I know text doesn't carry sarcasm well, but I really feel like if you'd read this forum at all for awhile my commentary was a comedic amalgamation of the ridiculous monster that is podiatry and her favorite forum, SDN.
You don't have to listen to people in the game describe unfortunate things they see, but consider the following - do you become optimistic when you read pie in the sky stories in the pre-pod forum? Cause that's confirmation bias. Take the good with the bad, maybe you can make something from it.
Should you continue? Most people do. Forever ago at DMU a hospital administrator explained to us that in fact we were all engaging in "sunk cost fallacy". We all of course immediately dismissed it or more likely didn't understand it, but I look back with some amusement on that lecture. Sunk cost is all over this (SDN) forum. A person looking outside of podiatry seeing nothing but opportunity should give sunk cost / AKA escalation of commitment consideration.
Its already been stated above - you have to have some degree of passion/interest etc. That's a tricky thing for this profession. The simple truth is NO ONE really understands this profession going into it unless maybe their daddy did it. I had no real appreciation of what I would be doing going into this. MDs/DOs can go in with child like wonder and then somewhat pick the thing that fits them best, maybe, if they are competitive. In podiatry its foot and ankle, no changing lines.
This is a really expensive degree. The pay-off is highly variable.
If you think I'm just some mad person then here's my thing. My life ain't bad. I like the city I live in. I either operate on my surgery day or I go home. My surgery volume has picked up a lot now that Covid is ...resolving. I'd like more rearfoot referrals, but they are picking up. I take no call except on my own surgery patients. I don't go to nursing homes. I don't get called in the middle of the night. We don't take Medicaid. I see my wife/kids every day at lunch. I'm right around the sweet spot of patient load - enough people to make money while also having the time to discuss more therapies/options etc and therefore potentially increase the visit value. I can't think of a negative reaction I've had with another physician in town. I've had worse jobs. Downsides currently. Lack of vision / leadership / management from the practice owner. We are leaving services and therefore money on the table. Probably the need to start my own practice in the next year - that's the ultimate sunk cost there - time spent working building up someone else's practice. I thought I could show them the light. Last of all, battling insurance is becoming a full time job. Looking back through my billing the other day (I shouldn't be the one doing this) I found a 11042 paid at $80 from a private insurance. Medicare pays $125. As insurance drives down the value of visits you either make less money or you see more patients. PP podiatrists only make money from the service their clinic offers unless they own additional modalities ie. labs, pharmacies, surgery centers and some of those things are scammy as hell. Your value is your collections from the surgeries you perform (and the patients will have globals afterwards), CPT in clinic (injection, nail surgeries, debridements, flexor tenotomies, etc), E&M in clinic, imaging (xrays, ultrasound), DME (orthotics, boots, braces, splints) and whatever cash, potions, laser dressings you dream up. I've explained this before but when you do an ankle fusion as a hospital doctor there is a much larger pot of money to be divided up based on the facility fee and the professional component. In PP If you want to be paid larger amounts of money you have to collect. You will have to bring in hundreds of thousands of dollars for your practice and remember that this money comes out of your patients' pocket. Food for thought.
