The Canadian Podiatrist and American Podiatrist Some Distinctions

[javajava]

Although both may have similar training under an identical model of education, it seems that canadian and american podiatrists are not the same.

For example, podiatrists only get full practice rights in a few provinces of Canada whereas american podiatrists get full practice rights and etc.

As well, another note worthy issue is compensation. I am a Canadian BC resident and our provincial government produces annual reports called `MSC financial reports' which openly displays compensation for various physcians of varying specialties for all of BC. When you look up practitioners of podiatric medicine there is a large disparity in their income relative to other physicians. It seems majority of podiatrists in BC (where they have equivilent practice rights as their american counterparts) make much less than a hundred thousand, even seventy thousand!
My question is why is there such a disparity in income between podiatrists in Canada vs America, especially in provinces where they are given full practice rights? I know some may say that "these pods have little to no surgical residency, thus smaller compensation", or "the extent of our training is much better than theirs as they got their DPM three decades ago". I am not sure as to the recency of their training, as I do not want to go through each podiatrists website. Is there a novel reason as to why this is the case?

This concerns me as I was interested in coming back to canada after completing a degree in podiatric medicine in america, as I've grown to love my city. However the income rates make it seem impossible to pay off student loans (ESP for International students!!).

So what is your take on this. Do you see any changes that may lead american and canadian podiatrists to be one and the same at all levels. Or is getting a degree in podiatry a one way ticket for a canadian to establish himself in only america.




PS. Here are the resources I used to come to my conclusions,

Map of Podiatrists in vancouver BC
http://maps.google.ca/maps?client=firefox-a&rls=org.mozilla:en-USfficial&channel=s&hl=en&q=podiatrists%20vancouver%20BC&um=1&ie=UTF-8&sa=N&tab=wl

MSC financial statements for all healthcare providers in BC
http://www.health.gov.bc.ca/msp/financial_statement.html

Money isn't a drive, but comfortable living is on my mind.

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[347932]

I've addressed this issue in various other threads and posts so feel free to look around a bit.

As far as "compensation", in BC there is a very small cap that the provincial gov't imposes for the provincial health care system to pay for podiatry services. Realistically, the need for podiatry services is great, but the population is not used to paying for services out of pocket, so they balk at anything like that. Once the system has capped out (I think it's $400 per year for podiatry services per resident, and that generally excludes orthotics), anything else is out of pocket. Some of population does have private insurance, which is becoming more and more common, but even some of those excluded podiatry services like custom orthotics. It's cash and carry, which can be VERY lucrative if you know what you're doing.

Even the surgically trained Pods in BC have trouble because the layman would prefer to have the system pay for surgery, so they go to the Orthopod down the street.

As I've mentioned in other threads, many pods make a very good living dispensing custom orthotics and doing forefoot surgery in their offices. You have to be a savvy business person to really succeed and almost have a salesman type attitude up there. It's doable but takes a lot of work.

I know a couple of Pods in the BC area so if you want more info, please PM me.

Also look here: http://foothealth.ca/

 

[Shireiqiang]

I personally know a few podiatrists in Alberta that make a very good living (+500k/year). These pods will do surgery usually one day a week. The bulk of their practices are in orthoses and wound care. I am sure that there are also podiatrist in Alberta that are making less than 100k/year, I know 500k is an exception, not the rule. I don't think the insurance issue is as big an issue as some may make it seem to be. BC and Alberta have similar scope of practice and insurance. I would definately talk to some podiatrists in your area.

 

[347932]

I personally know a few podiatrists in Alberta that make a very good living (+500k/year). These pods will do surgery usually one day a week. The bulk of their practices are in orthoses and wound care. I am sure that there are also podiatrist in Alberta that are making less than 100k/year, I know 500k is an exception, not the rule. I don't think the insurance issue is as big an issue as some may make it seem to be. BC and Alberta have similar scope of practice and insurance. I would definately talk to some podiatrists in your area.

I hate to tell you this, but they are trying to wow you with numbers. There are no podiatrists in Alberta grossing $500K. Believe me.

Sorry to disagree again, but insurance is very much an issue. Surgery by Orthop is covered by the national health care system . Cash pay for podiatry mostly. It is a huge issue.

 

[Shireiqiang]

The two podiatrists are family friends. I feel confident in their numbers. The purpose of my post is to state the fact that podiatrists can do well in BC or Alberta regardless of the insurance issue. By the way, a lot of Canadians are used to paying out of pocket fees for health care. When was the last time the government paid for routine oral care, or eye care? The Orthop issue is another topic.

 

[javajava]

So in a small nutshell, the chance for a Canadian podiatrist to do as well as his american counterpart is not that high, with a majority of 'vancouver podiatrists' doing seventy or below, however there a few 'he said she said' anecdotal stories to prove this wrong. As well, it seems podiatry is currently only a american 'thing' and not so much a canadian 'thing'. However they could be the same if insurance companies reimburse equivalently.

 

[347932]

So in a small nutshell, the chance for a Canadian podiatrist to do as well as his american counterpart is not that high, with a majority of 'vancouver podiatrists' doing seventy or below, however there a few 'he said she said' anecdotal stories to prove this wrong. As well, it seems podiatry is currently only a american 'thing' and not so much a canadian 'thing'. However they could be the same if insurance companies reimburse equivalently.

Not really no. You can make very good money if you know how. It's a business thing. Some say Canada is a BETTER place to make money since it's cash and carry, but not many Doctors are also good in the business world, which is also how it is in the USA. The methods are different. Many Canadians who do well sell a lot orthotics which at $400-$500 a pop can amount to a nice bundle. They also know how to sell themselves as surgeons and with good training, getting $1000 cash to do a hammertoe is not too shabby. You do 3 a month and there's a part of your overhead if you run a small, efficient operation.

 

[347932]

The two podiatrists are family friends. I feel confident in their numbers. The purpose of my post is to state the fact that podiatrists can do well in BC or Alberta regardless of the insurance issue. By the way, a lot of Canadians are used to paying out of pocket fees for health care. When was the last time the government paid for routine oral care, or eye care? The Orthop issue is another topic.

All is not what it seems sometimes. I was offered a job by a large group in Edmonton who professed to making that kind of money. The offered contract was nothing like what they told me it would be, and when I took a hard look at their numbers, none of them came even close to what they had initially told me they were bringing in. Be wary of creative accounting. It can make anything look great. I'm not doubting you. I'm just putting it out there.

Also, the Ortho issue up there is THE topic, unfortunately.

 

[javajava]

Not really no. You can make very good money if you know how. It's a business thing. Some say Canada is a BETTER place to make money since it's cash and carry, but not many Doctors are also good in the business world, which is also how it is in the USA. The methods are different. Many Canadians who do well sell a lot orthotics which at $400-$500 a pop can amount to a nice bundle. They also know how to sell themselves as surgeons and with good training, getting $1000 cash to do a hammertoe is not too shabby. You do 3 a month and there's a part of your overhead if you run a small, efficient operation.

I suppose its a toss up, with business skills being a important factor on what you land, heads or tails. However the compensation listing for each podiatrist by name in the MSC financial statement is still a scary factor for me.

 

[347932]

I suppose its a toss up, with business skills being a important factor on what you land, heads or tails. However the compensation listing for each podiatrist by name in the MSC financial statement is still a scary factor for me.

Isn't MSC from money just given by the provincial gov't for services? So since most money from Podiatric Services are either private pay or cash, it would stand to reason that the MSC value would be low for Podiatrists.

Also, the two podiatrists I know there are not on this master list. What does that mean?

 

[javajava]

I see I see, I was curious as to whether this included everything. Thanks Kidsfeet, I understand the limitations of this list, and thanks for answering my question.

 

[Shireiqiang]

Kidsfeet, I think I may know the Edmonton group you are talking about. Either way I see your point. Have you practiced in both countries? If so which did you like better?

 

[347932]

Kidsfeet, I think I may know the Edmonton group you are talking about. Either way I see your point. Have you practiced in both countries? If so which did you like better?

I have not practiced in Canada. I spent a lot of time researching practice in Canada and just couldn't justify returning there and not making use of the training I had. Many of my colleagues I know who returned to Canada either didn't have any residency training or trained at the BC program.

One thing that's VERY interesting is the scope of practice in the document that you can find within the link I posted above to Podiatry in BC. Also, it's very interesting how much power that the people who drafted this document have in letting people practice in BC and how these people they "let in" have to practice in that province. Basically, only foot surgery with no surgical treatment of any ankle structures. Also the "Board" can decide whether you can practice on your own, or if you have to work under another podiatrist until this "Board" decides you have enough experience. Interesting way to foster cohesion within a profession.

Read this thread too:http://forums.studentdoctor.net/showthread.php?t=798417

 

[darazon]

A lot of the podiatrist I knew in Alberta were doing well. The problem that I have with a lot of them is that they push the orthotics on everyone who comes through their door (not all of them though).

One pod in particular I know makes a TON of money (he bought a million dollar yacht). He also owns a lot of the clinics in Alberta, so he is employing a lot of other pods. I looked up his reviews one time from ratemydoctor.com and they all complained about the same thing -pushing orthotics.

There are a few in AB and BC who have hospital privileges (Haverstock, Kalla, Humble), but not very many.

It really makes it hard to decide to come back to Canada or not.

Kidsfeet; How hard was it to get a job after residency in the US?

Shireiqiang; How's school going? What are you thinking, go home or stay here after your done?

 

[Shireiqiang]

School is good, thanks for asking. I really have no clue what I am going to do. It really comes down to what type of residency I end up with. If I get a very surgically based residency it will be hard to go home and risk not getting to put that knowledge into practice. I think it would be especially hard to be able to fix patients problems and have to say to them "I have been trained to do this, but you have to go see Joe orthopod because I'm not legally able to do this type of surgery." What about you? I have my US status so I can work down here, so that option is definately there.

 

[darazon]

Not sure yet. It sits about a 50/50 chance either way. I'm trying to keep all options open. Dr. Harkless knows a lot of the surgical podiatrists in Calgary and Vancouver and I might visit them in the hospitals during my 4th year.

I feel the same way as you. I don't want to feel "over-qualified" for my entire professional career. I've often thought that perhaps I could help change things for the better -but as Kidsfeet has alluded to, that is an uphill battle.

 

[347932]

"I have been trained to do this, but you have to go see Joe orthopod because I'm not legally able to do this type of surgery."

One of my mentors in Canada says EXACTLY this when something he can't correct in his office comes in.

 

[347932]

Finding a job is not difficult at all. Finding a job that you feel is rewarding and see yourself growing in and with is an extreme challenge. Don't look for a "job". Look for a place that makes you feel like you're not working at all.

 

[347932]

I feel the same way as you. I don't want to feel "over-qualified" for my entire professional career. I've often thought that perhaps I could help change things for the better -but as Kidsfeet has alluded to, that is an uphill battle.

Follow your gut. If it tells you to go back to Canada and be "that guy/gal", the uphill battle won't seem so steep. I just couldn't do it. My gut called me elsewhere.

 

[Skippygonenuts]

What kind of process does it take to practice in the US if you went to school in Canada or vice versa?

And can a US student go to a Canadian pod school and come back to the US for residency/practice?

 

[Skippygonenuts]

What kind of process does it take to practice in the US if you went to school in Canada or vice versa?

And can a US student go to a Canadian pod school and come back to the US for residency/practice?

After looking up Canadian schools and seeing that there is only ONE pod school in all of Canada, I realize my question might just be pointless.

 

[347932]

What kind of process does it take to practice in the US if you went to school in Canada or vice versa?

And can a US student go to a Canadian pod school and come back to the US for residency/practice?

The school in Canada is not CPME approved and is not 4 years, so getting a residency in the US is not likely to happen.

 

[Skippygonenuts]

The school in Canada is not CPME approved and is not 4 years, so getting a residency in the US is not likely to happen.

Not to mention that their entire website is in french (i think that's french at least)...so the lectures are probably all spoken that way too..

a little discouraging to american students

 

[347932]

Not to mention that their entire website is in french (i think that's french at least)...so the lectures are probably all spoken that way too..

a little discouraging to american students

Indeed that is the case. Tu ne parle pas francais?

 

[CanPodStudent]

I am currently studying at the podiatric school in Canada and yes most of our classes are in french, but we still have classes with NYCPM (around 10). The program is 4 years long not 3(195 credits). If we want to do a residency, we have to do again our 4th year at NYCPM to get the american DPM. The residency is not an obligation in the province of Quebec, which explains why there is only 2-3 students per years that make the choice to go to NYCPM after obtaining the canadian DPM. One thing that is really nice in canada is that the tuition are really low ( around 3800 per year compared to 30 000 in USA). We also have small class size like the school in arizona (25 students per year).

 

[347932]

I am currently studying at the podiatric school in Canada and yes most of our classes are in french, but we still have classes with NYCPM (around 10). The program is 4 years long not 3(195 credits). If we want to do a residency, we have to do again our 4th year at NYCPM to get the american DPM. The residency is not an obligation in the province of Quebec, which explains why there is only 2-3 students per years that make the choice to go to NYCPM after obtaining the canadian DPM. One thing that is really nice in canada is that the tuition are really low ( around 3800 per year compared to 30 000 in USA). We also have small class size like the school in arizona (25 students per year).

Excellent. Thank you for the update. What is the reason they ask you to repeat the 4th year?

What is the status of Podiatrist in Quebec as far as being allowed to prescribe antibiotics and narcotics? Last I checked, they were still not allowed to do so. Have there been any changes?

I know some of the Pods in Quebec. PM if you ever want to chat!

 

[CanPodStudent]

I sent you a pm

 

[CanPodStudent]

have you actually received my PM? because when i look up in sent items, it says that i haven't sent anything.... but I did twice -.-

 

[347932]

I received them. Just been super busy.

 

[darazon]

Kidsfeet, I have a kind of odd question for you.

Lets say that when I finished school and residency, I went and obtained a DO degree. Can I practice full scope, prescribe narcotics, etc etc in Canada (Alberta specifically) and get fully reimbursed by Alberta Health Care? And can I do it without a DO residency?

 

[347932]

Kidsfeet, I have a kind of odd question for you.

Lets say that when I finished school and residency, I went and obtained a DO degree. Can I practice full scope, prescribe narcotics, etc etc in Canada (Alberta specifically) and get fully reimbursed by Alberta Health Care? And can I do it without a DO residency?

I haven't a clue. Not sure there are DOs in Canada like they have in the USA. I really don't know though and couldn't even tell you where to begin researching that.

 

[Shireiqiang]

Does anyone have official information on the scope of practice in alberta for podiatrists? Also, what is covered by alberta health care or other common insurance policies?

 

[347932]

Look here.

http://www.albertapodiatry.com/

Google is really a wonderful tool!

 

[Shireiqiang]

Thanks Kidsfeet, I had seen this website before. It doesn't have specifics for either of my questions? What about this google site? what is that? Come on Kids you're better than that.

 

[347932]

Thanks Kidsfeet, I had seen this website before. It doesn't have specifics for either of my questions? What about this google site? what is that? Come on Kids you're better than that.

My point was, with a few mintues to spare, google is an invaluable tool when looking for just about anything. There should a few numbers to call on that alberta website I linked, or do a google search for podiatrists in Alberta and call them and ask them directly. There is nothing like first hand information from the source. They would be a lot more help to you than anyone who doesn't practice in that region.

Call the big group in Edmonton, I think their name is The Foot and Ankle Institute or something or other. If Mark is still there as their administrator, he may be able to answer all your questions.

I'm trying to make YOU better.

 

[Shireiqiang]

Good call Kids, I totally agree that calling would be a good idea. Thanks for looking out for me.

 

[Abyss123]

Does anyone know if we can practice in the states if we went to school in the states but did a residency in Canada?

 

[dpmgrad]

Does anyone know if we can practice in the states if we went to school in the states but did a residency in Canada?

Majority of states in the US require at least 1 year of residency training from a CPME approved residency program (there are exceptions for those older DPMs that did preceptorships) in order to obtain a license to practice in that state. To my knowledge, there was only one CPME approved residency program in Vancouver, BC in the past. I am not sure if that residency program even exists and if it does exist, it is no longer CPME approved. However, if you did complete the training at Vancouver General Hospital when it was CPME approved, you should be able to practice in the states.