I feel like quitting

[iridocyclitiss]

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Hi
I just want to vent and also ask advice.

I’ll be out of pod school debt end of this year. I like what I do but honestly residency can be pretty toxic sometimes. It’s fine. I’m fine. I feel like I get great training but I think residency is making me hate podiatry just with knowing that I’m working 90 hours a week making no money and will be working 90 hours as an attending making a little more money. the grass is always greener somewhere else but asking the peanut gallery if they have seen or heard of success stories of people leaving podiatry and doing alright.

Seriously considering being a medical foot and ankle sales rep or getting an MBA (non science undergrad degree) vs another degree (finance/accounting)

 

[heybrother]

Do not work 90 hours a week as an attending. You'll eat a bunch of ultraprocessed hospital food, cheat on your wife, and end up having to pay child support and alimony out of a pot of money that isn't big enough that was supposed to make your family life better.

Reasonably full clinic schedule + reasonable payors + reasonable pathology and offering more will keep you in business if you can just get someone to pay you fairly.

 

[pod squad]

It’s fine. I’m fine.

Podiatry in a nutshell 🤣. This is why we need some sort of DPM to other medical career (i.e. RN, PA, NP) pathway. Our degree has literally zero transferability. I would say MBA is your best bet if you're looking to switch careers. If you're a good test taker and crush the GMAT, you may have success in getting into a good program. That being said, I know the post-MBA job market has been ROUGH lately. Who knows what it'll look like in 2-3 years time.

 

[Feli]

The point of residency being fairly hard is that everything after seems pretty cake by comparison.
(reason #271 to do a good podiatry residency and not a mediocre one)

That's amazing you're outta debt and not even done with training yet.
I would stick it out for at least a few years. You might be fairly happy without the $3k/mo standard loan pay your classmates mostly have.

I agree with above that podiatry edu/skill is unfortunately very minimally transferable.

 

[Feli]

Do not work 90 hours a week as an attending. You'll eat a bunch of ultraprocessed hospital food, cheat on your wife, and end up having to pay child support and alimony out of a pot of money that isn't big enough that was supposed to make your family life better.

Reasonably full clinic schedule + reasonable payors + reasonable pathology and offering more will keep you in business if you can just get someone to pay you fairly.

Other way around. 🙂

 

[Hybrocure]

Hi
I just want to vent and also ask advice.

I’ll be out of pod school debt end of this year. I like what I do but honestly residency can be pretty toxic sometimes. It’s fine. I’m fine. I feel like I get great training but I think residency is making me hate podiatry just with knowing that I’m working 90 hours a week making no money and will be working 90 hours as an attending making a little more money. the grass is always greener somewhere else but asking the peanut gallery if they have seen or heard of success stories of people leaving podiatry and doing alright.

Seriously considering being a medical foot and ankle sales rep or getting an MBA (non science undergrad degree) vs another degree (finance/accounting)

How the hell did you pay off your debt during residency lol.

In any case..residency is hard but that’s a good thing. Once you finish it everything else seems so easy in comparison. At least see it through IMO. You’ll at least be a fully qualified doctor if alternative plans fall apart

 

[wakaflocka88]

I highly doubt you will work 90 hours post residency. Don’t take call, don’t work for a practice that requires call without fair call pay. Don’t try to chase down cases just to fulfill the ego and board certification because it likely will come back to burn you.

Once you become a yes person and open the flood gates to whatever, then it’s harder to stop it.

Set some goals, network as much as you can to better position yourself over your colleagues and peers.

Congrats on the debt, you will feel infinitely less stress even if you got stuck in a low paying job

It will take a good couple years to feel more comfortable out of residency. I didn’t feel I hit my stride till year 3

 

[Hybrocure]

I highly doubt you will work 90 hours post residency. Don’t take call, don’t work for a practice that requires call without fair call pay. Don’t try to chase down cases just to fulfill the ego and board certification because it likely will come back to burn you.

Once you become a yes person and open the flood gates to whatever, then it’s harder to stop it.

Set some goals, network as much as you can to better position yourself over your colleagues and peers.

Congrats on the debt, you will feel infinitely less stress even if you got stuck in a low paying job

It will take a good couple years to feel more comfortable out of residency. I didn’t feel I hit my stride till year 3

Agree 100%.

You’ll discover in the first year or two what you can and can’t do comfortably. And more importantly what you actually want to do. Some people learn the lesson harsher than others.

You’ll do better being a non op or minimal op in PP even as an associate than you will trying to change your career path and doing most other jobs from scratch.

Reps work long hours, are also on call, and it’s very dog eat dog. We see the nice side of it because we are the doctor. There’s a reason why most reps are young guys who hop around from company to company year after year. Power through residency it’ll be worth it even if you don’t want to do any of the stuff you did as a resident.


And even if you still want to pursue a non podiatry job route…just finish the dang residency. It’ll make your resume look much better.

 

[GreenGreen]

Personally, I'd only take a rep job if it came from a very good company that put you on salary and not as a 1099. Too many reps are just 1099 and can be cut with little protection or notice.

Just my 2 cents.

 

[Dermato Fight Club]

Hi
I just want to vent and also ask advice.

I’ll be out of pod school debt end of this year. I like what I do but honestly residency can be pretty toxic sometimes. It’s fine. I’m fine. I feel like I get great training but I think residency is making me hate podiatry just with knowing that I’m working 90 hours a week making no money and will be working 90 hours as an attending making a little more money. the grass is always greener somewhere else but asking the peanut gallery if they have seen or heard of success stories of people leaving podiatry and doing alright.

Seriously considering being a medical foot and ankle sales rep or getting an MBA (non science undergrad degree) vs another degree (finance/accounting)

Don't quit. You have the opportunity to make more money than 99% of people living in the world. You will be fine, especially if you're debt free. You will not need work anywhere near those hours once you are out.

To give you an idea, I work 8-4 M-Thur and half day Friday and do pretty well. No hospital consults.

 

[shadesofgrey]

I'm about as "low" on podiatry as a career choice as possible. However, at this point you've already gotten through what makes the ROI so bad (opportunity cost and tuition). Despite the bitching on this forum there aren't that many jobs available that are going to pay as well as being a podiatrist, especially without the loans (you lucky bastard). You might as well finish up residency, and experience real life as an attending before giving up. It's a much different existence than as a resident. The time commitment is likely much less than what you are going through, but the stress is different. Initially postop's that aren't doing great are gonna feel like you are getting punched in the gut and there's the constant battle for motivation when treating RFC, but its different.

Also you're exactly right, there aren't many good transition jobs from podiatry. Being a sales rep takes a certain personality. The only thing worse than putting up with the overly friendly sales rep would be trying to be one. Sometimes I'll make a joke in the OR and I know it flopped but guess who is laughing like a hyena, the rep. Imagine trying to be buddy-buddy with every podiatrist you ever met cause your income depends on it. Rough.

I know this is the definition of the sunk cost fallacy but in this case I'd try and push through at least till you get out into practice.

 

[dpmgrad]

Hi
I just want to vent and also ask advice.

I’ll be out of pod school debt end of this year. I like what I do but honestly residency can be pretty toxic sometimes. It’s fine. I’m fine. I feel like I get great training but I think residency is making me hate podiatry just with knowing that I’m working 90 hours a week making no money and will be working 90 hours as an attending making a little more money. the grass is always greener somewhere else but asking the peanut gallery if they have seen or heard of success stories of people leaving podiatry and doing alright.

Seriously considering being a medical foot and ankle sales rep or getting an MBA (non science undergrad degree) vs another degree (finance/accounting)

Feel free to reach out to me privately about the MBA route. There are other positions beside being medical device sales rep. There are few DPMs that transitioned into medical science liaison route with pharma and have climbed their way up the medical affairs ladder in pharma. Some have gone into entrepreneur route or data science / data analytics / health analytics route.

 

[Forcewielder]

Hi
I just want to vent and also ask advice.

I’ll be out of pod school debt end of this year. I like what I do but honestly residency can be pretty toxic sometimes. It’s fine. I’m fine. I feel like I get great training but I think residency is making me hate podiatry just with knowing that I’m working 90 hours a week making no money and will be working 90 hours as an attending making a little more money. the grass is always greener somewhere else but asking the peanut gallery if they have seen or heard of success stories of people leaving podiatry and doing alright.

Seriously considering being a medical foot and ankle sales rep or getting an MBA (non science undergrad degree) vs another degree (finance/accounting)

Congrats and hopefully your remaining kidney can carry you the rest of your life (because how else does a resident pay off their debt ha). But in all sincerity take a minute and take a breath. Take a mental health break or see a therapist or if you have a dude from pre-podiatry days you can vent to then do so. It's easy to forget how good we have it when we compare ourselves to our "peers". Don't be afraid to take a lower pay, low stress job your first year to get your bearings. If you don't have the loans to deal with then you should be fine making lower pay because it should still beat most alternatives. Also, you should never work 90hrs/week as an attending. I've never seen that in our profession. I'm sure there are dudes that do that, but I'm doing 50-55 with plans to cut back eventually. Most doctors of any specialty where I work don't do more than 3-4 days a week with minimal to no call.

 

[air bud]

Congrats and hopefully your remaining kidney can carry you the rest of your life (because how else does a resident pay off their debt ha). But in all sincerity take a minute and take a breath. Take a mental health break or see a therapist or if you have a dude from pre-podiatry days you can vent to then do so. It's easy to forget how good we have it when we compare ourselves to our "peers". Don't be afraid to take a lower pay, low stress job your first year to get your bearings. If you don't have the loans to deal with then you should be fine making lower pay because it should still beat most alternatives. Also, you should never work 90hrs/week as an attending. I've never seen that in our profession. I'm sure there are dudes that do that, but I'm doing 50-55 with plans to cut back eventually. Most doctors of any specialty where I work don't do more than 3-4 days a week with minimal to no call.

Who is the dude who like literally made his own clothes and went to food Banks because he was afraid to spend money?

 

[iridocyclitiss]

For everyone asking how I have minimal debt it’s the first thing we always talk about - a high earning spouse.

Thanks for the advice. I feel like most of the burnout is just because we are so busy doing surgery and consults. I also have my own clinic which is fun. It can be a lot at the end of the day but I know it’ll make things easier down the road.

Grass is always greener and it’ll get better

 

[p100]

If you can work for yourself podiatry is very nice. If not then you are living a dog's life at the behest of barely literate admins, PP owner's wives, and taking crap from patients that are generally the dumbest people of society.

 

[Forcewielder]

If you can work for yourself podiatry is very nice. If not then you are living a dog's life at the behest of barely literate admins, PP owner's wives, and taking crap from patients that are generally the dumbest people of society.

Disagree. I've done well working rural. I've got a spouse that doesn't want to live rural so my commute isn't great (all highway without traffic but still over an hour). But there are ways to do well if you find your niche. Heck, my first year out I did nursing home care and made 180k. Still beats construction work. I did a summer of painting houses and there's no chance I could make it doing that long term.

 

[deleted1162946]

For everyone asking how I have minimal debt it’s the first thing we always talk about - a high earning spouse.

Thanks for the advice. I feel like most of the burnout is just because we are so busy doing surgery and consults. I also have my own clinic which is fun. It can be a lot at the end of the day but I know it’ll make things easier down the road.

Grass is always greener and it’ll get better

My highish income earning fiancé ($150k) also has a ton of student debt. If we call into Dave Ramsey we’d be probably laughed at.

Big shovel just huge mountain. I’m trying to convince her to tackle it head on and get it over with.

 

[Feli]

My highish income earning fiancé ($150k) also has a ton of student debt. If we call into Dave Ramsey we’d be probably laughed at.

Big shovel just huge mountain. I’m trying to convince her to tackle it head on and get it over with.

Yep, it is boring AF... but it's also the only way to go.
It's the just only way to ever free up your real and full earning/invest potential.

You will basically be stuck on baby step #2 for a veeery long time.
Ppl who keep using ccards and/or avoiding paying debt to be borrowing for car, truck, trips, home improvements, "investing," whatever, etc will be stuck there literally forever.

Roth/backdoor ($7k/yr or whatever it increases to) and 401/403 match (if true and immediate match... no delay/partial vest crap) or money into your own biz are the only possible exceptions. Anything "investing" besides that is basically just pissing into the wind when you have debt piling up interest against you, though. That means cash account or crypto or options any other alt invests are only kidding yourself... just pay the loans, esp with current student loan rates. All the hard work and delay gratification DOES get impactful once you start crossing things off for good (ccard debt... then auto loans.. then student high interest student loan... then all student loans... maybe house debt and/or super-fund retirement... etc). 👍

 

[GreenHousePub]

Only in podiatry would 150k be consider a high earner

 

[mandrew]

Hi
I just want to vent and also ask advice.

I’ll be out of pod school debt end of this year. I like what I do but honestly residency can be pretty toxic sometimes. It’s fine. I’m fine. I feel like I get great training but I think residency is making me hate podiatry just with knowing that I’m working 90 hours a week making no money and will be working 90 hours as an attending making a little more money. the grass is always greener somewhere else but asking the peanut gallery if they have seen or heard of success stories of people leaving podiatry and doing alright.

Seriously considering being a medical foot and ankle sales rep or getting an MBA (non science undergrad degree) vs another degree (finance/accounting)

What were your goals when you made the decision to attend Podiatry School? Never met an attending that works close to 90 hours per week.

 

[Hybrocure]

What were your goals when you made the decision to attend Podiatry School? Never met an attending that works close to 90 hours per week.

I have. The big ortho jobs that certain people compete over right out of residency can pull some hard hours. Especially if they’re taking limb salvage call in addition to bones. If they hire an ortho they won’t work 90 hours but if they hire a podiatrist they know the podiatrist will and will be happy for it.

it’s good money but you can burnout if you work too hard, especially if you don’t have someone to see consults and round for you.

 

[MicroPod]

The thing about many of the ultra high paying medical specialties is that they take call and often work pretty long hours. Ortho, NSGY, Interventional Cards, etc. In residency we got called pretty often but those specialties get consulted multiple times a day and often at night (at least at level 1 center). There’s a reason why the most competitive specialties aren’t the highest paying ones. Usually a mixture of good pay with good hours (which I guess you could argue pays similar amounts per time investment)

Then there’s podiatry… which can be a mixture of bad hours, call, and relatively bad pay which you don’t really see in other specialties.

 

[Feli]

The thing about many of the ultra high paying medical specialties is that they take call and often work pretty long hours. Ortho, NSGY, Interventional Cards, etc. In residency we got called pretty often but those specialties get consulted multiple times a day and often at night (at least at level 1 center). There’s a reason why the most competitive specialties aren’t the highest paying ones. Usually a mixture of good pay with good hours (which I guess you could argue pays similar amounts per time investment)

Then there’s podiatry… which can be a mixture of bad hours, call, and relatively bad pay which you don’t really see in other specialties.

100%... you get what you allow. ^
It's important to draw a line with call and ERs and stick to it. Podiatry has very few true emergencies.

Many orthos and vasc and gen and trauma etc surgeons will do an open fx in the middle of the night and then five TKAs the next day. It's rough... but they also get paid 2x-4x what most podiatrists do. They also usually take q4 or q5 call - or less.

For the OP, the podiatrist jobs to be really wary of are the ones where the dept DPMs are all taking a lot of call, getting called a lot, working hard, basically working like residents. It could be as simple as a VA where they have to take q2 call because they can't ever keep a third, or it could be a PP group that just is super aggressive with consults and always has many inpatients at nearby hostpital(s). There is really no way to not take as much call and hours as the other dept/group DPMs at those situations (probably even more than avg for their new hire). Unless the pay is fantastic or the call is very reasonable, those are BURNOUT jobs for podiatry. People laugh like podiatry can't be stressful, but it absolutely can. Again, you get what you allow (and what you sign up for). Although most of those bad hours jobs may pay well, being bald and chubby and divorced by 40 is never ideal.

Like @Hybrocure , I have also seen quite a few DPM attendings unfortunately working 80+ hrs/wk. They're usually one of 3 main types:

1. Pods simply taking a lot of call/inpatients - or even a ridiculous number of just office pts (and those evening/weekend notes). The is can be hospital employee DPMs with call/inpts. It can be private practice associates made to work hospitals, do late "after 5pm" add-on wound/amp crap, or made to work Saturday office. It could be guys trying to see 50-60+ patients/day - esp with taking add-ons or going into ER/hospital early/late for dumb midlevel calls that should just be sent to office next week, etc etc.
2. Solo PP just starting own office and doing EMR setup or physical office setup/ordering/logistics/marketing/etc into evenings and weekends (this was me for maybe 3-6mo... now drastically easier, no weekends).
3. The "famous" residency/acad types who work a lot and also travel a lot on and speak on many weekends - only to go back to 50+ pts in office on Monday. We all wanted to be those guys when we were students or residents... but a lot of them eat, sleep, and breathe podiatry.

 

[deleted285117]

The "famous" residency/acad types who work a lot and also travel a lot on and speak on many weekends - only to go back to 50+ pts in office on Monday. We all wanted to be those guys when we were students or residents... but a lot of them eat, sleep, and breathe podiatry.

Kinda sad isn’t it?

 

[DYK343]

but a lot of them eat, sleep, and breathe podiatry.

I took 9 months off this forum because thats how it began to feel.

 

[Retrograde_Nail]

I've never voluntarily eat, sleep, breathe podiatry. I just do it because of the volume I am seeing. But I actually do not like this profession at all. This profession is the most fragmented profession I have ever seen. So many organizations for such a small part of anatomy. Everybody steps over each other to earn a dollar. The constant restricting of others to conserve their own volume. The constant defamation of others. We have made no head way with earning respect from ortho. The constant risk of medi-mal cases because other podiatrists will throw you under the bus and ortho will too. MD/DO medicine docs still confused on what you can and can not do. It's a rat race. I've only tolerated it because I have a hospital job. If I had to work in private practice I am pretty sure I would have left the profession by now.

Finally there is worsening ROI due to saturation (which is happening). Everyone graduating is a "surgeon" which we really don't need anymore.

 

[Feli]

...The constant restricting of others to conserve their own volume. The constant defamation of others. ...

Absolutely.
Saturation is a terrible thing for any profession; it causes the cannibalism with underpaid associates and limiting of other DPMs at hospitals. It will be crazy to see how the higher podiatry debt loads and bigger grad classes of DPMs with new schools ramps it up further. No matter what might be said in pod schools' marketing attempts, the USA census or the senior population isn't increasing; they are putting higher numbers of podiatrists into the same sandboxes. I like the job, but when people ask why I don't join APMA, I kinda just laugh in their face and ask how many pod schools we are up to now (most truly don't know).

Our PP pods are out accepting walk-ins and fighting hard for appointment calls and facebook ad space and PCP refers. A lot will waive copays or coinsurances just to get and keep patients. There are new wacky OTC products and kickback refers or unnecessary 'ancillary services' that pop up every year. We have tons of questionable DME and vasc refers and "grafting" wounds, and "histology" of toenails and neuropathy vitamin sales going on. It's pretty much like chiropractors in a lot of cities.

Likewise, our Hospital/MSG pods are scared to death of their facility or group hiring another DPM because that'll dip into their surgery/rvu volume or neuter their negation power for future raises (the group/hospital will see the hundreds of apps they get for the position... and the new hire will certainly work happily for same/less money).

...and this is not to say that being a plastic surgeon in Coral Gables Miami or an ortho in Outer Banks NC probably isn't somewhat competitive, but podiatry is that way to the extreme in any city. You won't see the MD/DOs having to market hard and accept walk-ins... or take terrible ROI jobs. A simple search on Google Maps shows us podiatry is very dense for the demand of the services we provide. It's also plainly evidenced by the massive numbers of DPMs applying for hospital jobs (even VAs or rural jobs that get almost no MD/DO interest at all).

 

[futurenjdoc]

quit while you can . There are easier ways to get money than this joke of a profession

 

[HeySister]

Absolutely.
Saturation is a terrible thing for any profession; it causes the cannibalism with underpaid associates and limiting of other DPMs at hospitals. It will be crazy to see how the higher podiatry debt loads and bigger grad classes of DPMs with new schools ramps it up further. No matter what might be said in pod schools' marketing attempts, the USA census or the senior population isn't increasing; they are putting higher numbers of podiatrists into the same sandboxes. I like the job, but when people ask why I don't join APMA, I kinda just laugh in their face and ask how many pod schools we are up to now (most truly don't know).

Our PP pods are out accepting walk-ins and fighting hard for appointment calls and facebook ad space and PCP refers. A lot will waive copays or coinsurances just to get and keep patients. There are new wacky OTC products and kickback refers or unnecessary 'ancillary services' that pop up every year. We have tons of questionable DME and vasc refers and "grafting" wounds, and "histology" of toenails and neuropathy vitamin sales going on. It's pretty much like chiropractors in a lot of cities.

Likewise, our Hospital/MSG pods are scared to death of their facility or group hiring another DPM because that'll dip into their surgery/rvu volume or neuter their negation power for future raises (the group/hospital will see the hundreds of apps they get for the position... and the new hire will certainly work happily for same/less money).

...and this is not to say that being a plastic surgeon in Coral Gables Miami or an ortho in Outer Banks NC probably isn't somewhat competitive, but podiatry is that way to the extreme in any city. You won't see the MD/DOs having to market hard and accept walk-ins... or take terrible ROI jobs. A simple search on Google Maps shows us podiatry is very dense for the demand of the services we provide. It's also plainly evidenced by the massive numbers of DPMs applying for hospital jobs (even VAs or rural jobs that get almost no MD/DO interest at all).

My understanding is that waving a copay is insurance fraud. Could be wrong but don't think so.

 

[Feli]

My understanding is that waving a copay is insurance fraud. Could be wrong but don't think so.

Correct.

 

[msion]

Our PP pods are out accepting walk-ins and fighting hard for appointment calls and facebook ad space and PCP refers. A lot will waive copays or coinsurances just to get and keep patients. There are new wacky OTC products and kickback refers or unnecessary 'ancillary services' that pop up every year. We have tons of questionable DME and vasc refers and "grafting" wounds, and "histology" of toenails and neuropathy vitamin sales going on. It's pretty much like chiropractors in a lot of cities.

On the other hand, there is no shortage of medicaid patients even in major coastal cities as long as one is okay to treat the following:

1. The typical DM, ESRD on HD, noncompliant ones with multiple ulcers/amps and bounce from hospital to hospital.
2. The chronic pain patient with fibromyalgia also suffering diffuse bilateral foot and ankle pain, referred by pain management.
3. Ex-convicts now wanting disability for the new job due to 10+ years of plantar fasciitis and athletes' foot from "hard and dirty prison floors."
4. The ones who somehow think all the nails are ingrown and want them all pulled out on the first visit.
5. The ones from a psychiatric hospital needing their nails trimmed. Last time it was done was maybe 5 years ago.

But otherwise yes it's pretty cut throat in the PP world competing for the PPO, Medicare and even MCA patients.

 

[Carbon13]

I agree with Feli on the private practice issue.

I know several posters on here are MSG / Ortho / Hospital based.

I have been a solo PP owner for 5-6 years. Similar story starting as several people. Started out as I spent 1 year as an associate at a TFP based PP office prior to starting my own shop. I had top level training and consider myself pretty business savvy.

I scraped up everything I could the first 2 years. I was finally able to maintain a steady 20-25 patients per day while cutting some of the Medicaid / PRN nursing home junk. I was able to save a few bucks over the years with hopes of building my own office real estate in town.

Then, *BOOM*. 4-5 new pods have moved into my town of 80K in the past 2 years. That's in addition to the few TFP's & FAO.

Now, here we are. Competition is fierce as ever. I'm now worrying about things that most other specialists 5-6 years into practice probably aren't. Am I going to be able to keep my surgery block time with a decreasing volume? Etc.....

I feel some of the new guys are trying to do things they weren't trained well on or not yet efficient. Hearing rep stories of 3.5 hour Lapidus, etc...

Anyways. My point is. Saturation is a tidal wave coming for podiatry and will be more than capable of causing wide spread chaos throughout the profession. Nobody will be completely sheltered.

I wouldn't advise jumping into this mess unless you're 100%.

P.S. (wish I could post about something positive on this forum)

 

[heybrother]

I agree with Feli on the private practice issue.

I know several posters on here are MSG / Ortho / Hospital based.

I have been a solo PP owner for 5-6 years. Similar story starting as several people. Started out as I spent 1 year as an associate at a TFP based PP office prior to starting my own shop. I had top level training and consider myself pretty business savvy.

I scraped up everything I could the first 2 years. I was finally able to maintain a steady 20-25 patients per day while cutting some of the Medicaid / PRN nursing home junk. I was able to save a few bucks over the years with hopes of building my own office real estate in town.

Then, *BOOM*. 4-5 new pods have moved into my town of 80K in the past 2 years. That's in addition to the few TFP's & FAO.

Now, here we are. Competition is fierce as ever. I'm now worrying about things that most other specialists 5-6 years into practice probably aren't. Am I going to be able to keep my surgery block time with a decreasing volume? Etc.....

I feel some of the new guys are trying to do things they weren't trained well on or not yet efficient. Hearing rep stories of 3.5 hour Lapidus, etc...

Anyways. My point is. Saturation is a tidal wave coming for podiatry and will be more than capable of causing wide spread chaos throughout the profession. Nobody will be completely sheltered.

I wouldn't advise jumping into this mess unless you're 100%.

P.S. (wish I could post about something positive on this forum)

In essentially the last 10-11 years we've
-Had 1 ancient c&c pod retire due to Covid
-Had 1 forefoot surgical pod become disabled. He was the king of cheilectomies and neuromas. Maybe 2 years before me.
-Picked up a young guy, surgical, 10-11 years ago.
-Picked up an old guy (essentially non-surgical, told it was a low stress no-traffic town). Pushes custom orthotics for bunions.
-Picked up me
-Picked up a young podiatrist who just got fired by their hospital for being terrible at surgery. Whenever I'd ask about them the staff at their hospital would always demur and play quiet, but now that they are gone no one is holding back.
-Have another young podiatrist coming next year (strong ties to the town) who theoretically should be well trained in surgery
-And a hospital is trying to hire a FM doc who is married to a pod. The hospital was calling PP asking if anyone wanted to hire the pod. The hospital is the same hospital that just fired their pod. This pod went to a program a friend told me is terrible.
-And hilariously I have a student who is shadowing who wants to come back too in I guess 4-5 years. Hopefully I'll be dead by then.

I'm sure the older pods are just blown away by how many people are coming. Everyone I've spoken to who was here before wants to practice another 10-15 or has young children still.

I looked up our orthopedic foot and ankle guys who are all full scope. I was surprised that most are younger than I thought they were. One was supposed to retire and then didn't. He now attempts to be surgery only and have his PAs do all his follow-ups. Two of the foot and ankle orthos I've been told are still absolutely, insanely in love with medicine and will practice till the day they die.

 

[Mia McBhul]

If you can work for yourself podiatry is very nice. If not then you are living a dog's life at the behest of barely literate admins, PP owner's wives, and taking crap from patients that are generally the dumbest people of society.

living a dog's life?? sir, dogs live much much better

 

[caliking87]

This has been talked about before but I could also use internet advice

For someone WITH student loan debt, about to start residency but sees the writing on the wall with saturation, declining insurance reimbursement, climbing business costs, private equity takeover etc…
And also wishes to live in a saturated part of the country

What would you do? I don’t love podiatry enough to stick around for that reason alone. I’ve worked in a variety of other fields and enjoyed other jobs the same. Including blue and white collar jobs
I don’t know what to switch to? Everything else seems screwed also.
Any ideas? Open to anything, including blue collar but due to high student loan debt it needs to have potential to make decent money
Would love any ideas to explore

 

[heybrother]

It feels strange to be this "hopeful" but I feel like some of ya'll are giving up before you get started.

I'm a partner in a private practice. Last year I brought in $40K-ish extra in collections, but my pay only went up $7K.

What am I doing?

Starting my own practice. Found a former physician office building where the guy built a new building on the fancy side of town and wanted out. Just went under contract. If the contract goes through I'm going to own a building for less than houses are selling for in my neighborhood.

Can't wait to be paying rent to my own LLC in a few years. If I'd owned my current practice's building I'd have made an extra $50K last year and I'd have been patting myself on the back in the success thread.

I'm ditching my over priced EHR and writing to people on here about their experiences with another.

I'm getting rid of overpriced IT.

No more paying for health insurance for employees who don't show up.

I've got my businesses tax return up and I'm going through it line by line for expenses I'm going to kill at my new offices.

The fly in the ointment is @619 has their profile private so I can't write to them and ask even more people for advice.

Yes. Healthcare is a mess. I don't claim to have a lot of imagination, but I've had lots of jobs too and none of them paid $90 to talk to someone for 3 minutes

Fight for what you want. Plan on being a business person. Start reading up on incorporation in your state. Ask AI how to find a business. The answers are amazingly detailed and so helpful.

 

[Feli]

This has been talked about before but I could also use internet advice

For someone WITH student loan debt, about to start residency but sees the writing on the wall with saturation, declining insurance reimbursement, climbing business costs, private equity takeover etc…
And also wishes to live in a saturated part of the country

What would you do? I don’t love podiatry enough to stick around for that reason alone. I’ve worked in a variety of other fields and enjoyed other jobs the same. Including blue and white collar jobs
I don’t know what to switch to? Everything else seems screwed also.
Any ideas? Open to anything, including blue collar but due to high student loan debt it needs to have potential to make decent money
Would love any ideas to explore

That's the problem: you've invested too much time and money in podiatry... you are pretty much stuck now. You have paid all tuition.
Just get the most from residency, the best DPM job you can to start, then get to work on finding a better job or start your own office.
You WILL make money. You will make a fair bit if you work a bad employ job, a good bit if you are owner or facility employ job, a great bit if you do fraud and/or farm the work of others.

I will tell you this: you will experience burnout (or boredom, or frustration, or getting out of shape... or whatever you want to call it).
WCI is right... on many things, but in this link, read the "A Race Against Burnout" section). It literally is a race against burnout. Get mad. Feel hunted.

You have to knock out the student loan priciple asap after training. Paying the interest while in training is a great start.
Start tracking asap towards hospital job, solo PP, or whatever path you want.
Those poor DPMs who just pay minimums and hope for 20 or 25 year or whatever foregiveness have a bleak career outlook.
Fact is that you simply won't have the energy or drive at 40 that you do at 30.... not at 50 what you have at 40.
If you're sadly not retired by 60... well, same idea. 🙁

The time to get your budget in check, "live like a resident," keep applying for better jobs, start your own office, etc... is asap: in residency or immediatly after.
You don't have a looong 30 year career like you may think. You will be hopelessly crushed by interest if you don't pay meaningful amounts and not miss paying those larger payments monthly. People think it's ok to bumble around at associate and supergroup jobs with low income. It's not. You can make it work to pay off big debt with moderate income, but you will live a VERY low standard of lving if you make any meaningful loan payments at those common associate $125k-175k jobs.

Energy will just not get higher as you age. It probably hasn't hit you at all yet, but realize that wall is coming. Even if you can get a podiatry hospital job (Rvu or high salary) or have your own office, that taking call and doing early/late rounds and surgery and busy clinic and marketing in your 30s or maybe even through 40s will not be as sustainable long term. The PP hours per week eases up once you get schedule full; the hospital work does not. If you have residents - in either situ - to "help out" with workload, then they'll probably also be happy to eventually "help" try and take your high pay hospital/acad job or your PP area refers once there are a few chinks in your armor evident (taking a lot of vaca, working less hours, looking old, etc). Podiatry is awesome like that; saturation affects nearly any practice situation. It's dog eat dog. So, even if you "win," you won't be on top for too long... make it count. GL 🙂

...But yeah, you have assumed 100% of the pod debt (only add the interest from residency +/- fellow years).
You sadly won't find a non-pod job making as much or more than practicing podiatry. That's not to say you can't try.
However, you kinda need to get that out of your head and make a plan at this point. It can be an ok career.
Learn the skills in residency... but also learn to budget, get discipline, pay the student loan interest as a resident (seems impossible... but quite possible).

 

[Hybrocure]

This has been talked about before but I could also use internet advice

For someone WITH student loan debt, about to start residency but sees the writing on the wall with saturation, declining insurance reimbursement, climbing business costs, private equity takeover etc…
And also wishes to live in a saturated part of the country

What would you do? I don’t love podiatry enough to stick around for that reason alone. I’ve worked in a variety of other fields and enjoyed other jobs the same. Including blue and white collar jobs
I don’t know what to switch to? Everything else seems screwed also.
Any ideas? Open to anything, including blue collar but due to high student loan debt it needs to have potential to make decent money
Would love any ideas to explore

I’m in heavy student loan debt post residency. I work in a saturated and somewhat HCOL area. I do income based repayment.

People pay 10% tithes to their churches mine just goes to student loans instead.

 

[DarkPathMedicine]

I came out of residency with a large amount of student loans also. It was unbearable to think about how I was going to pay it all back, and I was paying it back during residency (~20K) and also the 4-5 years of the student loans pause (Covid Pandemic). Stuck with the job I have as an associate but paid it back slowly...no other choice really. With podiatry, I'm at least employable and I HAVE a job. Quitting podiatry and starting over didn't make sense to me since I have student loans and I could use what I have (although I wanted to quit long ago). I could have job hopped around but with moving and my significant didn't want to move due to stable job made it difficult. Currently on the SAVE plan (now defunct), but I'm almost done cleaning up my student loan mess. Then hopefully I can get out of podiatry and do something else.

 

[Sybly]

All best to you! Let students know problems of podiatry

 

[eyeeye_captain]

I won’t rehash all of the above because I wholeheartedly agree with it. Finish, plug away until you find the dream or at least something tolerable.

It’s not all that easy to be employable and at 6 figures. That debt’s gotta go. To cut down some of the greener grass you seek, I’ll give you some (probably bad) examples:

College friend who is extremely smart/dumb has a PhD in philosophy, with a lot of their thesis work done at some ridiculously famous European university for the field. Now at around 40, can’t find a tenure track and is a visiting professor at our alma mater making around $60k.

On the Pain board, there’s somebody complaining about their new grad PA. Apparently the going rate for one of those is $50/hr, and said lazy PA supposedly took the job because the hospital gigs are starting to fill up. He’s asking if it’s appropriate to cut her to $85k.

Your favorite “highly compensated” neighborhood podeyetrist wasn’t non-mortgage debt free until I’d hit PGY-11.