...Lastly, I disagree that you will lose millions in income if you don't do surgery. Cancelling half day of clinic or full day clinic, to do surgery will make you lose millions over your career. Do you guys actually see your EOB to see what you ACTUALLY get paid for surgery (NOT what you billed out)?
Clinic is where the money at (except if you own or buy into a surgery center).
You can survive (and thrive) in PP if you do minimal or no surgery. Usually there is some highly shady DME, wound care, or other nonsense going on if the income of a non-surgical PP is anywhere near a surgical DPM, but yeah, you survive either way. This is considering associate vs associate, partner vs partner, owner vs owner, etc. You can even survive doing legit injections, orthotics, warts, ingrowns, and various PPMR stuff with legit billing... if you hustle and/or find an areas with good insurance payers and/or very little competition.
However,
not doing surgery rules out 95% of any MSG, ortho, hospital employed, etc job for a DPM. Those are the best employed jobs, and all of those doors unfortunately close and will not re-open if you can't get OR privileges and do surgery at the facilities. If you do manage to find an opening and desire some rural hospital or clinic that wants a pure non-surgical DPM, wound master, ortho F&A feeder non-op DPM, etc... good! At those, you almost certainly won't get compensated nearly the same as a surgical DPM would in that same hospital or group. The non-surgical podiatrist simply does not generate the overall RVU/collections/revenues (admits, OR team $, advanced imaging, pre-op testing, refers, etc etc) as the DPM peer who is regularly scheduling cases. Those didn't matter much to the PP podiatry group who only wants office collections, but they absolutely matter to the MSG/hospital/ortho who owns the imaging, surg center shares, lab, pharma, PT, etc etc. So yeah, it wastes a lot of your training and it also costs you
millions... unless perhaps you intend to do solo PP with billing that's not exactly on the up-and-up?
Does anybody think ABFAS is just one giant monopoly? If a podiatrist graduates podiatry school, meets minimum surgical volume cut offs and graduates from an accredited residency training program don't you think they should be allowed to train to maximum of their training and education?
ABFAS sets the bar ridiculously high with their poor pass rates which are not comparable to ortho or any other specialty. ...
ABFAS is not the monopoly. If they are, then every ABMS board for MD/DO is similar and "monopoly." We are one of the few specialties that even has multiple recognized boards (ABFAS and ABPM). Most MDs just have
one board for each residency type and then sub-specialty within that board as optional. Pod is also one of the few MD/DO/DDS/etc specialties that unfortunately has fake boards ("non-recognized") with a fair amount of people who try to fool hospitals/public with them. It is
no wonder they're confused... if I barely understand it, how is a Chief of Surgery, HR manager, or similar MD/DO supposed to? If you do 4yrs OB residency after MD school and don't pass the ABOG that they all take... then you re-take it; there is not some "Amer Board of Maternal Fetal Medicine" or some other wacky unregulated easy alternate.
The plain fact is that Pod schools are very minimally selective on the front end, many are fairly bad at filtering in those 4yrs and their grads.... so DPM residency and boards are left to be the gatekeepers. That is being fixed at snail's pace. It doesn't make the hospitals/boards the enemy, though... they are protecting themselves, doing a public service, and filling a niche. Are the two regulated/recognized DPM boards making a buck in the process? Not very much, actually. The test construction and validation is time consuming and expensive, and there are not nearly as many DPMs as ortho, IM, FP, GSurg, or even dent to pay to take their respective board tests each year. Bottom line: MD/DO schools filter better coming in, and they have much more standardization among residency programs (esp MD ones)... so their recognized boards will naturally have higher pass rates since most of the weeding out and protection of the public/pts/profession was done long before boards and that last year of residency or at hospitals. Podiatry? Not so much. It is what it is.
*this is NOT to say MD/DO don't still have tons of turf battles and privileging politics among themselves... we need to remember that also*
...Hell, a surgery center wants you to bring them business, they aren't going to care. Overall you will find somewhere to bring your patients to and you're going to survive if you don't make ABFAS.
Yes, I concur... but you'd rather have 90% of the hospitals and ambu centers and jobs in any given area open to you than have them closed to you. It always makes sense to try for ABFAS. It will never hurt you.
