concerns about podiatry

[lyndamn]

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Hello 🙂

I'm really interested in podiatry. Though, I have some concerns. I've been researching more about it and I'm concerned about finding a job as a podiatrist and having enough patients per day or week.

What is the success rate?
And how patients per day do you see?
Also, is a job as a podiatrist enough to support a whole family?
Do you know any podiatrists who is having trouble financially?

In the end, no matter what you love to do... it all comes down to being able to support your family. I want to be sure it will be enough.

Any feedback would be appreciated. Thanks! 🙂

 

[PADPM]

Hello 🙂

I'm really interested in podiatry. Though, I have some concerns. I've been researching more about it and I'm concerned about finding a job as a podiatrist and having enough patients per day or week.

What is the success rate?
And how patients per day do you see?
Also, is a job as a podiatrist enough to support a whole family?
Do you know any podiatrists who is having trouble financially?

In the end, no matter what you love to do... it all comes down to being able to support your family. I want to be sure it will be enough.

Any feedback would be appreciated. Thanks! 🙂

Unfortunately your question does not have an answer. It's like asking how many customers a jeweler see daily and if a jeweler can support his family, etc. I know of very small jewelery stores that I'm sure barely scrape together a living, and I know jewelers who make millions.

Similarly, in podiatry, similar to ANY medical profession, there will be very successful practices and those not as successful. There will be practices that see few patients and those that are packed with patients.

Additionally, it's not just a matter of how many patients you treat weekly, but the type of service you are providing.

For example, I am fortunate and I'm a partner in a very large and successful practice with several offices and quite a few doctors. Some of the docs in our practice see a lot of "routine"/palliative care patients and can treat up to 65 patients daily. I treat the fewest amount of routine/palliative care patients in our practice and see a lot of new patients, probably a minimum of 7-8 daily, and treat an average of 35-45 patients daily. However, I treat more complex patients and also spend a lot of time in the hospital treating "in-patients".

Our office presently has 12 patients "in-house" for consultations or on our service and someone has to see those patients. Additionally, last night I was called in to see a patient in the ER for a bad infection and had to surgically intervene at 9 pm. Today, I had to make "rounds" on patients and had surgery in the afternoon. During that time, some of my partners were treating a LOT more patients, but I was performing surgery and seeing patients in the hospital.

So it's much more complex than simply asking how many patients you treat daily. There's a lot more to our profession than treating patients in the office for many practices.

Therefore, I'm sorry that there really is no easy answer. There are no guarantees when it comes to success in any career whether it be an accountant, lawyer, baker or candlestick maker.

However, statistically, the odds are that as a DPM you will be successful and make a better than average income which is documented in many surveys.

So first you must choose a profession that you believe will make you happy, then you must have confidence in yourself and a positive attitude and realize that the overwhelming majority of DPM's are doing very well and are successful, though there are no guarantees.

Good luck.

 

[Podophile]

If people like you, you will do well. Patients are almost incapable of judging your technical or surgical skill (unless you really mess up). But if they like you and can converse with you, they will say "Oh that Dr. So & So is a really great doctor" whether you actually are one or not. Your clinical skill could be middle of the pack or worse, and you'd still be seen as a great doctor and have the opportunity to be very successful.

If you want to make a lot of money as a doctor, take several interpersonal communication courses in college. Be nice to everyone you meet. MAKE them like you, even treat it like a game. This comes naturally to some people, but others have to put in quite a bit of practice. I've seen doctors who are total d*cks to staff and everyone around them and they seem miserable. But when that doc walks in the room, the game face goes on and the patients think that doctor really cares about them. And they come back, and they tell their friends.

Yes, you have an opportunity to make a very good living, but you'll live especially well if you can get people to like you.

 

[javajava]

Have a look at the Young Members Survey in the same sub forum a few posts down

 

[lyndamn]

Thanks everyone!
Do you know how valid this website is?

According to them, podiatrists, on average, make more than optometrists

 

[javajava]

I would trust BLS more

http://www.bls.gov/oes/current/oes291081.htm

Although the numbers collected by salaryCOM are true, im not sure if they are representative I hope they are though

 

[Creflo]

Always consider the debt repayment that goes along with the salary numbers that are out there. Also, taxes. First, taxes are deducted from salary, then loan repayment, then take what's left. Not trying to discourage you, but these things are easy to overlook when looking at podiatry salaries.

 

[347932]

First, taxes are deducted from salary, then loan repayment, then take what's left.

Not necessarily. You should find a way to take your loan payments out in pre-tax dollars if at all possible. It can be done and can save you heaps of money in the long run.

I just read that again, and I may have doubled what you wrote. If so, sorry about that.

 

[lyndamn]

Always consider the debt repayment that goes along with the salary numbers that are out there. Also, taxes. First, taxes are deducted from salary, then loan repayment, then take what's left. Not trying to discourage you, but these things are easy to overlook when looking at podiatry salaries.

Thank you for your response 🙂
Doesn't this apply to all other health professions as well? ....from being a medical doctor to an optometrist

 

[347932]

Thank you for your response 🙂
Doesn't this apply to all other health professions as well? ....from being a medical doctor to an optometrist

Yep.

 

[Creflo]

Thank you for your response 🙂
Doesn't this apply to all other health professions as well? ....from being a medical doctor to an optometrist

It does apply to other health professions, but many of the medical doctor and optometry schools are publicly supported and have much less tuition costs vs. podiatry schools.

Again, not saying podiatry is a bad deal, but I think that once practitioners actually see the real impact of taxes (not just federal, but state, local, social security, medicare, etc.) and then loan repayment, then the repayment of the accrued interest, they are often shocked at how the six figure salary can be diminished.

Good point, Kidsfeet, there are deductions out there for loan repayment, but my understanding is that this only applies to a portion of the repayment, and definitely not the full amount or even the majority amount for most practitioners. Please correct me if I am wrong, I'd like to know about the specific deduction for future use.

 

[347932]

Good point, Kidsfeet, there are deductions out there for loan repayment, but my understanding is that this only applies to a portion of the repayment, and definitely not the full amount or even the majority amount for most practitioners. Please correct me if I am wrong, I'd like to know about the specific deduction for future use.

If you take it out post tax then you can deduct a portion of it (mostly the interest) depending on how much your annual pre-tax income is. If it is "too" high, it's possible that you won't be able to deduct much. I'm not sure if student loan repayments are considered a non refundable business expense which also can be tax deducted.

That's why it MAY be wiser to work out with your employer to take it out pre-tax dollars, which will effectively lower your taxable income and then it's a truly win/win situation. Take it out pretax so you're paying in non taxed income and this also lowers your taxable income and pay less taxes. Talk to your accountant. They will be more up and up on the regs and what income is what.

 

[Feli]

Three things:

1) Diabetes isn't going anywhere (new McDonalds open all the time, and Coca Cola is a pretty successful business also). This is your "bread and butter" in podiatry surgery. It will be there always be a need for our services... diabetic foot education, footwear, wound care, recon, Charcot, etc.

2) Trauma will always be there. We live in an active society, and we drive cars, do construction, and enjoy the outdoors. While this is ortho's "bread and butter" that remains in good economy or bad, most pod surg programs also train us very very well for injuries to the foot and ankle.

3) Elective surgery and reconstruction is a bit of a "luxury," but deformities, skin lesions, heel pain, hallux valgus/rigidus, and flatfoot will stand the test of time (evolution is a slow process). While we will compete with Foot & Ankle orthos - either fellowship trained or personal interest - for these cases, we have great experience and skill in these pathologies. These are actually some of the most challenging recons (and the emphasis of my program), so they are what a lot of podiatry surgeons like to focus on. Basically, the hours are a lot better than trauma, the patients are less frustrating than diabetic or trauma, and the money is generally the best.

Rest assured, you have picked (or stumbled into?) a fantastic profession - for those who apply themselves to the fullest of their ability. I think that with the talents I was blessed with and the support network I have, I could've been good at many things, but I have basically no regrets with my choice of profession (and I'm not even making the "real money" yet). 😎

If people like you, you will do well. Patients are almost incapable of judging your technical or surgical skill (unless you really mess up). But if they like you and can converse with you, they will say "Oh that Dr. So & So is a really great doctor" whether you actually are one or not. Your clinical skill could be middle of the pack or worse, and you'd still be seen as a great doctor and have the opportunity to be very successful.

If you want to make a lot of money as a doctor, take several interpersonal communication courses in college. Be nice to everyone you meet. MAKE them like you, even treat it like a game. This comes naturally to some people, but others have to put in quite a bit of practice. I've seen doctors who are total d*cks to staff and everyone around them and they seem miserable. But when that doc walks in the room, the game face goes on and the patients think that doctor really cares about them. And they come back, and they tell their friends.

Yes, you have an opportunity to make a very good living, but you'll live especially well if you can get people to like you.

This is a good post.^ The arrogant surgeons survive by being elite in the OR, though. If you ever need big results in terms of surgery, I'd honestly pick a large ego subspecialist. They are busy, they try to save the world, and the call room at 2am is far from family. Conversely, the "nice guys" are often so nice because they would get the pants sued off them if they weren't such hand-holders. I don't see why you can't have the best of both worlds, though, and I feel religion plays a large role in that aspect... so I'd consider adding some personal growth, Sunday mornings and otherwise, to the college schedule (and beyond) 😉

 

[newankle]

I see practitioners needing to merge and form larger groups for two reasons and getting worse. Primary care docs/referrers are being captured by hospital systems and controlling who they refer to (not solo practitioners). Also with decreasing reimbursements large groups can help keep overhead lower, provide more services, and negotiate with insurers to get better reimbursements. I think these issues will become even more important in the future and the small practices an solo practitioners will suffer except in very rural areas.

 

[PADPM]

I see practitioners needing to merge and form larger groups for two reasons and getting worse. Primary care docs/referrers are being captured by hospital systems and controlling who they refer to (not solo practitioners). Also with decreasing reimbursements large groups can help keep overhead lower, provide more services, and negotiate with insurers to get better reimbursements. I think these issues will become even more important in the future and the small practices an solo practitioners will suffer except in very rural areas.

👍

 

[hoaxbuster]

Hi. I have been a podiatrist for over thirty years. It has its ups and downs and there are a lot of things that I have seen that could have gone to making for a better profession but were just glossed over. You can make a good living in podiatry without being a surgeon. I think there is to much emphasis on surgery that it is a real detraction. I was reading about the California parity issue and read a post here today that got me thinking especailly in light of what happened to podiatrists in South Carolina. A lot of us rely on income streams from a couple or regular payors and when one of them cuts us off it really hits home. I am glad that I do not practice in South Carolina. For me the independence of having a solo practice has been the best as I like to be my own boss. Some months are good others are not but that is all part of business.

 

[Feli]

I see practitioners needing to merge and form larger groups for two reasons and getting worse. Primary care docs/referrers are being captured by hospital systems and controlling who they refer to (not solo practitioners). Also with decreasing reimbursements large groups can help keep overhead lower, provide more services, and negotiate with insurers to get better reimbursements. I think these issues will become even more important in the future and the small practices an solo practitioners will suffer except in very rural areas.

I wholeheartedly agree:
The supergroup (large pod, pods + ortho, pods + vasc, limb salvage team, or even multispecialty supergroup) is the way to go... make a strong group, and swallow up solo practitioners (or buy folded/retired practices and plug in associates/partners) as you grow. There's no question about it. Medicine is rapidly evolving. Then, once the group is formed, it's up to the group to negotiate their buyout with the hospital systems, who will control all the patients. As a prime example, the West Penn guys were waaay ahead of their time on this: build a helluva private practice, then become hospital employees and ride off into the $un$et (yet the love their job and teaching, leading the profession, etc... so they stay around as clinicians). Weil group and other DPM mega-practices will probably sell out eventually also... everyone has their price.

...Right now, we have rural solo startup, pod private prac, hospital employee, VA, multispec, ortho, etc career options. In 20yrs, there will basically only be a couple real career options in my eyes:
-hospital (aka govt) employee
-concierge medicine (cater to those who don't want to wait for overworked + underpaid docs offering 5min appointments)
-industry R&D (not really an option for most ppl)

Basically, with exceedingly few exceptions, everyone will eventually have a VA-type physician job... or go concierge. JMO

 

[fivescrew]

Let me see if I can ask this right....

I have ZERO business sense and even less in the area of marketing myself. It's a main reason I'm switching careers. Is there room\opportunities in podiatry for people willing to trade potential big bucks for decent paying, stable jobs?


You mentioned the VA. I'm really interested in a job with veterans and between the degrees I'm looking at(DPM, Aud.D. and now DPT) it certainly seems the jobs are there but is it still a safe way to go or do you foresee those jobs disappearing one day as well?

 

[lyndamn]

I wholeheartedly agree:
The supergroup (large pod, pods + ortho, pods + vasc, limb salvage team, or even multispecialty supergroup) is the way to go... make a strong group, and swallow up solo practitioners (or buy folded/retired practices and plug in associates/partners) as you grow. There's no question about it. Medicine is rapidly evolving. Then, once the group is formed, it's up to the group to negotiate their buyout with the hospital systems, who will control all the patients. As a prime example, the West Penn guys were waaay ahead of their time on this: build a helluva private practice, then become hospital employees and ride off into the $un$et (yet the love their job and teaching, leading the profession, etc... so they stay around as clinicians). Weil group and other DPM mega-practices will probably sell out eventually also... everyone has their price.

...Right now, we have rural solo startup, pod private prac, hospital employee, VA, multispec, ortho, etc career options. In 20yrs, there will basically only be a couple real career options in my eyes:
-hospital (aka govt) employee
-concierge medicine (cater to those who don't want to wait for overworked + underpaid docs offering 5min appointments)
-industry R&D (not really an option for most ppl)

Basically, with exceedingly few exceptions, everyone will eventually have a VA-type physician job... or go concierge. JMO

Thanks for the business perspective of podiatry 🙂 It got me thinking though... and maybe I'm thinking way too in the future... but how do you go about forming such a large group like the one you described? Some people may not have the connections. And how do you know where to locate?

 

[javajava]

Is it hard getting a position as a hospital staff

are they decently compensated as government workers tend to be paid lower than their private practice counterparts

 

[hoaxbuster]

Is it hard getting a position as a hospital staff

are they decently compensated as government workers tend to be paid lower than their private practice counterparts

Go to the phone book and look up podiatrists. Be polite, tell the office staff person who answers that you are a student and that you would like to ask the doctor a few questions. Set a goal, maybe five or ten podiatrists and ask them the same questions you posted. Tell us what you discover.

 

[PodunkUDPM]

Go to the phone book and look up podiatrists. Be polite, tell the office staff person who answers that you are a student and that you would like to ask the doctor a few questions. Set a goal, maybe five or ten podiatrists and ask them the same questions you posted. Tell us what you discover.

Can you give me a quick recap of what happened in South Carolina please? I missed the news and would appreciate it. Thank you.

 

[Podfather]

Can you give me a quick recap of what happened in South Carolina please? I missed the news and would appreciate it. Thank you.

Because of the economic problems in many states they are making budget cuts. One place many look is Medicaid. South Carolina recently dropped "podiatry services" and I believe chiropractic, some dental, and optometry. They did this in Texas several years ago and realized it actually cost them more and re-added Podiatry.

Some states never included Podiatry. In my area very few doctors participate in Medicaid. I do but the majority of my colleagues, because of the reimbursement, do not . If Medicaid were dropped it would affect very few. I do agree that we need to be a bit concerned with this behavior not because of Medicaid but rather we do not want to see this trend as healthcare changes develop. Not time to panic but as with anything political we need to be proactive and keep our eyes open.