Podiatrist salary at hospital vs. private practice

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Originally Posted by PADPM

Your interview, appearance, attitude, etc., should be your greatest assests..

This was the most important in my experience. And maybe even more important was convincing people that they "need" you. Most practices would be well off with plenty of the residents they interview/get in contact with. And many podiatry group practices don't really need to hire an associate when they do. It's your job to make them believe that they do...

Originally Posted by Kidsfeet

Please don't think that because you were selected for a job that was there and were looking for the best candidate and you happened to fit the bill you marketed yourself like those of us in private practice do everyday, all the time.

So you ask a question about whether or not the position was on the open market, so to speak, and then you follow up with this comment? You made your point in the previous paragraph and then (without any knowledge of the situation) proceed to further the most negative aspect of the point. And since you asked, the position did not exist until after I made a contact and was allowed to meet with/give a presentation to some of the big wigs. Again, there was no "ad" for the position. Of course, there were certain things that had to already be in place for all of this to work and I may have gotten a little lucky in that sense.

Originally Posted by Kidsfeet

You missed the point of my saying about you being out on the street.

You must have been on the syrup again. Because to say that somehow ALL hospital employees, in EVERY scenario have ZERO business sense (that is exactly what your statement implies) is false.

Originally Posted by Kidsfeet

Get a lawyer and get him or her to charge you thousands for the same advice I can give you here.

This sums YOU up. Kidsfeet's advice = worth same $$ as a professional attorney. You know everything, including all things that a professional in a field completely different than your own would know. Unreal.

Oh darn PADPM I'm not very good looking! Time to hit the gym!

Originally Posted by RockyIV

You must have been on the syrup again. Because to say that somehow ALL hospital employees, in EVERY scenario have ZERO business sense (that is exactly what your statement implies) is false.

Maybe my experience has shown me something yours hasn't, yet. I'm not saying ZERO, but certainly less than someone who is in it everyday. Thanks for taking my comments to the extreme. That tells me a lot about you.

This sums YOU up. Kidsfeet's advice = worth same $$ as a professional attorney. You know everything, including all things that a professional in a field completely different than your own would know. Unreal.

I also love the fact that you chose to only highlight the negative stuff in my post, rather than focus on the congratulatory aspect. That again tells me a lot about you, as well.

Whether you chose to believe what I say or not is immaterial to me. My Dad is an engineer, but throughout his life he gave me a lot of good advice about a lot of things that had nothing to do with his job. You would think that someone as clearly talented as you would take everything with a grain of salt, but also take advice for what it's worth. I certainly don't know as much as a good attorney. If you read my thread on Immigration you'll see that I gave advice based on MY immigration experience. The advice I gave cost me $60 000 to get from the best immigration attorney I could afford, and I gave it out here on my own time, free of charge.

Maybe I have something to contribute other than podiatric knowledge. Maybe I know a thing or two about contract negotiation.How many contracts have you negotiated or helped others to negotiate? Maybe I can save your skin on a bad Surgery Center deal. How many of these types of ventures have you worked on both sides? Maybe not. Ask your lawyer. Happy spending.

In our practice we are also afraid to overpay new associates so I think that potential for losing money on new hires isn't completely an issue of podiatry practices versus other practices but more an issue of how big and healthy the practice is. We have just signed two new orthopaedic surgeons to start later this year - another sports orthopod and a spine orthopod. If they don't produce enough and/or leave then we also will lose money and be unhappy just as any other practice would. However, the more partners there is then that risk is spread out and we all take a little hit as opposed to a single practitioner that brings in someone that doesn't work out who would take a bigger personal hit.
FYI a good way to make more ancillary income is to setup a dispensary pharmacy. This obviously works better for larger practices. I don't think imaging or surgery centers work very well to make money any more.

Maybe I focus on the negative because a majority of your posts are negative when someone disagrees or presents an experience different than your own. As far as the congratulatory aspect...this is basically what you are doing



The fact that Ricky Bobby said "with all due respect" does not change what was said after. Much like your "congratulations, but you clearly don't know what you've accomplished or gotten yourself into. You have zero understanding of contract negotiations, surgical centers, etc...but seriously, I'm happy for you."

Originally Posted by Kidsfeet

Ten years down the road you're unemployed with no idea how to run a business because you were a hospital guy and didn't bother learning all that stuff because you thought you wouldn't need it?

This is what you said. You generalize me as a "hospital guy" who "didn't bother learning" all of the business stuff because "I thought I wouldn't need it". I twisted nothing. You made this over-generalization of all hospital employees.

Originally Posted by RockyIV

This is what you said. You generalize me as a "hospital guy" who "didn't bother learning" all of the business stuff because "I thought I wouldn't need it". I twisted nothing. You made this over-generalization of all hospital employees.

Are you going to have your own office manager?

Will you be managing your own staff?

Will you ever have to fire anyone?

Will you ever do interviews for staff positions?

Will you ever have to personally deal with a staff member who steals from you?

Will you ever have to personally deal with staff not showing up and run the front desk to keep your doors open and not flush a day down the toilet because someone is sick?

Will you be directly responsible for all the billing you do?

Will you be running your own Public Relations campaign?

Will you have to go to a bank with a demographics study to get them to give you a loan to finance your new office?

Will you be aware of how much EVERYTHING you use costs?

Will you be trying to evaluate EMR systems to see which one you can afford and integrate into your office without having to invest in new hardware?

Will you be intimately involved in evaluating the various digital radiograph systems and figure out which one is most cost effective?

Will you worry about how much taxes you are paying for your business?

How much will that X-Mas bonus be for your hard working staff? Can you even afford to give one?

How much does it cost to replace that broken podiatry chair anyway? Can you get it used? Isn't there some kind of gov't incentive when purchasing new medical equipment?

Wow, I ran out of Lidocaine! How could I be so stupid. Wasn't the office manager supposed to keep track of that? Crap, national back order. Whoa...

OMG, the phones/internet/computers went out. WTF? I can't make a living if I can't communicate with my patients!!!

These are things that go through a business owners head all the time. You know how many people I know that went the hospital route and don't have a single clue about all these things? Will you two or three years out?

Originally Posted by newankle

I don't think imaging or surgery centers work very well to make money any more.

Agreed. Imagine that, someone else besides me thinks the same way!

Originally Posted by RockyIV

"congratulations, but you clearly don't know what you've accomplished or gotten yourself into. You have zero understanding of contract negotiations, surgical centers, etc...but seriously, I'm happy for you."

Sorry, but where exactly in my post did I actually say these things about YOU specifically??

If you say "Nowhere, but you implied it!", I'm going to ROFLMAO.

Originally Posted by Kidsfeet

Are you going to have your own office manager?

Will you be managing your own staff?

Will you ever have to fire anyone?

Will you ever do interviews for staff positions?

Will you ever have to personally deal with a staff member who steals from you?

Will you ever have to personally deal with staff not showing up and run the front desk to keep your doors open and not flush a day down the toilet because someone is sick?

Will you be directly responsible for all the billing you do?

Will you be running your own Public Relations campaign?

Will you have to go to a bank with a demographics study to get them to give you a loan to finance your new office?

Will you be aware of how much EVERYTHING you use costs?

Will you be trying to evaluate EMR systems to see which one you can afford and integrate into your office without having to invest in new hardware?

Will you be intimately involved in evaluating the various digital radiograph systems and figure out which one is most cost effective?

Will you worry about how much taxes you are paying for your business?

How much will that X-Mas bonus be for your hard working staff? Can you even afford to give one?

How much does it cost to replace that broken podiatry chair anyway? Can you get it used? Isn't there some kind of gov't incentive when purchasing new medical equipment?

Wow, I ran out of Lidocaine! How could I be so stupid. Wasn't the office manager supposed to keep track of that? Crap, national back order. Whoa...

OMG, the phones/internet/computers went out. WTF? I can't make a living if I can't communicate with my patients!!!

These are things that go through a business owners head all the time. You know how many people I know that went the hospital route and don't have a single clue about all these things? Will you two or three years out?

Ah, but you forgot THE most important issue;

"Do I prosecute that little old lady who keeps opening my cabinet drawers and steals all the corn pads and Band-Aids".

Originally Posted by PADPM

Ah, but you forgot THE most important issue;

"Do I prosecute that little old lady who keeps opening my cabinet drawers and steals all the corn pads and Band-Aids".

Holy crap! We have a little old lady like that in our office too!! LMAO!!

Originally Posted by Kidsfeet

Sorry, but where exactly in my post did I actually say these things about YOU specifically??

If you say "Nowhere, but you implied it!", I'm going to ROFLMAO.

I'll quote you again...

Originally Posted by Kidsfeet

Ten years down the road you're unemployed with no idea how to run a business because you were a hospital guy and didn't bother learning all that stuff because you thought you wouldn't need it

Originally Posted by Kidsfeet

you criticize others for something you won't have to do at all

Originally Posted by Kidsfeet

You won't have to do any of that stuff and have no idea how difficult what you propose really is. It's very easy from your position to think what an easy time it is to market yourself, blah, blah, blah

Originally Posted by Kidsfeet

Awesome stuff! I'm being honest. Congratulations. Some suit is going to do all that stuff you're talking about for you.

Everything you claimed was clearly directed at me. Anyone with half a brain reading this thread realized that long ago.

As for your list of 21 questions. I could answer "yes" to 15 of them (although 2-3 of the questions are things that many partners in a practice couldn't even say yes too). Including the all important final question. Of those 15 "yes" answers I would say almost half I could have answered "yes" to just during residency.

You make a lot of assumptions about me. And maybe you justify it by saying that all of these smart a** questions are only there to "help" people think about everything that goes into having your own practice. If that is the case, spare me. I had my own small business prior to and during Podiatry school. I don't need your advice, I've had my own failures to learn from. Hearing all about yours is just depressing.

Originally Posted by RockyIV

As for your list of 21 questions. I could answer "yes" to 15 of them (although 2-3 of the questions are things that many partners in a practice couldn't even say yes too). Including the all important final question. Of those 15 "yes" answers I would say almost half I could have answered "yes" to just during residency.

You make a lot of assumptions about me. And maybe you justify it by saying that all of these smart a** questions are only there to "help" people think about everything that goes into having your own practice. If that is the case, spare me. I had my own small business prior to and during Podiatry school. I don't need your advice, I've had my own failures to learn from. Hearing all about yours is just depressing.

Jeez man. So when you're going to be employed by this hospital system you're going to be doing all these things?

Also, you need a dose of humble pie, brother. Now who is acting like the great and powerful ____? "You don't need my advice"? Everyone needs help once in awhile. With all your big talk, I would hope you learned that during your business days. I learn from people everyday and am only offering MY advice. I haven't seen any of yours that pertains to me, but I'll keep looking. I'm sure I can learn a thing or two from you, so keep posting. That doesn't mean I won't inject my past experience into it, whether you think it's valid or not. Somebody else might learn something. If you think you don't need my advice, great. Maybe you don't. But I bet you might learn something, however little, if you toned down the attitude just a bit.

Originally Posted by Kidsfeet

So when you're going to be employed by this hospital system you're going to be doing all these things?

Why would you twist that reply around and ask another condescending question?

Originally Posted by dtrack22

Why would you twist that reply around and ask another condescending question?

NONE of the hospital people I know do any of that. He may be talking about what he did in the PAST, but I doubt very much that he is going to do any of that EVER in his hospital job.

What MOST (not ALL as is constantly implied in this thread about my replies) hospital employees do is show up to work and go home. Period. They've never seen an encounter form, never had to pour over monthly revenue, deal with lawyers and accountants about business (NOT personal) taxes, hire staff...etc. I find it extremely hard to believe that this position RockyV apparently created for himself will have him do even half the stuff on the list I provided. If so, I'm wrong about HIS position. I'm talking from MY experience dealing with people in these types of positions. If RockyV has truly done something unusual with it, wonderful. Hopefully, it will be a new model for other positions of this type in the future. I've seen MANY groups get swallowed up by large hospital system and the very reason they "allowed" it to happen was precisely because they didn't have to deal with any of that anymore. At least for a couple of years when the deal falls apart and they are left to deal with a huge juggernaut when trying to re-establish themselves in private practice. Just like the VA issue with DPM not being able to participate as expert witnesses brought up in another thread, this was one of the many reasons I left the area I was in. Overnight, I saw half my patient load disappear because of a group being bought out and all the referrals going to them. That being said, your head would spin if you talked to them now and how stuck they are with NO recourse. Do you have the cash to fight multi-billion dollar organization? Neither do I.

You think his reply "Spare me", isn't condescending? Words of a big shot. Sorry.

Originally Posted by Kidsfeet

You think his reply "Spare me", isn't condescending? Words of a big shot. Sorry.

So in answer to my question, you were being condescending because "he did it first"?

Originally Posted by dtrack22

So in answer to my question, you were being condescending because "he did it first"?

No, I'm generally condescending dontcha know??

What's interesting to me is you single out MY comment as being condescending, but not the amount of condescension in every one of his posts.

Call me out anytime. I don't mind, but at least be equal about it and do it across the board. And please don't feed me the, "well you're an Asst Mod" line. Puhlease.

Originally Posted by Kidsfeet

And please don't feed me the, "well you're an Asst Mod" line. Puhlease.

So you don't feel like moderators should be held to a higher standard?

Originally Posted by Kidsfeet

I find it extremely hard to believe that this position RockyV apparently created for himself will have him do even half the stuff on the list I provided. If so, I'm wrong about HIS position.

I will do just over half of the stuff on the list provided.

Originally Posted by RockyIV

So you don't feel like moderators should be held to a higher standard?

I don't feel because of my position I should allow others to feel like they should roll over me. I will defend myself and my views ESPECIALLY because of that. Should moderators just shut up when they get attacked?? What kind of community would that foster? I don't feel like I was being insulting or speaking inappropriately. If you did, report the post. Plain and simple.

I will do just over half of the stuff on the list provided.

Good for you! Hopefully you will learn a great deal and in case things don't work you'll be g2g. Once again, I know many who can't say the same. Kudos.

I think the above posts are right. My dad owns and runs a chemical company. There is a lot that goes into running a business. So more $=more stress. Also jus because someone makes $300K in a private practice doesnt mean thats what they make. They may put that down for tax purposes. However they may have multiple credit cards for "business" expenses, etc

I talk about that all the time. These private practice numbers have got to be skewed for the reason that you gave about business expenses.

I wonder if that's why the BLS and APMA have such a gap between their reported numbers. The BLS most likely goes off tax info, whereas the APMA is probably self-reported, where you are more likely to give the number including "business" expenses so that you look better among your peers... I could be way off, but I think I may be on to something here....

i think its the opposite of what you are saying. I think they actually make more than they are saying. You always want to report a lower income for lower taxes

Originally Posted by Hockeyfan23

i think its the opposite of what you are saying. I think they actually make more than they are saying. You always want to report a lower income for lower taxes

Yeah.... that IS what I said.... The BLS using numbers from tax info, so pods report low. The APMA probably uses self-reported numbers, so pods report higher to make themselves look better among their peers. The number they report to APMA is probably not tax-based whereas the BLS is. BLS reports like 120k APMA reports like 190k. So.......

Originally Posted by PADPM

I think that one of the greatest factors in starting salary is geographic location, and the other is the type of position accepted. As I've stated, I personally don't know any grads receiving those initial high salary offers at podiatric practices vs. institutions and orthopedic groups. As a general rule, the last 2 have deeper pockets.

Naturally, graduating a top program increases your chances of obtaining a great position, but honestly, many of these institutions or orthopedic groups may not have the knowledge regarding the quality of podiatric residency programs.

Your interview, appearance, attitude, etc., should be your greatest assests.

I spoke with a colleague the other day who was telling me about this incredible resident at his hospital. The kid apparently is the total package with great training, great skills, personality, etc. The residency program is VERY well known and respected. However, the kid wants to practice close to his family/home-town. As a result, he's accepted on offer with an older DPM who would like this young doc to build up the rearfoot/reconstructive side of the practice. I do NOT know the details of the contract, but the actually base salary was $85,000.

Yes, that seems low, but this young doc may see it as an opportunity to build a practice, own a piece of the practice and eventually own the practice,while at the same time serving his community. There are those who will say he's shortchanged himself, is crazy to take this offer, etc., but everyone has a different motivation, and initial salary isn't always the top factor.

I've stated many times on this site that if you are skilled, treat your patients well and are ethical, there is no reason why you won't make an excellent living. Additionally, although many of these grads are getting high offers initially, it's also been my experience that a few years down the line the numbers balance out among most of the grads, regardless of who they chose to work for initially.

How that person will be able to pay down his loan with that kind of salary? Even pharmacists make more than that...If podiatrists are taking that kind of salary, it's not surprising the profession is having a tough time "getting off the ground" so to speak.

Originally Posted by Temperature101

How that person will be able to pay down his loan with that kind of salary? Even pharmacists make more than that...If podiatrists are taking that kind of salary, it's not surprising the profession is having a tough time "getting off the ground" so to speak.

I have posted my personal resident experience with my own job-hunt process in the 2011 Pod Practice Survey thread, which may be of some help to you. Just to show other options.