Market Harvesting/Why we shouldn't worry about more Podiatry Colleges

[Adam Smasher]

I was reading through the pre-pod forums and noticed there are more attendings commenting than there are pre-pods. This led me to wander into some interesting hypotheticals.

What if it's already over? What if the decline in applicants is permanent? I think the negativity can be excessive but I'm not going to be a useful idiot for the apma either. Look at the salient facts:

• $250k+ debt
• 7 years
• 120-160k mean salary according to PM News

That's it. Pre-health students ain't stupid. Podiatry isn't a bad choice, there are just too many better options out there. If we can't change at least 2 of those bullets, it's going to stay that way.

This brings me to my main point. Market harvesting is what happens when a business wants to squeeze the last bit of profits from a dying brand. Think print media. Most of us don't read newspapers or magazines anymore, but some people have gotten the Sunday paper for years and won't stop. There's a core market segment who will pay whatever it takes for the product because for them, it's an institution. As a result, newspapers increase subscription fees, because demand is inelastic for these consumers. They also increase ad space and fire reporters. So writing quality dips because they're overworked. The end result is a product that's overpriced garbage, but the business is a boomin'.

Where do podiatry colleges fit in? Note that most/all the schools are affiliated with some college of health professions. They've already got expensive lecture halls and anatomy labs for PAs or DOs so why not get some tuition paying DPMs in the room. And we learned from COVID that lectures can be watched online. Clearly the cost of producing a DPM is down, especially if you can take advantage of a pre-existing academic framework.

What about demand for the DPM degree? We know overall demand is down, but consider there may be a segment of the pre-health applicant pool that is hell-bent on podiatry no matter the cost. So we may very well see tuition steadily increase!

So the number of schools doesn't matter, I think they know they're not filling their classes. The overarching universities just want an inexpensive ancillary revenue stream. We may not be too far away from 15 colleges with 30-40 matriculants each.

---

Members don't see this ad.

 

[icebreaker32]

Yah lots of fixed costs and not too expensive to hire a few full time and part time podiatrists.

A major problem with podiatry like you said is other healthcare professions have gotten better and are in demand, podiatry in many ways, despite longer residencies has stayed the same.

Removing the cost of education and years spent there are still serious issues with salary and saturation etc

The average salary looks reasonable enough, but there are many making far less and far more than the average…….less of a guarantee of average salary, especially in early years

As far as PP the benefits are less. Health insurance not as good. Not very often signing bonuses, relocation allotment and loan repayment or forgiveness, less vacation. Less CME money also. I have seen hospital employed podiatrists buying textbooks at national conferences. Made small talk and joked who buys textbooks anymore and if so they buy them on Amazon. They had so much CME money they could not figure out how else to use it and textbooks counted.

Saturation in many markets

Current generation wants a job with lots of vacation and does not want to be a small business owner……they want better life/work balance. After putting in years PP can sometimes offer this when the stars are aligned, even then it can potentially change without notice for lots of reasons. MDs very often get 6 weeks of vacation. They very often bitch if on weekend call too often. Maybe on call every 4-6 weeks and get a a half or full day for administrative tasks per week Yes their clinics are very busy, they spend 2 minutes and charge a high level E&M.

If go rural and take more call usually make more money. Not like podiatry PP cost of living lower so we can pay you less. Also many podiatrists have to buy in practice or surgery center if they even can to up salary. MDs don't have to do this, they can do just fine working for hospitals. Some specialties like ortho are often independent and have buy ins to be partner, but only because they are making serious money by doing so.

You can argue we are not MDs. True. We now have MD length and cost of training, so what profession should we compare ourselves to?

As far as the cost of obtaining the degree. It seems the government trend is towards lower smaller payments based on income with a path to forgiveness, so that will not detour future students. Most do not worry about a 10 year monthly payment to payoff loans these days unless they are doing very well. This along with the fixed costs the DO schools already have covered should keep podiatry around. The amount of applicants goes up and down for lots or reasons....other better options available is certainty one of them. The length of time for the education is not going anywhere. Many could do what they do with less training and many residencies are not that great, but there will not be one or two year residencies. What percent are now doing fellowships?

 

[air bud]

5k CME and 5 days CME. It's hard to spend 5k on CME. You have to do multiple conferences probably with a cadaver lab. Most PP will get 1k CME. That doesn't even pay for your hotel at ACFAS. In the past I have bought books on Amazon, collected the CME monies then returned the books....🤫 I wish I could use CME to buy lead or OR glasses.

Hospital pays 73 percent of my health insurance which has a $1500 dollar deductible within the system. 10 dollar copays. Most meds are free. I know people who pay even less of a percentage).
Short term/long term disability coverage (I will carry an outside disability policy to supplement).

5 percent 401k match. My first job they basically maxed out the employer contribution. My old partner has been there for 10 years and has gotten about 400k of tax free contributions to her 401k.

DCFSA- 5k I spend on childcare this year is tax free

FSA (no HSA option but oh well).

Prepods who have never worked have no idea the value of pretax money. Now try and practice in a state with a high state income tax, higher COL, more expensive schooling, higher borrowing rates, lack of job mobility.....

So when I was with a small private Ortho group...
I paid 1600 a month for health insurance, 400 a month for disability, 600 a month for child care (I know that is cheap vs people in metro areas), no 401k match/contributions....that is a huge amount of money but at least health was pretax. I don't know how people survive with multiple kids living in an expensive metro. You better have a spouse that makes more than you.

If you can't get into a hospital where you have the opportunity to bonus/take paid call then at least do a VA where you get all the same or better benefits. But more and more private pods are going to gobble up these hospital/VA jobs as the get integrated into their community. Leaving new grads stuck in predatory private practice.

 

[newfeet]

I was reading through the pre-pod forums and noticed there are more attendings commenting than there are pre-pods. This led me to wander into some interesting hypotheticals.

What if it's already over? What if the decline in applicants is permanent? I think the negativity can be excessive but I'm not going to be a useful idiot for the apma either. Look at the salient facts:

• $250k+ debt
• 7 years
• 120-160k mean salary according to PM News

That's it. Pre-health students ain't stupid. Podiatry isn't a bad choice, there are just too many better options out there. If we can't change at least 2 of those bullets, it's going to stay that way.

This brings me to my main point. Market harvesting is what happens when a business wants to squeeze the last bit of profits from a dying brand. Think print media. Most of us don't read newspapers or magazines anymore, but some people have gotten the Sunday paper for years and won't stop. There's a core market segment who will pay whatever it takes for the product because for them, it's an institution. As a result, newspapers increase subscription fees, because demand is inelastic for these consumers. They also increase ad space and fire reporters. So writing quality dips because they're overworked. The end result is a product that's overpriced garbage, but the business is a boomin'.

Where do podiatry colleges fit in? Note that most/all the schools are affiliated with some college of health professions. They've already got expensive lecture halls and anatomy labs for PAs or DOs so why not get some tuition paying DPMs in the room. And we learned from COVID that lectures can be watched online. Clearly the cost of producing a DPM is down, especially if you can take advantage of a pre-existing academic framework.

What about demand for the DPM degree? We know overall demand is down, but consider there may be a segment of the pre-health applicant pool that is hell-bent on podiatry no matter the cost. So we may very well see tuition steadily increase!

So the number of schools doesn't matter, I think they know they're not filling their classes. The overarching universities just want an inexpensive ancillary revenue stream. We may not be too far away from 15 colleges with 30-40 matriculants each.

If some one is hell bent on podiatry then I would say they should do it. If you know all the obstacles about the profession and you still chose it then you should be fine. If someone is on the fence between PA or DPM. I would lean toward telling them to go to PA school.

Personally I would be encouraging my kids to look at other health care professions or non health care gigs. Though my kids seem to already get that even in their doctor play they always start off with "I don't want to be a podiatrist".

 

[air bud]

I was reading through the pre-pod forums and noticed there are more attendings commenting than there are pre-pods. This led me to wander into some interesting hypotheticals.

What if it's already over? What if the decline in applicants is permanent? I think the negativity can be excessive but I'm not going to be a useful idiot for the apma either. Look at the salient facts:

• $250k+ debt
• 7 years
• 120-160k mean salary according to PM News

That's it. Pre-health students ain't stupid. Podiatry isn't a bad choice, there are just too many better options out there. If we can't change at least 2 of those bullets, it's going to stay that way.

This brings me to my main point. Market harvesting is what happens when a business wants to squeeze the last bit of profits from a dying brand. Think print media. Most of us don't read newspapers or magazines anymore, but some people have gotten the Sunday paper for years and won't stop. There's a core market segment who will pay whatever it takes for the product because for them, it's an institution. As a result, newspapers increase subscription fees, because demand is inelastic for these consumers. They also increase ad space and fire reporters. So writing quality dips because they're overworked. The end result is a product that's overpriced garbage, but the business is a boomin'.

Where do podiatry colleges fit in? Note that most/all the schools are affiliated with some college of health professions. They've already got expensive lecture halls and anatomy labs for PAs or DOs so why not get some tuition paying DPMs in the room. And we learned from COVID that lectures can be watched online. Clearly the cost of producing a DPM is down, especially if you can take advantage of a pre-existing academic framework.

What about demand for the DPM degree? We know overall demand is down, but consider there may be a segment of the pre-health applicant pool that is hell-bent on podiatry no matter the cost. So we may very well see tuition steadily increase!

So the number of schools doesn't matter, I think they know they're not filling their classes. The overarching universities just want an inexpensive ancillary revenue stream. We may not be too far away from 15 colleges with 30-40 matriculants each.

Great post. Was the 300 or so applicants for last year's class when do we find out about this year's class? We at least need multiple years of data to form a trend come on guys we are scientists anecdotal evidence doesn't work.

Definitely agree, I see how it's harder for these standalone colleges to absorb costs associated with lost students but for a place like dmu, nothing really changes. Wet lab is still being used by all the do students and those lecture Halls are designed to hold three or 400 people already. You just have the dedicated staff to Podiatry and that's it. It's not like any real money is being made by the crappy nail clinics on campus.

 

[DYK343]

THe applicant pool is certainly down (guestimating by about 100 applicants) but its not in a death spiral.

Granted 100 applicants is a bigger deal when its histoprically ~1000 applicants.

Curious what 22 numbers are.

Also to generalize Gen Z they tend to be money savy, minimalist, and dont take on debt. They are much smarter with their money than millenials were.

 

[newfeet]

Great post. Was the 300 or so applicants for last year's class when do we find out about this year's class? We at least need multiple years of data to form a trend come on guys we are scientists anecdotal evidence doesn't work.

Definitely agree, I see how it's harder for these standalone colleges to absorb costs associated with lost students but for a place like dmu, nothing really changes. Wet lab is still being used by all the do students and those lecture Halls are designed to hold three or 400 people already. You just have the dedicated staff to Podiatry and that's it. It's not like any real money is being made by the crappy nail clinics on campus.

Are there any true standalone schools left? NYCPM is with Touro.

 

[icebreaker32]

5k CME and 5 days CME. It's hard to spend 5k on CME. You have to do multiple conferences probably with a cadaver lab. Most PP will get 1k CME. That doesn't even pay for your hotel at ACFAS. In the past I have bought books on Amazon, collected the CME monies then returned the books....🤫 I wish I could use CME to buy lead or OR glasses.

Hospital pays 73 percent of my health insurance which has a $1500 dollar deductible within the system. 10 dollar copays. Most meds are free. I know people who pay even less of a percentage).
Short term/long term disability coverage (I will carry an outside disability policy to supplement).

5 percent 401k match. My first job they basically maxed out the employer contribution. My old partner has been there for 10 years and has gotten about 400k of tax free contributions to her 401k.

DCFSA- 5k I spend on childcare this year is tax free

FSA (no HSA option but oh well).

Prepods who have never worked have no idea the value of pretax money. Now try and practice in a state with a high state income tax, higher COL, more expensive schooling, higher borrowing rates, lack of job mobility.....

So when I was with a small private Ortho group...
I paid 1600 a month for health insurance, 400 a month for disability, 600 a month for child care (I know that is cheap vs people in metro areas), no 401k match/contributions....that is a huge amount of money but at least health was pretax. I don't know how people survive with multiple kids living in an expensive metro. You better have a spouse that makes more than you.

If you can't get into a hospital where you have the opportunity to bonus/take paid call then at least do a VA where you get all the same or better benefits. But more and more private pods are going to gobble up these hospital/VA jobs as the get integrated into their community. Leaving new grads stuck in predatory private practice.

VA has good benefits. There are some large healthcare systems that probably have better. There are some small community hospitals that have a better pension.....3 percent per year. VA is 1 percent. The healthcare insurance is certainly good and you can take it with you when you retire (not free, but not expensive either)....you don't ever even need to get Medicare. Some doctors work here their last 5 years to slow down a bit and get the insurance benefits they can take with them into retirement.

The best benefit to me is work/life balance. Your paperwork is most often done when you leave work everyday. No call ever in many settings. You take most of your generous vacation time as you are not worried about missing out on your production like many hospital settings. Federal holidays mixed in also is nice.

THe applicant pool is certainly down (guestimating by about 100 applicants) but its not in a death spiral.

Granted 100 applicants is a bigger deal when its histoprically ~1000 applicants.

Curious what 22 numbers are.

Also to generalize Gen Z they tend to be money savy, minimalist, and dont take on debt. They are much smarter with their money than millenials were.

certainly money savy, but they take lots of vacation also

 

[air bud]

Still no prepods
Edit- just realized posted in the too late to turn back forum.

 

[dtrack22]

Are there any true standalone schools left? NYCPM is with Touro.

Being affiliated with a medical school or university isn’t the same as actually being integrated. If you share some faculty and admin overhead but the DPMs have their own building/facilities that are completely separate from the other programs, then a significant drop in enrollment will probably hurt. Is NYCPM still at their same Harlem location or did campus move to join whatever Touro MD/DO programs are in NYC? Its also interesting that NYCPM is nowhere to be found on the Touro college/university network website… Admissions

Compared to DMU where those same lecture halls and labs and clinic spaces that pod students used would still be filled with 200 DOs and PAs and DPTs that already use them alongside the DPMs, if the DPM program were to shut down. I think that was airbuds point.

 

[newfeet]

Being affiliated with a medical school or university isn’t the same as actually being integrated. If you share some faculty and admin overhead but the DPMs have their own building/facilities that are completely separate from the other programs, then a significant drop in enrollment will probably hurt. Is NYCPM still at their same Harlem location or did campus move to join whatever Touro MD/DO programs are in NYC? Its also interesting that NYCPM is nowhere to be found on the Touro college/university network website… Admissions

Compared to DMU where those same lecture halls and labs and clinic spaces that pod students used would still be filled with 200 DOs and PAs and DPTs that already use them alongside the DPMs, if the DPM program were to shut down. I think that was airbuds point.

Ah I thought it was complete take over.

 

[de Ribas]

THe applicant pool is certainly down (guestimating by about 100 applicants) but its not in a death spiral.

Granted 100 applicants is a bigger deal when its histoprically ~1000 applicants.

Curious what 22 numbers are.

Also to generalize Gen Z they tend to be money savy, minimalist, and dont take on debt. They are much smarter with their money than millenials were.

Someone mentioned numbers were around 700 for 2022 apps.

 

[DYK343]

Someone mentioned numbers were around 700 for 2022 apps.

If true that may be a death spiral

 

[Pronation]

If true that may be a death spiral

Wow. Big if true.

 

[air bud]

Ah I thought it was complete take over.

I think we all know who wears the pants in that relationship. Insert meme/clip/theme from many classical early 2000s movies marketed towards the bros.

 

[air bud]

Someone mentioned numbers were around 700 for 2022 apps.

700 individual applicants? Sounds like we need 700 seats then.

 

[Boba Foot]

Are there any true standalone schools left? NYCPM is with Touro.

TUSPM is part of the Temple system but podiatry is on its own campus, with its own faculty and facilities. It’s owned by Temple but doesn’t share the same benefit of splitting facilities with a med school that other pod schools do.

They could actually probably benefit financially from moving the pod school to their main campus, but North Philly is so rough that I think it would be a much harder sell for new students.

 

[de Ribas]

700 individual applicants? Sounds like we need 700 seats then.

They are working on it. We need seats for all applicants. Not leaving anyone behind.

 

[Adam Smasher]

I wasn't being anecdotal, I was being hypothetical. Anecdotes are at least sort of level 5 evidence. A hypothesis is just that.

Anyway, if I'm wrong, podiatry won't be in a death spiral, we'll simply have another residency crisis. Have a great weekend, fam!

 

[Feli]

...Also to generalize Gen Z they tend to be money savy, minimalist, and dont take on debt. They are much smarter with their money than millenials were.

This is a very important aspect... for sure.

I will say that, in PP, it's very hard to get and keep good employees. This goes from restaurants to manufacturing to even hospitals. Its sometimes hard to find ppl who will show up, much less excel. It is probably a good thing for employees, but it is a strain for HR or especially small biz and entrepreneurs.

The quiet quitting and job hopping and expecting to get paid to compensate for commute or too work from home if possible are much more frequent. That's unlikely to go away.

It is more important than ever to incentivize 'old school' good workers to try to retain them... but businesses still lose them too a competitor or going back yo school or otherwise.

With regard to podiatry/ professional schools, it will be tough. The smart and the hard working, who med and other professional schools have always been appealing to, will look at ROI. It is very quick to google that now. Few can compete with MD or RN for the time spent and pay afterwards. It's clear from even MD match and CRNA competitiveness that people want to work $marter not harder.

I have no idea what the solution is for podiatry. I would say the best thing to do is look at desired MD specialist aspects: selectivity on the front end and consistently awesome training... but scarcity is obviously needed also. So, maybe we will debt burden and devalue grads into the ground. Maybe applications demand will speak for itself if the value isnt there. "There is a tendency for things to right themselves."