Debt

[whiskers]

I want to advise each of you to be very careful with education debt. As of September approximately 10% of borrowerd were in default on their federal education debt.

Podiatry in my opinion can be a huge risk and if mannaged incorrectly can lead to a ruined life and poverty.

Do your research on % of those who start pod school who get kicked out, starting incomes, job opportunities and understand that your only option may be depending on yourself to start your own practice and if you are 300k in debt when you finish residency, who is going to lend you 150k to start your own practice?

better yet, guess what, even if you get the loan, you have no guarantee that patients will flock to your office at 40/week.

I highly recommend that each pod student anticipate that they will not find a job and be willing to start from scratch.

Good luck.

 

[jonwill]

I highly recommend that each pod student anticipate that they will not find a job and be willing to start from scratch.
Good luck.

I agree that each student should be careful with debt. Especially in today's economy. However, you are a bit off on your assessment above. The majority of residency graduates go in with either a multispecialty, ortho, hospital, or existing podiatry group.

Out of the MANY graduated residents that I personally know, only a couple went out on their own. The rest all went in with one of the above mentioned groups. Starting out on your own used to be the status quo for podiatry. However, as podiatry has evolved into a surgical subspecialty (performing the majority of foot surgery in the country), a lot of these other opportunities have become very viable.

 

[dinofeet]

I agree that each student should be careful with debt. Especially in today's economy. However, you are a bit off on your assessment above. The majority of residency graduates go in with either a multispecialty, ortho, hospital, or existing podiatry group.

Out of the MANY graduated residents that I personally know, only a couple went out on their own. The rest all went in with one of the above mentioned groups. Starting out on your own used to be the status quo for podiatry. However, as podiatry has evolved into a surgical subspecialty (performing the majority of foot surgery in the country), a lot of these other opportunities have become very viable.

Great post whiskers....fantastic response jonwill (you seem to always contribute positively in this forum). There's a lot of uncertainties, however, same can be said of other profession such as dentistry, MD/DO and such. The economy is threating everyone regardless...or so it seems...let's hope things will turn soon. I am not so worried about getting into debts as much as who's willing to lend me money for pod school in this economic tough time.

 

[dinofeet]

I want to advise each of you to be very careful with education debt. As of September approximately 10% of borrowerd were in default on their federal education debt.

Podiatry in my opinion can be a huge risk and if mannaged incorrectly can lead to a ruined life and poverty.

Do your research on % of those who start pod school who get kicked out, starting incomes, job opportunities and understand that your only option may be depending on yourself to start your own practice and if you are 300k in debt when you finish residency, who is going to lend you 150k to start your own practice?

better yet, guess what, even if you get the loan, you have no guarantee that patients will flock to your office at 40/week.

I highly recommend that each pod student anticipate that they will not find a job and be willing to start from scratch.

Good luck.

Hey whiskers, what's your story? I came across some of your old post and....you're still playing this same old tune? What happened to you? Did a pod touch you inappropriately or something? Merry Xmas...oh yeah, no quarantee that Santa will come either right????

 

[diabeticfootdr]

Podiatry in my opinion can be a huge risk and if mannaged incorrectly can lead to a ruined life and poverty.

The key here is "in your opinion", because there is no evidence the pod graduates are any more likely to default on their loans than MD students.

The economy will be going through tough times, therefore, it would probably not be wise to be a stock broker, a banker, a credit analyst. Likewise, it would be wise to avoid aspects of medicine or podiatry likely to be affected by the economy, like cosmetic podiatry or a cash only orthotics business. It would be a smart choice to concentrate on diabetic foot problems and/or trauma which won't be affected by the economy. Also, to enroll in your state medicaid program, in case some privately insured patients change to state aid. Generally, the practice of medicine is somewhat sheltered from these type of economic issues. That's not to say the rest of your life is sheltered, ability to get a loan, mortgage, etc.

Bottom line is, if you're a ***** with no medical or business sense you will fail at any health profession. Podiatry is not a $150k/year hand out that you can sit on your rear and put no effort into it. It's hard work and requires some ingenuity. The people who will make the most money are those that are not afraid to negotiate, are outspoken, and can advertise themselves.

This post seems like fear-mongering to me.

To the readers:
Ask yourself this question, why would some professionals active in a profession dissuade you from entering? Either, 1. they are extremely caring and empathetic and truly believe the profession is a bad choice, or 2. they are making a killing and fear their own success, causing panic to limit their competition.

 

[GetnMyFtNtheDor]

Posted by: Diabeticfootdr
"Bottom line is, if you're a ***** with no medical or business sense you will fail at any health profession. Podiatry is not a $150k/year hand out that you can sit on your rear and put no effort into it. It's hard work and requires some ingenuity. The people who will make the most money are those that are not afraid to negotiate, are outspoken, and can advertise themselves"


Agreed

 

[G0dFather]

agree w/ the DOC

 

[GymMan]

Really, debt is big in all health professions. In any field you can go bankrupt. A chiropractor can have 5 centers & make tons of $, or go broke & file bankruptcy. No guarantee in life. Read my signature quote.

 

[whiskers]

These are unprecidented financial times.

Anyone who does not think that a new or established Pod will not experience the wrath of the economic peril is short sighted in my opinion.

For starters, what are pod students going to do *IF*
the federal gov slashed funding for most of those PODIATRY residencies and opted to fund only essential core MD/DO residents?

I mean, in terms of the federal government, do they really need podiatry residents when they are barely solvent and the country is tanking financially? There are already too many pods in many peoples opinions and really, what do they provide a hospital other than that federal residency cash??? The attendings could do their own surgeries, and the hospitals probably would be happier about that anyway.


Honestly does america need more bunion and hammer toe surgeries at the expense of the tax payers paying for the surgery and the training of the resident?

 

[jonwill]

These are unprecidented financial times.

Anyone who does not think that a new or established Pod will not experience the wrath of the economic peril is short sighted in my opinion.

For starters, what are pod students going to do *IF*
the federal gov slashed funding for most of those PODIATRY residencies and opted to fund only essential core MD/DO residents?

I mean, in terms of the federal government, do they really need podiatry residents when they are barely solvent and the country is tanking financially? There are already too many pods in many peoples opinions and really, what do they provide a hospital other than that federal residency cash??? The attendings could do their own surgeries, and the hospitals probably would be happier about that anyway.


Honestly does america need more bunion and hammer toe surgeries at the expense of the tax payers paying for the surgery and the training of the resident?

By those standards, you could basically make that argument about ANY resident. And yes, hospitals/attendings really do need the residents simply because of the work load. It's not just doing cases. It's rounding on dozens of patients and doing many floor and ER consults daily. Who else is going to do it?

I love it when people treat podiatry like it is some "optional" medical specialty. Who's going to do all of the foot and ankle trauma at countless hospitals across the country? Who's going to handle all of the DM foot infections, gangrene, osteo, etc? Sure, we do plenty of elective procedures (such as bunions and hammer toes) but we also do a ton of procedures that are not elective.

IF the federal government were ever to slash funding except for "essential core residencies" (which would never happen), podiatry would most likely be kept as NO ONE else does what we do. Podiatry has grown to what it is today precisely for that reason, we are greatly needed. Anyone who thinks differently obviously has no idea what podiatrists do in the first place.

 

[krabmas]

By those standards, you could basically make that argument about ANY resident. And yes, hospitals/attendings really do need the residents simply because of the work load. It's not just doing cases. It's rounding on dozens of patients and doing many floor and ER consults daily. Who else is going to do it?

I love it when people treat podiatry like it is some "optional" medical specialty. Who's going to do all of the foot and ankle trauma at countless hospitals across the country? Who's going to handle all of the DM foot infections, gangrene, osteo, etc? Sure, we do plenty of elective procedures (such as bunions and hammer toes) but we also do a ton of procedures that are not elective.

IF the federal government were ever to slash funding except for "essential core residencies" (which would never happen), podiatry would most likely be kept as NO ONE else does what we do. Podiatry has grown to what it is today precisely for that reason, we are greatly needed. Anyone who thinks differently obviously has no idea what podiatrists do in the first place.

And - the rate of BKA's and AKA's would go up exponentially.

Read this...

http://www.mayoclinicproceedings.com/pdf/8307/8307rc.pdf

 

[toothsome]

Quick question. I have scanned this thread so this may have been discussed but does the figures given include undergraduate debt along with medical school debt?

 

[Gryhu]

I believe thats what he's trying to say.

300k? Thats a little high. Maybe if you went to a $50k/year private school and had zero scholarships or grants.

 

[GymMan]

There's no doubt with an aging pop. that DPM's will be needed for far more than toe surgery. But, insurance co.'s will be more selective in WHICH DPM gets the nod. Therefore, its going to be the BEST trained ones that get the coverage. Look at it this way, if you had limited funds to disburse would you give it to the MOST qualified or least?

 

[215512]

There's no doubt with an aging pop. that DPM's will be needed for far more than toe surgery. But, insurance co.'s will be more selective in WHICH DPM gets the nod. Therefore, its going to be the BEST trained ones that get the coverage. Look at it this way, if you had limited funds to disburse would you give it to the MOST qualified or least?

What determines this? Seems straightforward but does that mean a fresh pod wont get coverage even if coming from a high-powered PM&S 36?

 

[toothsome]

Yea, to me that makes no sense. If a patient needs something done and it is covered why would this matter? On the same note, how does an insurance company determine the difference between Dr. X and Dr. Y abilty to do something? I bet they have a magic eight ball like the government too!

 

[Feli]

Yea, to me that makes no sense. If a patient needs something done and it is covered why would this matter? On the same note, how does an insurance company determine the difference between Dr. X and Dr. Y abilty to do something? I bet they have a magic eight ball like the government too!

Training matters more in terms of getting onto hospital staff, acquiring academic positions, or becoming a group partner. In terms of insurance companies and HMOs, many will just sell to the lowest bidder (who has the minimal qualifications).

If Doc A will accept a $70 fee for each office visit but Doc B won't take any less than $100, then guess who gets the contract? A lot of successful docs are on many insurance plans, but you will see that many tend to drop certain poor-paying ones after they acquire enough patients from other plans.

 

[toothsome]

Training matters more in terms of getting onto hospital staff, acquiring academic positions, or becoming a group partner. In terms of insurance companies and HMOs, many will just sell to the lowest bidder (who has the minimal qualifications).

If Doc A will accept a $70 fee for each office visit but Doc B won't take any less than $100, then guess who gets the contract? A lot of successful docs are on many insurance plans, but you will see that many tend to drop certain poor-paying ones after they acquire enough patients from other plans.

My thoughts exactly. The only way I think they will choose one doctor over another other than price would be Malpractice claims. If Dr. A has 5 malpractice claims Im sure they will choose Dr. B regardless if he is less experience and is a little more expensive with 0 malpractice claims. I could be wrong however.

 

[whiskers]

In my opinion education and medicine are BOTH in a big bubble right now similar to the housing and credit ones that recently went belly up.

It is my opinion that the health insurance industry has over inflated the wages and earnings of hospitals and physicians etc by overleveraging individuals on what they can REALL afford medically. It is based on a premise that more money will be paid into an insruace plan than will go out.

As people continue to lose their jobs and/or their health insurance, less money is being paid into these huge insurance companies meaning they can not sustain the pay outs... and more and more people are paying out of pocket.

15-25 dollars in real money seems logical for out of the pocket doctors visit with minor procedure... And it is only a matter of time until the insurance companies recognize this and a bunion should cost no more than 150 dollars.

Now couple this type of reimbursement with a 150-200k student loan and you are in big trouble.

Couple this with the dismal graduation rates at some colleges and you get my point, it is a huge gamble.

Take it seriously and don't let the need to be a doctor cloud your financial judgement.

Reimbursements for care probably are not going to go up would be my bet.

Check out this link on college education/

http://www.forbes.com/forbes/2009/0202/060.html

 

[whiskers]

Furthermore,

As reimbursements go down, hospitals will receive less of that insurance/government money that keeps them afloat.

Residents are many times a LUXUARY, not an essential component of a fully functional facility.

If a place is having financial problems, guess what, they might just decide to cut nonessential residents and guess who probably would be 1st???

Hospitals could do just fine without pod residents from what I can see by utilizing the podiatrists on staff to do their own work without a resident.

I mean every pod residency has Podiatrists on staff that are capable of doing their own cases they bring ot the hospital.

Plus some hospitals may go insolvant because they don't have enough money or not enough credit. And the hospital that buys them might not want a pod residency.

I think that it is wise to select a financially stable hospital system because being a good pod residency really won't stop a system from going under from what I can see.

I think that the profession should consider this scenereo/



Just my thoughts on how the present economy could impact salaries and residency availability.

 

[Gryhu]

So then all medicine is in trouble with your scenario, not just podiatry. Dude you're so negative about everything. Sure, things might happen the way you present it, but there's also a good chance that it won't.

Even if things do take a turn for the worst, I doubt that the 500+ or so graduating pod students every year will be left to die in an alley somewhere.

 

[whiskers]

Even if things do take a turn for the worst, I doubt that the 500+ or so graduating pod students every year will be left to die in an alley somewhere.[/QUOTE]


Actually that is how people die in much of the rest of the world if they don't have enough money and those who don't die live a very different life than even our poorest here in America.

I know, it is hard for the average American pampered youth to understand that REAL poverty can be really really bad.

I don't make up the rules of life, I'm just the forecaster and another naysayer not to be takes seriously.

But seriously, the housing and credit markets are filled with people who would not take responsible financial advice.

I'm just a Pod forecaster aka the Podcaster posting my opinions on this site. Disagree all you want.

I will not be allowed to starve by my fellow pods!

PS, I also think that it is important to consider a schools financial status before attending, because anything can happen in this day and age. I personally wonder if all can weather this financial mess.

 

[saintelsewhere]

Boo freaking hoo.

I mean COME ON. Yes debt management is an important aspect of any sort of medical education, but this is so dramatic and fatalistic that it's just silly. (There's a lot of silliness on these forums I've discovered.) If the financial aspect is such a HUGE DEAL, then don't go to podiatry or any other graduate/med school, and pay cash for everything you buy. It's really that simple.

Yes the credit market is crap and the economy sucks right now. Guess what? That's what happens when you live in a capitalist society, it goes through cycles. You can complain about it and make it a reason not to do anything you care about, or you can decide that you feel SO strongly about something that you will make it happen no matter what. There's always a way.

 

[goalie712]

What a Doom and Gloom post, sounds like my dad. Honestly nothing is secure, and never really was. If you want something guaranteed than start putting stock in your death.

Podiatry won't disappear, but even if it does what is a better profession. My engineer buddies are getting laid off left and right, along with my friends working in industrial chemistry. Every medical profession is bracing for a financial hit. Major companies are laying off thousands. Singling out Podiatry isn't fair, the way I see it we are all screwed so do something you will enjoy while being fiscally responsible.

If you want a secure job, be a nurse. But if you want to listen to someone complain about their job, then talk to a nurse.

 

[kelus]

I usually make it a point to stay very positive on these forums. but i feel i must chime in on this one.
I have to agree with whiskers on this one. (especially about the bubble that his health care in this country.)
though i can understand why its hard to take whiskers seriously ,the world looks so very nice when your guaranteed to get money every semester to blow/ (JK)
sure, things will probably work out for the best. But with the way things look now, EVERy POD and pre pod should consider the amt of debt his/her education will bring. As much as i think being a dpm is a honor, its also a investment. At this point in time, a 200,000 investment in a system thats about to bust should be approached cautiously and taken very seriously. you must consider the risk that whiskers is right!
in my meager opinion every pre pod and pod student should be a uneasy about whats to come. im not saying every one should quit and become dentists. I just see alot of truth in what whiskers is saying. all health professions are feeling the pressure.
im all for optimism, but we should still deeply consider our place in a system that may be in trouble .
i hate to be a downer....
besides, we all know capitalism died when the gov had to bail out banks and big corps.
welcome to a new world - adjust accordingly