D
deleted1149159
Don’t tell Kanye…
Funny, my son was a huge fan. Had flags, t-shirts. When he heard what Ye said, they all went in the trash.
Don’t tell Kanye…
It's pathetic isn't it?I have nothing to add to this thread, but I laugh every time I read the title
I went to TUSPM from 2012-2016. Worst teachers I have ever had, and the school just wants your money, they couldn't care less about you with regards to educating you or any kind of academic support. I really hope that more people considering Podiatry school think again, because you are basically wasting your life when you could be doing something better. Podiatry as a profession is headed downhill as more and more people learn the truth about i.You’re totally the reason why, not the salary to debt ratio the profession is producing 😂. Read both attachments.
View attachment 359976
So what's your story?I went to TUSPM from 2012-2016. Worst teachers I have ever had, and the school just wants your money, they couldn't care less about you with regards to educating you or any kind of academic support. I really hope that more people considering Podiatry school think again, because you are basically wasting your life when you could be doing something better. Podiatry as a profession is headed downhill as more and more people learn the truth about i.
That's a shame. It shouldn't. I'm not a stud and I can get prepped / positioned / plated in under just under 30 minutes if I'm perfect in the sagittal on my 1st throw. Crushing the 1st MPJ fusion is the cornerstone to crushing a 1st MPJ + panmetatarsal head resection + 4 toes. If you can do the 1st MPJ in 30-40 you can complete the 9 procedure cases in under 2 hours.I'm reminded of this thread again and my poor decision as I retract and stand there dissociating for a 1st MTP fusion that took us 4 hrs to do....
Suturing is the worst part especially the toes with thin skin. A back breaking wrist cramping task.That's a shame. It shouldn't. I'm not a stud and I can get prepped / positioned / plated in under just under 30 minutes if I'm perfect in the sagittal on my 1st throw. Crushing the 1st MPJ fusion is the cornerstone to crushing a 1st MPJ + panmetatarsal head resection + 4 toes. If you can do the 1st MPJ in 30-40 you can complete the 9 procedure cases in under 2 hours.
Amen. I don't miss much about residency but I miss having 2 people to close.Suturing is the worst part especially the toes with thin skin. A back breaking wrist cramping task.
What can you possibly do for 4 hours for a first MTPJ fusion.I'm reminded of this thread again and my poor decision as I retract and stand there dissociating for a 1st MTP fusion that took us 4 hrs to do....
I was asked to review 25 cases by an old school MIS doc who does MIS like some docs trim nails.
He can do 10 cases a day. Done in office and same crap for every patient. Stab incisions to rasp an “exostosis” on every toe and every slight prominence on the foot. Stab incision for a flexor tenotomy on every toe, etc. The most time was spent anesthetizing the toes and surgical sites.
No hardware. No layered closure. No skin sutures. Just a steri strip.
This guy is knocking these out in minutes and billing 15-20 procedures per patient and making crazy money.
He’s a pig and the issue is all the “exostectomies” he does on every patient.
When patients were interviewed, not one ever had a complaint of any “bumps” or prominences.
So while you’re spending hours doing a TAR for 950 bucks, this guy is doing 10 cases and making enough to buy a car daily.
But I believe that will be coming to a screeching halt very soon. And you may be reading about the money he’s paying back to Medicare.
do people actually think they can get away with this forever?I was asked to review 25 cases by an old school MIS doc who does MIS like some docs trim nails.
He can do 10 cases a day. Done in office and same crap for every patient. Stab incisions to rasp an “exostosis” on every toe and every slight prominence on the foot. Stab incision for a flexor tenotomy on every toe, etc. The most time was spent anesthetizing the toes and surgical sites.
No hardware. No layered closure. No skin sutures. Just a steri strip.
This guy is knocking these out in minutes and billing 15-20 procedures per patient and making crazy money.
He’s a pig and the issue is all the “exostectomies” he does on every patient.
When patients were interviewed, not one ever had a complaint of any “bumps” or prominences.
So while you’re spending hours doing a TAR for 950 bucks, this guy is doing 10 cases and making enough to buy a car daily.
But I believe that will be coming to a screeching halt very soon. And you may be reading about the money he’s paying back to Medicare.
For real. Maybe he was watching it fuse in real-time?What can you possibly do for 4 hours for a first MTPJ fusion.
Absolutely. I can tell you stories that would make your head explode. There are lots of what I call one trick ponies.do people actually think they can get away with this forever?
These guys aren’t performing the newer MIS procedures under C arm with hardware.Wow this is incredible. Do you think I have enough time to start up a little surgical suite in my office to do these before Medicare stops reimbursing these? Thanks in advance for your legal and practice management advice.
This feels like hyperbole. What did you guys actually do for 4 hours on one joint? Like I need a play by play of what happened in each 30 minute interval of that casestand there dissociating for a 1st MTP fusion that took us 4 hrs to do....
Don’t tell Feli this, he likes to lump people doing the stuff you describe with those doing the same osteotomies percutaneously as he does open 😉These guys aren’t performing the newer MIS procedures under C arm with hardware.
15-20 procedures PER PATIENT ???!!!???I was asked to review 25 cases by an old school MIS doc who does MIS like some docs trim nails.
He can do 10 cases a day. Done in office and same crap for every patient. Stab incisions to rasp an “exostosis” on every toe and every slight prominence on the foot. Stab incision for a flexor tenotomy on every toe, etc. The most time was spent anesthetizing the toes and surgical sites.
No hardware. No layered closure. No skin sutures. Just a steri strip.
This guy is knocking these out in minutes and billing 15-20 procedures per patient and making crazy money.
He’s a pig and the issue is all the “exostectomies” he does on every patient.
When patients were interviewed, not one ever had a complaint of any “bumps” or prominences.
So while you’re spending hours doing a TAR for 950 bucks, this guy is doing 10 cases and making enough to buy a car daily.
But I believe that will be coming to a screeching halt very soon. And you may be reading about the money he’s paying back to Medicare.
Easily 15-20 per patient. A flexor tenotomy toes 2-5 bilaterally. An MTPJ capsulotomy 2-5 bilaterally. That’s up to 16 right there. Then they take a rasp and a stab and remove an “exostosis” from 5-8 different sites. And that’s just the icing on the cake.15-20 procedures PER PATIENT ???!!!???
If you work with wounds, you’re going to do perc flexor Tenotomies. They seem to go hand in hand, but that level of grift is astounding.
It was a slow motion trainwreck consisting of someone who shouldn't be operating, an agressive rep, someone who don't know their anatomy, trying to "learn, explore" new toys and a combo of other stuffThis feels like hyperbole. What did you guys actually do for 4 hours on one joint? Like I need a play by play of what happened in each 30 minute interval of that case
Wow, in the facilities I work, this provider would be reported. Barring any unforeseen complications or equipment failure, this is truly bordering on malpractice.It was a slow motion trainwreck consisting of someone who shouldn't be operating, an agressive rep, someone who don't know their anatomy, trying to "learn, explore" new toys and a combo of other stuff
It was a slow motion trainwreck consisting of someone who shouldn't be operating, an agressive rep, someone who don't know their anatomy, trying to "learn, explore" new toys and a combo of other stuff
Why don't you want free steak dinners?That’s why I stick to the tried and true hardware. Do not let reps try to sell you on the next great invention. Seen that Arthrex MaxForce MPJ fusion plate? Dumb. If a procedure can be done with Synthes screws and plates, keep it simple.
I have not used the arthrex version but I have used other companies basically same plate with slightly different tech. I agree expensive and not gonna fly at a ASC. But they are FAST and make really easy 1st MPJ positioning. Its basically fool proof and nearly impossible to over dorsiflex/plantarflex the hallux when ligned up with the plate. I've been using them over the last 1.5 years (Not arthrex version) and have had good results - though not really any different than lag screw and plate. Stitches in somewhere between 35-45min. Onto the next.That’s why I stick to the tried and true hardware. Do not let reps try to sell you on the next great invention. Seen that Arthrex MaxForce MPJ fusion plate? Dumb. If a procedure can be done with Synthes screws and plates, keep it simple.
So does anyone know what their 1st MPJ hardware costs? ie. what does a Synthes plate + screw cost? or this Maxforce thingy above?
Anyone using just 2 screws?
One of my attendings back in the day was using a Synthes locking plate. The impression I was under was the plate + locking screws drove the cost up to $1600.
How much do you all think an ASC gets for a Medicare 1st MPJ fusion?
I have not used the arthrex version but I have used other companies basically same plate with slightly different tech. I agree expensive and not gonna fly at a ASC. But they are FAST and make really easy 1st MPJ positioning. Its basically fool proof and nearly impossible to over dorsiflex/plantarflex the hallux when ligned up with the plate. I've been using them over the last 1.5 years (Not arthrex version) and have had good results - though not really any different than lag screw and plate. Stitches in somewhere between 35-45min. Onto the next.
Why don't you want free steak dinners?
Zimmer stratum has been my go to recently for 1st MPJ fusions.I’m mainly Stryker/Wright and I recently checked how much my cases have been costing because our ASC uploads the implant cost sheet to the EMR. I was honestly shocked. Locking plates each around $1600. Screws around $150 each. They even charge for the drill bits and guide wires.
Which system is this? The part that takes me the longest is getting the sagittal alignment. One time I felt I had it right on the flat plate but post op the patient weight bearing ended up being a tick dorsiflexed and felt it. Ugh.
Oh lord, the amount of infidelity taking place between these people is an STI party from what I'm seeing so far.Bro. I only use companies that supply me with smoking hot female reps. Steak dinner second on the list.
And this is almost certainly with the ASC discount! In hospital its more, guarenteed.I’m mainly Stryker/Wright and I recently checked how much my cases have been costing because our ASC uploads the implant cost sheet to the EMR. I was honestly shocked. Locking plates each around $1600. Screws around $150 each. They even charge for the drill bits and guide wires.
Used stratum for a year. 1st mpj plate is tough on a small foot. But nothing compresses like stratumZimmer stratum has been my go to recently for 1st MPJ fusions.
its scary at times. Ive almost cracked a metatarsalUsed stratum for a year. 1st mpj plate is tough on a small foot. But nothing compresses like stratum
I think it's a little over $6300. Someone feel free to fact check me on this number.How much do you all think an ASC gets for a Medicare 1st MPJ fusion?
Zimmer stratum has been my go to recently for 1st MPJ fusions.
I use it mostly for 1st MPJ fusions.Oh wow. I just looked up their system and I am very intrigued now. It takes out a lot of the plate positioning guess work. Do you use it for other bone work or only MPJ fusions? Plate and frag screw? Do you feel comfortable with this fixation for
That’s why I stick to the tried and true hardware. Do not let reps try to sell you on the next great invention. Seen that Arthrex MaxForce MPJ fusion plate? Dumb. If a procedure can be done with Synthes screws and plates, keep it simple.
Oh wow. I just looked up their system and I am very intrigued now. It takes out a lot of the plate positioning guess work. Do you use it for other bone work or only MPJ fusions? Plate and frag screw? Do you feel comfortable with this fixation for
No the opposite it requires perfect plate fixation. The prongs are 2 points of contact so you can't rotate. Once you have drilled the holes for the prongs you bought the placement. Unless you cut off one of the prongs so then can rotate.Oh wow. I just looked up their system and I am very intrigued now. It takes out a lot of the plate positioning guess work. Do you use it for other bone work or only MPJ fusions? Plate and frag screw? Do you feel comfortable with this fixation for
Ummmm...
Anyone using just 2 screws?
Doing this MIS how do you get the denuded cartilage out? Just "milk" it out thru the stab incision? Scope?I did this morning. Did it perc with joint prep using a burr.
Otherwise I’m using a dorsal plate with no crossing screw(s). I do like the Arthrex plate because without crossing screws I need to be able to compress through the plate. I liked the Checkmate plate (arthrosurface I think?) because of the external compression mechanism (a clamp essentially).
There’s no wrong way to fuse a big toe. I’ve seen plenty that have healed with nothing more than a few k-wires. I lied, anything that takes you 4 hours means you’re doing it wrong.
You wouldn't be the first one here to get lured in by shiny metal bits.Ok stop it. I’m not using it. The Zimmer reps near me are all men anyways.
You ever see a dr pimple popper clip? 😂Doing this MIS how do you get the denuded cartilage out? Just "milk" it out thru the stab incision? Scope?
Doing this MIS how do you get the denuded cartilage out? Just "milk" it out thru the stab incision? Scope?
I use screws occasionally (2 for MPJ, 2-3 for Lapidus... all across MCJ, none of the intercuni silliness). 1 screw + pin or 2 screw + pin can work too. Not for diabetics, not for most older ppl, not for very many ppl at all. It works though. I do it for young ppl Lapidus sometimes... mainly to lessen chances of HWR vs plate.So does anyone know what their 1st MPJ hardware costs? ie. what does a Synthes plate + screw cost? or this Maxforce thingy above?
Anyone using just 2 screws?
One of my attendings back in the day was using a Synthes locking plate. The impression I was under was the plate + locking screws drove the cost up to $1600.
How much do you all think an ASC gets for a Medicare 1st MPJ fusion?
Also have the same question. My friend just graduated NP school, and was doing it while full time RN. Her first job out of school is 115K, M-F 9-5, holidays paid time off, no call, no consults, no nursing homes, + benefits. She also found it in 1 week, 20 min from her home.Inflation is 8.8% YoY. Why are podiatry associate salaries still barely $100k?
What's your podiatry story?Also have the same question. My friend just graduated NP school, and was doing it while full time RN. Her first job out of school is 115K, M-F 9-5, holidays paid time off, no call, no consults, no nursing homes, + benefits. She also found it in 1 week, 20 min from her home.
Most job offers in podiatry are in low 100K, but I do have friends who got 200K+ offers in the hospital, but require constant call and complicated surgeries on a daily basis and require relocation. But those jobs are rare for a new grad after the residency.
No wonder, less and less people applying to pod schools. They should get back non-surgical podiatry and let people practice non surgical podiatry without residency. And only people who want and mart enough to do surgery can go to residency/fellowship and get top surgical hospital jobs. No way all those residency programs are graduating well trained surgeons. And even if they were, there are just not enough of those positions.
Newly grad. Was committed to be in a specific location due to family. Applied early in the fall to everything available in the area. Got a PP position working for a solo practitioner. Base + bonus (not sure if would be possible). No call, working in two locations. One location is very slow. My boss said we just need to market more. I am relatively happy with everything so far, but was not able to do many surgeries, just grafts and exostoses for now. My biggest concern is that it is very slow some days. When I started, some days I saw 4 patients a day, now 10-18. It is not very busy. So, I am not hopeful about the bonus. In my free time I go to doctor's offices and give brochures and cards, and set up lunches. Boss pays for lunches.What's your podiatry story?
Interesting career move. Reminds me of how Nova Southeastern used to have their accelerated DO program for podiatrists who had graduated from at minimum a 2-year residency. However, you'd have to be facing some truly awful job prospects before you make that kind of jump.Met a DPM NP last week. After speaking with her, I am really considering doing the same thing after I am done with residency if things are still going downhill.
I am from a state that NP has full scope. She does everything head to toe. Will spend a day or so with her to see what it all entails.