jobs after residency

[SportPOD]

Is the APMA statistic that the median gross income of practice owners accurate? Is 400k for a pod practice owner/partner a lot, or is it average like the study indicates? I'm curious because the lifestyle, nature of the work, and the income seem almost too good to be true!

I've kind of gone over this on another thread, but let me clear up the air about gross versus collected. Gross income is what is billed to the insurances. All medical providers will bill a certain amount to the insurances, but will only get paid about 2/3 to 3/4 of what they billed. So the gross income is not the actual net income of that practice. Net Income is collected income, what the insurance companies will pay you. Of course there is a very small minority of insurances who will pay you what you ask for, but the majority will have what they call a "provider discount" which is stating to the insured that they are using an "in-network" provider.

So taking in mind that the average is $400K and if you take 3/4 of that, then you come up with $300K as the net collection and usually overhead expenses is about 50% of your practice (it can be less than that, but for sake of arguement) you will take home $150K. Now remember there are people out there who will make more than this and people who will make less than this. If you are joining up a group, the overhead does reduce because there are more people sharing on the costs.

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[iceman69]

For a second I thought that gross income might be what the podiatrist's pre-tax salary...I appericate you clearing this up.

 

[HenryH]

I've kind of gone over this on another thread, but let me clear up the air about gross versus collected. Gross income is what is billed to the insurances. All medical providers will bill a certain amount to the insurances, but will only get paid about 2/3 to 3/4 of what they billed. So the gross income is not the actual net income of that practice. Net Income is collected income, what the insurance companies will pay you. Of course there is a very small minority of insurances who will pay you what you ask for, but the majority will have what they call a "provider discount" which is stating to the insured that they are using an "in-network" provider.

So taking in mind that the average is $400K and if you take 3/4 of that, then you come up with $300K as the net collection and usually overhead expenses is about 50% of your practice (it can be less than that, but for sake of arguement) you will take home $150K. Now remember there are people out there who will make more than this and people who will make less than this. If you are joining up a group, the overhead does reduce because there are more people sharing on the costs.

Thanks for sharing. Do you know if non-pod-only group practices (such as orthopaedic groups) are generally receptive to podiatrists? I ask because, in my city, many orthopaedic surgeons still seem to be taking on most of the foot/ankle surgeries, especially those sustained during sports-related activity. In fact, I don't think there is a single podiatrist that does "surgery surgery" around here. Then again, when I browsed the websites for most of the podiatrists in my city, none of them seem to have completed 36-month residencies. Do you think the orthopaedic groups, etc., would be more receptive to hiring a podiatrist who has completed a 36-month residency?

 

[iceman69]

In the midwest, the ortho groups seem pretty receptive to pods, at least in the Twin Cities, Milwaukee, and from what my interviewer at SCPM indicated Chicago to an extent. I guess it really depends on your training, who you know, and if you hussle and the local demand for F&A work. According to the APMA 2007 practice survey, MN, WI are among those states with the highest demand for pods. Summit Ortho, the biggest ortho group in St. Paul, MN has a pod and one F&A ortho doing all their below the knee work. I think it's market dependent. If you want to do a lot of gnarley sports med stuff, you'll need to be good...and network, and willing to work more than most other podiatrists tend to. Maybe one of the attendings or residents around here can provide some more insight beyond speculation.

 

[Feli]

...I think it's market dependent. If you want to do a lot of gnarley sports med stuff, you'll need to be good...and network, and willing to work more than most other podiatrists tend to. Maybe one of the attendings or residents around here can provide some more insight beyond speculation.

This is all true to my limited knowledge; nothing good comes easy. However, you will begin to realize, even while you are just a student, that even if you work hard, there is also a lot of political BS that exists...

Here's one example in Florida right now:
http://www.flsenate.gov/data/session/2008/Senate/bills/billtext/pdf/s1016.pdf

 

[NatCh]

For a second I thought that gross income might be what the podiatrist's pre-tax salary...I appericate you clearing this up.

I think some confusion may be from SportPOD and me using different definitions.

When I refer to gross income it is pre-expense income that is actually collected, rather than the amount billed. You can bill however much you want, but you will only receive whatever you receive. For instance did you catch the story last Fall about the profligate podiatrist in WI who was billing ludicrous amounts? He could bill five million dollars if he wanted to, but I think it would be totally inaccurate for him to say his gross income is five million dollars if he really only collected a few hundred thousand.

Net income is what I have after expenses.

How was the APMA survey worded? I do not recall.

If you are talking about your salary and not your business income, I believe you can call your pre-tax salary "gross" income and what is left after taxes "net" income.

I could be all wrong though; it wouldn't be the first time. Is there an Accountant in the house?

If you are joining up a group, the overhead does reduce because there are more people sharing on the costs.

This is why small groups tend to result in higher incomes, but there can be a point of diminishing returns though. As the group grows bigger and bigger expenses will likely increase even though there are more people to share costs. When groups get very big they require professional business people to make it run. CEO's, CFO's, COO's, all command six-figure incomes. Then there's the small army of support personnel, plus lots of hidden areas for inefficiency. Fortunately if your Administrative team is clever they will come up with other ways to turn the group income into more money, such as lab services, radiologic services, and real estate trusts.

 

[SportPOD]

I think some confusion may be from SportPOD and me using different definitions.

Yes, I think that is probably where some of this confusion does lie is the terminology which can be interchangeable.

Gross (not the ewww gross) can either be labeled as the income billed out (what you're asking for the insurances to pay) or what is coming into the practice before taxes, expenses.....

Net income can be labeled as income coming after the insurances decide how much to pay you after their provider discounts or it can be the amount of money after taxes.

This is why it is important to see the books before you join the practice to make sure that the gross income isn't over inflated due to it being just income that is billed out and not the "true income" of the practice which is "net income".

Remember, have a tax lawyer and/or accountant as one of your best friends!

P.S. there will be a quiz later in the day.

 

[SportPOD]

Thanks for sharing. Do you know if non-pod-only group practices (such as orthopaedic groups) are generally receptive to podiatrists? I ask because, in my city, many orthopaedic surgeons still seem to be taking on most of the foot/ankle surgeries, especially those sustained during sports-related activity. In fact, I don't think there is a single podiatrist that does "surgery surgery" around here. Then again, when I browsed the websites for most of the podiatrists in my city, none of them seem to have completed 36-month residencies. Do you think the orthopaedic groups, etc., would be more receptive to hiring a podiatrist who has completed a 36-month residency?

yes, this is true every day. There are some areas where ortho groups might be non-receptive, but it may also be due to some old time orthopod who has a grudge against podiatry (for whatever insane reason). With the training that you receive as a three year podiatrist, most of these groups are going for the podiatrist, because of the scope of practice that we can bring into the practice. Alot of orthopedic foot and ankle surgeons, do not want to deal with diabetic foot care, warts or ingrown nails. For a multi-speciality group, that can be a large population (AKA revenue) which can be left out.

 

[iceman69]

That's lucky for me! One of my closest friends is a CPA...

 

[Stafocker]

Stafocker, thanks for the advice. Do you know if Georgia is oversaturated with podiatrists? I ask because GA is the state I've grown up in, and so I would like to come back here after school and be an associate, partner, etc.

Also, when it comes to landing an associateship, how does the process work? If I want to practice in GA, is it imperative that I do a residency in that state? When I graduate from my residency program and am ready to find a job as an associate, do I just fire off my resume to practices in the city I want to work in?

Thanks...

EDIT: Some of these "podecdotes" are somewhat alarming; check this out: http://www.network54.com/Forum/23927/message/1170498910/fear. I really am interested in podiatry, but do the majority of these horror stories carry weight (and there are plenty, especially on that forum)? Howcome there aren't countless horror stories from MD/DO or DDS/DMD grads? Not trying to stir up any negativity, but I want to look out for my future as a marketable professional.

Been a while, sorry, here's some postings about Georgia for jobs for pods:

Source APMA member's site.

GEORGIA—PM&S-36 resident position available for entry at the second-year level. Must have National Boards Parts 1, 2, & 3 passed and able to get a Georgia podiatry license. Please contact Brent Nixon, DPM, MBA, Chief of Podiatry/Residency, Director Department of Medical Specialties (111) Atlanta VAMC Decatur, GA 30033. E-mail [email protected] or call 404-321-6111 ext. 6589, 404-225-1470, or 520-241-3228.


GEORGIA—Seeking podiatrist to work in Waycross area. Must have a Doctor of Podiatric Medicine (DPM) degree and completed residency program in podiatric surgery with training in endoscopy procedures, charcot reconstruction procedures, and trauma reconstructive surgery. Must have at least one year of experience beyond residency training. Must also have a state of Georgia podiatrist’s license, or be eligible for the same. Submit résumés to Vicci Nails, 2003 Alice Street, Waycross, GA 31501 or fax 912-283-3590.


GEORGIA—Atlanta and surrounding areas. Opening for selective individual in established, multi-location practice. Seeking board-eligible/certified podiatrist desiring opportunity for buy-in. Must be personable, ethical, self-motivated, and conscientious. Serious inquiries only. Send CV and three professional references to [email protected] or fax 770-413-9437.


GEORGIA—Podiatrist needed in the greater Atlanta, Athens, Augusta, Columbus, and Macon areas. Growing podiatric medical service looking for someone who wants to supplement their income. We are a young, fun, and hip company enjoying tremendous growth and have immediate openings for the right candidates. Part-time and full-time positions are available. Keep your current job and earn extra income or consider a full-time position. Our flexible schedule allows you to work with us for as little as three days per month up to six days per week. Great benefits available for full-time employees. We provide an established patient base, excellent pay, billing, and scheduling. You need to provide excellent podiatric skills and compassionate care. To learn more about us, please send us your CV, and specify your current location and availability. E-mail [email protected].


GEORGIA—Seeking associate for well-established, busy, five-physician, multi-location group practice in beautiful southern Georgia, for general podiatry, wound care, and palliative services. PSR-12 minimum, board-eligible/qualified preferred. Generous compensation and benefit package. Fax cover letter and CV to 912-283-2598 or e-mail to [email protected].


GEORGIA—A well-established, successful, multi-physician practice in south Georgia with three office locations and an ambulatory surgery center seeks a full-time, PSR-24/36-trained podiatrist. Our practice has an experienced support staff and offers an excellent benefit package including paid malpractice insurance, group medical, and disability insurance. We also offer a 401(k) and profit-sharing plan. Please send CV to Valdosta Podiatry Associates, PC, c/o Avis Griffin, 2718 North Oak Street, Valdosta, GA 31602 or e-mail [email protected]. Visit our Web site at www.valdostapodiatry.com.


GEORGIA—Excellent opportunity for either a recent graduate PSR-24/36 or an experienced practitioner to join a large, well-established, group practice in beautiful Georgia. Experienced support staff, generous salary, malpractice insurance, health insurance, profit sharing, 401(k), etc. For consideration, please mail curriculum vitae, two references, and a brief biography to Steven Arminio, DPM, Foot and Ankle Centers of NE GA, 575 Professional Drive, Suite 300, Lawrenceville, GA 30045 or call 770-963-5161, ext. 224.

 

[HenryH]

Hey, thanks for those job listings; it's nice to see that there are some pretty nice-looking jobs out there. One thing, though...do you have any idea how much the base salary, percentage scheme, etc. would be for any of those? I'm just wondering, because I have seen plenty of openings for associate dentists which list base salary/percentage amount, but no (or very few) podiatry associate openings divulging the same information.

 

[Stafocker]

Hey, thanks for those job listings; it's nice to see that there are some pretty nice-looking jobs out there. One thing, though...do you have any idea how much the base salary, percentage scheme, etc. would be for any of those? I'm just wondering, because I have seen plenty of openings for associate dentists which list base salary/percentage amount, but no (or very few) podiatry associate openings divulging the same information.

sorry it varies so much, i really don't have any clue