How does the fact that people are living longer and there is an increase population in the future, etc. weigh in this?
It seems that adding new schools is definitely not beneficial to the field in general, but won't the demand for podiatrists increase just based on an increase in older populations, and arguably less healthy populations, in the (near) future? I feel like some of the saturation will be mitigated?
Youre right on 0 of 2... a third idea is the only semi-legit argument for more pod schools / more DPM demand:
-the overall USA population is not going up, will soon be going down
-overall older populations and life expectancy is not going up
...(unhealthy + die younger cancels out older "healthy")... and overall life expectancy actually down with pandemic
-diabetic/obese is rising as a % of overall USA population
Most first world countries have
negative population growth with better use of birth control and other social factors. USA is on the tipping point... still technically tiny "growth" on census due to a good amount of immigration, but birth rates decline, just like every first world country. "Growth" for USA is record lows and will soon be negative.
People are living a
bit longer, bit that's only some of them. Some die much sooner due to unhealthy lifestyle and/or COVID, etc. The few who are age 90, 95 100, etc are uncommon and not as significant as you think in actual overall stats. Many of them are not living at home either. Modern medicine and nutrition/exercise knowledge are canceled out by obesity almost as fast. As mentioned above, the vaaast majority of seniors who have transportation and who you see in a podiatry office will be toenail, callus, arthritis care... nothing operative. It's all fine and good, and it still makes money and helps them, but many have lower activity, suspect bloodflow, etc where and procedure or surgery options are limited or zero (assuming the doc is conscientious). Basically, if I see 80yo new patient for "bunion" on my list, I'm not thinking surgery.... greater than 50/50 they will just get a bunion pad, perhaps an Xray if they wish... and 80% they'll also request toenail care.
🙂
...Our American love of over-eating, for better or worse, has been the only real boon to podiatry demand. We are the country that invented fast food and could probably turn Lionel Messi or Adriana Lima or Roger Federer or Bruce Lee into soft 300lb beasts given enough time. It's well-documented that Asians and their kids from low BMI countries tend to get high BMI when they come here. So, there is podiatry work on diabetic foot exams and cutting toenails due to Dunlap disease, but those are elementary skills a podiatry student learns within a couple months of 3rd year clinics.
🙁
If you're ethical, large and unhealthy folks are almost invariably not good elective surgical candidates, though. There will always be morbidly obese who need wound care or a toe amp... that demographic has steadily gone up a bit. I don't typically try to cash in off that at work. You will find DPMs doing lateral ankle work on 400lb Tiny Tiffany just like a few questionable Orthos do 3 three ACL jobs on her. Some DPMs will undertake hero Charcot nail + frame work and refuse to just cast on Bob BBQ who is a 300lb diabetic with A1c of 12% and stands 5'6" tall. The elective and semi-elective work is
hiiighly suspect at best on the BMI 30, 35, 40+ set... especially diabetics with poor control. Some of it might be a function of poor training, some of it might be DPMs just wanting to do procedures or get paid... I really don't know. It often makes us all look bad. But, again, it's not unique to podiatry... it's seen in other specialties also: procedure$ clearly destined for a collision with the ol' iceberg.
Aging gets hopeless after a point also. American medicine will make you upset at times with a 90 year old (or 75yr old dialysis) patient with zero chance getting 4 revasc cath attempts, toe amp that predictably fails, more revasc... when the proper thing was simply betadine the toe, ultrasound, maaaybe one cath, and more betadine until BKA. Medicine, especially hospital medicine, loves to bankrupt patients, family, and taxpayers on clearly lost causes. Quite lame.
The infection and injury diabetic foot stuff will find you and it needs to be done well, but it's generally simple and NOT glamorous (hence MDs happily getting rid of it). Personally, to capitalize best and quickly on diabetes increasing, I just buy a lot of NVO shares. 😇
...these are the
COMMON myths that one may encounter regarding podiatry - or any medical profession:
- people are living longer (false)
- population is increasing (false)
- diabetes is on the rise (true, but not a panacea... and also fairly undesirable work)
- USA has an active population (yes, some are... but that has been roughly the same size for decades... for every hardcore cross-fitter or IG model, there are probably 3 chubby videogamers)
It's fine to consider these things, but don't just take them at face value. Look up "United States life expectancy by year" and "United States population growth by year" and "first world nations population growth" and other stuff.