumatologists. And the list goes on.

No one is performing hip replacements other than orthopedic surgeons. No one is performing retina surgery other than ophthalmologists, no one is performing brain surgery other than neurosurgeons, etc.

I really can not think of a truly unique service DPMs can provide or do provide that can't in some way be duplicated by others.

Sorry, that's my honest opinion. And please don't respond that no one else wants to do it or that we do it better than anyone else. Those are empty words that ultimately mean nothing.

 

[teambringit]

I'm not sure podiatry has the ability to offer a truly unique service. Palliative care can be performed by nurses, PAs , etc. Conservative care for foot and ankle ailments can be performed by NPs , PAs, orthopedists, physical therapists, physiatrists and sometimes GPs. Surgical care of the foot and ankle can be performed by orthopedists and amps can be performed by general or vascular surgeons. Derm issues can obviously be taken care of by dermatologists. And of course there is overlap with what we do and rheumatologists. And the list goes on.

No one is performing hip replacements other than orthopedic surgeons. No one is performing retina surgery other than ophthalmologists, no one is performing brain surgery other than neurosurgeons, etc.

I really can not think of a truly unique service DPMs can provide or do provide that can't in some way be duplicated by others.

Sorry, that's my honest opinion. And please don't respond that no one else wants to do it or that we do it better than anyone else. Those are empty words that ultimately mean nothing.

There is overlap in many areas of medicine. Chill out bro.

 

[GypsyHummus]

I'm not sure podiatry has the ability to offer a truly unique service. Palliative care can be performed by nurses, PAs , etc. Conservative care for foot and ankle ailments can be performed by NPs , PAs, orthopedists, physical therapists, physiatrists and sometimes GPs. Surgical care of the foot and ankle can be performed by orthopedists and amps can be performed by general or vascular surgeons. Derm issues can obviously be taken care of by dermatologists. And of course there is overlap with what we do and rheumatologists. And the list goes on.

No one is performing hip replacements other than orthopedic surgeons. No one is performing retina surgery other than ophthalmologists, no one is performing brain surgery other than neurosurgeons, etc.

I really can not think of a truly unique service DPMs can provide or do provide that can't in some way be duplicated by others.

Sorry, that's my honest opinion. And please don't respond that no one else wants to do it or that we do it better than anyone else. Those are empty words that ultimately mean nothing.

I think that GPs are starting to feel the squeeze of the midlevel providers. Heck, even gas is getting taken over by nurses. And there are even cardio nurse practitioners now. Many docs not in the surgical specialties are feeling the overlap squeeze of the NP and PA. The only truly safe ones are in dentistry and specialization like you mentioned.

can you become super specialized in one area of the foot or ankle? Like just focus solely on reconstructive ankle surgery? Or become super specialized in a type of rear foot care?

Could a pod go into biomechanics research to develop new technologies, like an anti rolling insole? Maybe an anti fungal sock? Something entrepreneurial to diversify the portfolio?

 

[plant based]

I think that GPs are starting to feel the squeeze of the midlevel providers. Heck, even gas is getting taken over by nurses. And there are even cardio nurse practitioners now. Many docs not in the surgical specialties are feeling the overlap squeeze of the NP and PA. The only truly safe ones are in dentistry and specialization like you mentioned.

can you become super specialized in one area of the foot or ankle? Like just focus solely on reconstructive ankle surgery? Or become super specialized in a type of rear foot care?

Could a pod go into biomechanics research to develop new technologies, like an anti rolling insole? Maybe an anti fungal sock? Something entrepreneurial to diversify the portfolio?

Maybe I'm naive....but I believe if you truly have a passion for the profession, you will push the limits of current foot & ankle care and have a very long and fruitful career, despite the overlaps. I wish people would focus more on what we can bring to the profession and our patients, rather than bickering and complaining like I see so much on this forum.

 

[ExperiencedDPM]

There is overlap in many areas of medicine. Chill out bro.

First of all, I'm not your bro. Second of all, I was asked a question and gave an honest answer. No where in my post did I say that you can't make a good living. Nor did I say that we were the only profession with overlap.

However, I did say that we don't really have any one unique quality that we "own" and THAT was the question. Feel free to chime in and tell me what UNIQUE things DPMs do that isn't also being reproduced by other fields?

So you can chill out and read what I wrote carefully. It's not doom and gloom. It's factual.

Someone asked a specific question regarding what we do unique and that's my answer.

I've said many times, do what you do well, do it honestly and don't look at patients as dollar signs and you will succeed. But with increased competition, increased deductibles, increased copays and increasing govt regulations, it 'ain't getting easier.

I don't know if you're a student, resident, etc., but I can tell you that it's not the same as it was many years ago and it's getting tougher for everyone in medicine.

 

[ExperiencedDPM]

Maybe I'm naive....but I believe if you truly have a passion for the profession, you will push the limits of current foot & ankle care and have a very long and fruitful career, despite the overlaps. I wish people would focus more on what we can bring to the profession and our patients, rather than bickering and complaining like I see so much on this forum.

We bring a LOT to the table, but talk talk is cheap. We have to convince others, not our own that we have great training and qualities. All professions have bad apples but we need to weed them out of our profession since we are so small. Guys like the DPM in Pennsylvania who got nabbed in the largest single doctor case of Medicare fraud in history. One DPM and 5.2 million in fraud.

There are great academic seminars out there and you don't have to limit yourself to Podiatric seminars. Go to a vascular seminar, go to an Ortho seminar. Then there are these practice management seminars that don't give a crap about quality of care. It's all about how to make money. Sell the patient all kinds of crap. Bill for braces for "fall prevention" that don't have one valid study confirming that BS. Sell every patient a pair of $500 orthotics. Tell everyone they need your laser to cure fungal nails, thought realistically the results suck.

Be better than those guys and be ethical and do what's best for your patient not your wallet. And if you do that, ultimately your wallet will get heavier. Bring the profession to the next level and don't emulate the guy who had his picture in the paper telling people for that 100th time about the dangers of flip flops.

This profession has afforded me the opportunity to have a beautiful home, nice cars, a nice lifestyle, exotic vacations and paid the college tuition for my kids. And it was all done honestly and providing the best quality care.

So I'm not doom and gloom, but we can't just tell everyone about our skills. We have to prove it with our actions. When I first applied to the hospital I work, I had to fight for the most basic privileges. Now I've "earned" privileges to do any procedure within our scope and have performed surgery on the hospital CEO, ,CMO, chief of anesthesia and a family member of the chief of surgery.

It's because they never once saw me do anything dishonest or unethical in my career and word gets out quickly.

Do the right thing and realize there are a lot of folks overlapping so you have to do it better.

 

[dr.phoot]

We bring a LOT to the table, but talk talk is cheap. We have to convince others, not our own that we have great training and qualities. All professions have bad apples but we need to weed them out of our profession since we are so small. Guys like the DPM in Pennsylvania who got nabbed in the largest single doctor case of Medicare fraud in history. One DPM and 5.2 million in fraud.

There are great academic seminars out there and you don't have to limit yourself to Podiatric seminars. Go to a vascular seminar, go to an Ortho seminar. Then there are these practice management seminars that don't give a crap about quality of care. It's all about how to make money. Sell the patient all kinds of crap. Bill for braces for "fall prevention" that don't have one valid study confirming that BS. Sell every patient a pair of $500 orthotics. Tell everyone they need your laser to cure fungal nails, thought realistically the results suck.

Be better than those guys and be ethical and do what's best for your patient not your wallet. And if you do that, ultimately your wallet will get heavier. Bring the profession to the next level and don't emulate the guy who had his picture in the paper telling people for that 100th time about the dangers of flip flops.

This profession has afforded me the opportunity to have a beautiful home, nice cars, a nice lifestyle, exotic vacations and paid the college tuition for my kids. And it was all done honestly and providing the best quality care.

So I'm not doom and gloom, but we can't just tell everyone about our skills. We have to prove it with our actions. When I first applied to the hospital I work, I had to fight for the most basic privileges. Now I've "earned" privileges to do any procedure within out scope and have performed surgery on the hospital CEO, ,CMO, chief of anesthesia and a family member of the chief of surgery.

It's because they never once saw me do anything dishonest or unethical in my career and word gets out quickly.

Do the right thing and realize there are a lot of folks overlapping so you have to do it better.

wow.... hope someday I get a mentor like you when I step into the profession!

 

[GypsyHummus]

We bring a LOT to the table, but talk talk is cheap. We have to convince others, not our own that we have great training and qualities. All professions have bad apples but we need to weed them out of our profession since we are so small. Guys like the DPM in Pennsylvania who got nabbed in the largest single doctor case of Medicare fraud in history. One DPM and 5.2 million in fraud.

There are great academic seminars out there and you don't have to limit yourself to Podiatric seminars. Go to a vascular seminar, go to an Ortho seminar. Then there are these practice management seminars that don't give a crap about quality of care. It's all about how to make money. Sell the patient all kinds of crap. Bill for braces for "fall prevention" that don't have one valid study confirming that BS. Sell every patient a pair of $500 orthotics. Tell everyone they need your laser to cure fungal nails, thought realistically the results suck.

Be better than those guys and be ethical and do what's best for your patient not your wallet. And if you do that, ultimately your wallet will get heavier. Bring the profession to the next level and don't emulate the guy who had his picture in the paper telling people for that 100th time about the dangers of flip flops.

This profession has afforded me the opportunity to have a beautiful home, nice cars, a nice lifestyle, exotic vacations and paid the college tuition for my kids. And it was all done honestly and providing the best quality care.

So I'm not doom and gloom, but we can't just tell everyone about our skills. We have to prove it with our actions. When I first applied to the hospital I work, I had to fight for the most basic privileges. Now I've "earned" privileges to do any procedure within out scope and have performed surgery on the hospital CEO, ,CMO, chief of anesthesia and a family member of the chief of surgery.

It's because they never once saw me do anything dishonest or unethical in my career and word gets out quickly.

Do the right thing and realize there are a lot of folks overlapping so you have to do it better.

How stressful is the lifestyle of a podiatrist? I have family in medicine, surgery specifically, and they are up in the wee hours of the night finishing paperwork after doing 12 hour surgery days.

As a pod who does surgery, how many hours a day do you say you do paperwork vs seeing patients/surgery stuff?