What can we (you and I) do to help increase podiatrists salaries?

[Steveington]

In addition with the polls I have going about the discussion about low wages and salaries, I wanted to ask what we (you and I as individuals) can do to improve our own and other podiatrist salaries.
I think that there are some things that we can do as a profession to help, such as limiting the number of new grads and schools that would help. But I want to have this thread focus more on what we can do as individual podiatrists.

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[Steveington]

As our practice is growing and as we hire our own associates, we are going to pay them a good salary and benefits. (It's more than double what I made when I first came out) Having a clear path to partnership is important... not having moving goal posts.

 

[Steveington]

When I was employed by a rural hospital (it closed) I know that I helped another podiatrist down the line. My clinic was busy and it was always in the black. I was in the good graces from the hospital administration as I had weekly surgeries and my patients would use the lab and imaging departments too. When one of the admins left the state to go to another hospital in Florida, he reached out to me wanting to get a list of all the equipment I used at the hospital. He let me know that he was opening up a position at his new hospital for a podiatrist because he saw the benefit from having one there.
I think that as we continue to show our worth, hospitals and multi specialty groups will want us to come onboard. This will increase the demand for podiatry.

 

[Shiyuan]

I think making it known more and more to other specialists our training and value is paramount. Like the idiom goes: “we don’t just cut toenails.”

Heres a quick story:

I was only 1 week out of residency (took a job at a large MSG in FL) when our group’s Harvard-trained, very well published dermatologist came for MY opinion on a longitudinal melanonychia... And again, here I was a fresh, brand new attending! Very empowering.

I honestly do feel like since podiatry has moved into the realm of foot recon/trauma (and also limb salvage/wound care), more docs see how invaluable we truly are. Same goes with the NP/PAs, they ask my opinion almost daily on patient care.

BUT... the public is a different story. A patient I treated for a very basic traumatic wound to her leg was almost beyond herself. If I recall, she said something like “since when did podiatrists treat wounds?”. In my head I was 😒🤪😐 but of course it was a good opportunity to inform her what we really do. Some people get it, but others don’t.

 

[air bud]

I am going to make more memes.

 

[AttackNME]

I think what we are doing here in SDN with open dialogue about the issues is helpful, there are people who see these posts that may be lurkers but in position of power to make changes

 

[Feli]

There is no easy answer.

An owner DPM or group wouldn't hire if they didn't think they couldn't make at least 100k/yr from an associate. Otherwise, its not worth it to them... hassle of hiring, risk bringing competition to the area, risk rep and logistics, risk of associate flopping in terms of pt liability or collections, etc. They don't care if tuition doubled... it's all about collections.

So, that leaves hospital jobs or big groups that can pay more due to more services, testing, call needs, not running their finances well, govt money injects, etc. That's not for everyone, though... one of the big draws of podiatry is hours/lifestyle.

...I think two things will happen: passive and active solutions.

The passive is that supply/demand will correct it, and (unfortunately), there will be more and more govt jobs. That's the case with MD also: when people come out with 300k+ loans, they are scared. More and more seek PSLF and a 'safe' job. I think that's the point, unfortunately: we are creeping towards socialized medicine.

We will also see the active solutions with more DPMs well trained: better and more hospital and MSG jobs are created by well trained DPMs who want to use and be paid for their skills. They pave the way. Also, the PP groups, esp larger and VC ones, are also changing to realize they won't find or keep any quality of associate in most places with the 100k plus 25 percent old ways. Many are quite a bit better and more viable than "doc X needs an associate with eventual buy out." Last, entrepreneur route is always there; bank funding is rough compared to years past... but hospitals are more likely to assist now than ever.

 

[heybrother]

VC where I am want 20% of the profit from your office forever. Perhaps the original owners will receive profit sharing from the downstream business ie. vascular, woundcare, PCR but the future associates and worker bees will not.

 

[Feli]

VC where I am want 20% of the profit from your office forever. Perhaps the original owners will receive profit sharing from the downstream business ie. vascular, woundcare, PCR but the future associates and worker bees will not.

For sure, but most associates, esp new, want base first and foremost... so there's a massive diff 150k vs 100. Baby steps

 

[icebreaker32]

Cut supply.....until then refuse to take PP jobs with a low base...easier said then done and open even more solo PP offices...also easier said then done and a bit dated as far as the evolution of healthcare delivery....then there has to be some sort of evolution to supergroups or larger groups with fair buy in process......but again none of this will likely happen with out lowered supply......diabetes will not save us.

 

[Pronation]

Cut supply.....until then refuse to take PP jobs with a low base...easier said then done and open even more solo PP offices...also easier said then done and a bit dated as far as the evolution of healthcare delivery....then there has to be some sort of evolution to supergroups or larger groups with fair buy in process......but again none of this happen with out lowered supply......diabetes will not save us.

Ok but what else can I do to help? I need diabeetus to save us. I have piles of Twinkies and lots of candies available to my patients in the waiting room. I'm thinking of starting contests like on that show Man V. Food - eat 20 Twinkies in 10 minutes and win a $100 gift card to McDonald's.

 

[icebreaker32]

Ok but what else can I do to help? I need diabeetus to save us. I have piles of Twinkies and lots of candies available to my patients in the waiting room. I'm thinking of starting contests like on that show Man V. Food - eat 20 Twinkies in 10 minutes and win a $100 gift card to McDonald's.

Yah until supply of the graduating podiatrist comes way down.....better be proactive

Make darn sure the prevalence of diabetes does not decrease.....the increased prevalence was supposed to make the profession in high demand and did not.....so we are all screwed if it does not continue to increase

Maybe a social media campaign for women to wear high heels more often so there are more bunions and hammertoes.....better get the Kardashians involved stat.....wait we can not afford them, might have to settle for a wear yellow social media campaign to fight toenail fungus and save lives

 

[NatCh]

Is low pay really the biggest problem though? Pick through this forum long enough and it seems like the regulars are all making $300K and up (even the unhappiest ones). At a conference this weekend I was chatting with some colleagues at a mandatory cocktail session and everyone was talking about buying 2nd, 3rd, 4th houses.

Edit: something is making people unhappy but maybe lack of income isn't it?

 

[619]

s low pay really the biggest problem though? Pick through this forum long enough and it seems like the regulars are all making $300K and up (even the unhappiest ones). At a conference this weekend I was chatting with some colleagues at a mandatory cocktail session and everyone was talking about buying 2nd, 3rd, 4th houses.

Just putting this out there -- maybe self-esteem and feeling respected is a bigger issue?

I disagree. This forum is a bubble of the pods making $300K plus. Which is only a handful of us. Majority of new graduates are still starting out at $100k base. Obviously they are not on this forum or never post until their situation changes then they post their success story.

I will also be ashamed if I am 3-5 years out and still making around $120K - $140K working as an associate. I think any PP who has an associate 3-5 years out and your associate is still making less than $150k then don't be surprised he/she is looking for new opportunities. Truth is, by 5 year mark in a job, your income is where it is going to be (for the most part forever). Don't think that your income will magically increase at year 10 being an associate at the same Job and practice. Only way to increase your income by 50% or even double it is to find a new job.

So low pay is still the biggest problem which goes along with low self esteem and feeling respected. Imaging the traveling OR nurse or the CRNA making more than YOU the surgeon.

 

[NatCh]

I disagree. This forum is a bubble of the pods making $300K plus. Which is only a handful of us. Majority of new graduates are still starting out at $100k base. Obviously they are not on this forum or never post until their situation changes then they post their success story.

I will also be ashamed if I am 3-5 years out and still making around $120K - $140K working as an associate. I think any PP who has an associate 3-5 years out and your associate is still making less than $150k then don't be surprised he/she is looking for new opportunities. Truth is, by 5 year mark in a job, your income is where it is going to be (for the most part forever). Don't think that your income will magically increase at year 10 being an associate at the same Job and practice. Only way to increase your income by 50% or even double it is to find a new job.

So low pay is still the biggest problem which goes along with low self esteem and feeling respected. Imaging the traveling OR nurse or the CRNA making more than YOU the surgeon.

I hear what you are saying but I think that bubble is a lot bigger than a handful.

 

[heybrother]

I hear what you are saying but I think that bubble is a lot bigger than a handful.

My presumption is that some of the people you spoke to are old school private practice owners. My concern is that their future associates/new owners will never be as close to successful as the last generation was.

-Our debt is too high.
-The future of our reimbursement is too low.
-All the money is flowing to the hospital people.

Cigna just sent me my new fee schedule. I didn't ask for it. Nothing new happened. They just said - here's your new schedule.

They cut my reimbursement for 11750 from $220ish to under $170. Meanwhile, my partner is grandfathered in at $260. He makes more for an Austin than I make for a Lapidus.

I accepted long ago that ankle cases would make up a small fraction of what I do. That's just vanity. My reimbursement in the last 2 years has been dramatically cut by 3-4 major insurance payors and it wasn't that high to start with. I am desperately trying to add new services to balance out substantial losses. My partner the other day was mad that we had to give a nurse a $2 raise. Her raise would easily have been paid for by what we lost on any matrixectomy performed on a United or a Cigna or an Aetna patient.

 

[NatCh]

My presumption is that some of the people you spoke to are old school private practice owners. My concern is that their future associates/new owners will never be as close to successful as the last generation was.

-Our debt is too high.
-The future of our reimbursement is too low.
-All the money is flowing to the hospital people.

Cigna just sent me my new fee schedule. I didn't ask for it. Nothing new happened. They just said - here's your new schedule.

They cut my reimbursement for 11750 from $220ish to under $170. Meanwhile, my partner is grandfathered in at $260. He makes more for an Austin than I make for a Lapidus.

I accepted long ago that ankle cases would make up a small fraction of what I do. That's just vanity. My reimbursement in the last 2 years has been dramatically cut by 3-4 major insurance payors and it wasn't that high to start with. I am desperately trying to add new services to balance out substantial losses. My partner the other day was mad that we had to give a nurse a $2 raise. Her raise would easily have been paid for by what we lost on any matrixectomy performed on a United or a Cigna or an Aetna patient.

I'm friendly with a number of colleagues, some older, some younger. Nobody (other than my partners) is showing me their tax forms of course but it sure sounds like everyone is doing pretty well financially. I guess everyone could be talking s***, I suppose. Excessive paperwork seems to be the most common complaint.

Sorry about your new fee schedule.

 

[heybrother]

I'm friendly with a number of colleagues, some older, some younger. Nobody (other than my partners) is showing me their tax forms of course but it sure sounds like everyone is doing pretty well financially. I guess everyone could be talking s***, I suppose. Excessive paperwork seems to be the most common complaint.

Sorry about your new fee schedule.

I'm just going to have to save aggressively, have no hobbies, and buy my 3rd house off my investments.

 

[Pronation]

I hear what you are saying but I think that bubble is a lot bigger than a handful.

Because those of us with good jobs and making good money recognize how incredibly lucky we got by landing these gigs, especially a gig that’s not in the middle of nowhere. A good portion of us got screwed at the start as associates. So that’s now 7-8 years of training plus another 2 years of making garbage income. So that’s 10 years of your life before you can make almost what a hospitalist makes, except they work 7 days on and 7 days off.

I got my job with pure luck. Do you know how many weeks I had to practice on a banana before landing my job? If I came in tomorrow and they said “we feel that you’ve started using too much teeth” and I lost my job, I don’t know that I could score another gig like this - it could take me years of searching/interviewing before I was again picked over HUNDREDS of applicants.

 

[NatCh]

Because those of us with good jobs and making good money recognize how incredibly lucky we got by landing these gigs, especially a gig that’s not in the middle of nowhere. A good portion of us got screwed at the start as associates. So that’s now 7-8 years of training plus another 2 years of making garbage income. So that’s 10 years of your life before you can make almost what a hospitalist makes, except they work 7 days on and 7 days off.

I got my job with pure luck. Do you know how many weeks I had to practice on a banana before landing my job? If I came in tomorrow and they said “we feel that you’ve started using too much teeth” and I lost my job, I don’t know that I could score another gig like this - it could take me years of searching/interviewing before I was again picked over HUNDREDS of applicants.

Sounds like you're doing well now financially but are anxious about job security, yeah?

 

[air bud]

Sounds like you're doing well now financially but are anxious about job security, yeah?

Yes I have spoken about the stress associated with these jobs knowing you can't just say oh well I will go find another one. Although I have repeatedly just gone and found another one...but it came at a cost.

 

[NatCh]

Yes I have spoken about the stress associated with these jobs knowing you can't just say oh well I will go find another one. Although I have repeatedly just gone and found another one...but it came at a cost.

Job security is definitely a concern. Maybe more so than low wages? I'm guessing it depends on each individual.

Hypothetical question -- which would you all rather have?
A) 50% increase in salary now, guaranteed for the next 5 years then come-what-may after that
B) Current salary plus annual cost of living increases guaranteed for the next 30 years

 

[podwho]

Job security is definitely a concern. Maybe more so than low wages? I'm guessing it depends on each individual.

Hypothetical question -- which would you all rather have?
A) 50% increase in salary now, guaranteed for the next 5 years then come-what-may after that
B) Current salary plus annual cost of living increases guaranteed for the next 30 years

No one can guarantee a job for 30 yrs ever. Take the extra money and hustle for the next one.

 

[Pronation]

Job security is definitely a concern. Maybe more so than low wages? I'm guessing it depends on each individual.

Hypothetical question -- which would you all rather have?
A) 50% increase in salary now, guaranteed for the next 5 years then come-what-may after that
B) Current salary plus annual cost of living increases guaranteed for the next 30 years

C) Endless supply of hookers and blow

 

[NatCh]

No one can guarantee a job for 30 yrs ever. Take the extra money and hustle for the next one.

It’s a hypothetical…

 

[NatCh]

C) Endless supply of hookers and blow

I like your style.

 

[DYK343]

Yes I have spoken about the stress associated with these jobs knowing you can't just say oh well I will go find another one. Although I have repeatedly just gone and found another one...but it came at a cost.

Employers want experience and board certification. Being 5 years out and ABFAS certified with RRA made job hunting much much much easier than as a graduating resident. At least in my experience.

I was able to secure the new hospital position fairly easy and had several other hospitals that were interested in hiring me. I feel like as a graduating resident I would get 5% returns on emails/cold calls for an interview. This go around It was probably 60-70% wanted to talk to me/interview me. Night and day difference.

 

[air bud]

Employers want experience and board certification. Being 5 years out and ABFAS certified with RRA made job hunting much much much easier than as a graduating resident. At least in my experience.

I was able to secure the new hospital position fairly easy and had several other hospitals that were interested in hiring me. I feel like as a graduating resident I would get 5% returns on emails/cold calls for an interview. This go around It was probably 60-70% wanted to talk to me/interview me. Night and day difference.

Yup totally

 

[Pronation]

Employers want experience and board certification. Being 5 years out and ABFAS certified with RRA made job hunting much much much easier than as a graduating resident. At least in my experience.

I was able to secure the new hospital position fairly easy and had several other hospitals that were interested in hiring me. I feel like as a graduating resident I would get 5% returns on emails/cold calls for an interview. This go around It was probably 60-70% wanted to talk to me/interview me. Night and day difference.

Seeing posts like this only gives me more motivation to open up my own associate mill. How low do you think I could go? Think 55k is doable? Or do I need to call it a fellowship at that point?

 

[dtrack22]

Job security is definitely a concern. Maybe more so than low wages? I'm guessing it depends on each individual.

Hypothetical question -- which would you all rather have?
A) 50% increase in salary now, guaranteed for the next 5 years then come-what-may after that
B) Current salary plus annual cost of living increases guaranteed for the next 30 years

I think you’re on to something when it comes to fear/job security. Generally, if you were to lose your job as an employed podiatrist, you have limited options, most of which are not desirable.

1) open up your own practice. Probably go further into debt, and definitely take a rather large initial income hit. Meh.

2) easily find a job working for another podiatrist. You can probably stay relatively local, but now you get podiatry associate pay (ie huge income hit).

3) do travel work. Oh wait that is in limited supply for podiatrists and therefore not something you can easily/consistently do to stay put (location-wise) and keep a high income. This one isn’t even really an option.

4) find new hospital employed job. This could take a lot of time. For it to be expedient, you are 100% moving, and more than likely it will be to another state or region of the country.

We aren’t talking ortho who could get hired virtually anywhere or do locums work. Or primary care, or Psych or peds or Gen surg or…

Losing my job terrifies me, I would be forced to open up my own practice again if I wanted to stay put. I don’t want to do that.

As for the hypothetical, I’m still rolling the dice and taking my extra $180k per year for 5 years. Clearly I have a gambling problem…

 

[NatCh]

I just saw this on FB:

DPMs on Facebook​

Sunny Patel ·
https://www.facebook.com/#
·

Helllo my name is Dr. Sunny J Patel, I am the Chief Medical Officer at Achilles Foot and Ankle Center, Inc. our group is hiring if any one is interested or knows anyone who is interested
Associate Position - Kilmarnock, VA (base salary $300k)
Largest Podiatry Practice in Central VA looking for podiatrist for office setting in Eastern, VA. Sports medicine, wound care, high risk foot care, orthotics, ingrown toenails, in office tenotomies, in office wart, lesion, mass removals, injections. Need to live within 30 min of Kilmarnock. $300,000 base salary, bonus structure, health insurance, PTO, paid malpractice insurance, CME, 401K.
please submit CV to [email protected] or DM me for more info

 

[Pronation]

"Chief Medical Officer"