Is this a good Offer?

[DMEpod]

The majority of hospitals don't pay podiatry for call, we are a redundant service most places. I did it for 2 years with a small (gas money) stipend that came with it to build my practice volume. It is not worth it without a large stipend at all. Filled my clinic with wounds and post op pus or amp cases. Just ended up bogging down my regular outpt schedule. Once I got a steady patient base I immediately stepped down although there are plenty of pods lining up for the call and other free calls around town.

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[Utvolsdpm]

lmaoo your pic absolutely kills me, is that Cusack from NYCPM??

It looks like you’re right. It came from an advertisement about the latest present lectures - this being the exciting topic “A New Look at Geriatric Gait Issues in the Geriatric Patient”

Hopefully no C and D letters come. I’m not pretending to be this gentleman I aspire to be more like him.

 

[SouthPod7]

Was there an on-call podiatrist who took care of that patient?

If I remember correctly the patient was seen by a general surgeon employed by the hospital that took her in for a debridement that same night. That hospital didn't employ any podiatrists because they had no problem finding podiatrists to take call for free.

 

[Pronation]

It looks like you’re right. It came from an advertisement about the latest present lectures - this being the exciting topic “A New Look at Geriatric Gait Issues in the Geriatric Patient”

Hopefully no C and D letters come. I’m not pretending to be this gentleman I aspire to be more like him.

I wish you all the best in becoming a nationally recognized onychomycologist.

 

[Feeter]

The majority of hospitals don't pay podiatry for call, we are a redundant service most places. I did it for 2 years with a small (gas money) stipend that came with it to build my practice volume. It is not worth it without a large stipend at all. Filled my clinic with wounds and post op pus or amp cases. Just ended up bogging down my regular outpt schedule. Once I got a steady patient base I immediately stepped down although there are plenty of pods lining up for the call and other free calls around town.

I have seen around $300 to $500 per day for podiatry to take call at community hospitals. Apparently this was based on some national data. at my last hospital job we were getting $300 per day for any call days greater than 8 a month. So if you took 10 days of call a month they'd give you $600.

In my opinion if you are taking limb salvage call it should be at least 1k a day to make it work as you'd have to reduce clinic volume when you are on call or do add ons at the end of the day after clinic.

 

[Pronation]

I have seen around $300 to $500 per day for podiatry to take call at community hospitals. Apparently this was based on some national data. at my last hospital job we were getting $300 per day for any call days greater than 8 a month. So if you took 10 days of call a month they'd give you $600.

In my opinion if you are taking limb salvage call it should be at least 1k a day to make it work as you'd have to reduce clinic volume when you are on call or do add ons at the end of the day after clinic.

Taking limb salvage call in private practice is hot garbage. A majority of hospitals are not going to pay a podiatrist to take call because there’s a line of other desperate podiatrists ready to do it for free due to our horrible over saturation. A hospital will just make ortho or gen surg deal with these patients if there’s a local PP podiatrist that refuses this stuff. Only sometimes when the other surgical specialties raise a big enough stink will a hospital consider paying the only PP pod in town to take call. Or the hospital will pull a super dirty move and say the pod has to take call for the hospital (for free of course) if they want surgical privs there.

 

[Poddy2Hotty]

Taking limb salvage call in private practice is hot garbage. A majority of hospitals are not going to pay a podiatrist to take call because there’s a line of other desperate podiatrists ready to do it for free due to our horrible over saturation. A hospital will just make ortho or gen surg deal with these patients if there’s a local PP podiatrist that refuses this stuff. Only sometimes when the other surgical specialties raise a big enough stink will a hospital consider paying the only PP pod in town to take call. Or the hospital will pull a super dirty move and say the pod has to take call for the hospital (for free of course) if they want surgical privs there.

Where I'm at Podiatry is the only on call provider that is unpaid. Ortho takes the good insurance non DM2 trauma and dumps the rest on Podiatry. I feel bad for the guys taking the free call and told them to stop taking call ("go on strike") for a month in order to get at least 500/day and in which case I would come back on with them. (Ortho getting 2k/day here). Was close to getting this done then a pp group in the area went behind everyone's back and worked out a deal to take call for free in order to be the only ones to have access to the hospital wound care center and low income federally funded clinics (which can be very lucrative). Complete scum move as those clinics and the wound care center need to be staffed anyway even if call guys were getting paid 500/day.

But then again am I surprised? Nope classic Podiatry move.

 

[DMEpod]

Where I'm at Podiatry is the only on call provider that is unpaid. Ortho takes the good insurance non DM2 trauma and dumps the rest on Podiatry. I feel bad for the guys taking the free call and told them to stop taking call ("go on strike") for a month in order to get at least 500/day and in which case I would come back on with them. (Ortho getting 2k/day here). Was close to getting this done then a pp group in the area went behind everyone's back and worked out a deal to take call for free in order to be the only ones to have access to the hospital wound care center and low income federally funded clinics (which can be very lucrative). Complete scum move as those clinics and the wound care center need to be staffed anyway even if call guys were getting paid 500/day.

But then again am I surprised? Nope classic Podiatry move.

That stuff happens everywhere. One of the hospitals here, the pods attempted to go on "strike" from call because of no pay. Of course a group decided to pick up all those unwanted call days to bill more flap closures. We are really our own worst enemy at times.

 

[dtrack22]

That stuff happens everywhere. One of the hospitals here, the pods attempted to go on "strike" from call because of no pay. Of course a group decided to pick up all those unwanted call days to bill more flap closures. We are really our own worst enemy at times.

There’s far too many of us

 

[Hybrocure]

That stuff happens everywhere. One of the hospitals here, the pods attempted to go on "strike" from call because of no pay. Of course a group decided to pick up all those unwanted call days to bill more flap closures. We are really our own worst enemy at times.

lol, 4 simple interrupted stitches to the tip of a toe = flap

 

[Feli]

There’s far too many of us

That stuff happens everywhere. ... We are really our own worst enemy at times.

Alpha and omega right there ^^^

 

[GreenHousePub]

Where I'm at Podiatry is the only on call provider that is unpaid. Ortho takes the good insurance non DM2 trauma and dumps the rest on Podiatry. I feel bad for the guys taking the free call and told them to stop taking call ("go on strike") for a month in order to get at least 500/day and in which case I would come back on with them. (Ortho getting 2k/day here). Was close to getting this done then a pp group in the area went behind everyone's back and worked out a deal to take call for free in order to be the only ones to have access to the hospital wound care center and low income federally funded clinics (which can be very lucrative). Complete scum move as those clinics and the wound care center need to be staffed anyway even if call guys were getting paid 500/day.

But then again am I surprised? Nope classic Podiatry move.

I'm in this situation right now. A guy I contract with was taking free call (24/7/365) for the local community hospital for years. He's out for several months due to an injury and the hospital is turning to me, expecting me to take the free consults.

I have refused each and every one of them. I overhead ortho asking administration "can't we force them to come in?"

Chief of orthopedics messaged me through a secure app demanding to know why we haven't set up "coverage" due to the injured guys absence. I never replied.

 

[Shiyuan]

Chief of orthopedics messaged me through a secure app demanding to know why we haven't set up "coverage" due to the injured guys absence. I never replied.

 

[DYK343]

I would staunchly refuse to take free call.
I got $700 a day plus whatever I collected in the past.

 

[SouthPod7]

I'm in this situation right now. A guy I contract with was taking free call (24/7/365) for the local community hospital for years. He's out for several months due to an injury and the hospital is turning to me, expecting me to take the free consults.

I have refused each and every one of them. I overhead ortho asking administration "can't we force them to come in?"

Chief of orthopedics messaged me through a secure app demanding to know why we haven't set up "coverage" due to the injured guys absence. I never replied.

Holy cow. That level of entitlement is absolutely astonishing.

It’s also a real window into how much sway ortho has in hospital politics by the nature of how much $$$ they bring to the table.

Also, how could one “force” another specialty to take unpaid call? Just curious how that Ortho chief was planning to enforce that.

 

[DYK343]

Also, how could one “force” another specialty to take unpaid call? Just curious how that Ortho chief was planning to enforce that.

By making it required to hold privileges at the hospital.

I would assume a lawyer could get involved and if gen surg/OB/Ortho are taking paid call then DPMs should too.

 

[Feli]

By making it required to hold privileges at the hospital.

I would assume a lawyer could get involved and if gen surg/OB/Ortho are taking paid call then DPMs should too.

Exactly.. plenty of hospitals require it for all on staff - even if the docs aren't hospital FTEs.

Some will be very vague as to how the call is paid or if it's paid.

You need to ask that and check the bylaws when asking for an application or applying for privileges.

 

[AttackNME]

If I remember correctly the patient was seen by a general surgeon employed by the hospital that took her in for a debridement that same night. That hospital didn't employ any podiatrists because they had no problem finding podiatrists to take call for free.

If they don’t have problems finding a podiatrist to do it for free, then why did gen surg do it?

Taking limb salvage call in private practice is hot garbage. A majority of hospitals are not going to pay a podiatrist to take call because there’s a line of other desperate podiatrists ready to do it for free due to our horrible over saturation. A hospital will just make ortho or gen surg deal with these patients if there’s a local PP podiatrist that refuses this stuff. Only sometimes when the other surgical specialties raise a big enough stink will a hospital consider paying the only PP pod in town to take call. Or the hospital will pull a super dirty move and say the pod has to take call for the hospital (for free of course) if they want surgical privs there.

It’s not like all other surgical specialties get paid either depending on the bylaws. If the hospital is big enough, they can make all of their employed surgical services take call for free. It sucks but makes it hard for us bargain for paid call

I'm in this situation right now. A guy I contract with was taking free call (24/7/365) for the local community hospital for years. He's out for several months due to an injury and the hospital is turning to me, expecting me to take the free consults.

I have refused each and every one of them. I overhead ortho asking administration "can't we force them to come in?"

Chief of orthopedics messaged me through a secure app demanding to know why we haven't set up "coverage" due to the injured guys absence. I never replied.

Good for you to be in a good enough financial situation to refuse additional work. This would have been a good opportunity for you to educate your ortho colleague on your lack of a formal call schedule. It’s the same in my community, i know when a certain podiatry group are out of town because all of a sudden I get called for consults. I’ll take it to take care of the patients and if it’s not too inconvenient for me. If I don’t feel like it, I’ll ask them to divert to the hospital that has formal on-call podiatry

 

[wakaflocka88]

I'm in this situation right now. A guy I contract with was taking free call (24/7/365) for the local community hospital for years. He's out for several months due to an injury and the hospital is turning to me, expecting me to take the free consults.

I have refused each and every one of them. I overhead ortho asking administration "can't we force them to come in?"

Chief of orthopedics messaged me through a secure app demanding to know why we haven't set up "coverage" due to the injured guys absence. I never replied.

I’m glad to hear you stand your ground as you should. I smile every time I see on the OR board “ toe amp - ortho trauma doc”

 

[Pronation]

It’s not like all other surgical specialties get paid either depending on the bylaws. If the hospital is big enough, they can make all of their employed surgical services take call for free. It sucks but makes it hard for us bargain for paid call

I haven’t heard of other surgical specialties taking free call. What specialties have you seen taking free call?

 

[PeaJay]

Exactly.. plenty of hospitals require it for all on staff - even if the docs aren't hospital FTEs.

Some will be very vague as to how the call is paid or if it's paid.

You need to ask that and check the bylaws when asking for an application or applying for privileges.

I would recommend that you make sure to check with the hospital when credentialing to see if there is a “courtesy staff” category.

Courtesy staff can operate and practice within scope, but typically do not have to meet many of the bylaw requirements (% of med staff meetings, call coverage, call radius, ect)

Courtesy staff typically cannot vote and thus live under other people’s rules, but there is something to be said of not having call forced upon you.

 

[Poddy2Hotty]

Chief of orthopedics messaged me through a secure app demanding to know why we haven't set up "coverage" due to the injured guys absence. I never replied.

 

[dtrack22]

Chief of orthopedics messaged me through a secure app demanding to know why we haven't set up "coverage" due to the injured guys absence. I never replied.

Well you should have replied, “we will begin providing coverage when you start taking call for free.”

 

[AttackNME]

I haven’t heard of other surgical specialties taking free call. What specialties have you seen taking free call?

Every specialty that works for my local big hospital. Including ortho and vascular take call for free as required by their bylaws

 

[Boba Foot]

Well you should have replied, “we will begin providing coverage when you start taking call for free.”

Too passive aggressive. "Pay me" is quick and to the point.

 

[Feli]

Every specialty that works for my local big hospital. Including ortho and vascular take call for free as required by their bylaws

Yeah, there are plenty that just firmly require it... no getting around it.
The hospital employ docs are basically paid for it baked into compensation, but PP ones are not paid. I have seen hospitals/systems in both Mich and NMex that do it that way. I don't really know what they'll do if a doc refused to come in, but all on staff will be on the call schedule (or somebody from their group will take their place).

The funny thing is, for DPMs, I've seen some of these hospitals let the guys without surgical training, particularly the wound masters the hospital hires, slide and not take any call. We are one of the only professions where it is very hard to know what you can call the docs for since our training is so... uh... variable?

 

[icebreaker32]

We are one of the only professions where it is very hard to know what you can call the docs for since our training is so... uh... variable?

That is why some hospitals have podiatry call only for Diabetic Foot.

 

[DYK343]

Every specialty that works for my local big hospital. Including ortho and vascular take call for free as required by their bylaws

Are they employed by the hospital directly? If so they have no say because its built into their salary.

If PP I wouldnt be taking free call no matter how big or cool the hospital.

There is zero chance im sitting around not doing much of anything waiting for a call that may or may not happen for free.

That said my hospital has 7 days of call built into my salary. But its built in and required for the job. PP? No way.

 

[msion]

Yeah, hospital admins always try to use the word "contract" or "bylaw" to guilt/threaten people into taking call for free.
Happened to me not too long ago. Medstaff admin called me and asked if I feel it's the right thing to do to deny a patient's care. Something also about medstaff privileges come with call requirements. Apparently the other DPMs were MIA.

I essentially told them to check in with finance/hospital CMO on this matter. If they want me to stop bringing my quick PPO elective cases to the outpatient side then I will take the cases to another system. I will also stop utilizing their radiology services for any CT/MRIs.

Never heard back.

As I stated in other threads, surgeries are not lucrative by any means for a PP doctor if you bill correctly. Those facility fees do mean a lot for the hospitals.