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BubbaWub

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Enjoy this nice little read, happy Friday!!

www.shorenewsnetwork.com

Doctor Offers Medical Advice for Better Shooting After Attempted Trump Assassination

A Pensacola podiatrist is feeling the wrath of social media after a disturbing post he made on his Facebook page regarding the failed assassination attempt on
www.shorenewsnetwork.com www.shorenewsnetwork.com
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I was going to write about what shoes allowed the shooter to climb the roof that the Secret Service felt uncomfortable doing.
 
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If libs of Tik tok see this he’s fired for sure.

He’s probably miserable at upperline seeing 40 patients a day at 30% collections.

edit: too late. x.com
 
The biggest irony is that podiatrists are now the target. Unfortunately, our field is often judged by its weakest members.
 
You guys are lookin at this all wrong:

We had an article from AMA that podiatrists are not doctors.
These articles and re-posts repeatedly call him "a doctor."He is merely a podiatrist.

Our parity has been achieved? 🤔

JustAPedicurist said:
If libs of Tik tok see this he’s fired for sure.

He’s probably miserable at upperline seeing 40 patients a day at 30% collections.

edit: too late. x.com
Click to expand...
Yeah, he is getting fired for sure... his social medias are taken down, and the reviews are in:

doctor.webmd.com

Dr. Michael Allen, Podiatry | Pensacola, FL | WebMD

Dr. Michael Allen, is a Podiatry specialist practicing in Pensacola, FL with undefined years of experience. This provider currently accepts 26 insurance plans including Medicaid. New patients are welcome.
doctor.webmd.com doctor.webmd.com

www.healthgrades.com

Dr. Michael Allen, DPM - Podiatry Specialist in Pensacola, FL | Healthgrades

Dr. Michael Allen, DPM is a podiatry specialist in Pensacola, FL. He is affiliated with HCA Florida West Hospital. He is accepting new patients and telehealth appointments.
www.healthgrades.com www.healthgrades.com

Poor dude is probably scrambling to get an attorney and say somebody hacked his account and posted that.
He will get an extremely long weekend off work. He's going to be lucky to get an even worse associate or VC job... and that's probably after moving cross-country and/or take a long layoff to let this blow over. Not to mention his future firearms rights or state medical boards or hospitals won't take a possible FBI or state pharma board investigation lightly. That could be reportable or just linger on his name long term.

Uff da. Wonder if he did a fellowship...
 
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Feli said:
Poor dude
Click to expand...
1721435227784.png
 
Retrograde_Nail said:
This is something that will ruin his career. He might need to legally change his name. His wife might divorce him over the embarrassment. I mean this is bad and not very smart. The internet is written in ink not pencil. This will live on forever.
Click to expand...
It’s one thing if you’re like 18. But this was honestly a pretty crazy thing for him to post.

People are already bombing his reviews because of that comment.

I’ve posted a lot of crazy stuff in my time. But there’s a line where you go from comedy to “creepy dark” and he hit that.

He’s may be a normal dude. Just got a bit too fiesty. But that’s a rough thing to post especially with Facebook set to public
 
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Feli said:
You guys are lookin at this all wrong:

We had an article from AMA that podiatrists are not doctors.
These articles and re-posts repeatedly call him "a doctor."He is merely a podiatrist.

Our parity has been achieved? 🤔
Click to expand...

I don’t say this often, but Feli is a genius. This article calls us doctors multiple times!!

I can sleep easy at night knowing the folks at shore news network has recognized us finally.

There is always a silver lining.

Thank you
 
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Retrograde_Nail said:
This is something that will ruin his career. He might need to legally change his name. His wife might divorce him over the embarrassment. I mean this is bad and not very smart. The internet is written in ink not pencil. This will live on forever.
Click to expand...
The internet tends to only care about things for like a week, maybe a month, maybe like 3 months if insanely viral.

Although if someone keeps showing his employers this time and time again it might cause him issues. But the internet is very good at forgetting minorly viral things.
 
Robin-jay said:
The internet tends to only care about things for like a week, maybe a month, maybe like 3 months if insanely viral.

Although if someone keeps showing his employers this time and time again it might cause him issues. But the internet is very good at forgetting minorly viral things.
Click to expand...
Hawk Tuah
 
Yeah he’ll likely stop getting harassed at some point but everytime you Google his name these articles will pop up and his 1 star reviews. And as mentioned he’s been reported to the state board..

Anyways, new grads without a job you can call/email Pensacola upperline

Good lesson for everyone though. Absolutely no politics on social media. People get too butthurt. This guy did take it way too far though
 
Is nobody smart enough to make anonymous accounts for ****posting anymore?
 
Robin-jay said:
The internet tends to only care about things for like a week, maybe a month, maybe like 3 months if insanely viral.

Although if someone keeps showing his employers this time and time again it might cause him issues. But the internet is very good at forgetting minorly viral things.
Click to expand...
I don't think it works this way, sir. You might realize that once you're an attending.
This should be a good warning for any DPM, particularly younger ones.

The damage has been done... reviews, screenshots, ill will. The twitter and FB roasts can't even be counted.
He has 100% scrubbed his social media... and should obtain attorney advice on this.
The problem is: his employer and his hospitals all did the same. They want nothing to do with this either.
His employer that fired him took much heat, lost money, and will assure their staff references "keeps showing his employers this time and time again."

Job gaps or taking any job you can get on a whim is damaging for a podiatrist, particularly early career. Source = common sense, and trust me brah. Podiatry always has fairly limited job options regardless, and he will have VERY limited options now. He'd be wise to go by his middle name and change appearance at least a bit for future jobs, web presence, etc.

He may never recover. Sad but true. The guy has worked at that Upperline venture capital group job for years. They got tons of angry reviews and surely got hundreds of press and angry phone calls, patients leaving on account of this.... and fired him accordingly. He can't just omit that job or his Pensacola hospitals (probably his only job since residency, not board cert yet). He will need to list those for future applications (jobs, privileges, licenses) for the foreseeable future.

Nooo prospective employer wants that attention if even a few people in the new town put 2+2 together. An assassination attempt and guy who might win president again won't be "old news" anytime soon. It's very likely only the real predatory and underpaid associate jobs or maybe house call jobs will take the risk on him now. Why would any hospital or MSG or any good podiatry job which gets many applications risk the baggage? This will cripple his earnings and job options for quite awhile. You'd honestly much rather have early-career malpractice or pharmacy board discipline or sexual harassment suit; those things are lame - but they're compartmentalized. What he did went totally widespread and is very damaging stuff...

1721780449195.png
 
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Feli said:
I don't think it works this way, sir. You might realize that once you're an attending.
This should be a good warning for any DPM, particularly younger ones.

The damage has been done... reviews, screenshots, ill will. The twitter and FB roasts can't even be counted.
He has 100% scrubbed his social media... and should obtain attorney advice on this.
The problem is: his employer and his hospitals all did the same. They want nothing to do with this either.
His employer that fired him took much heat, lost money, and will assure their staff references "keeps showing his employers this time and time again."

Job gaps or taking any job you can get on a whim is damaging for a podiatrist, particularly early career. Source = common sense, and trust me brah. Podiatry always has fairly limited job options regardless, and he will have VERY limited options now. He'd be wise to go by his middle name and change appearance at least a bit for future jobs, web presence, etc.

He may never recover. Sad but true. The guy has worked at that Upperline venture capital group job for years. They got tons of angry reviews and surely got hundreds of press and angry phone calls, patients leaving on account of this.... and fired him accordingly. He can't just omit that job or his Pensacola hospitals (probably his only job since residency, not board cert yet). He will need to list those for future applications (jobs, privileges, licenses) for the foreseeable future.

Nooo prospective employer wants that attention if even a few people in the new town put 2+2 together. An assassination attempt and guy who might win president again won't be "old news" anytime soon. It's very likely only the real predatory and underpaid associate jobs or maybe house call jobs will take the risk on him now. Why would any hospital or MSG or any good podiatry job which gets many applications risk the baggage? This will cripple his earnings and job options for quite awhile. You'd honestly much rather have early-career malpractice or pharmacy board discipline or sexual harassment suit; those things are lame - but they're compartmentalized. What he did went totally widespread and is very damaging stuff...

View attachment 389815
Click to expand...
MDs get away with worse. This guy didn’t hurt any patient. There are docs out there (like Dr Death) who hop from job to job after constant malpractice.


We all know the docs in our towns who party pretty damn hard after conferences. Should they lose their job too? A lot of them do good work. Some of them, the best work. Some of them may say the same stuff at a coke fueled rant at a strip club.


Well that’s up to interpretation. This guy said an absolutely idiotic and dark thing on social media. It doesn’t discredit him as a doctor IMO. I don’t think it affects his surgery or his day to day operations with patients. But that’s life when you work for an organization rather than a practice. You’re just another cog in the machine whether it’s a hospital, MSG, etc.
 
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Feli said:
I don't think it works this way, sir. You might realize that once you're an attending.
This should be a good warning for any DPM, particularly younger ones.

The damage has been done... reviews, screenshots, ill will. The twitter and FB roasts can't even be counted.
He has 100% scrubbed his social media... and should obtain attorney advice on this.
The problem is: his employer and his hospitals all did the same. They want nothing to do with this either.
His employer that fired him took much heat, lost money, and will assure their staff references "keeps showing his employers this time and time again."

Job gaps or taking any job you can get on a whim is damaging for a podiatrist, particularly early career. Source = common sense, and trust me brah. Podiatry always has fairly limited job options regardless, and he will have VERY limited options now. He'd be wise to go by his middle name and change appearance at least a bit for future jobs, web presence, etc.

He may never recover. Sad but true. The guy has worked at that Upperline venture capital group job for years. They got tons of angry reviews and surely got hundreds of press and angry phone calls, patients leaving on account of this.... and fired him accordingly. He can't just omit that job or his Pensacola hospitals (probably his only job since residency, not board cert yet). He will need to list those for future applications (jobs, privileges, licenses) for the foreseeable future.

Nooo prospective employer wants that attention if even a few people in the new town put 2+2 together. An assassination attempt and guy who might win president again won't be "old news" anytime soon. It's very likely only the real predatory and underpaid associate jobs or maybe house call jobs will take the risk on him now. Why would any hospital or MSG or any good podiatry job which gets many applications risk the baggage? This will cripple his earnings and job options for quite awhile. You'd honestly much rather have early-career malpractice or pharmacy board discipline or sexual harassment suit; those things are lame - but they're compartmentalized. What he did went totally widespread and is very damaging stuff...

View attachment 389815
Click to expand...
I'm not here to be a contrarian or Devil's advocate, and while I agree it's very likely he posted this on FB, you can't ever actually know.

If someone hacked my facebook, or created a facebook with my name and picture, and posted trash that was horrific and full of racism, sexism, and whatever you can think it, I should absolute have no consequences following that scenario.

The fact that he was fired and had consequences to a social media post is mind-blowing.

This is a prime example of being found guilty without a trial.

While I agree that this individual likely posted this, we can't ever know because anyone could claim to be him on social media. It makes no sense to me.

Unless he admitted to making the post, then he could sue the hell out of the place that fired him. I certainly would sue someone for ruining or uprooting my career saying I did something on social media.
 
Hybrocure said:
...
We all know the docs in our towns who party pretty damn hard after conferences. Should they lose their job too? A lot of them do good work. Some of them, the best work. Some of them may say the same stuff at a coke fueled rant at a strip club.


Well that’s up to interpretation. This guy said an absolutely idiotic and dark thing on social media. It doesn’t discredit him as a doctor IMO. I don’t think it affects his surgery or his day to day operations with patients. ...
Click to expand...
I would agree: he's probably fine as a doc... but that's how things work. I don't make the rules.

If it's recorded, typed, photographed, tweeted, posted... it's bulletin board material for public judgement, employer consequences, whatever.

Tons of cops and nurses and etc have lost their job or had serious consequences for uniform pics or even just wearing their badge on social media, dating websites, OF, and similar. Ditto for dumb stuff they might do in their neighborhood or bar or whatever that gets recorded and posted - by them or others.

Heck, the guy who owned LA Clippers got death threats and had to sell the $2,000,000,000 professional team over private conversation that was recorded without his knowledge. He never posted anything or intended to tell anyone besides one lady those thoughts... but they were abrasive ideas. That's just the world we live in today; once things are posted and spread widely, there can be consequences. People rage.

In this day in age, you'd rather have a Harvard MD saying in court that you gave an antibiotic that the pt was allergic to and killed them... than you would having a screenshot go viral of an inflammatory racist/sexist/etc social media post you made. 🙂

Robin-jay said:
...Unless he admitted to making the post, then he could sue the hell out of the place that fired him. I certainly would sue someone for ruining or uprooting my career saying I did something on social media.
Click to expand...
Yes, because an associate fairly new out of podiatry school and training has more attorney money than a large venture capital group? Unlikely. They can let him go simply for the negative publicity and patient outrage and lost goodwill he brings to their business (whether he posted or got his account hacked, same negative outcome to them). "Social media policy" and "personal conduct policy."

His only move is to follow attorney advice on what to say/do regarding the posting, try to avoid any state license discipline or hospital consequences that are long-term reportable, lay low, change name/appearance, and eventually try to move on (almost certainly in another state/area). As above, this could have consequences even beyond podiatry jobs or income or boards/cases... divorce, mental health, firearms rights, long term money troubles, eventual retirement ability/age, etc. I'd hope he can sidestep most of that, but I think we'd all agree he is, at the least, 100% blackballed from one of the largest podiatry employers with Upperline (and possibly one of the largest hospital systems in HCA).
 
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Feli said:
Yes, because an associate fairly new out of podiatry school and training has more attorney money than a large venture capital group?
Click to expand...

He’s been practicing longer than you have. His bio said that he was at CSPM when they moved to the Oakland campus which was like 2002. He’s not a new grad. He was a middle-of-his-career private practice owner who sold then then worked for Upperline
 
Feli said:
I don't think it works this way, sir. You might realize that once you're an attending.
This should be a good warning for any DPM, particularly younger ones.

The damage has been done... reviews, screenshots, ill will. The twitter and FB roasts can't even be counted.
He has 100% scrubbed his social media... and should obtain attorney advice on this.
The problem is: his employer and his hospitals all did the same. They want nothing to do with this either.
His employer that fired him took much heat, lost money, and will assure their staff references "keeps showing his employers this time and time again."

Job gaps or taking any job you can get on a whim is damaging for a podiatrist, particularly early career. Source = common sense, and trust me brah. Podiatry always has fairly limited job options regardless, and he will have VERY limited options now. He'd be wise to go by his middle name and change appearance at least a bit for future jobs, web presence, etc.

He may never recover. Sad but true. The guy has worked at that Upperline venture capital group job for years. They got tons of angry reviews and surely got hundreds of press and angry phone calls, patients leaving on account of this.... and fired him accordingly. He can't just omit that job or his Pensacola hospitals (probably his only job since residency, not board cert yet). He will need to list those for future applications (jobs, privileges, licenses) for the foreseeable future.

Nooo prospective employer wants that attention if even a few people in the new town put 2+2 together. An assassination attempt and guy who might win president again won't be "old news" anytime soon. It's very likely only the real predatory and underpaid associate jobs or maybe house call jobs will take the risk on him now. Why would any hospital or MSG or any good podiatry job which gets many applications risk the baggage? This will cripple his earnings and job options for quite awhile. You'd honestly much rather have early-career malpractice or pharmacy board discipline or sexual harassment suit; those things are lame - but they're compartmentalized. What he did went totally widespread and is very damaging stuff...

View attachment 389815
Click to expand...
I mean come on guys...I know someone who became a resident then practiced as a sex offender....
 
dtrack22 said:
He’s been practicing longer than you have. His bio said that he was at CSPM when they moved to the Oakland campus which was like 2002. He’s not a new grad. He was a middle-of-his-career private practice owner who sold then then worked for Upperline
Click to expand...
Ouch. That is crazy. That would make him 50 or older then. He sure looks a lot younger in all of the news stories and web pics unless they're old pics. I didn't search too hard, but it looked like any social or job or hospital bio was scrubbed after the FB fallout.

I figured he was a newish DPM grad since he's not board cert by either podiatry board - unless they scrubbed him from their webpages last week also (don't think they can if he passed and pays dues).

Hope he lands on his feet. It'll be an uphill struggle.
 
air bud said:
I mean come on guys...I know someone who became a resident then practiced as a sex offender....
Click to expand...
Same. We have at least one pod in our state who's done and gone at multiple hospitals for sexual harassment complaints... but still practicing away in the office cutting nails for "pathology sample" and doing wound "grafts" and doing ABI to send to the supergroup vasc offices. He probably makes more than me, lol.

That's why it's crazy this Michael Allen guy typing social media stuff will probably hurt him worse than actual legal or patient care settlement/conviction.

We need a reality show with this assassination advice guy, the Dave Ramsey caller guy, and other aspiring dark horses of podiatry? I'd watch the first 10mins. Maybe.
 
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air bud said:
I mean come on guys...I know someone who became a resident then practiced as a sex offender....
Click to expand...

I knew someone in school who physically abused his girlfriend for an entire year during Pod school, was convicted of a felony on strangulation charges. He still got a residency and is practicing now
 
Feli said:
Same. We have at least one pod in our state who's done and gone at multiple hospitals for sexual harassment complaints... but still practicing away in the office cutting nails for "pathology sample" and doing wound "grafts" and doing ABI to send to the supergroup vasc offices. He probably makes more than me, lol.

That's why it's crazy this Michael Allen guy typing social media stuff will probably hurt him worse than actual legal or patient care settlement/conviction.

We need a reality show with this assassination advice guy, the Dave Ramsey caller guy, and other aspiring dark horses of podiatry? I'd watch the first 10mins. Maybe.
Click to expand...
“Dark Horses of Podiatry” is hilarious
 
PODIATRYCRAZE said:
Does upperline pay well?
Click to expand...
No its another predatory super group. They pay above average salary for private practice podiatry with a challenging bonus structure where you have to make them a significant amount of money before you get a whiff of extra bonus cash. Its a giant pyramid scheme to make the top dogs rich and the new associates, fresh out of residency who don't know any better, feel special they got a job greater than 150K.
 
Retrograde_Nail said:
No its another predatory super group. They pay above average salary for private practice podiatry with a challenging bonus structure where you have to make them a significant amount of money before you get a whiff of extra bonus cash. Its a giant pyramid scheme to make the top dogs rich and the new associates, fresh out of residency who don't know any better, feel special they got a job greater than 150K.
Click to expand...
So basically the school/residency model where only the top dogs get rich and they promise everyone will do well
 
Upperline was moving into my previous job’s “territory” (large MSG)… I was told by my staff one of the owners called in and wanted to speak to me directly (guess they wanted to know their competition?). I told my staff to ignore them.
 
Shiyuan said:
Upperline was moving into my previous job’s “territory” (large MSG)… I was told by my staff one of the owners called in and wanted to speak to me directly (guess they wanted to know their competition?). I told my staff to ignore them.
Click to expand...
Unless your group is large and profitable, they'll likely push out or buy our your group at some point. They've done that in many areas (bought or forced sale on many solo and small group and large groups), esp south and midwest.

It's basically podiatry's version of TeamHealth for ER docs. 😐
 
upperline cracks me up. The old guys who sold out and who started it post all over social media about "value based care" they are creating. They have about 20 administrators. Oversaturation allows them to create this employment model. Younger docs suffer. Hire more admin, less profit to the docs. Repeat.
 
HeySister said:
upperline cracks me up. The old guys who sold out and who started it post all over social media about "value based care" they are creating. They have about 20 administrators. Oversaturation allows them to create this employment model. Younger docs suffer. Hire more admin, less profit to the docs. Repeat.
Click to expand...
At the end of the day you’re a doctor working under Joe or Jane with a bachelors degree determining your fate as just a number.

Imagine slaving every day chatting with patients, doing procedures, surgeries etc and some dude who just got up out of bed and logged into his work from home job sends out the message you aren’t meeting your quota
 
HeySister said:
upperline cracks me up. The old guys who sold out and who started it post all over social media about "value based care" they are creating. They have about 20 administrators. Oversaturation allows them to create this employment model. Younger docs suffer. Hire more admin, less profit to the docs. Repeat.
Click to expand...
Yep. Older docs suffer too (if they're not owner).
You basically get your 35% of collections or whatever... and give away 20% (or more if you're productive) to non-working and minimally working "admins." You get to do basically all of the things a practice owner needs to anyways (train staff, organize supplies, frame a schedule, meet MDs and gain refers), but you can't retain or control things. You get told what to wear, what office(s) to be at, what supplies, what hours, and what services and products are "recommended" for you to use and refer to.

Some podiatry groups that were pretty big and profitable have sold out to them (but owners probably get shares and/or 'admin' income from associates they bring into the supergroup).

It's crazy. As long as there are not enough hospital jobs for DPMs and they don't want to "admin" their own office, this is what we'll have. It'll be groups like Upperline (becoming coast to coast) or Foot and Ankle Mid Atlantic (East coast) or the group I worked for briefly (UT, NM, OR). They all have the same model, same "protocols," same mostly average-to-below docs, etc. It's podiatry's version of what Walgreens or CVS are for pharmacists or Walmart optical for optomitrists. Some patients do ok with it, others don't like it. The owners of these supergroups win big either way. though.

I am REALLY hoping the non-compete ban holds up so people aren't trapped in these for decades. They can keep applying for hospital jobs or saving up to have their own office - without leaving the area if they don't want to.
 
Feli said:
Yep. Older docs suffer too (if they're not owner).
You basically get your 35% of collections or whatever... and give away 20% (or more if you're productive) to non-working and minimally working "admins." You get to do basically all of the things a practice owner needs to anyways (train staff, organize supplies, frame a schedule, meet MDs and gain refers), but you can't retain or control things. You get told what to wear, what office(s) to be at, what supplies, what hours, and what services and products are "recommended" for you to use and refer to.

Some podiatry groups that were pretty big and profitable have sold out to them (but owners probably get shares and/or 'admin' income from associates they bring into the supergroup).

It's crazy. As long as there are not enough hospital jobs for DPMs and they don't want to "admin" their own office, this is what we'll have. It'll be groups like Upperline (becoming coast to coast) or Foot and Ankle Mid Atlantic (East coast) or the group I worked for briefly (UT, NM, OR). They all have the same model, same "protocols," same mostly average-to-below docs, etc. It's podiatry's version of what Walgreens or CVS are for pharmacists or Walmart optical for optomitrists. Some patients do ok with it, others don't like it. The owners of these supergroups win big either way. though.

I am REALLY hoping the non-compete ban holds up so people aren't trapped in these for decades. They can keep applying for hospital jobs or saving up to have their own office - without leaving the area if they don't want to.
Click to expand...
PM News posting day after day of the newest hires to the slave wheel
 
Feli said:
Unless your group is large and profitable, they'll likely push out or buy our your group at some point. They've done that in many areas (bought or forced sale on many solo and small group and large groups), esp south and midwest.

It's basically podiatry's version of TeamHealth for ER docs. 😐
Click to expand...
They couldn’t afford my last group 😜
 
This reply is late but I wanted to comment on supergroups and corporate medicine and why I think private practice podiatry scales badly.

If you're a stakeholder in Upperline (or whatever organization) and you're thinking about opening/acquiring another location, you're thinking about maximizing revenues and minimizing costs.

Unlike hospital employed pods who have ancillary lab/imaging revenue and facility fees rippling outwards from all you do, the one and only source of revenue in PP is podiatry services, including DME and possibly some retail creams/plastic garbage. This is obvious, but it means adherence to treatment protocols is paramount for milking patients and maximizing revenues.

On the cost side, yeah your new location needs rent + utilities + equipment + computers and yeah you're saving money because you already have the EHR and billing infrastructure in place. But the biggest component of costs is likely to be staff wages, benefits, and taxes on those wages. Your labor force will consist of:
1. Receptionists to work the front desk, answer phones, schedule appts
2. Medical assistants
3. A "branch manger" to handle day-to-day minutiae and can fill in in roles 1 and 2 above when needed
4. Oh yeah and at least one doctor

We've discussed elsewhere that the reception/assistant salary is basically determined by their job market and they will bail with little notice for the next salary bump in another office. Similar true for managers, but that might be worth its own thread. Perhaps out of some sense of professional loyalty you'd prefer to pay the doctors a reasonable salary but this is the only opening you have to earn profits (and see a return on your investment). So what are you going to do? If you pay them badly they might sleep-walk through their clinic day, but that's all you need for podiatry clinic anyway as long as they're following the protocols.

The other problem the supergroup investor has that solo/small group PP does not is that the small group can at least cultivate some esprit de corps. My practice has gone through some rough waters over the years and I've had personnel stick around just out of loyalty, whereas a more impersonal big business would have people abandoning ship. The only way to compensate for this: pay people more (lower ROI). The end result is that patients are treated like products on an assembly line, staff function like wage-slaves, and the doctors are beasts of burden pulling the whole thing along, how lovely.

I have to chuckle to think that whether you're a pre-health student considering podiatry or an investor considering opening a podiatry office, you arrive at the same conclusion: podiatry is a bad investment, buy crypto instead.
 
Adam Smasher said:
... Upperline (or whatever organization) and you're thinking about opening/acquiring another location, you're thinking about maximizing revenues and minimizing costs.

Unlike hospital employed pods who have ancillary lab/imaging revenue and facility fees rippling outwards from all you do, the one and only source of revenue in PP is podiatry services, including DME and possibly some retail creams/plastic garbage. This is obvious, but it means adherence to treatment protocols is paramount for milking patients and maximizing revenues. ...
Click to expand...
They don't lose money on basic podiatry/DME/OTC that normal small or solo PP groups do (larger groups too), but they have other revenue sources. It's how they offer higher base than normal PP and attract new grads and docs (or keep them in buyouts). The biggest podiatry ones with scalable business model all make the bulk of their money on "ancillary services," particularly vascular. They advertise this right on their website.

Common ancillary services for big pod groups/supergroups =
  • DME ("custom AFO" bracing whenever insurance covers it... often try to extend it beyond F&A to back braces, knee, etc if they can),
  • cash DME (sometimes a shoe store or prefab ~$100+ 'orthotics' they can buy or produce in bulk... GoodFeet on small scale)
  • cash "pharma" (compound creams, glorified vitamins, whatever for neuropathy, skin, circulation, pain, etc)
  • testing (ABI, sudoscan, whatever else might pay)
  • "path lab" (stain nail clippings, ENFD... whatever's quick and high margin),
  • vascular/veins (funnel refers to IR, IC type doc/facility they own)
  • wound care ("grafts," dressings, etc that pay),
  • physical therapy,
  • etc etc etc. (many options with larger group buy power and arranging kickbacks from vendors)

The "vascular" intervention guys have the high ticket services, though. That refer train is the end game for these large pod supergroups and multi-state groups. At one point, my prior group owner was mass texting all group docs weekly and sometimes almost daily with reminders and screenshots of angiogram to encourage us to make vascular refers. Other times, it was "congrats to Dr. X" who averaged [huge $ number] per patient and hit a big bonus on grafts last month. The ancillary services, particularly "vascular center," is a big investment (for a pod group) that pays the owners well if they get it busy - and they trickle some to the employed pods to incentivize that.

It's similar to how big ortho groups own MRI, PT, DME, surgery centers... onco groups own nearby imaging and chemo and labs and maybe ASC, whatever. Hospitals obviously do it too by owning nearly all of the services. The podiatry ones are almost surely more dangerous as there is just oversupply of DPMs and more eagerness to try to make a buck (similar to chiro).

Regardless, in these setups, there is naturally a lot of increased testing and treatment when the group owns those tests and tx, but it's hard to question medical necessity... although insurances will often peg them for severe overutilization versus non-group peers (ie, grafts) eventually. If one of their ancillary gets shut down or neutered by CMS or major payers, they move on to pushing their docs toward their other ancillary and changing their incentives for that one. The pods working for Upperline, etc quickly realize that refers to services the group owns and ordering tests = bonus. It's exactly what why we went into schooling in the first place. 🙂
 
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