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[heybrother]

My negative thing - the number one way to generate surgical cases is to undertreat patients. There's always pathology in people who you shouldn't operate on, but there's plenty of minor resolvable aches and pains that people try to turn into cases that shouldn't exist. They want the prestige of being a surgeon.

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[CutsWithFury]

Sure, for now. There are 35k orthopedic surgeons in the US. Graduating 600 pods a year for 30 year careers gives a running average of 18,000 practicing pods at any given time. Add in the 2000 or so foot and ankle ortho pods and that’s 20,000 dedicated foot/ankle surgeons. Obviously many pods do very little or no surgery, but their aspirations to do so have never been higher and graduates coming out now have a surgically focused training and surgically focused expectations. New graduates are replacing retiring pods who for the most part existed in a different time with different training. Many meet a different reality. Nonetheless, 20,000 foot and ankle surgeons (plus General ortho, sports ortho, ortho trauma, and the ortho hand guy who is on call this week all do some foot and ankle in their practice too) is a lot. I recant my statement, our profession is not at critical saturation, but the surgical aspect of our profession is probably close.

I’m in practice and I can tell you there are plenty of people who need surgical intervention.

Complications in surgery happen. I’ve seen bad complications done by other podiatrists and foot and ankle ortho in my community. I’ve had complications myself. All situations patients needed revision surgery.

Wounds...you like them? I certainly do. There will always be diabetic foot ulcers. There will always be gangrene from severe PVD. Podiatry and vascular surgery will always be intertwined. Get yourself a good vascular surgeon and become best pals. you will never be low on lower extremity limb salvage opportunities.

Like toenails and calluses? I certainly do. Biggest issue with painful toes is that they have underlying acquired MSK deformities that always need to be fixed to prevent the calluses and toenails from bothering patients. Plant that seed early and watch it grow.

I love me some ankle sprains. Screw the fractures. The money is in complications from ankle sprains. Most common surgeries I do are scope with or without microfracture of OCD + brostrom +/- syndesmosis repair. So many pathologies can occur with badly sprained ankles. Ortho will always balk at a bad ankle sprain 100% of the time. Patients always say “ortho said it would have been better if I broke it....” I hear that all the time.

Ortho: “It’s not fractured therefore here is a boot and do some PT”.

Patient: “But doc my ankle is still swollen 1 year later”

Ortho: “It’s not fractured therefore there is nothing to fix”

Patient:

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If you know what you are looking for there is pathology that other provides over look

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You need to work in areas where there isn’t good access to care. If you want to live in a city then you will always have stiff competition for volume. You need to be where the general public does not desire to usually live. Set up shop there and kill it. Use the money to go on vacations where you want to be.

 

[Pronation]

You need to work in areas where there isn’t good access to care. If you want to live in a city then you will always have stiff competition for volume. You need to be where the general public does not desire to usually live. Set up shop there and kill it. Use the money to go on vacations where you want to be.

Sad but true

Pay, pay the price
Pay, for nothing's fair

 

[G0dFather]

Get yourself a good vascular surgeon and become best pals. you will never be low on lower extremity limb salvage opportunities.

The money is in complications from ankle sprains. Most common surgeries I do are scope with or without microfracture of OCD + brostrom +/- syndesmosis repair.

There has never been words said more true that this before.. LEGEND!