Hospital offer, Should I take it or not?

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JewOnThis

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This question is directed to practicing podiatrists.

I received an offer from a well known hospital around my area. I am debating whether not I should take up the offer. They offered me great pay with benefits, but the major downfall is this is a nonsurgical position. They have a couple of surgical pods and F&A orthos on staff. My job duty would be wound care and general podiatry. No calls.

I do like surgery, but it's not a must do for me. What worries me more is being ABFAS board certified and getting on or denied by insurance panels later on if for some reason I decide to leave the hospital.

Any inputs from experienced pods would be appreciated.

Also, I am ABFAS RRA Qual and ABPM Certified.

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Personally I think letting your surgical training fall to the wayside would be a mistake.

Who knows in what direction your career might go. You might be happily employed by that hospital for your entire career or maybe only for a year.

Most doctors I've met have worked in more than one practice though, and the question of board certification always seems to come up. Once the window of opportunity to become board certified closes it won't likely open again.
 
Thank you for your input.

This feels like a "one in a lifetime" opportunity, I feel like I should take it.

I know most hospitals only recognize ABFAS regardless of what Marc Benard (delusional ABPM director) says. But does anyone know of any pods getting full privilege with just ABPM certification?
 
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This question is directed to practicing podiatrists.

I received an offer from a well known hospital around my area. I am debating whether not I should take up the offer. They offered me great pay with benefits, but the major downfall is this is a nonsurgical position. They have a couple of surgical pods and F&A orthos on staff. My job duty would be wound care and general podiatry. No calls.

I do like surgery, but it's not a must do for me. What worries me more is being ABFAS board certified and getting on or denied by insurance panels later on if for some reason I decide to leave the hospital.

Any inputs from experienced pods would be appreciated.

Also, I am ABFAS RRA Qual and ABPM Certified.

Do you mind providing a salary range?
 
Natch has a good point. I might take it, considering low reimbursements for surgery and the hospital model may pay better, and no call. Tough decision, I would probably take the job.
 
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Thank you for your input.

This feels like a "one in a lifetime" opportunity, I feel like I should take it.

I know most hospitals only recognize ABFAS regardless of what Marc Benard (delusional ABPM director) says. But does anyone know of any pods getting full privilege with just ABPM certification?

Well then, if that's what your gut tells you to do then you probably should take the job so you don't end up wondering "what if" later on.

I don't know about the ABPM thing. Didn't Dr. Lee Rogers, who used to post on this forum regularly, say he willingly stopped his own ABPS certification process?
 
A vote for "don't take it". This could cripple your potential future opportunities. I would take a different job where you could at least become board certified in foot surgery first, so at least you have other options should the need arise. You will be the nail nurse for the entire hospital. I don't know of a salary high enough that could make it worth doing that job.

I also don't like hospital jobs (or working for the man in general) because while that first 3 year contract may be sweet, they are going to look at your production over those years. Then they'll use that against you when deciding how much to pay you, and your 2nd contract may not be as lucrative as your first. Then you're in a position that doesn't pay very well, AND you haven't done a single case in 3 years. Good luck getting privileges at any other hospital at that point, so you'll be stuck in this now mediocre-paying, dead-end job. You are also the same as any employee, i.e. very easily replaceable.
 
Natch has a good point. I might take it, considering low reimbursements for surgery and the hospital model may pay better, and no call. Tough decision, I would probably take the job.

Mostly I'd be concerned about crippling one's future, as g squared 23 put it. This job situation sounds like the proverbial "putting all your eggs in one basket."
 
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A vote for "don't take it". This could cripple your potential future opportunities. I would take a different job where you could at least become board certified in foot surgery first, so at least you have other options should the need arise. You will be the nail nurse for the entire hospital. I don't know of a salary high enough that could make it worth doing that job.

I also don't like hospital jobs (or working for the man in general) because while that first 3 year contract may be sweet, they are going to look at your production over those years. Then they'll use that against you when deciding how much to pay you, and your 2nd contract may not be as lucrative as your first. Then you're in a position that doesn't pay very well, AND you haven't done a single case in 3 years. Good luck getting privileges at any other hospital at that point, so you'll be stuck in this now mediocre-paying, dead-end job. You are also the same as any employee, i.e. very easily replaceable.

Good input.

Becoming ABFAS certified is nice, but didnt ABFAS just change the diversity again recently? I know of some people who do a decent amount of surgery but cannot get all the diversity.

The truth is, maybe just in my area, there are a lot jobs out there just wanting a general podiatrist or a wound care expert. Very few ortho groups, multi specialty, or even hospitals need a surgical podiatrist. Those people will never become board certified in ABFAS. But you can obtain board certification else where such as ABPM and CWS or other wound care association.

I agree with Lee Rogers point of view.
I dont agree with all the aspects of ABFAS. Especially nowadays, podiatry is not only seen as a surgical sub specialty.

Background: In my residency, I averaged a total of 5-6 Tars a month and 10 ankle fusions a month at a known program.
 
Mostly I'd be concerned about crippling one's future, as g squared 23 put it. This job situation sounds like the proverbial "putting all your eggs in one basket."

If I was to take this job, I would be putting all my eggs in one basket.


Other reasons why I am considering this job is:
My family enjoys living here. I have children in a good school district, Spouse has an awesome job. I can finally settle down permanently, and not ever have to worry about being replaced like in PP. I dont have to worry about billing. I only deal with RVU patients which the hosptial is going to provide me. Other podiatrists have worked there for 10 years and have no complaints.
 
Background: In my residency, I averaged a total of 5-6 Tars a month and 10 ankle fusions a month at a known program.

With that background I'm thinking you could get another excellent offer elsewhere that includes surgery, and that you'd likely have the diversity to get ABFAS cert. if you were to go in that direction.

Tough choice, but at least you get to face this choice. It's a good problem to have.
 
Moving for me at the moment does not seem like a good option. I'm sure there are opportunities out there in lesser desirable areas.

I will update the thread once I hear more.
 
I had the pleasure of having dinner with Dr. Rogers this evening and I can assure you that not having ABFAS certification has not negatively affected him in the least. His career trajectory is extraordinary, inspirational, and it reinforces that there's more than one way to do things, so JewOnThis if you decide to take that hospital job then full speed ahead! Commit and don't look back.
 
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I had the pleasure of having dinner with Dr. Rogers this evening and I can assure you that not having ABFAS certification has not negatively affected him in the least. His career trajectory is extraordinary, inspirational, and it reinforces that there's more than one way to do things, so JewOnThis if you decide to take that hospital job then full speed ahead! Commit and don't look back.
NatCh please elaborate more. I don't like the idea of paying the fees for certification, but feel like I need some sort of certification. One hospital I'm familiar with requires that you either be within the window of collecting cases, or qualified, or certified, but it doesn't need to be Abfas, it can be Abpm or multispecialty. I guess one could do surgery indefinitely at a surgery center without any certification?

Patients and most md and do docs don't know the difference between Abpm and Abfas. Sometimes I wonder if I'm getting Abfas just for my own satisfaction.
 
I had the pleasure of having dinner with Dr. Rogers this evening and I can assure you that not having ABFAS certification has not negatively affected him in the least. His career trajectory is extraordinary, inspirational, and it reinforces that there's more than one way to do things, so JewOnThis if you decide to take that hospital job then full speed ahead! Commit and don't look back.

I understand what you are implying, but I also understand that I am not "Lee Rogers".
He is more published and established than I am at the moment.

I will most likely take the position, just waiting to meet with up the staff again to negotiate some terms.
 
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I understand what you are implying, but I also understand that I am not "Lee Rogers".
He is more published and established than I am at the moment.

I will most likely take the position, just waiting to meet with up the staff again to negotiate some terms.
I agree. Big names get big breaks. Interesting thread and situation. I would think that offer through real hard for reasons others have said. $$$ and a job is great but it's lifelong happiness in your work that should be an important factor. Throw in the overall family happiness curve ball and it gets real sticky. Good luck.
 
Ten years ago Lee Rogers wasn't "Lee Rogers." He was still in training, just like a lot of you guys. He got involved in the development of a very large network of wound care centers, then his company was bought by another company for an amount that makes my head spin. I don't think it's for me to post the actual number but he and his partners sold their business for an amount that is absolutely staggering. You all know he ran for Congress, but since then has moved on to producing films, one of which was shown at the Cannes Film Festival. I'm kind of amazed he still gives a darn about podiatry but maybe he's passionate.

Take home message: Take an interest in something, get good at it, and think bigger.
 
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Ten years ago Lee Rogers wasn't "Lee Rogers." He was still in training, just like a lot of you guys. He got involved in the development of a very large network of wound care centers, then his company was bought by another company for an amount that makes my head spin. I don't think it's for me to post the actual number but he and his partners sold their business for an amount that is absolutely staggering. You all know he ran for Congress, but since then has moved on to producing films, one of which was shown at the Cannes Film Festival. I'm kind of amazed he still gives a darn about podiatry but maybe he's passionate.

Take home message: Take an interest in something, get good at it, and think bigger.

I have a lot of respect for Lee Rogers. Personally I think he should take over ABPM. Maybe then, ABPM certified podiatrists would have a fighting chance in obtaining hospital surgical privileges without needing ABFAS certification.
 
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I have a lot of respect for Lee Rogers. Personally I think he should take over ABPM. Maybe then, ABPM certified podiatrists would have a fighting chance in obtaining hospital surgical privileges without needing ABFAS certification.
I'm not trying to be antagonistic, but there is something I've never really understood and maybe you can clarify it for me. Why would you expect a medical board to help with surgical privileges? I mean, general surgeons don't get board certified in internal medicine in order to get surgical privileges, why should we expect our medical board to grant surgical privileges? I don't mind being called ignorant on this matter because I am.
 
Good question. I am assuming that you have never taken the ABPM examination.

ABPM, from what I understand (and been explained by Marc Benard numerous times) is both surgery and medicine, even though their abbreviation stands for American board of podiatric medicine. They are supposed to represent the profession as a whole. Unlike, ABFAS who only recognizes podiatric surgeons (I mean foot and ankle surgeons). lol
 
Moving for me at the moment does not seem like a good option. I'm sure there are opportunities out there in lesser desirable areas.

I will update the thread once I hear more.

I would take it especially if its in a hospital I think I can spend the rest of my career in. I am personally not a big fan of surgery and don't think I will be doing any in the next 5 to 10 years. That sounds like a great position to me.
 
Good question. I am assuming that you have never taken the ABPM examination.

ABPM, from what I understand (and been explained by Marc Benard numerous times) is both surgery and medicine, even though their abbreviation stands for American board of podiatric medicine. They are supposed to represent the profession as a whole. Unlike, ABFAS who only recognizes podiatric surgeons (I mean foot and ankle surgeons). lol
No, I have never taken the ABPM exam, in-training or the real deal. I have considered it recently, but never done it. I personally wouldn't use it to try to get surgical privileges, which is probably why I never took it, never saw the purpose.

I still don't get why a self-named medical board should be used to get surgical privileges. I'm sure you can see why this wouldn't make much sense to someone not familiar with our boards.

By the way, I think if you feel good about the job, I don't see any reason why you shouldn't take it. Besides the lack of surgery, it sounds like a good job and as @newfeet said, if you can see yourself being there long-term, it sounds like a winner.
 
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A vote for "don't take it". This could cripple your potential future opportunities. I would take a different job where you could at least become board certified in foot surgery first, so at least you have other options should the need arise. You will be the nail nurse for the entire hospital. I don't know of a salary high enough that could make it worth doing that job.

I also don't like hospital jobs (or working for the man in general) because while that first 3 year contract may be sweet, they are going to look at your production over those years. Then they'll use that against you when deciding how much to pay you, and your 2nd contract may not be as lucrative as your first. Then you're in a position that doesn't pay very well, AND you haven't done a single case in 3 years. Good luck getting privileges at any other hospital at that point, so you'll be stuck in this now mediocre-paying, dead-end job. You are also the same as any employee, i.e. very easily replaceable.


There are some of excellent points made above. As correctly stated, hospitals aren't in the business of handing out large salaries. So even though in the beginning you may do well financially, your numbers will be scrutinized and salary will be adjusted up or down according to RVUs. As I've stated before, the positive aspect of RVUs is that you're not penalized for poor paying insurance carriers.

You have to truly self reflect. If the hosptial already employs surgical podiatrists and foot/ankle orthopods, can you deal with the probability you'll be considered the palliative podiatrist? So you perform wound care and a patient ultimately requires surgical intervention, and now it has to be punted to someone else. You won't be the ""glamour" podiatrist at the hospital and will certainly be called for nail clippers consults and palliative procedures. This may seem okay now, but may get frustrating or demeaning sooner than you think. If you were winding down your career, this would be a perfect gig. But you're young and well trained and may be shooting yourself in the foot. Yes, the pay is good and you don't have to relocate your family. But you can also be replaced for many reasons and then you're screwed because you haven't performed a case in X amount of years. I personally am of the belief that ABFAS cert is important.

Please consider your true value or job security if you are their palliative guy. If you are getting paid well, what's to prevent them from replacing you with a less costly wound care nurse who can provide excellent wound care as well as palliative care. NPs and PAs are already doing this in some facilities.

The bottom line is that you and your wife ultimately have to make the decision. Please avoid the knee jerk reaction of accepting the offer simply because it pays well. Create a pros and cons list consider all the comments in this thread and then move ahead with an educated decision.

Good luck.
 
They offered me great pay with benefits, but the major downfall is this is a nonsurgical position. They have a couple of surgical pods and F&A orthos on staff. My job duty would be wound care and general podiatry. No calls.

Would the hospital force you to refer any and all surgical cases to the other docs? Even doing general podiatry, wound care and palliative care would provide you with patients who need/would benefit from surgical procedures (gastrocs, hallux IPJ fusions, MPJ fusions, met head resections, flexor tenotomies, HT repair, amps, etc.). If you were given privileges and allowed to treat these patients to the full extent of your training then I could see this being plenty to keep you professionally satisfied (from the little you've described). If not, I find it hard to see someone staying there for a long time at which point, as others have mentioned, you could be in a bad spot from a board certification standpoint.
 
Would the hospital force you to refer any and all surgical cases to the other docs? Even doing general podiatry, wound care and palliative care would provide you with patients who need/would benefit from surgical procedures (gastrocs, hallux IPJ fusions, MPJ fusions, met head resections, flexor tenotomies, HT repair, amps, etc.). If you were given privileges and allowed to treat these patients to the full extent of your training then I could see this being plenty to keep you professionally satisfied (from the little you've described). If not, I find it hard to see someone staying there for a long time at which point, as others have mentioned, you could be in a bad spot from a board certification standpoint.

Basically what I wrote above.
 
Would the hospital force you to refer any and all surgical cases to the other docs? Even doing general podiatry, wound care and palliative care would provide you with patients who need/would benefit from surgical procedures (gastrocs, hallux IPJ fusions, MPJ fusions, met head resections, flexor tenotomies, HT repair, amps, etc.). If you were given privileges and allowed to treat these patients to the full extent of your training then I could see this being plenty to keep you professionally satisfied (from the little you've described). If not, I find it hard to see someone staying there for a long time at which point, as others have mentioned, you could be in a bad spot from a board certification standpoint.

Yes I would be referring all surgical cases to other docs.

All the podiatrists there are well trained and some of them are nonsurgical as well. One of podiatrists did a very well known top grade residency and did a fellowship at a well known program. She has been there for almost 10 years and has not done a single case since.
 
That would be the deal breaker for me, but that's entirely a personal/professional satisfaction matter.

Sounds turrible. I'd rather do surgery and make less money, that's just me though.
 
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