Memes of Podiatry

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Back in day when googling about podiatry, wasn’t there a website called something “angel” that was discouraging people from going into podiatry, but the SDNers would say that site was ran by disgruntled podiatrists. Someone’s gotta remember this. 😅
 
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Back in day when googling about podiatry, wasn’t there a website called something “angel” that was discouraging people from going into podiatry, but the SDNers would say that site was ran by disgruntled podiatrists. Someone’s gotta remember this.

When I was externing this one director pulled this website up, made me read it, then asked my thoughts… so strange that he did that
 
It's fascinating, back in the 90s if you wanted a website, angelfire was a quick and easy way to get your message out. People made some money back in those days before the dot-com bust. It was a great time to be a kid because you knew more about the internet than the grownups.

As to the content, this is the problem with being excessively negative. It was easy to dismiss content in those days as the ravings of a lunatic especially because as a pre-pod or pod student you might have a mentor who was pretty happy and pretty cool. So yeah I'll be critical of podiatry here but I always emphasize it might work out for the right person and it's really not a horrible life like others will suggest
 

Wow crazy to read this now as an attending. Also wasn't there another strongly antipodiatry website? Or maybe it was just a poster on Podiatry post website??? I seem to remember another website?
 
It's fascinating, back in the 90s if you wanted a website, angelfire was a quick and easy way to get your message out. People made some money back in those days before the dot-com bust. It was a great time to be a kid because you knew more about the internet than the grownups.
Remember Geocities too?! Anyone could just go and create a site. My brother used to make some cash on the site doing that, mainly in the early php days for COD1/CS teams.
 
And in private practice you take your 3% Medicare cut a year.
I honestly see PP as a losing proposition if things continue the way they are now. I know a pod from my hometown who wants to retire in about 5 years and I know he wants me to buy his practice but I think I honestly would just prefer to work for the community hospital there instead. The hospital previously tried to buy him out and hire him but I think he was asking for too much. He does own the building where he practices though so that may be why.
 
I honestly see PP as a losing proposition if things continue the way they are now. I know a pod from my hometown who wants to retire in about 5 years and I know he wants me to buy his practice but I think I honestly would just prefer to work for the community hospital there instead. The hospital previously tried to buy him out and hire him but I think he was asking for too much. He does own the building where he practices though so that may be why.
For the most part I don't understand how a person who makes $265K and has no patient base/is brand new etc would consider leaving for a world where (a) you have to negotiate with insurance (b) you have to take yearly cuts from Medicare (c) you have to actually collect money from patients (d) you are subject to the costs of vagaries of things like Athena/EHRs/MIPS (e) and you literally have to buy the practice from someone.

There's money that can be made in PP, but there's too much deterioration. Older pods talk about how much better it used to be, but its strange to be doing something for 5 years and mostly see it getting worse during that time.
 
For the most part I don't understand how a person who makes $265K and has no patient base/is brand new etc would consider leaving for a world where (a) you have to negotiate with insurance (b) you have to take yearly cuts from Medicare (c) you have to actually collect money from patients (d) you are subject to the costs of vagaries of things like Athena/EHRs/MIPS (e) and you literally have to buy the practice from someone.

There's money that can be made in PP, but there's too much deterioration. Older pods talk about how much better it used to be, but its strange to be doing something for 5 years and mostly see it getting worse during that time.

I keep reading the hospital doc salary blurbs to one of my PP partner and we are just blown away. PP just can't compete with 265k on 15 patients a day and one surgery a week. The reimbursement just isn't there unless you are doing tons of cash pay or super sketchy stuff (everyone gets cam boots, orthotics and grafts).

Also for the younger docs, the loan repayment that comes with hospital jobs is life changing.
 
I keep reading the hospital doc salary blurbs to one of my PP partner and we are just blown away. PP just can't compete with 265k on 15 patients a day and one surgery a week. The reimbursement just isn't there unless you are doing tons of cash pay or super sketchy stuff (everyone gets cam boots, orthotics and grafts).

Also for the younger docs, the loan repayment that comes with hospital jobs is life changing.
Loan repayment with hospitals is actually not super common. And maybe capped at 100k max. At least directly. There is still PLSF though

I was doing 235k 20-30 patients a week and 1 surgery a week for a couple of years. Good times, lots of mountain fun. But alas life goes on.
 
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Alright let’s say I go full on budget mode... crashing with friends, living on ramen, and using the local food pantry. Could I realistically pay off my student debt, avoid it spiraling out of control, and get financially stable in a short amount of time after residency?
 
... PP just can't compete with 265k ... reimbursement just isn't there unless you are doing tons of cash pay or super sketchy stuff (everyone gets cam boots, orthotics and grafts).
1) Reimbursement is there if you pick good area (payers, network well, build it well).
2) Compensation - although it should be decent - is not the main reason for PP imo.
3) Freedom, control, good structure, ultimate job security... those be the actual "benefits" of PP owner/partner, for me.

I got pretty sick of calling other guys "my boss," having crappy unreliable staff, good staff pulled to work with owner or to another hospital dept, getting told what my on-call schedule was, being told my working days/hours, getting my productivity snipped by owner/managers' decisions, admins changing, and just generally not being able to improve the situation I was in (or any improve I did help$ others more than it help$ me). So yeah, there's that...


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Alright let’s say I go full on budget mode... crashing with friends, living on ramen, and using the local food pantry. Could I realistically pay off my student debt, avoid it spiraling out of control, and get financially stable in a short amount of time after residency?
We're in the wrong thread for all these musings, but its really all about income, debt, and cost control.

Without trying to dox myself - there was an income transition at my residency from one of the earlier years to later years. I had grown used to living on the lowest possible salary ie. I ate almost every single meal at the hospital that I could and literally brought food home from the hospital for my wife. When my pay went up slightly - I had enough money suddenly for a small amount of savings. So more money does open the door to setting yourself straight.

The problem/tricky thing about transitioning to being an attendings is that there may be costs that your practice doesn't pick up. So for example - if you had really affordable resident hospital insurance for your family and then you switch to PP where they don't subsidize your wife/kids at all - your salary may increase but you may find yourself picking up an extra $15,000 in costs for your family. Your pay increased, but so did an expense that used to be covered by someone else.

The other tricky thing for some people upon graduating is that you have likely been putting your life on hold. You may need to buy a car or buy your spouse a care because you've been driving the same 10+ year old car since high/school, college. You might think - I want to keep living in an apartment to save money (maybe it does, maybe it doesn't) but your wife is tired of having your 2-3 kids sharing a bedroom in a 2 room apartment or duplex and wants a house with a backyard. Except you don't have any cash for this. Also, when you buy a house - jokingly, like 8 things are going to break right away. Last year - my roof sprang a leak on some national holiday. The past owner had replaced it right before we moved in, but it was done cutthroat and they didn't repair where the roof and fireplace met. I had a warranty and called them and some kid from 3 hours away drove out and caulked it. Looked like crap so I just had a professional fix it and it was $1200. Money well spent to never have this issue again, but houses require maintenance. Within 2 weeks of buying my house the garage door broke, the oven broke, and the dishwasher broke. Yeah.

So - if you graduate and get a high enough paying job and keep things under control - yes, your money situation will improve. I will tell you though that theoretically - you are supposed to start saving this money. So - let's put student loans and house payments aside for a second. Right now you can save a bit over $20K into a 401k a year if you are working. You can put $7K into a ROTH IRA a year for yourself. If you had a non-working spouse - you should do the same for her/him. If you had an HSA that qualified - you could put like $8K for a couple. Where I'm going with this is - if you immediately start saving appropriate your net worth can really start taking off, but you'll have less "functional fun" cash. Like if you do what I just said (and are married) - you should rapidly have like $23,000+$7000+$7000+$8000 heading directly into savings that you never touch. Read the medical forum where people are saving $100K a year.

*Now if Feli sees this - he'll take the opposite side which is that none of these savings things are worth it because you likely have a student loan at 7-8% and it will outgrow your investments. In a perfect world - you'd have enough money to strongly attack both, but most won't. Under some people's approach you'd do enough 401k to get a match, do ROTH IRA, and then probably just hit student loans after that. Where it gets even more miserable though is that 5 years ago - home loans were dirt cheap. Now a home loan average across the country is 7%. You can refinance in time if rates come down, but some of the "easy" decisions people made in the past where they neglected the home loan and attacked investments may be more complicated in the future.
 
I honestly see PP as a losing proposition if things continue the way they are now. I know a pod from my hometown who wants to retire in about 5 years and I know he wants me to buy his practice but I think I honestly would just prefer to work for the community hospital there instead. The hospital previously tried to buy him out and hire him but I think he was asking for too much. He does own the building where he practices though so that may be why.
You mean a business model where the cost of supplies/labor continues to increase yet the reimbursement continues to decrease is unsustainable?
 
Alright let’s say I go full on budget mode... crashing with friends, living on ramen, and using the local food pantry. Could I realistically pay off my student debt, avoid it spiraling out of control, and get financially stable in a short amount of time after residency?

Depends on what your definition of a short time is. 2-3 years? Unlikely, unless you land a high earning hospital employed position in a low cost of living area with loan repayment straight out of residency. A high earning spouse and no kids would help significantly (assuming spouse agrees to maintain this financial lifestyle which isn’t always the case). Starting a PP from scratch or becoming an associate, zero chance in that timeframe.

10 years? I guess you could do PSLF or budget your meager mustache paycheck but now you’ve sacrificed and paid your dues and suffered until your FOURTIES (or later if you started school older)
 
BREAKING: PRESIDENT TRUMP TO AUTHORIZE IMMEDIATE RELEASE OF ACTUAL PODIATRY SCHOOL ADMISSION DATA.
 
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