Job Market

[necodaak8]

What are some of your thoughts regarding the following thread posted in 02? I noticed that some of the major pod posters on this board did not respond in this thread so curious about some of your thoughts.


http://forums.studentdoctor.net/showthread.php?t=44019

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[that1guyfromFL]

What are some of your thoughts regarding the following thread posted in 02? I noticed that some of the major pod posters on this board did not respond in this thread so curious about some of your thoughts.


http://forums.studentdoctor.net/showthread.php?t=44019

It seems likely that the major posters in the this forum today were not as involved or involved at all in 2002, just as those who posted a lot in 2002 are, for the most part, no longer here.

From what I have heard/read Podiatry has changed a lot in the last 10 years and the situation being described in that thread is (thankfully) not the norm today.

 

[Brodiatrist]

It seems likely that the major posters in the this forum today were not as involved or involved at all in 2002, just as those who posted a lot in 2002 are, for the most part, no longer here.

From what I have heard/read Podiatry has changed a lot in the last 10 years and the situation being described in that thread is (thankfully) not the norm today.

The fact is that we occupy a very very small and intimate piece of the health care pie. The number of practicing podiatrists and current graduates is negligible to that of MDs. As a result, according to the APMA, over 60% of new graduates find jobs by word of mouth rather than job postings, etc. The important point is that there is no job shortage.

 

[PodunkUDPM]

We literally JUST had a thread about this. http://forums.studentdoctor.net/showthread.php?t=682924

Also, if you use the search function you will find other threads on this topic as well.

 

[necodaak8]

It seems likely that the major posters in the this forum today were not as involved or involved at all in 2002, just as those who posted a lot in 2002 are, for the most part, no longer here.

From what I have heard/read Podiatry has changed a lot in the last 10 years and the situation being described in that thread is (thankfully) not the norm today.

You make a good point in terms of when the posts were being made. It is amazing to see how quickly podiatry has changed in 10 years. What have been some of the major changes allowing the profession to grow?

 

[jonwill]

I'm currently job hunting and it is fine. Their is plenty out there for a well trained pod. I'm currently waiting on final offers. All offers are well into the 100's. And all jobs were found through word of mouth.

 

[215353]

I'm currently job hunting and it is fine. Their is plenty out there for a well trained pod. I'm currently waiting on final offers. All offers are well into the 100's. And all jobs were found through word of mouth.

Are these offers coming from Hospitals, Podiatry groups, or Orthopedic groups? I am also curious to see what kind of benefits/ perks you might be debating on when comparing these offers. If you don't mind sharing your current experiences with the job hunt, we pre-pods would be intrigued to hear about it.

 

[jpevball]

Actually, we pod students would also like to here about it.

 

[Paulywog]

Salaries are overrated. Many job offers have salary plus commission after so much revenue is earned. Let's say you have to bring in 3x your salary before you hit your comission or bonus. With a lower salary, you can hit your commission sooner. The more revenue you bring in, the bigger the percentage of commission you earn and therefore a higher take home pay. This is a great incentive for Podiatrists to work hard. Looking merely at salaries is over rated. When looking at jobs being offered, look at the whole package (That's not what she said) and do some calculations. Jpevball, Cali time in 10 days. See you soon.

 

[jonwill]

I've been involved with podiatry, ortho, and hospitals at this point. They all offer a base plus incentives the first few years which leads to partnership in all the podiatry groups and one of the ortho groups. The incentive structure is around 2.5 times your salary and ranges from 35-40%. They all include license fees, CME money, health insurance, mal-practice, cell phone/pager, etc. Some offer a car lease (some not until you make partner), others offer a buy in to surgery centers, etc.

A nice base salary is important because you may not hit your bonus your first year (depending on how much work you have to put into building a patient base).

As I've been working on things for the past 4-5 months, my own personal experience is better training = better opportunities. I've had an ortho group tell me in the beginning, "unless you know how to fix a tibia, don't bother interviewing". I've got buddies all across the country. Those at the "status quo" programs are finding jobs but they aren't making as much. I would suggest that there almost appears to be two tiers. My friends that are trained in the basic surgeries (mostly forefoot) are doing OK but those trained in rearfoot reconstruction and trauma as well are getting very good offers. But I would also add that this has less to do with long term earnings (ie just because you only do forefoot surgery doesn't mean you won't be very successful in the long run).

As others have suggested, when searching for a job, their are many things to consider. Starting salary, long term earning potential, hours, call, location, partnership, personality (yours and theirs), etc. At least, these are all things that I am considering. I'll keep everyone posted.

 

[215353]

I've been involved with podiatry, ortho, and hospitals at this point. They all offer a base plus incentives the first few years which leads to partnership in all the podiatry groups and one of the ortho groups. The incentive structure is around 2.5 times your salary and ranges from 35-40%. They all include license fees, CME money, health insurance, mal-practice, cell phone/pager, etc. Some offer a car lease (some not until you make partner), others offer a buy in to surgery centers, etc.

A nice base salary is important because you may not hit your bonus your first year (depending on how much work you have to put into building a patient base).

As I've been working on things for the past 4-5 months, my own personal experience is better training = better opportunities. I've had an ortho group tell me in the beginning, "unless you know how to fix a tibia, don't bother interviewing". I've got buddies all across the country. Those at the "status quo" programs are finding jobs but they aren't making as much. I would suggest that there almost appears to be two tiers. My friends that are trained in the basic surgeries (mostly forefoot) are doing OK but those trained in rearfoot reconstruction and trauma as well are getting very good offers. But I would also add that this has less to do with long term earnings (ie just because you only do forefoot surgery doesn't mean you won't be very successful in the long run).

As others have suggested, when searching for a job, their are many things to consider. Starting salary, long term earning potential, hours, call, location, partnership, personality (yours and theirs), etc. At least, these are all things that I am considering. I'll keep everyone posted.

Are these job opportunities M-F jobs or will you be working all week? I ask this question because the Podiatrist I have shadowed only works M-F. One of the many selling points for Pod is that you can work as much or as little as you want...but if you are working for a Pod group, Ortho group, or Hospital...don't they dictate how much you should be working?

Outside of salaries/ benefits...can you or someone else explain what exactly is expected of you (in terms of how much you work) if you are going to work within a group practice? The only Pod shadowing experience I have had is with a Pod who is in private practice. Unfortuntely I don't see myself and other future pods going this route since it seems working within Pod groups or Ortho groups is becoming more main steam.

 

[215353]

Realistically, is it possible to join a Pod group or Ortho group and still have a small private practice of your own?

For example, say I was able to join an Ortho group and I worked M-F during the week. Would I have the time to run my 1-2 room office for my private practice and solely do chip and clip on the weekends? This way I have a base salary from the Ortho group and I am making some extra cash doing nails on the weekend.

Would the Ortho group allow this? Is this even realistically possible? Does this make any sense? From some of the replies it seems like it wouldn't because I would be taking away business from my practice within the Ortho group...thus I would not hit my revenue goals.

I don't have a firm grasp of what is expected or what is possible when working in a group practice. If anyone can shed light on this I would really appreciate it.

 

[PADPM]

You ask some excellent questions. At the present time, our offices are extremely busy and all of our doctors unfortunately (or fortunately due to being busy) work 6 days a week.

I don't like working Saturday mornings, I don't want to work Saturday mornings, etc., but many of our patients can't come in during the workday and need Saturday morning hours and due to our busy offices, it's the only way we can handle the overflow and still be able to have time during the week to leave the office and perform surgery, etc.

It's a good and bad problem.

Unless your "private" office is a significant geographic distance from the group practice, I doubt if any contract will allow you to practice privately. Remember, this group will be paying YOUR malpractice, license fees, professional membership fees, etc., and if you have your own practice on the side, they may want you to pay a pro-rated portion of those fees.

Additionally, it may make it seem as if you're not REALLY committed to them and already have one foot out the door until you build your OWN practice. It will appear that they are simply a temporary job until your own practice builds.

But, that's just my opinion. Our group would not allow that situation in your contract for the above reasons.

 

[NatCh]

Realistically, is it possible to join a Pod group or Ortho group and still have a small private practice of your own?

For example, say I was able to join an Ortho group and I worked M-F during the week. Would I have the time to run my 1-2 room office for my private practice and solely do chip and clip on the weekends? This way I have a base salary from the Ortho group and I am making some extra cash doing nails on the weekend.

Would the Ortho group allow this? Is this even realistically possible? Does this make any sense? From some of the replies it seems like it wouldn't because I would be taking away business from my practice within the Ortho group...thus I would not hit my revenue goals.

I don't have a firm grasp of what is expected or what is possible when working in a group practice. If anyone can shed light on this I would really appreciate it.

1. The above scenario is unlikely due to conflict of interest
2. The above scenario does not make sense, at least to me. If you work for an ortho group and make $150K-$250K (or more?) per year, would you really want to burn up your weekends doing chip and clip for what would amount to pocket change? It seems like a recipe for early burnout. I think of this career as a marathon, not a sprint.

 

[Feli]

A lot of good points in this thread. The bottom line is that there's a need for our skills. That is pretty obvious.

... I think of this career as a marathon, not a sprint.

Definitely agree.

My program is nearly 40yrs old and has 100+ alumni by now. Some do a lot of RRA, some don't do much/any (even though they have simliar training). Some guys are the practice keystone making managerial decisions on every day, and others are associates who want little/nothing to do with the business end. Some are FTEs of hospitals or residency directors. It all depends on what you want to do.

Some very sharp guys are making an absolute killing doing office and forefoot sx, inpatient consults and wound care, and barely any RF surgery. Others are doing a lot of RRA and trauma at the expense of higher malpractice, long term global f/u, and usually lower net income, but that's what they like to do. To each his own. In the end, the guys I see rounding the earliest, working weekends, and staying for late add on cases are usually doing the best financially (provided they have at least made partner).

I still go back and forth on what I want to do. Some days, I'll call about practices for sale, read PMgmt, and browse office supplies. Other days, I'll read some good articles or texts and think how it'd be cool to be a residency or pod school attending/admin and research/lecture a lot. In the end, you can create hybrid practice situations if you want. No matter what your practice situation, you will need both science and business sense to be maximally successful. The science/surgery training is obviously the hard part since good residencies don't grow on trees yet anyone can read pod mags or go to prac mgmt lectures.

...One of the many selling points for Pod is that you can work as much or as little as you want...

It all depends how much autonomy you have. Watch a junior associate tell the practice owner they don't want to cover Saturday post-ops or won't do more than one weekend of call each month, and see how many bonuses they hit or long they last. The practice owner? Sure, do whatever you like... but you will probably lose referrals/consults because of that unless you have partners/associates covering. If you want a career you can mold to your needs/wants, you should aim for a track that is focused on entrepreneurship or early partnership so you see the books and the money flows through your hands...
"One must either be the hammer or the anvil."

In the APMA study after APMA study, hours worked per week and ABPS cert were the main things that statistically predicted to more gross income for DPMs. You have to get out of bed in the morning, and you should have more to offer your customers than the next guy (aka complex surgery or diagnostics that lets you gain/keep cases other DPMs refer out). Those two principles are sorta common sense and apply to any business under the sun.

 

[PADPM]

Feli,

EXCELLENT post. For a doctor that is relatively early on in your training, you are quite observant and have really hit the nail right on the head. I believe you've got an excellent future and seem to be quite aware and mature.

I believe that one of your points in particular is extremely important. You must be willing to wake up in the morning and be prepared to work. Each one of the doctors in our practice works extremely hard and works long hours. A lazy doctor in our practice simply does not last very long. With about 15 docs in the practice, there is no room or tolerance for a lazy doctor.

However, hard work starts at the top. The senior/founding partner works as hard and as long as the newest associate. And no one, including a new associate is asked to do anything that a partner doesn't currently do or hasn't recently done.

In our practice, egos are checked at the door or once again you won't last long.

I never forget my roots. So despite my accomplishments, my "status" within our practice and all my "fancy" credentials and the fact that I do perform some complicated surgical procedures, it's not "beneath" me to make a housecall for a patient that has been a loyal patient of mine. Some of my patients have stuck with me through thick and thin and I will never forget those patients or turn my back on them, nor will I pass them off to an associate. If unfortunately one of those patients comes on hard times and can't pay, I will never turn them away, and similarly if one of those patients becomes ill and needs me to come to the home to simply cut his/her nails, I'm happy to oblige.

I do whatever I can for my patients and to enhance our practice. We didn't build a large practice with an "attitude". There have been days when I was at the hospital with my residents applying an ex-fixator and on the way home stopped to make a house call to "just" cut some nails for a patient in need. And I can tell you that the housecall patient appreciated my services more than any patient I ever took to the O.R.

Our entire practice is based on this philosophy, and maybe that's why a few local practices have closed their doors and our practice has fortunately constantly grown. We're simply not lazy and don't have large egos.

I treat patients for foot and ankle disorders, whether it be simple or complicated, when and where they need my services. I work hard, I believe my patients know that and appreciate that fact and I'm rewarded for my work emotionally and financially.