My DPM shadowing experience and my concern for the field, help answer please

[YeastyMan]

Hi all,

So I shadowed my first POD doctor today.
He owns a private practice for over 30 years at a city south of 1 million people.
The shadowing experience was great, I saw toe amputation, and multiple surgeries.

However, when I talked to him about the profession, he strongly recommend me to pursue MD/ DO for the following reasons
1) He doesn't make as much as people think, probably 150 k after tax, rent, staffs, and material cost. (He drives a pretty crappy car...)
2) He has to hustle A LOT. He heavily relies on new patients and referral systems from a near by hospital. He kept repeating that he doesn't feel like he's part of the MD/ DO club
3) The field of practice seems limited.
4) Sometimes, he gets only 1 or 2 patients a day
5) In order to have steady streams of patients in the podiatry field, you need to be located by a hospital or work for the hospital.

I'm probably going to shadow him for a few more days. He has more surgeries coming up.
Could someone please address the concerns I have raised?
Is podiatry a viable profession? It doesn't seem to be a lot of bang for the buck, and podiatry doctors seem to have to hustle a lot.
Also, if anyone has any questions, I'll be happy to relay the questions to him.

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[PsychPod]

I would say 150k gross isn't too bad. It sounds like he is working a general 40 hours a week maybe less.

In private practice, its more about being a bad-a business man as well as an awesome doctor.
What the demographics of the city? How big? How many other pods in the city? How old is the doctor and how is his business skills (aka website/marketing techniques/loyalty programs/referral systems/etc).

I'm only asking so much because I shadowed a pod in a town of about 50k.
There is only one other podiatrist, and the pod was very involved in community (hs football games, soccer games, local minor league baseball team, etc)
I don't know the dollar amount he makes a year but he drives a BMW 335i 2014, and is probably late 30's.
So it definitely depends on location, business acumen, etc.

MD/DO is definitely a good route to go, but I feel like there is a closer resemblance to DDS than to either of those two. I would suggest you shadow a dentist as well as a podiatrist before making your decision which way you want to apply!

 

[YeastyMan]

The district is south of 1 million people.
I don't want to reveal the exact location for confidentiality reason.
There are many private pods in the city though.
The doctor is around 50-60 years old, with pretty good business skills.
I know that his schedule is a bit unpredictable at times, sometimes he get off early (1pm) sometimes he stays in the practice pretty late.
He told me that he worked during July 4th weekend, so I'm sure that his work load is north of 40 hours...

Also, he actually showed me three paychecks he received today, and the amount is around 2-4 hundred bucks.... That's not a lot of bang for the buck if you ask me

 

[FootAndAnkle]

Hi all,

So I shadowed my first POD doctor today.
He owns a private practice for over 30 years.
The shadowing experience was great, I saw toe amputation, and multiple surgeries.

However, when I talked to him about the profession, he strongly recommend me to pursue MD/ DO for the following reasons
1) He doesn't make as much as people think, probably 150 k after tax, rent, staffs, and material cost. (He drives a pretty crappy car...)
2) He has to hustle A LOT. He heavily relies on new patients and referral systems from a near by hospital. He kept repeating that he doesn't feel like he's part of the MD/ DO club
3) The field of practice seems limited.
4) Sometimes, he gets only 1 or 2 patients a day
5) In order to have steady streams of patients in the podiatry field, you need to be located by a hospital or work for the hospital.

I'm probably going to shadow him for a few more days. He has more surgeries coming up.
Could someone please address the concerns I have raised?
Is podiatry a viable profession? It doesn't seem to be a lot of bang for the buck, and podiatry doctors seem to have to hustle a lot.
Also, if anyone has any questions, I'll be happy to relay the questions to him.

One thing you may want to keep in mind about this podiatrist is that because he has owned his own practice for over 30 years, he was starting to practice, it was when podiatry (and medicine in general) was where you could make money hand over fist if you employed the proper business tactics, when insurance still paid well and wasn't as much a ball-and-chain companion, and medicine was more fun. Since then, things have only gotten worse for physicians (though treatments have continued to advance), with the work becoming more onerous and monitored while reimbursements decreased. Because money doesn't come as easily as back then, he may have some frustration about this, especially if his business practices have been unable to increase his practice revenue sufficiently to offset the declining environment. I don't think this is going to be something avoided by other physicians, rather just 'padded' a bit more for those in high paying specialties (that being said, I know a podiatrist who made more than anesthesiologists usually do before he retired, so your specialty doesn't always lock in your level of income). If you check out this thread, you will find a link in one of the posts to 2012 MGMA salaries for specialists, including podiatrists, so that may give you a better idea of income distribution.

The field of practice is limited by definition, so that part is true.

As a D.P.M., it's also true you're not part of the M.D./D.O. "club" as far as having an unrestricted license and you may sometimes encounter physicians who do not respect/do not know about podiatrists, but the ones who have worked alongside them usually are quite pleased with the profession and respect our area of expertise. If podiatrists end up having unrestricted licenses in the future (which I personally think they should have by now, but would be difficult to achieve), I think any perceived inequality will be reduced to the level of M.D. vs. D.O., which is largely petty (though frustrating for many due to postgraduate training issues).

Many podiatry offices are fast-paced, but this is also not unique to the field. I know physicians from primary care to dermatology that run things very quickly - remember physicians sacrifice a lot of time and money for their training and licensure so why wouldn't they maximize their ROI by working efficiently and using smart business practices?

Final note - the podiatrist you are shadowing may be nearing retirement, may not have been as motivated, or may not be employing the best business/marketing strategies, which could thus leave him with a subpar practice. I shadowed a podiatrist like this once (soon retiring and not as interested any more), but thankfully he recognized this and directed me to other more engaged practices. Perhaps you could look for another shadowing experience to help fill out what may be missing from the perspective of the podiatrist you are shadowing?

 

[PsychPod]

I'll be honest it sounds like it may be in an oversaturated area and the pod is growing old.
You may see good business skills, but there's a good chance there isn't.
Walk in next time, and ask yourself if you would choose this place to be your Dr. See what marketing techniques he is using, see if he is truly enjoyable to interact with. Like the above poster, it sounds like he isn't really doing as much as he could and may be easily approaching retirement or may just be a "settler" and doesn't want much more.

It also comes down to what state you're in, the attitude of the doc, etc. Don't be scared off of podiatry due to one podiatrist which isn't doing as well as you hoped.
Look up ortho practices with a DPM on board and ask to shadow him.
Then look up multi-pod clinics and ask if you could shadow an entire day with them, etc.

Like I said, with pod school you're learning a skill set and getting a license to do something very specific that others can't.
How you use those skills, market those skills, means everything.

Example:
- Instead of just getting referrals ONLY from the local hospital, he should also be in contact with all the local GP's, gyms, nutrition experts and even chiropractors. That way when those people have customer's who have foot/ankle problems, they can be directed over to his clinic. And he can do the same for his patients who are suffering from mal-nutrition/back-pain/general medical needs. The more broad you can expand your referral system the more people you treat. Offer free services for the local high school football team (i.e. be on the sidelines doings tapings/helping with sprains/etc) and you'll meet the parents of the players and normal fans. Same goes with offering discount services to people who use a certain gym (maybe get intimate with a Crossfit gym where high impact olympics lifts can do a lot of damage of the feet). It's a lot about what you're doing to get your name out there. A.k.a being the go-to "foot and ankle guy" in your town.

I guess that's the way my mind works being an Interdisciplinary Studies major (Bio-Business). Entrepreneurial at heart haha.

 

[YeastyMan]

One thing you may want to keep in mind about this podiatrist is that because he has owned his own practice for over 30 years, he was starting to practice, it was when podiatry (and medicine in general) was where you could make money hand over fist if you employed the proper business tactics, when insurance still paid well and wasn't as much a ball-and-chain companion, and medicine was more fun. Since then, things have only gotten worse for physicians (though treatments have continued to advance), with the work becoming more onerous and monitored while reimbursements decreased. Because money doesn't come as easily as back then, he may have some frustration about this, especially if his business practices have been unable to increase his practice revenue sufficiently to offset the declining environment. I don't think this is going to be something avoided by other physicians, rather just 'padded' a bit more for those in high paying specialties (that being said, I know a podiatrist who made more than anesthesiologists usually do before he retired, so your specialty doesn't always lock in your level of income). If you check out this thread, you will find a link in one of the posts to 2012 MGMA salaries for specialists, including podiatrists, so that may give you a better idea of income distribution.

The field of practice is limited by definition, so that part is true.

As a D.P.M., it's also true you're not part of the M.D./D.O. "club" as far as having an unrestricted license and you may sometimes encounter physicians who do not respect/do not know about podiatrists, but the ones who have worked alongside them usually are quite pleased with the profession and respect our area of expertise. If podiatrists end up having unrestricted licenses in the future (which I personally think they should have by now, but would be difficult to achieve), I think any perceived inequality will be reduced to the level of M.D. vs. D.O., which is largely petty (though frustrating for many due to postgraduate training issues).

Many podiatry offices are fast-paced, but this is also not unique to the field. I know physicians from primary care to dermatology that run things very quickly - remember physicians sacrifice a lot of time and money for their training and licensure so why wouldn't they maximize their ROI by working efficiently and using smart business practices?

Final note - the podiatrist you are shadowing may be nearing retirement, may not have been as motivated, or may not be employing the best business/marketing strategies, which could thus leave him with a subpar practice. I shadowed a podiatrist like this once (soon retiring and not as interested any more), but thankfully he recognized this and directed me to other more engaged practices. Perhaps you could look for another shadowing experience to help fill out what may be missing from the perspective of the podiatrist you are shadowing?

You're probably right about the nearing retirement part.
That is why I am shadowing another DPM doctor tomorrow.

 

[PsychPod]

You're probably right about the nearing retirement part.
That is why I am shadowing another DPM doctor tomorrow.

Good luck brah. Let us know how it goes!

 

[YeastyMan]

I'll be honest it sounds like it may be in an oversaturated area and the pod is growing old.
You may see good business skills, but there's a good chance there isn't.
Walk in next time, and ask yourself if you would choose this place to be your Dr. See what marketing techniques he is using, see if he is truly enjoyable to interact with. Like the above poster, it sounds like he isn't really doing as much as he could and may be easily approaching retirement or may just be a "settler" and doesn't want much more.

It also comes down to what state you're in, the attitude of the doc, etc. Don't be scared off of podiatry due to one podiatrist which isn't doing as well as you hoped.
Look up ortho practices with a DPM on board and ask to shadow him.
Then look up multi-pod clinics and ask if you could shadow an entire day with them, etc.

Like I said, with pod school you're learning a skill set and getting a license to do something very specific that others can't.
How you use those skills, market those skills, means everything.

Example:
- Instead of just getting referrals ONLY from the local hospital, he should also be in contact with all the local GP's, gyms, nutrition experts and even chiropractors. That way when those people have customer's who have foot/ankle problems, they can be directed over to his clinic. And he can do the same for his patients who are suffering from mal-nutrition/back-pain/general medical needs. The more broad you can expand your referral system the more people you treat. Offer free services for the local high school football team (i.e. be on the sidelines doings tapings/helping with sprains/etc) and you'll meet the parents of the players and normal fans. Same goes with offering discount services to people who use a certain gym (maybe get intimate with a Crossfit gym where high impact olympics lifts can do a lot of damage of the feet). It's a lot about what you're doing to get your name out there. A.k.a being the go-to "foot and ankle guy" in your town.

I guess that's the way my mind works being an Interdisciplinary Studies major (Bio-Business). Entrepreneurial at heart haha.

I love your entrepreneurial spirit!!
I'm going to give podiatry another go after I shadow another DPM tomorrow. I'll update you guys on my experience.