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If they only collect $300k you didn’t need to hire an associate. The associate could have done that starting a brand new office with no established patient base or referral sources.
How much impact is this forum having on enrollment?
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If they only collect $300k you didn’t need to hire an associate. The associate could have done that starting a brand new office with no established patient base or referral sources.
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Yes but we all know that this is the podiatry way. Hire a new associate and screw them while you build your own practice. This type of crap doesn't happen routinely like this in fields that are not grossly oversaturated.
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Yeah, I would agree w dtrack... no need to hire at that point.
I have friends who collect $1.xxM in solo PP and have not or won't ever bring on an associate (and no, they usually don't take home 50% typically as some of that is from wound wizardry which has high overhead % or high staffing levels to have staff do RFC).
To even consider an associate when solo, one has to be bursting-at-the-seams busy (40+pts/day every day, double and triple booked, booked out months for elective) and ready to give up 20-30% of their own pts. The correct answer is still usually to just figure out how to see more and/or collect more per visit (hire more staff, schedule better, trim payers, etc).
...If one does hire an associate when grossing 700k (~20pt/day), then they'd probably get the typical pathetic first year associate contract of $125k and 30% or $150k and 25% or something... with virtually zero chance of bonusing first year. You'd have to give them a quarter of your own patients and over half of new patients (fairly risky if they're not proven to be likable) and give them the typical hospital consults and wound center and "go market yourself" pep talk. Not ideal for either party.
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No one ever knows what they could collect. That risk is amplified with student loans and lack of business training from school, a risk that most new grads cannot take
what is a fair salary for a new grad in PP? I wanna hear some number crunching, it’s not rocket science how much people make as owners and how much they can afford to pay new grads. Let’s put some numbers out there of what we consider fair.
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I agree, this would be important for new grads to consider before joining someone in solo practice. So then what situation with a solo or group practice is it “appropriate” to consider hiring? And what would that contract look like?
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A fair salary for new grad in PP is about $200k for $500k collections (assume 50% overhead, owner doesn't hire to lose money).
Collections can't be assumed since some associates are lazy or just suck, so $150k salary + 35% over $350k makes the most sense.
$150k is enough to live off but doesn't take a huge risk either. They have an easy path to $200k+.
~$20k/yr will also be "benefits" (malprac, cme, licensing, hospitals, maybe sign/retention bonus), so that gets factored in...
If the associate can collect more in the future despite same "benfits" cost, they deserve more: maybe escalators 40% after 500k and 45% after 650k collections?
I would likely do something like that above (could do a bit more guaranteed base for someone I know is good... but then just even it out with bonus start later or lower %), but my area doesn't support that growth due to size. I will just work awhile and then one day try to sell for a fair price to somebody really good so that it's a smooth handoff for the patients and refer docs. My city has less than 15k ppl (maybe 20k in catch area), so it should statistically support one full-time DPM... yet there is me full-time and three part-time... because podiatry and saturation of podiatry. Lol.
As mentioned, that "fair salary" just barely ever happens... podiatry's saturated and owners have no reason to offer that.
The only places that offer that $200k guaranteed or that neighborhood will be VERY busy large/medium groups and supergroups. Large groups will get it back on very high pts/day. Supergroups might do it on pts/day, but they also own the labs, DME shop, vasc, PT and make the money that way. They can basically pay 30% and give some kickbacks for related refers by their DPMs that they make a ton off of. Those will increasingly become the new normal for DPM grads.
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Based on my personal experience, when I was an applicant, SDN was one of my primary resources. I also sought information from Reddit (bearing in mind the need for selectivity, as not all advice is reliable). Unlike allopathic/osteopathic, podiatry lacks the abundance of easily accessible resources and widespread information sharing through word-of-mouth. While I believe that these forums do have some influence on enrollment, I also see them as platforms for individuals to express their opinions, which can contribute to the overall improvement of the profession. In the future, I hope to see the following developments:
- A more organized leadership structure in the field of podiatry.
- Improved standardization of residency training programs.
- Enhanced board exam performance for both current students and practicing podiatrists.
- Greater unity and a shared passion for the podiatry profession.
- Better salary and compensation opportunities for podiatrists.
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Interesting insight from a first year pod student.
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...consider than many podiatry "leaders" benefit from too many schools, residents, DPM. They benefit via job security, creating well-paid faculty positions, industry sponsor$, government funding, low-cost labor, and other means.
(see also: pharmacy, chiropractic, optometry, and the opening of many DO schools)
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2nd 🙂 + spent too much time reading SDN, for better or worse.
...consider than many podiatry "leaders" benefit from too many schools, residents, DPM. They benefit via job security, creating well-paid faculty positions, industry sponsor$, government funding, low-cost labor, and other means.
(see also: pharmacy, chiropractic, optometry, and the opening of many DO schools)
You raised a valid and insightful point. I share your viewpoint that conflicts of interest can arise. In the context of podiatry, it would indeed be beneficial to address and mitigate conflicts of interest to maintain transparency, objectivity, and accountability. As a student, I find myself uncertain about the specific ways in which I can actively contribute to addressing this issue.
Do you have any suggestions for effectively mitigating conflicts of interest to ensure continued progress in podiatry?
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It’s like asking why can’t we just have world peace? Humans have roamed the earth for centuries and still can’t figure it out. It’s human nature. Need the right group of people in power to make meaningful progress that can continue after their reign
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In terms of enrollment this year, we were told at our graduation party that enrollment is indeed down again this year... don't remember the exact numbers but sounds like they had 500ish applicants, with a total of 700 ish seats open not including the texas school. Unsure how many students actually matriculated.
Is this forum keeping students away from podiatry? maybe? I think this forum points out that the job market and ROI are hot garbage and PA and NP is a better option with less cost. I think the forum poses good questions that are unfortunately not answered very well by podiatry leaders, with @diabeticfootdr being the one exception. Like him or hate him he's literally the only one who answers questions.
Is this forum keeping students away from podiatry? maybe? I think this forum points out that the job market and ROI are hot garbage and PA and NP is a better option with less cost. I think the forum poses good questions that are unfortunately not answered very well by podiatry leaders, with @diabeticfootdr being the one exception. Like him or hate him he's literally the only one who answers questions.
I like these things but just to echo previous posters I don't think we will start seeing these changes until the mustache pods retire, and irreversible damage to podiatry and the job market is even worse.
MortonExtension
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there will just be new mustaches. There are mustaches of every generation. That’s a common misconception that they will all just retire… more will just appear
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Why do you suppose the entire board of directors for ABPM, as well as the exec director, attempted to remove him... and then walked out on him and the past president en masse?
Venerating ppl who act in their own self-interest by peddling easy answers is what keeps getting this profession into tough spots. LCR can sell answers for everyone being "$urgical" board certified and easy route, Harkless can sell new pod $chools, LECOM can sell "everyone gets a re$idency," APMA and large PP owners can say there's a need for tons of DPM associate$ with pop growth and aging ppl and diabetes and blah blah. That rhetoric doesn't mean we truly need those things or that they're actually the correct answers. 🙂
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If paid less than 150K and mediocre benefits this profession makes absolutely no sense for most from a ROI standpoint. One should not offer a salary less than this. Honestly podiatry would make a lot more sense if our salary for all was equal to PCPs. We all know this is not true. Our availability of jobs regardless of compensation is also poor not just for residency graduates, but should one that already has a job (poor, mediocre or good) want to move or find themself in a situation they need a new job.
Most MDs say healthcare wise if MD/DO did not work out they would have been a PA if not something else outside of healthcare care in computers or an engineer. Times have really changed and most are not hung up on only choosing healthcare carers where one is called a doctor like years past. Once upon a time it was being an MD or being a dentist or one of the other doctor alternatives. The opposite is largely true now. It is all about ROI and work life balance and podiatry often falls short here despite the marketing campaign you instantly have a great job, with a great salary where you are home before 5pm every night with no after hour phone calls.
A large group or organization can more easily take the risk, but if a solo practice doctor can not take the risk also and pay at least 150K and benefits for an associate then they should not hire. This lower than ideal, but fair enough initial salary should be offered for a couple years. After a couple years the practice has to be busy enough and the doctor producing enough to justify the salary. After that point compensation should be made largely or completely based on production as an associate or partner. If production would not be enough or more to cover the 150K and benefits as an associate or partner moving forward it is usually best to part ways. Either the demand/growth was over estimated by those hiring or the wrong person was hired. It happens and is a risk taken by both parties.
The reality is one most often can and will hire a podiatrist for much less than 150K because we are saturated. If you were opening an office would you hire a medical assistant and pay much more than the going rate? Probably not. Hiring a podiatrist is no different. We are saturated and are not an essential healthcare specialty where one can except anywhere close to MGMA compensation at most jobs.
Based on our training podiatry does not offer jobs with a fair initial salary to most residency graduates. There will be no significant increase in salaries from demand due to old boomers or diabetes that will change this.
Only a significantly decreased supply will significantly change things. While decreased enrollments will instantly help for residency placement it will take many, many years of lower enrollments than this to significantly improve our job market.
Most MDs say healthcare wise if MD/DO did not work out they would have been a PA if not something else outside of healthcare care in computers or an engineer. Times have really changed and most are not hung up on only choosing healthcare carers where one is called a doctor like years past. Once upon a time it was being an MD or being a dentist or one of the other doctor alternatives. The opposite is largely true now. It is all about ROI and work life balance and podiatry often falls short here despite the marketing campaign you instantly have a great job, with a great salary where you are home before 5pm every night with no after hour phone calls.
A large group or organization can more easily take the risk, but if a solo practice doctor can not take the risk also and pay at least 150K and benefits for an associate then they should not hire. This lower than ideal, but fair enough initial salary should be offered for a couple years. After a couple years the practice has to be busy enough and the doctor producing enough to justify the salary. After that point compensation should be made largely or completely based on production as an associate or partner. If production would not be enough or more to cover the 150K and benefits as an associate or partner moving forward it is usually best to part ways. Either the demand/growth was over estimated by those hiring or the wrong person was hired. It happens and is a risk taken by both parties.
The reality is one most often can and will hire a podiatrist for much less than 150K because we are saturated. If you were opening an office would you hire a medical assistant and pay much more than the going rate? Probably not. Hiring a podiatrist is no different. We are saturated and are not an essential healthcare specialty where one can except anywhere close to MGMA compensation at most jobs.
Based on our training podiatry does not offer jobs with a fair initial salary to most residency graduates. There will be no significant increase in salaries from demand due to old boomers or diabetes that will change this.
Only a significantly decreased supply will significantly change things. While decreased enrollments will instantly help for residency placement it will take many, many years of lower enrollments than this to significantly improve our job market.
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MoostashPod
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That was an excellent post. This is truth right here that all pre-pod, pod students, and residents (as well as graduates) should read.
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Your local pre-MD/DO student (me) intruding on the professional forums again, but here is my take by way of analogy:
While I've never had a strong interest in DPM, I will say that SDN has somewhat influenced me to consider DO school (on the surface, I've been aware of osteopathic medicine and its full scope of practice in America since at least the mid-90s, but never really considered it until sometime after 2010) - I have had two, maybe three, accounts here on SDN in case anyone is calling my bluff, since 2002, high school graduation year. Part of it is through reading SDN, another is by reading Norman Gevitz, PhD's The DOs: Osteopathic Medicine in America. For comparison purposes, I have wanted to be some kind of physician since kindergarten (1989-1990 - my late father was a Philippine - trained MD practicing in America since the early 1970s till 2020).
Now, all this rambling aside, what does this have to do with podiatric medicine and podiatrists?
Whether we like it or not, the internet - including Student Doctor Network - is where many people get their information, including information on professions. So, whether it is working for the better or not for podiatric medicine and its doctors overall, I do not know, but I have no doubt the light bulb, if you will, is turning on in the heads of many students - and as an aside, SDN is where I first learn about some of the new medical schools being built each year.
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13,323 PharmD graduates in 2022
AACP released Sept 2022 data, showing that the number of PharmD graduates finally dropped below 14000 after six straight years above the 14000 mark. It looks like next year it will drop below 13000; and the following year it will drop below 12000. The 6.3% year over year decline (from 2021 to...
forums.studentdoctor.net
Worth a look - pharmacy appears to be experiencing ...a reevaluation also.
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Pharmacy needs to learn from podiatry and send some of their leaders over here STAT…..a handful that post on SDN are the obviously the cause for this.13,323 PharmD graduates in 2022
AACP released Sept 2022 data, showing that the number of PharmD graduates finally dropped below 14000 after six straight years above the 14000 mark. It looks like next year it will drop below 13000; and the following year it will drop below 12000. The 6.3% year over year decline (from 2021 to...
Worth a look - pharmacy appears to be experiencing ...a reevaluation also.
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Pharmacy hit the break point. For sure. They had all of the hallmarks podiatry is experiencing (and ignoring) right now:
- Podiatry has worsened ROI of the degree due to low pay, low demand (ditto for PharmD)
- Podiatrists turn to bad underpaid/overworked podiatry supergroup and PP jobs (pharmacy has most of their grads in retail pharma)
- Podiatry does fellowships just to hope to get a decent job (pharmacy added residency to try to get the few hospital jobs)
- Podiatry tuition is out of control with opening greedy new schools (ditto for PharmD)
- Podiatry has a very tough time getting loan for solo PP of yesteryear due to monster loans and bad income : debt ratio (same for pharmacists opening/buying their own biz)
Podiatry leaders seem to be blind to all of this, though.
We have goofballs signing up on SDN to post one or two times about how good they (not you) have it as a podiatrist... ppl who graduated decades ago... and who get income from training or employing younger DPMs, lol. Podiatry is set on currently saying how good the new schools are, trying to keep garbage residencies open and open new ones in a hurry (to float the new schools), trying to approve more fellowships to make director jobs and delay those ppl entering the saturated job market instead of keeping those much needed attendings/cases in resident training, and trying to make boards easier and fake CAQ to give the board money and lure people who can't pass the primary surgery board (despite "surgical" residency) a better chance in a very saturated field.
Most of all, the top pod leadership cheerleaders in the profession want to keep up the talking points of growing diabetes and elderly and growing the profession (read: growing tuitions, growing member dues, growing corporate sponsors, growing their job security)... and they are definitely looking to dismiss anyone who says otherwise. I had a talk last week with a DPM about to graduate, and the offers they were considering were abysmal. There is a REAL disconnect between the podiatry high castle and those out there working, so the saturation bubble will grow until student interest breaks it and/or too many DPMs default on loans or even declare bankrupt... no joke (see: Caribb MD schools). Buckle up.
Podiatry's been a good field for some DPMs, but that has been on the decline since I started (AZPod is a fine school but was not needed... we need good residencies and fewer DPMs chasing the finite jobs).
Podiatry practice loans are dry, most jobs are rough, good jobs are few, great jobs are unicorns and/or in bumblepuck, USA.
Pharmacy is the best example of a highly saturated profession that was once pretty good.
Optometry is another with shaky ROI and many grindy jobs that barely pay the loans.
Chiro or counselor/therapy are even more saturated, but I think their incoming students must know that well.
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What do you mean?
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He’s mocking the podiatry leadership that blames SDN for the enrollment dip and sends a few goons over to post drive by’s, never to be heard from again. He’s saying pharmacy leadership should do the same thing as ours and publicly blame the forums for their failures
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SDN has had a profound impact on my life.
Where else can I get hounded by grown adults day in day out while also being made into a meme?
I've learned so much about lobsters, locking threads, and how to bill for skin flaps while doing a partial chemical matrixectomy.
Even my wife has realized how healthy and empowering SDN has been for me.
Comments include, but are not limited to:
"Its OK if you can't find a job, just put 'SDN MoDeRaToR' on your resume."
"Are you gonna grow up to be an SDN ModErAtor just like your dad??" - while rocking our child
(Actual comments)
Came on here as a super gungho prepod ready to take on the world, came out jaded. I'm OK with that.
I enjoy residency, like what we do so far. Understand it may not be representative of the real world.
Most of all appreciate the people on here willing to share their ideas, opinions, expertise.
Even if you guys hate each other, I value that you guys are at least talking, discussing, spam reporting ideas.
Where else can I get hounded by grown adults day in day out while also being made into a meme?
I've learned so much about lobsters, locking threads, and how to bill for skin flaps while doing a partial chemical matrixectomy.
Even my wife has realized how healthy and empowering SDN has been for me.
Comments include, but are not limited to:
"Its OK if you can't find a job, just put 'SDN MoDeRaToR' on your resume."
"Are you gonna grow up to be an SDN ModErAtor just like your dad??" - while rocking our child
(Actual comments)
Came on here as a super gungho prepod ready to take on the world, came out jaded. I'm OK with that.
I enjoy residency, like what we do so far. Understand it may not be representative of the real world.
Most of all appreciate the people on here willing to share their ideas, opinions, expertise.
Even if you guys hate each other, I value that you guys are at least talking, discussing, spam reporting ideas.
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MortonExtension
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My question for you @Weirdy is why don't you Moderate DN hard enough?
Hybrocure
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What’s DN?
MortonExtension
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spit my drink out