If you had the chance to go back in time, would you still do Podiatry again?

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CHOPSTIX

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Hi everyone,
This question has been asked in medical and dental threads so my question is the same to the podiatric residents and Podiatrists - If you had the chance to go back and choose, would you choose to go into podiatry again?

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hi everyone,
this question has been asked in medical and dental threads so my question is the same to the podiatric residents and podiatrists - if you had the chance to go back and choose, would you choose to go into podiatry again?

definitely!
 
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Absolutely.
 

hey doc,

just for curosity, did you had to repeat all 4yrs in the carribean med school or you got any credit. Plus Pod school must have been arnd $150K in loans and then another $150K loans frm med school. followed by 3yr residency. thats like 4-5yrs pod school + 1 yr residency + 4yrs med school + 3yrs residency = 13-14yrs easily.

im just wondering how do you justify spending 13-14yrs of life in education and a loan of $350K-400K on your head.

i am a very strong supporter of people doing what they like. iam sure you didnt like podiatry and went the MD way. but all these loans and yrs spent in education. can you give some insight plzz. we have many MDwannabes prepods who could take inspiration from you and follow that path:)

I mean no disrespect. its totally out of curosity.
 
hey doc,

just for curosity, did you had to repeat all 4yrs in the carribean med school or you got any credit. Plus Pod school must have been arnd $150K in loans and then another $150K loans frm med school...
Grad school was nowhere near as expensive decades ago. I would guess it cost, at most, 50% the tuition we pay today.^

To OP... yes, I'd definitely make the same decision.
 
hey doc,

just for curosity, did you had to repeat all 4yrs in the carribean med school or you got any credit. Plus Pod school must have been arnd $150K in loans and then another $150K loans frm med school. followed by 3yr residency. thats like 4-5yrs pod school + 1 yr residency + 4yrs med school + 3yrs residency = 13-14yrs easily.

im just wondering how do you justify spending 13-14yrs of life in education and a loan of $350K-400K on your head.

i am a very strong supporter of people doing what they like. iam sure you didnt like podiatry and went the MD way. but all these loans and yrs spent in education. can you give some insight plzz. we have many MDwannabes prepods who could take inspiration from you and follow that path:)

I mean no disrespect. its totally out of curosity.

Well let's see. 4 years of podschool $75,000 in debt. 2 years of residency.
5 years of practice, busiest practice in the state. 2500 new patients a year. Averaged 2 buns a week, 4 permanent nails a day and a hammertoe a day, and a misc. surgery a day. Grossed 280k the first 10 months in practice(opened on march1st). grossed around 600k a tear after that. debt free. sold my practice. Went to the Caribbean with a bathing suit and 300k from the sale. finished med school did 4 years of residency had about 200,000 in a savings account at the end of residency.

I didn't really think podiatry had a good future, although I was doing quite well. Actually, what happened is Clinton got elected, my gross went down slghtly, I think it went from like 640 to 630's, but I didn't likle the trend, I almost immediately sold, went md and never looked back.

Look I come from 20 years ago in podiatry, I miss podiatry and running a practice, although I wouldn't want to do it again. I just had an opportunity that sounded too fun to pass up. And believe me it was a fun ride. I miss medschool intensely these days.

Let's see that's alot of school and training 14 years after college.
I think I'll apply to Law school. I wonder if they have a student forum.
 
my gross went down slghtly, I think it went from like 640 to 630's, but I didn't likle the trend, I almost immediately sold, went md and never looked back.

:eek:

Sounds like you had a pretty successful practice....So lemme get this straight so I understand a little better....

Your annual gross had a downward trend of around ~$5-9k so that was justification enough for you to switch to MD ??
 
Well let's see. 4 years of podschool $75,000 in debt. 2 years of residency.
5 years of practice, busiest practice in the state. 2500 new patients a year. Averaged 2 buns a week, 4 permanent nails a day and a hammertoe a day, and a misc. surgery a day. Grossed 280k the first 10 months in practice(opened on march1st). grossed around 600k a tear after that. debt free. sold my practice. Went to the Caribbean with a bathing suit and 300k from the sale. finished med school did 4 years of residency had about 200,000 in a savings account at the end of residency.

I didn't really think podiatry had a good future, although I was doing quite well. Actually, what happened is Clinton got elected, my gross went down slghtly, I think it went from like 640 to 630's, but I didn't likle the trend, I almost immediately sold, went md and never looked back.

Look I come from 20 years ago in podiatry, I miss podiatry and running a practice, although I wouldn't want to do it again. I just had an opportunity that sounded too fun to pass up. And believe me it was a fun ride. I miss medschool intensely these days.

Let's see that's alot of school and training 14 years after college.
I think I'll apply to Law school. I wonder if they have a student forum.

Wow! how old are you? im impressed that you went to carribean with 300K in pocket. that must have been vaccation everyday.

So how is the MD practice working for you. whats your speciality? and what school did you graduated from.
 
nice practice. i am impressed.

hope you are doing well as an MD.:thumbup:
 
:eek:

Sounds like you had a pretty successful practice....So lemme get this straight so I understand a little better....

Your annual gross had a downward trend of around ~$5-9k so that was justification enough for you to switch to MD ??

Actually I heard at a CME that a classmate had gone to a banana medschool. I called him and he was encouraging. I looked into it and since medicine was what I really wanted to do, and that was the key, I went for it. I do regret wasting time in podiatry.

The practice situation I was in was good, but I felt managed care was going to be brutal to me. My practice had been about 20% medicare, now it's virtually 100%. Bunions paid $1900 then, now what? Nails paid $370, now what? Hammertoes paid $900, now what?
 
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Actually I heard at a CME that a classmate had gone to a banana medschool. I called him and he was encouraging. I looked into it and since medicine was what I really wanted to do, and that was the key, I went for it. I do regret wasting time in podiatry.

Yes, that is the key.
 
Actually I heard at a CME that a classmate had gone to a banana medschool. I called him and he was encouraging. I looked into it and since medicine was what I really wanted to do, and that was the key, I went for it. I do regret wasting time in podiatry.
The practice situation I was in was good, but I felt managed care was going to be brutal to me. My practice had been about 20% medicare, now it's virtually 100%. Bunions paid $1900 then, now what? Nails paid $370, now what? Hammertoes paid $900, now what?

Your points are practical but these are only gonna affect people who think Podiatry as a pure surgical speciality. I honestly like all the aspects of podiatry (biomech,pallitative,surgery,etc). I know podiatrists who make in 250K range just by cutting ingrown toe nails and trimming calluses and i dont understand why people think thats a bad thing. we had a DO kid who said cutting toe nail is not surgery. who cares what it is, even in this day it pays $450 (bluecross blueshielf illinois). Thats a 10-15 min procedure we are talking about. or prescribing orthoses,etc.

In that light, can you please engligten the group what are the current rates of medicaid for bunion or hammer toe. that will really help in gettin the sole surgery ambition of many people back to ground:laugh: i know the horrible medicaid rates from wisc and illinois and that changed my mind completely. please do mention the rates.

What was the name of the banana medical school? did you had to do all 4yrs or you got credit.

Please give details. iam sure there are people who might take this oppurtunity and go the MD way. In that way we can have less applicants (and only genuinely interested applicants) applying for pod residency.
 
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I don't know what they are. But I know they are lower than they were.
The best day in podiatry is to see about 35 people and do 12 permanent nails. I had those stats several days. For some reason I couldn't get that 13th nail surgery. I had days where my billings would be over 10k.
The money is drying up. Incidentally I used 2 different orthotic labs and made alot of my own from prefabs and the major lab I used told me I was their biggest client. That surprised me.

My practice is irrelevant, you are the people going into podiatry, it's your practices that are important.
And I do sincerely wish you all the best of luck. When I graduated almost no one was signing with big clinics. It's great that some do now, but it is likely that the great majority of residents are not signing 6 figure contracts.
 
I don't know what they are. But I know they are lower than they were.
The best day in podiatry is to see about 35 people and do 12 permanent nails. I had those stats several days. For some reason I couldn't get that 13th nail surgery. I had days where my billings would be over 10k.
The money is drying up. Incidentally I used 2 different orthotic labs and made alot of my own from prefabs and the major lab I used told me I was their biggest client. That surprised me.

My practice is irrelevant, you are the people going into podiatry, it's your practices that are important.
And I do sincerely wish you all the best of luck. When I graduated almost no one was signing with big clinics. It's great that some do now, but it is likely that the great majority of residents are not signing 6 figure contracts.

I have yet to see someone sign for less than 6 figures. Realistically, our education costs around 150K so who would sign for less? It all comes down to production and podiatric medicine is procedural medicine. I know of various multispecialty groups where the pods are the top producers. I know a few guys that signed with small groups who couldn't front a large base so the base salary was less than 100k but with production, they made over 100k their first year out.
 
I have yet to see someone sign for less than 6 figures. Realistically, our education costs around 150K so who would sign for less? It all comes down to production and podiatric medicine is procedural medicine. I know of various multispecialty groups where the pods are the top producers. I know a few guys that signed with small groups who couldn't front a large base so the base salary was less than 100k but with production, they made over 100k their first year out.
Is 6 figures the norm then not exception? The only ones signing less would be if they CAN'T ink a deal for more, yes? Unless you're a bad pod I guess most can get this?
 
Is 6 figures the norm then not exception? The only ones signing less would be if they CAN'T ink a deal for more, yes? Unless you're a bad pod I guess most can get this?

No, it is definitely not the exception. The norm is for pods to sign on with an existing group, whether it be pod, multispecialty, ortho, or hospital. If you're going to produce hundreds of thousands of dollars a year, why would you sign for any less? This is a big difference from 15-20 years ago. As podiatry has transitioned to mainstream medicine, so has the salary. We are no longer being signed on by a solo pod for an "apprenticeship" in his shopping center office! We are members of medical staff and hold hospital privileges across the country. Times have changed.

No other specialist would sign a sub-par contract. Why would you? Podiatrist = Foot & Ankle Surgeon. Do you know any other surgeons signing on for 60K???:laugh:
 
No, it is definitely not the exception. The norm is for pods to sign on with an existing group, whether it be pod, multispecialty, ortho, or hospital. If you're going to produce hundreds of thousands of dollars a year, why would you sign for any less? This is a big difference from 15-20 years ago. As podiatry has transitioned to mainstream medicine, so has the salary. We are no longer being signed on by a solo pod for an "apprenticeship" in his shopping center office! We are members of medical staff and hold hospital privileges across the country. Times have changed.

No other specialist would sign a sub-par contract. Why would you? Podiatrist = Foot & Ankle Surgeon. Do you know any other surgeons signing on for 60K???:laugh:
Yeah you're right. Maybe vet surgeons to work on animals may sign that little though. :p
 
:eek::eek::eek::eek:

Wow! Just to be clear trachea, you had several days in a row that you were doing nail surgeries at 12 per day!

Were you advertising? If so what did you do?

If you could pick three things that you did or that your group did that increased patient flow and made you busy, what would they be?
 
:eek::eek::eek::eek:

Wow! Just to be clear trachea, you had several days in a row that you were doing nail surgeries at 12 per day!

Were you advertising? If so what did you do?

If you could pick three things that you did or that your group did that increased patient flow and made you busy, what would they be?

No. I had several days over the course of my practice that I did 12 11750s.
I was the only pod for an a population of 400,000
I did advertise in varios media.
I ran stats right before I left practice, and in the preceding 12 months I had done Nails on 750 unique patients. Hammertoes on 200+, Bunions on 80+, I averaged 9 new patients a day, 8 heel spur injections a day, 180+ misc surgeries a year, and had a large C&C and orthotics practice.
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I really hope you enjoy what you do now. And you must hate managed care.
Thanks for sharing.:)
 
Thank you all for your responses! It seems like most of you would choose podiatry again if given the option. This is very different from the responses that MD/DO physicians gave in another thread. Most of them seem very frustrated with lower reimbursements, managed care, and malpractice insurance.
 
I really don't want to burst anyone's bubble, but I can tell you as a FACT, that there are a lot, yes a lot of DPM's signing contracts for less than 6 figures.

Please don't forget, that when a practice pays a new DPM 6 figures, they ALSO have to pay for malpractice, CME dollars, APMA dues, ABPS dues, ACFAS dues, hospital dues, possibly health insurance, etc., etc. So there are a significant amount of other expenses that are incurred before the new hire ever even sees a patient.

And the chances of most new hires going into a practice where they are only "surgeons" is minimal. Although many would love to enter surgical "only" practices, the reality is that those types of practices are very limited in availability.

With the econonmy in it's present state, the low rate of imbursements, the high rate of malpractice premiums, the high rate of overhead, etc., salaries are NOT on an upward trend, and jobs are hard to find.

So please don't be surprised if you ultimately don't receive a 6 figure offer right off the bat, especially if you are receiving other benefits. You can not compare yourself to other surgical specialties. Starting orthopedic surgeons or urologists may actually make $250-300,000 the day they complete their residency, and that simply doesn't happen with podiatry.
 
I really don't want to burst anyone's bubble, but I can tell you as a FACT, that there are a lot, yes a lot of DPM's signing contracts for less than 6 figures....
Definitely. It's important to be realistic.

In our practice management course, we reviewed the findings of the APMA young members' survey this past week. The APMA YMC average salaries for associates in first year in practice was around $65k (more in the west, less in the northeast) with nearly half of respondants landing in the $50-75k range for that first year. I'm no math major, but I think the $65k mean also then means that for every one guy got great training, a good job connection, a $150k salary in year one... there are then probably about nine others who sign for circa $50-60k for that first year in order for the overall average to hold true.

What I'd be more interested in would be the average signings of people who completed 3+yrs surgical training and passed the ABPS qualified exam. In the end, the first year $ amount doesn't really matter a whole lot, though. I think the overall benefit package, job quality, and future partnership/productivity opportunities would be a lot more important to me personally... we'll see.
 
When i was interviewing at cspm the three residents there said they all were signing 200+ contracts out the gate? is this because they come from a bay area 3 year pm&s36 residency?
 
it probably helped that they were dressed in the finest threads from the hippest bay area stores.

sorry, couldnt resist. thetachi, i got a little worried that you thought we were friends.



also, it is a matter of principle that i never stoop to the level of using emoticons. but i may or may not be laughing as i write this.
 
ahh cmon Bud, thetas been behaving lately, give em a break!

It crossed my mind as i was skimming the last few posts that perhaps many of these 1st year associates are women not wanting to work much, and or are interested in part time positions to be avail for kids or having kids. So maybe take that into account of the 'skewed' data. That might have been brought up in the survey though, sorry if its redundant.
 
it probably helped that they were dressed in the finest threads from the hippest bay area stores.

sorry, couldnt resist. thetachi, i got a little worried that you thought we were friends.

I knew it was cause they dressed in all of the hip stores, and dont worry-i mean can people even be friends online? ps Im sure if jew me you uw66 all actually met us 4 would probably end up getting along HAHA seriously i mean we have no idea about each other than this forum. You and UW may really love cats, and jew might love pokemon and me i might love vans slip ons or we may all be huge fans of hip hop music or whatever. Just examples but you get the hint.

ps it was TOUGH to not abuse another emoticon...but i resisted. You're welcome
 
alright. I agree with UW. I am willing to call a truce with thetachi.
The woman pod thing is a good theory. I know from the aacpm website that it breaks down gender by schools, and some schools are more evenly balanced. I think that womens enrollment has increased over the past few years, but have not finished residency yet. Does anybody know of any stats out there that take women vs. men into consideration

new thread anyone? just curious. i am a dude.

my typing/punctuations sucks, sorry, both hands in braces after dual carpaltunnel/ulnar nerve surgery.
 
Anything less than a 6 figure salary is an insult to the level of training and no podiatry graduates should settle for such a scam. My wife just graduated from pharmacy school and was offered a salary of $120-140K/yr. Podiatrists should stop eating their young...period.
 
I have yet to see ANYBODY from my program sign for less than mid 100's. A few were guaranteed 200K. There is nothing wrong with a small pod group starting someone at a BASE of 60-70K because the group is assuming all of the risk and the new doc has no patient base. But they'd better have some sweet incentives that will reward the doc for production. One of my buddies signed for a base of 75K but with production incentives made double that his first year out.

No offense but I didn't go to school for 11 years and go into debt 6 figures to make 65K a year. I believe the correct terminology would be "sucker"!!!
 
I'm reading a lot of emotional posts regarding what you THINK you are worth vs. what the market will pay.

Don't shoot the messenger. I am not telling anyone that you are not worth as much as our allopathic colleagues, but I am telling you that unless you have actually SEEN your friend's contracts of $200,000 or more, I simply do not believe it...PERIOD.

The statements are all over the place. Contracts being signed for $200,000 and others being signed for $65,000 plus incentives, and some people making the "assumption" that averages are low because some grads are taking "part time" positions, etc.

Well you can be insulted, pound your chest about your great training, etc., but the facts remain the facts. As someone involved in a VERY large practice, I can tell you that in order for our group to pay a new grad $200,000, we would have to be guaranteed that doctor would generate at LEAST $500,000 his/her first year to make it worth our efforts.

And the chance of a new doctor generating a half million dollars his/her first year out are VERY slim.

Our practice has over 13 doctors and is growing, so I know of what I speak. Between all our office locations and nursing home visits, we saw a combined 100,000 patient visits last year. So I am very aware of how much we can afford to pay a new hire, how much overhead is involved, how much a new hire must generate to make it profitable, etc.

The idea that a new hire is making a base salary with incentives, makes MUCH more sense than signing a contract of $130,000, $150,000, $200,000, etc. We simply could not and WOULD not sign a new hire at those numbers because we don't know if that doctor would produce or have incentive to work hard.

We do NOT encourage our doctors to perform procedures simply to boost his/her income, and we monitor that very carefully. However, we also don't want to hand the new doctor a high income and than that doctor has no incentive to work hard. Our formula has worked well. Work hard and you WILL be rewarded. Don't work hard and you will set your own destiny.

In today's times, with low reimbursements, high overheads, high malpractice premiums, we simply can not afford to hand over high salaries simply because you are well trained. We aren't stroking egos, we are hiring well trained doctors and providing YOU with an opportunity to potentially make an excellent income if you provide quality care and work hard.

And I believe that's what most of these "low" ball contracts are actually offering. They are not an insult, they are realistic. Doctors can not afford to simply hand over and commit to high six figure salaries until YOU begin creating that income. It's simply a matter of economics, not pride.
 
Well you can be insulted, pound your chest about your great training, etc., but the facts remain the facts. As someone involved in a VERY large practice, I can tell you that in order for our group to pay a new grad $200,000, we would have to be guaranteed that doctor would generate at LEAST $500,000 his/her first year to make it worth our efforts.


Our practice has over 13 doctors and is growing, so I know of what I speak. Between all our office locations and nursing home visits, we saw a combined 100,000 patient visits last year. So I am very aware of how much we can afford to pay a new hire, how much overhead is involved, how much a new hire must generate to make it profitable, etc.

ok so how much do YOU start your new hires at and how much do they make after like 5 years, assuming they perform as best they can? THEN do you give them the seemingly coveted 200K+ a year prize? how do YOU work it?
 
Wow this making me more interested in joining the armed services now that HPSP program is offered to Pods. benifits of navy, decent salary + stipend in college, no big loans to worry, and a sense of pride for serving your country.

I dont know whether fair or unfair.$65k is way too less. i agree with PADPM that no new practice will risk $200K that easily. but we have humoungous amounts of loans on our head and nearly 11-12yrs time spend in educational mill. if we get anything less than $120k than all all this effort is worthless.
 
...I dont know whether fair or unfair.$65k is way too less. i agree with PADPM that no new practice will risk $200K that easily. but we have humoungous amounts of loans on our head and nearly 11-12yrs time spend in educational mill. if we get anything less than $120k than all all this effort is worthless.
Well, I think the key is probably just to avoid being blinded by the base salary or earnings in the first year... and to have an attorney read over the contracts so you fully understand them.

I would gladly take a $65k base in the first year if I loved the job/location and knew that I could rapidly increase earnings/ownership as I built my patient/referral base. Likewise, $150k off the bat isn't too spectacular if you have barely any room for growth/ownership in the future and will have to leave the city if you quit the group.

Pretty much all that tends to be talk about here is initial signing figures, but looking at what you are netting 3, 5, 10, etc years out and what % of your billings you are pocketing (as opposed to still just lining the pockets of the group/hospital) is a certainly lot more important in the grand scheme of things...
 
Well, I think the key is probably just to avoid being blinded by the base salary or earnings in the first year... and to have an attorney read over the contracts so you fully understand them.

I would gladly take a $65k base in the first year if I loved the job/location and knew that I could rapidly increase earnings/ownership as I built my patient/referral base. Likewise, $150k off the bat isn't too spectacular if you have barely any room for growth/ownership in the future and will have to leave the city if you quit the group.

...

I was thinking PADPM said its a Salary offer , no base pay or bonusses or percentage. If its a base pay offer then heck if somebody is offering $50k also as a base pay i think its not a bad deal because if you are a good physician and marketting guy. you can add more moolah to it by generating a good patient flow.

But from PADPM post, i am getting an impression that he said its $65K salary. nothing more nothing less. no bonusses, no extra money for the patients you bring in, etc.
 
I really don't want to burst anyone's bubble, but I can tell you as a FACT, that there are a lot, yes a lot of DPM's signing contracts for less than 6 figures..

Are these offers just flat Salary (aka no bonus/incentives,etc) or these are base pay offers with more income possiblity depending upon the number of patients you get?
 
I'm not going to get into specifics regarding how much we pay the doctors in our group.

Nor did I state that we start our doctors at 65K. What I DID state is that it's not unrealistic to start a doctor at that number, with the idea that the new doctor must look at the big picture, and not just live for the moment. You are investing in a long term relationship, and if you believe there is a future, than you must have confidence in YOUR abilities to build the practice and produce income and prove yourself. It may not be handed to you on a silver platter.

If you think you're THAT valuable, it's quite simple. Open your OWN practice and test the waters to see how many years it will take you to pocket that elusive $200,000.....and THEN you'll be very appreciative to make half that amount!!

We do not pay on "incentives" or pay "bonuses" for orthotics, surgeries, etc., because we have found that actually leads doctors to perform unnecessary procedures or over-utilize, and our practice was built on ethics and not on "milking" the system.

However, we do "track" patient referrals, productivity, hours worked, etc., and doctors are automatically rewarded without asking for a raise. When we notice that they are seeing more patients, patients are asking to see them, their billings are going up, etc., they are financially rewarded accordingly. When he/she receives his/her weekly check, he/she will notice a pay increase without ever having asked for it....it's automatic.

That keeps the doctor VERY happy and let's the doctor know he/she is appreciated and the hard work and efforts were have not got unnoticed.

This formula has worked and has kept doctors IN our practice with virtually no turnover. And our doctors put in a lot of hours and are compensated fairly.

The few doctors that I know that DID pay an associate a lot of money on day one no longer have that associate. All of those relationships did not last longer than one year.

Look LONG term, not short term and leave your ego somewhere else. Be patient, be honest and provide EXCELLENT care and your income will escalate accordingly. But you may have to prove your worth, DESPITE your training. It 'ain't easy. There are a lot of other guys/gals trained just as well as you.
 
I think for most of you out there in residency and getting closer to the day when you join residency, you should listen to PADPM's words. I've posted in the past about billing and what to expect when you get out and start billing.
Those of you in residency and are in the 2nd or third year, you need to start learning to code and bill what you're seeing (especially when you have a residency run clinic). This way you know how to bill appropriately.
One thing that everyone is not realizing when you join a private practice is that from the day you start seeing patients to about 6 months out, you ARE NOT producing any income, because you are seeing those patients under the main docs insurance numbers. Why is this? Because it can take that long for some insurances to credential you. Is there a way around this? Certain states allow podiatry residents to have a full license so you can start the application process early IF you are staying in that state. So while you are seeing those patients under the main doc, that doc isn't making that much money off of you, unless you are seeing 40 patient/day from the first day you join.

As PADPM has alluded to, you have to be realistic with what the offers are being presented to out there. I've heard of the big numbers out there and I know that certain places give those numbers, but they also have a ceiling because as podiatrists we have a ceiling to what we can collect from the insurances. Remember, just because you bill $2000 for a bunion (or any other procedure for that manner) doesn't mean you ARE going to collect that much, it depends on your contract with that particular insurance company that you are billing. Also, if the office that hires you pays for your malpractice (which isn't a lot the first couple of years) and health benefits you are starting out in a hole. So don't just look at the first year, look at where you will be in 5 or 10 years out at the practice.
 
If you think you're THAT valuable, it's quite simple. Open your OWN practice and test the waters to see how many years it will take you to pocket that elusive $200,000.....and THEN you'll be very appreciative to make half that amount!!

I guess I better join the practice management club, because, I would rather start up on my own, than work for someone for 65K
 
I guess I better join the practice management club, because, I would rather start up on my own, than work for someone for 65K


+infinity....i mean seriously everyone did/are we really getting into incredible debt and spending our best years in school for 65K? that's peanuts lets be honest. I think I speak for MOST when I say that we as surgeons and physicians are ENTITLED to an excellent 150K+ salary, there are VERY few types of people that work as hard as us to get to the career stage (out of residency and ready to practice). So please don't tell me that the "norm" is practices that are not trying to generate a great income in addition to having great ethics and all that.
 
No offense "ThetaChiNAU1856" but you aren't "entitled" to anything. You don't seem to get it....I didn't say that you don't have the POTENTIAL to earn the big money you think you're "entitled" to, however you are going to have to EARN that money.

Very few practices are simply going to hand you a check because you are "entitled" to it or "deserve" it. At the present time there are a lot of well educated people out of work, with ivy league educations that are "entitled" to jobs, but are collecting unemployment.

If you are paid $150,000, and you generate $300,000 for that practice, then the doctor has probably LOST money. And I don't know of any doctors that are hiring you to lose money. Office overhead runs at LEAST 50% at the minimum. So isn't the doctor that owns the practice "entitled" to make money on YOU? Or is he hiring YOU out of the kindness of his heart? Isn't medical practice a business? He's paying for your malpractice, your vacation, your CME credits, your "perks", your professional dues, etc., so in order for him to make a "profit", you realistically probably have to generate around $450,000 your first year.

So, as I've stated and re-stated, in reality you've got to learn to stuff your ego in your pocket, and consider all those other well educated people that are currently on unemployment. Have confidence in your abilities and the money WILL arrive, but maybe not on the FIRST day of your contract.

All I'm attempting to say is that you will have to prove yourself. Residency will end and the real world will start. Now you have to EARN a living by actually producing an income. In reality no one hands over a check "carte blanche", because most offices simply can't afford to do that in this economy, it's too large a risk.

Handing over a large check gives the new hire no incentive.

So look at the BIG picture and look at the END of your first year, not at the first day of your contract. Because if your contract has some incentives or increases with production, than if you make the same amount at week 52 as you did on the first week, YOU did something wrong.
 
+infinity....i mean seriously everyone did/are we really getting into incredible debt and spending our best years in school for 65K? that's peanuts lets be honest. I think I speak for MOST when I say that we as surgeons and physicians are ENTITLED to an excellent 150K+ salary, there are VERY few types of people that work as hard as us to get to the career stage (out of residency and ready to practice). So please don't tell me that the "norm" is practices that are not trying to generate a great income in addition to having great ethics and all that.

Nice timing. I was reading this article just yesterday regarding the sense of entitlement in today's students:
http://www.nytimes.com/2009/02/18/education/18college.html

I'd encourage you to own your own practice not just for reasons of income but for reasons of independence. If you start your own practice you will likely make even less than $65K for the first few years, but there's a satisfaction to be had from being your own boss and not having a senior doctor (or worse, an Administrator who has no medical training but finished undergrad with a C+ average in Business Management) looking over your shoulder and telling you how to practice.

Personally I could never ever work for someone else again. No way, no how. I couldn't have anyone tracking my productivity and urging me to work harder, nor could I have to run my proposed vacation time by someone. When you see the direct result on your income from your own work (or lack of it) that's a better motivator than having someone give you a bonus once in awhile.

PADPM brings up a good point: OVERHEAD. Your income and the employer's happiness with your production will be related to the practice's overhead. When discussing your contract you should approach the terms for future buy-in (it will be vague without hard numbers but at least have a vague framework as to how they plan to determine the price). Find out how much overhead they are running, because it will matter to you. Who cares how hard you work if you spend it all on overhead? Like I've said here a million times before, CONTROL YOUR OVERHEAD. For what its worth, I'm running at about 20%-25%. That's why I can work 2.5 days per week, go biking or snowboarding the rest of the time, and make more than average. Plus, I don't have any bosses pressuring me. It's all on myself.

IMO, making a living as your own boss and controlling your own schedue is more rewarding than any income.
 
I'm reading a lot of emotional posts regarding what you THINK you are worth vs. what the market will pay.

Don't shoot the messenger. I am not telling anyone that you are not worth as much as our allopathic colleagues, but I am telling you that unless you have actually SEEN your friend's contracts of $200,000 or more, I simply do not believe it...PERIOD.

The statements are all over the place. Contracts being signed for $200,000 and others being signed for $65,000 plus incentives, and some people making the "assumption" that averages are low because some grads are taking "part time" positions, etc.

Well you can be insulted, pound your chest about your great training, etc., but the facts remain the facts. As someone involved in a VERY large practice, I can tell you that in order for our group to pay a new grad $200,000, we would have to be guaranteed that doctor would generate at LEAST $500,000 his/her first year to make it worth our efforts.

And the chance of a new doctor generating a half million dollars his/her first year out are VERY slim.

Our practice has over 13 doctors and is growing, so I know of what I speak. Between all our office locations and nursing home visits, we saw a combined 100,000 patient visits last year. So I am very aware of how much we can afford to pay a new hire, how much overhead is involved, how much a new hire must generate to make it profitable, etc.

The idea that a new hire is making a base salary with incentives, makes MUCH more sense than signing a contract of $130,000, $150,000, $200,000, etc. We simply could not and WOULD not sign a new hire at those numbers because we don't know if that doctor would produce or have incentive to work hard.

We do NOT encourage our doctors to perform procedures simply to boost his/her income, and we monitor that very carefully. However, we also don't want to hand the new doctor a high income and than that doctor has no incentive to work hard. Our formula has worked well. Work hard and you WILL be rewarded. Don't work hard and you will set your own destiny.

In today's times, with low reimbursements, high overheads, high malpractice premiums, we simply can not afford to hand over high salaries simply because you are well trained. We aren't stroking egos, we are hiring well trained doctors and providing YOU with an opportunity to potentially make an excellent income if you provide quality care and work hard.

And I believe that's what most of these "low" ball contracts are actually offering. They are not an insult, they are realistic. Doctors can not afford to simply hand over and commit to high six figure salaries until YOU begin creating that income. It's simply a matter of economics, not pride.


Yes, I've actually seen the contracts. I always ask to see so I have an idea what I'm looking for when I start the job search. Mid-100's isn't that uncommon to start at. I don't know what's so hard to believe about that?
 
as far as entitled I was referring to those students coming out of a top tier PM&s36 residency not just any old resident.
 
as far as entitled I was referring to those students coming out of a top tier PM&s36 residency not just any old resident.

Doesn't mean squat. No entitlement in the business world. I don't care how skilled or educated you are, if you can't make the practice any money then you're a liability.
 
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