Some MDs make that ballpark too (pediatrician).
Unfortunately some DPMs do make this income but higher income is not impossible to reach.
How much can you make starting out of residency?
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Unfortunately some DPMs do make this income but higher income is not impossible to reach.
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The average salary of a podiatrist for a very long time was the same as that of a family physician. Now (possibly because hospitals are arguably subsidizing that specialty) family practice make more than podiatrists on average.
Most podiatrists do not make the average salary for their profession. There are many making well below that (wether initially or forever) and many who are making far above the average (wether initially or eventually).
There are certainly more than a few family physicians looking at a successful podiatrist and mentioning I should have been a podiatrist. The grass is always greener and outsiders are not usually aware of the pros/cons of another's profession.
Hospitalists are kind of like a commodity with a certain price so to speak if you want to hire one in a given market. Even if hospitalists are under a wRVU compensation model, the number of patients per provider and codes used are pretty standard. Most podiatrists are still in private practice and most of what they earn is based on production, which varies greatly based on volume, type of insurance, coding and other sources revenue (some totally legit and others not so much).
In addition to salary, the average benefits package for a podiatrist in PP is much lower than that of most MDs. Benefits are rarely discussed on here.
Most podiatrists do not make the average salary for their profession. There are many making well below that (wether initially or forever) and many who are making far above the average (wether initially or eventually).
There are certainly more than a few family physicians looking at a successful podiatrist and mentioning I should have been a podiatrist. The grass is always greener and outsiders are not usually aware of the pros/cons of another's profession.
Hospitalists are kind of like a commodity with a certain price so to speak if you want to hire one in a given market. Even if hospitalists are under a wRVU compensation model, the number of patients per provider and codes used are pretty standard. Most podiatrists are still in private practice and most of what they earn is based on production, which varies greatly based on volume, type of insurance, coding and other sources revenue (some totally legit and others not so much).
In addition to salary, the average benefits package for a podiatrist in PP is much lower than that of most MDs. Benefits are rarely discussed on here.
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Benefits are rarely discussed here because most podiatrist in PP get zero benefits. A new grad believes that an employer paying for malpractice is counted as benefits. Sounds as ridiculous as your landlord saying your luxury apartment comes with a bathroom.
One poster the other time mentioned not even having maternity leave.
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...and everyone is still disgruntled, LOL
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They should be discussed.
To an extent I get it. PP has less sources for revenue most often than a Hospital, MSG or Ortho etc. Sometimes a podiatrist is even doing a "favor" for a desperate young doctor they know who could not find a job and they are really not sure if they are busy enough for an associate yet. Certainly it is not predatory to low ball with no benefits in this situation saying this all I can do we and can give this a try and see if it works out.
The reality is the days of doctors working like crazy, with little work/life balance and getting under paid as younger doctors are gone in most specialties.
It is pretty standard for a doctor to get 30 days off and have decent benefits even in PP settings outside of podiatry. I am not saying all doctors use the full 30 days as many are hungry for more wRVU or bonus.
If you can honestly only afford 10K per month or less and hardly any benefits then you can not yet afford an associate podiatrist. The irony is that until the supply and demand are in balance with enough good jobs for all, they can in fact afford a podiatrist that cheap. It is a mix of older doctors that just believe this model is a right of passage and meant to weed out lazy associates and doctors that are predatory scum bags. The older doctors will be aging out soon and the supply/demand needs to improve to end the predatory scum bag business model.
The income potential might be high in PP and some might be very happy, but the reality is if there were enough Hospital, Ortho and MSG for all podiatrists then the current PP model might go the way of the dinosaurs.
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Not sure I agree with this one. Though anecdotal, of four prospective employers I talked to while applying for jobs this past winter only one didn't discuss benefits. He very might have well offered benefits, but I didn't really take the guy and his pay offer seriously enough (30% straight, no base, with questionable patient load) to dig any deeper. All of these PP employers were in Texas, if that matters.
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I think you’d see very few people taking associate jobs out of residency but an increasing number of people switching to PP after 5-7 years of practice as an employed doc. You have a higher income ceiling as a business owner. But people out of residency aren’t equipped to run a business and the higher starting salaries of employed positions would attract them. Then, once they realize that their income is capped, they are more comfortable with billing and coding, hiring/firing, etc. they leave the employed position to start their own practice. As long as you can make good money in the private setting, it will never go away in.
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You are probably correct unless lack of referrals made PP go away entirely in certain markets. Otho groups are not going away anytime soon, so there would always be opportunities there if they are podiatry friendly.
Not sure if that many would go solo. The PP opportunities that would be left would be good ones. Good benefits, good initial salary and fair partnership buy in, with surgery center ownership etc. Eventually an eat what you kill income model.
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PP will never go away. The one thing I didn't see discussed above (I'm sure discussed elsewhere) besides a higher income ceiling is Freedom. Freedom to hire every single staff member, training, using instrumentations/hardware, schedule control, etc. A very underrated aspect that new grads may not think about. More and more of my colleagues are leaving their MSG/Ortho/Hospital practices for this reason. Money is important, but every hand here would go up if asked if they would take a pay cut for more freedom/autonomy. Now the headaches of running a business are another story.
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Perusing and saw a job posting for a non op pod with Olympia Ortho in WA. They’re winning.
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Insurance companies will ultimately be the ones to decide the future of the Private practice model. And I don't think PP will ever go away. The insurance companies will rather deal (bully) a PP than fight with a hospital group. Just like insurance companies had a direct hand in the evolution of private surgery centers (to compete with hospitals and reduce cost) because it saves them money. Insurance companies decided to reimburse well for surgery center and every corner shop opened a surgery center in the past 2 decades. On the other hand, insurance companies can also kill surgery centers if they decide to slash reimbursement so it goes both ways. Remember when everyone said obamacare will be the end of the PP model due to new regulations, EHR etc but look where we are. PP model is still strong and not going anywhere.
Regardless of referral, most patients google for the doctor closest (convenient) to them or call up their insurance and see who is in-network and go see that doctor. Gone are the days when a hospital moves to the area and takes all the referral. Healthcare is now in the hands of the patient and patients can go where ever they want to go. I get a good number of new patients from them just goggling and finding me online and I happen to have good reviews and close to them with convenient parking. If other PP stop referring to me, I know I will be fine. But if i get kicked out of insurance, or take away my website and google my business page then I am screwed. My point is there are many avenues to get new patients.
I realize that this question is very situation dependent, but based on what you mentioned in this post, would you recommend new grads avoid the instant gratification of the higher salaried hospital jobs and rather pursue something like a PP orthopedic group where the initial income may be lower (but not significantly) but the ceiling is likely higher in regards to pay? Essentially the less glamorous early years building the practice will be all worth it in the end..
Early in my past job hunting I was told by an orthopedic PP group that the contract you sign day 1 with a hospital will likely be the best contract you sign and further improvements are usually minimal in relation to the increases in production/volume, but in contrast, signing with a PP ortho (I feel this may be less true with a PP pod group) the contract only improves as production/volume increases...
Is this simply a sales pitch? Or for those who have hospital based jobs, do you find that the income potential is significantly limited? Hopefully this makes sense.
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Every situation is different and unique so there isn’t one answer for something as broad as you mentioned. From my own experience, at my prior ortho job, my income was decent and it was purely reflective on how hard I was willing to work (bring in new patients, cases, DME, etc etc) because volume will determine your ceiling. In my current MSG job, my pay is based on wRVU which technically doenst have a ceiling because if I want to work more, I earn more as the backlog of referrals just keep growing. It’s nice to have a steady stream of patients without having to do a lot of self marketing and such. Your choice, if you can find these jobs.
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Many hospital jobs are becoming more like PP podiatry (because they acquired PP podiatrists in some markets) with much better benefits and a higher base. Lots of office with typical mix of PP patients and surgery maybe half day a week, with only the occasional hospital patient. Many regular posters on here have worked at hospitals in more underserved areas and had lots of trauma and diabetic foot, so the hospital jobs vary. It is certainly not unheard of for your salary to decrease initially when you go off the income guarantee at a hospital for podiatry or any other specialty. Some go straight wRVU and others are a combination base, wRVU and maybe other factors like satisfaction scores.
Ortho jobs typically have a much higher ceiling and involve ER call etc. You will be working your ass off to reach that ceiling. You might have 6 surgeries the weekend you are on call. You might not even have time to mess with C&C and simple things like ingrown nail follow-ups etc. A nurse or non operative podiatrist might do that. They expect your salary will exceed your guarantee when you go off of it. If you are below the guarantee, they either overestimated their demand for another podiatrist or it is not a good fit for how you want to practice.
So largely what you have been told it true, but individual opportunities in any setting vary greatly. There are outliers in any settings economically, especially if you have ownership as a partner in ortho, MSG or even PP. You obviously can not be an owner as a hospital employee, but you can do well and some have nice pensions. Ironically, I know of podiatrists in ortho that are partners and partial owners of a hospital.
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I was bored so I liike to browse. I considered podiatry but I am a dentist. New grad no residency in a non saturated can do $150k-$200k realistically. With a 1 year advanced residency you can make more. I know most of the people I stay in touch with are 2-3 years in with no residency and are at $250-$320k as general dentists. Only 4 years of school and no residency just to add to the convo. Podiatrists seem to do very well though. You all are highly trained with the 3 year residency so I hope you guys get paid fairly. Cheers.
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I’m curious if the dentistry model eats its young like podiatrists do. Your colleagues that a clearing 300+, are they working for themselves or for another dentist?
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How much debt do you or your colleagues have?
I have $169k (went in state). Other colleagues were less $120-$150k again in state school that offered a lot of scholarship. I have other friends that were $250k and went to private but parents helped a lot. It all depends on where you go. Private dental School is the death of you financially and forces you to work a lot or buy a practice and stress a lot. I know some people in the $400k+ range and this is what they do.
Yes they are working for a mother dentist. My $500k+ friends work for themselves but set up shop in a suburb or rural area. Really dentistry is all about demographics. If you aren't in a major city and you work 5 days a week there is really no excuses not to make $20k per month before taxes.
Butter issue is private dental schools. $400-$700k all in costs to attend with interests makes life very challenging.
Recently received a job offer in a medium size town (300k population) with 275k base salary and $55 per wRVU. Might take it.
Current job I am at was out of residency with above 200k salary with 4 weeks vacation, 4% 401k match. $46 per wRVU.
If you are doing inpatient work, general podiatry and reconstructive limb salvage(charcot work) in a wRVU system then you should be able to get 300k easily once you are established. Generating 6000 wRVU in that setting is very easy imo. Then it is just a matter of having efficient clinic and adequate support staff to go from 6000 to 7000 without getting burned out. What you get paid per wRVU seems to be all over the place though. Mid 40s seems to be the theme but I was offered two jobs recently in South (not rural) that was $55 per wRVU. Hope this information helps
Current job I am at was out of residency with above 200k salary with 4 weeks vacation, 4% 401k match. $46 per wRVU.
If you are doing inpatient work, general podiatry and reconstructive limb salvage(charcot work) in a wRVU system then you should be able to get 300k easily once you are established. Generating 6000 wRVU in that setting is very easy imo. Then it is just a matter of having efficient clinic and adequate support staff to go from 6000 to 7000 without getting burned out. What you get paid per wRVU seems to be all over the place though. Mid 40s seems to be the theme but I was offered two jobs recently in South (not rural) that was $55 per wRVU. Hope this information helps
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275k base with $55 per RVU is very solid for first year offer.
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Forgive me for the stupid question. But does that mean that you start out with 275K base and say for example you generated 3000 RVU so you multiple that by 55 and you get 165K added to the 275K for a total of 440K that year?
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No there is a threshold. Above 3k RVUs each one generated is 55 bucks. Most of the time the 3k is even math in terms of base, but sometimes can be tiered. And remember not all RVUs are equal. Some contracts have a sliding scale like fee for service. My last job I got 100 percent of each RVU.
So a 275 base with 55 per RVU means would anything above 5000 RVUs would bonus.
Offer is whatever wRVU generate multiplied by 55. 275k is base but if you generate 6000 wRVU then you get 6000 times 55. But if you generate less than 5000 you still get 275k guaranteed for first two years. So you don't make less than 275k for the first two years but you can make more if you generate more than 5000wRVU. Hope that clarifies it.
Reading some of this thread makes me sad but is true. I feel I got lucky.
First contract: Two years 270k (some of that is loan repayment money) no production 6 weeks off a year 4 days in clinic/OR/hospital and 1 admin day that is a day off if notes are done and no meetings. 4% 401k match, paid health insurance.
Second contract: Same as above plus wRVU bonus which wasn’t great cause of COVID.
Third contract: 300k plus wRVU bonus around $50 per. I’ll gross around 370k this year. Quality of life is high with 4 day work weeks and 6 weeks off. I'm not doing 1k wRVUs a month but I do enough and have a good work life balance.
I’m not that busy in the OR, I’ll probably average just over 1 per week at this rate.
According to MGMA I’m a little underpaid, I tried hard to negotiate but didn’t get much. However it’s nice to do deal with what my PP friends deal with and be able to go home and be done. I also got a cost of living adjustment in the contract that I didn’t expect to get in.
I am not on call. I don't feel burned out. So compared to OBs and other specialties I feel pretty fortunate.
First contract: Two years 270k (some of that is loan repayment money) no production 6 weeks off a year 4 days in clinic/OR/hospital and 1 admin day that is a day off if notes are done and no meetings. 4% 401k match, paid health insurance.
Second contract: Same as above plus wRVU bonus which wasn’t great cause of COVID.
Third contract: 300k plus wRVU bonus around $50 per. I’ll gross around 370k this year. Quality of life is high with 4 day work weeks and 6 weeks off. I'm not doing 1k wRVUs a month but I do enough and have a good work life balance.
I’m not that busy in the OR, I’ll probably average just over 1 per week at this rate.
According to MGMA I’m a little underpaid, I tried hard to negotiate but didn’t get much. However it’s nice to do deal with what my PP friends deal with and be able to go home and be done. I also got a cost of living adjustment in the contract that I didn’t expect to get in.
I am not on call. I don't feel burned out. So compared to OBs and other specialties I feel pretty fortunate.
True. There are some family physicians I work with that do put in time. They take call, round, ER, do scopes and some OB. But because they refer to the specialists and order labs and images at the hospital I think they get subsidized (legally on their wRVUs/ base of course) on the other stuff they do and one I work with will be close to 500k this year.
How many patients are you seeing per day? Seems too good to be true. In rural or urban setting? That's a great contract. Haven't been able to negotiate 6 weeks off. Most offers have been 4 weeks off.
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not sure how can generate those many rvus without OR...must be a lot of people.
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My set up is very similar but I’m in OR 1-2 days per week so that generates a lot of wRVU for me. But sadly I don’t get a chunk off time like that, let alone 6 weeks! But I can’t complain about the pay and benefits, it’s awesome.
Im rural. It’s a little more complicated than that what I wrote. My wRVU is based off a 250k base. I have some other clinics that I do that pay daily rate with no bonus. Those other clinics I counted into my base but I do 4-6 of those clinics (depending on patient load) a month in other towns, the more I do the more I get paid, and do surgery there but those don’t count to the bonus. So it’s a combination of base, bonus, other clinics.
Depends where I am but I see 20-25 a day. Looking at my numbers I was averaging 1.77 wRVU earlier this year and last month I was at 2.1 wRVU per patient on average. That includes surgeries and wound care in that average.
A big positive for dentistry is no residency. Dental school is more expensive but you can start making real money 3 years sooner.
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Dentists don't have to accept Medicare or private insurance. You can literally set your own prices. You can increase the prices every year.
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+ no insurance or midlevel issues. Great deal if you don't graduate from NYU
I think some states require 1-year residency though but I could be wrong
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There is no medicare but many deal with Medicaid (awesome!).
Midwestern Dental school tuition is $83,000 per year. And after you graduate with over $500k in debt, you get to take a sub $200k job working for a private equity group…I mean, dental office. I’m not so sure the grass is any greener
We as dentists take insurances so insurance usually sets our price. The issue with setting your own fees is that you do not have a lot of patients when you do this unless you have been established for a while. PPO insurance practices do well but you earn what you work for.
The big pro mentioned here is you do not have to a residency. And if you go where you are needed then 4 years later a well paying $200k+ job working normal hours is very possible. Me and my spouse were fortunate to not have a lot of debt to none because we attended state schools with scholarships.
Getting $200k+ for 3 years while others are in residency or dentistry specialty residency is huge for retirement because now you have 3 added years of compounding interest in the market. So if I were to do an endo residency which is 3 years and another $150k debt. I could come out making like $300-$400k working but I gave up on $600k+ pre tax of compounding interest in the market. So at the same savings rate it would take me a bit to catch up. Of course this is all pre tax calculations.
The big pro mentioned here is you do not have to a residency. And if you go where you are needed then 4 years later a well paying $200k+ job working normal hours is very possible. Me and my spouse were fortunate to not have a lot of debt to none because we attended state schools with scholarships.
Getting $200k+ for 3 years while others are in residency or dentistry specialty residency is huge for retirement because now you have 3 added years of compounding interest in the market. So if I were to do an endo residency which is 3 years and another $150k debt. I could come out making like $300-$400k working but I gave up on $600k+ pre tax of compounding interest in the market. So at the same savings rate it would take me a bit to catch up. Of course this is all pre tax calculations.
I mean how do you think private hospitals get funded? They are everywhere and they will only grow. But yes the grass is not always greener but I like my normal hours and my $300k income with no life or death situations and a good work life balance - which is hard to come by these days.
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Not sure if links are allowed. Below is 2018 APMA survey.
We can argue the numbers, but in the words and numbers are lots of truths that are repeated time and time again on here. I imagine maybe the top 2% and bottom 5% of earners are not represented.
Most employed in PP have been there than 5 years. Not typically a longterm career option with turnover. Occasionally it leads to partnership.
Some do very well in PP as owners (groups do better than solo), but MSG employee/partners and Hospital employees on average do better.
We can argue the numbers, but in the words and numbers are lots of truths that are repeated time and time again on here. I imagine maybe the top 2% and bottom 5% of earners are not represented.
Most employed in PP have been there than 5 years. Not typically a longterm career option with turnover. Occasionally it leads to partnership.
Some do very well in PP as owners (groups do better than solo), but MSG employee/partners and Hospital employees on average do better.
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I'm just a podiatrist who has never been fly fishing and has mediocre mtb skills....what bike am I supposed to get?!
VagabondDoc
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Where are these 300K jobs at? lol. First year out i made 177K, i'm not year 4 of practicing and this year should be around 218K, but put up with a lot of B.S :-(
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I’d start looking now. Some are posted, some are not. You have work experience to bring to the table compared to these new grads fresh out of residency/fellowship. You should be netting more than 218k with 4 years of experience. The two jobs I know of from a few months ago just got filled by people that have been out 2-3 years and were picked over fellows fresh out. Sucks for them.
VagabondDoc
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Always looking for better opportunities, currently see 50+ patients a day and do nursing homes. where out west?lol
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50 x low per patient visit of $100 = $5000 per day x 250 work days in a year = $1.25m. Even if you worked for $50 per person and clipped nails all day thats over 600k. You're just getting a third of that... eesh. I wouldnt walk, but run from your current situation.
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You are getting ripped off big time. I’m sorry 4 years later this is happening. You should look over your numbers and GTFO
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Thank you! Ive been looking LOL.
VagabondDoc
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What state do you practice in?
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Is this a uniquely Podiatry thing? Is there any other specialty that routinely sees 50+ patients a day?
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Derm? Radiology (sort of, not really)?
There's no way I could do a good job seeing 50+ patients per day.
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Only way see that many effectively requires you to have a crack staff, and not let patients talk your ear off. It's an art, and unfortunately the "crack staff" can get burned out easily, which translates into you doing more, which ends up burning you out. Then you train up another crack staff, and the cycle continues. That's been my experience anyway...
