New Jersey Job Offers, which is best!!?!?

[HardRoadPaved]

Butterfly IQ+ has definitely changed the market. $2k for a probe and small yearly fee pretty much reduces the entry to using these devices as everyone has a Ipad/iphone/android product. The newer device has needle identifier so you can capture the necessary images for documentation.

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[DYK343]

Lets say you have 2 bunions with a couple of hammertoes, a fibula orif, a detach/reattach, and a flatfoot.

I am envious of your turnaround time for your hospital. Cherish that for all its worth.

No way that many cases could be done around here and I'm pretty fast in the OR.

Our popliteal blocks take 45min to an hour. Then another hour waiting for the guy on lunch or break to go clean the rooms. Then when were ready the OR nurse is on their break. Thats basically my scenario every OR day.

Usually at least 1 hardware contamination with a giant hole thrown in there.

 

[ExperiencedDPM]

I stopped once I read the jobs were in NJ. I’ve reviewed dozens of contracts for positions in NJ and have never read one that was even remotely fair.

Scope of practice is great, sleazeball factor of many practices is even greater. All these guys are legends in their own minds.

New Jersey needs another DPM as much as podiatry needs another school.

Go west young man (woman).

 

[heybrother]

I am envious of your turnaround time for your hospital. Cherish that for all its worth.

No way that many cases could be done around here and I'm pretty fast in the OR.

Our popliteal blocks take 45min to an hour. Then another hour waiting for the guy on lunch or break to go clean the rooms. Then when were ready the OR nurse is on their break. Thats basically my scenario every OR day.

Usually at least 1 hardware contamination with a giant hole thrown in there.

Nameless person: Ya'll want a pop block?

Me: What I want more than anything is for this case to start on time. You'll note that its an hour before the case. I'm here. You're here. The patient is here. I want the case to start on time. You'll also note I'm the only case.

Nameless person: We'll definitely have the pop block done and the case starting on time.

1 hour later I see the patient wheeling their way back.

Me: Is that patient already blocked? Are they on their way to the OR?

Nameless person: Naaa. We're wheeling them back to the PACU to block them. Also we have a student we're going to let do the block.

 

[G0dFather]

***If I owned or had stake in a well run surgery center then the argument for low surgical reimbursements may not hold. I'm considering this investment in my future and if anyone has advice on this it would be appreciated.

Here is NY and NJ one can buy shares into a sx center ( have first hand exp in this) ... you should look into that in your area, its nice to get an extra "dividend" monthly ... helps to buffer the pain of those reimbursments LOL

 

[G0dFather]

I'm not a pod but man.....this has been an eye opening thread. I share a similar experience. As a PM&R physician, I make more money rounding on patients in the subacute rehab (SNF) setting than interventional pain physicians while working half the hours. It's all volume (35-50 patients/day). I'd imagine this is the case with Ophthalmology as well. Their procedures probably do pay pretty well but they make A LOT of money seeing upwards of 60 patients per day in clinic.

My man !! But i be seeing you all in the sx centers lining up pain injections left and right ! That is def a HIGH ticket item in your specialty.. i hear you tho rounding on pts all day is the way !

 

[G0dFather]

Butterfly IQ+ has definitely changed the market. $2k for a probe and small yearly fee pretty much reduces the entry to using these devices as everyone has a Ipad/iphone/android product. The newer device has needle identifier so you can capture the necessary images for documentation.

Try the phillips lumify probe instead... its a few K more but well worth it and comes with a 5 year warranty... the wire probe interface for the butterfly is a disaster if your going to put some wear and tear on it

 

[dtrack22]

I am envious of your turnaround time for your hospital. Cherish that for all its worth.

No way that many cases could be done around here and I'm pretty fast in the OR.

Yeah if pop blocks are taking that long then I’d imagine you would struggle to get 5 cases done if you’re wanting blocks on a couple of em.

The hypothetical flatfoot is the only case listed that would take more than 35-40 min but sure that’s around 4 hours of operating time and another 5 hours of turnover time, so a 7am to 4pm type of day.

Is that why you work 60 hour weeks? Because you can only get 3-4 cases done in a day?

the wire probe interface for the butterfly is a disaster if your going to put some wear and tear on it

Were you letting patients chew on it or something?

 

[DYK343]

Yeah if pop blocks are taking that long then I’d imagine you would struggle to get 5 cases done if you’re wanting blocks on a couple of em.

The hypothetical flatfoot is the only case listed that would take more than 35-40 min but sure that’s around 4 hours of operating time and another 5 hours of turnover time, so a 7am to 4pm type of day.

Is that why you work 60 hour weeks? Because you can only get 3-4 cases done in a day?


Were you letting patients chew on it or something?

Our hospital is horribly inefficient. For every 30 min of surgery time I have 1 to 1.5hrs waiting time to start the next one. It does have a large part of my extended hours. I do about 3-5 cases a week on average. Sometimes more. Sometimes less. But the amount of time my butt is in that chair in the surgeons lounge with fox news blaring idiocracies is stifling.

Where I currently am is pretty bad but from my travels as a student/resident I saw a lot of hospital inefficiencies. I dont think its that uncommon to have long turnovers at hospitals (which is why im looking at surgery center buy ins).

 

[air bud]

Totally agree with what dtrack said about efficient surgery. In a few months when I switch to 2 days a week with ortho I will have one clinic day in each location ( different towns). I was talking with the hospital the other day and they wanted to know about block time. I said I don't want any, I will add on cases when I need to or take them to my other town 2 hours away where I work for the hospital. They pushed back on that but I said I am not going to give up potential clinic time. Like dtrack I can see everyone I need to as I get started in two days. I would rather have people wait that sit on my ass one day since no surgeries scheduled.

Also I am going to pay a portion of over head ( less than 1/3 for two days a week (ortho (2 of them) is only in clinic 2-2.5 days a week) and get 100 percent of collections. Eat what you kill makes total sense to them they were dumbfounded when I told them typical contracts for podiatry.

 

[G0dFather]

Were you letting patients chew on it or something?

im giving REAL advice and trying to help people save money ... cut your nonsense out ... go make your 4k in the OR bro ... clowntown

 

[dtrack22]

im giving REAL advice and trying to help people save money ... cut your nonsense out ... go make your 4k in the OR bro ... clowntown

I have a butterfly, I’m curious as to how your cord failed

 

[G0dFather]

I have a butterfly, I’m curious as to how your cord failed

check out the above ....the wire-probe interface is the problem .... unfortunate i didnt watch something like this in time .... but what this guy describes happened to me and others, check out 2.33 and onward ..... for 2k you shouldnt have to be tip toeing with the device (if it was like 750$ or less id say WTH) ,,, now compare that with the phillips lumify, there is no comparison

 

[dtrack22]

Never had that issue though I used the case and only had the probe for a month or so before the iQ+ came out and butterfly let me trade out my unit for the new one. The new model has a different cord probe interface. Cords are now replaceable. Not sure if that will make a difference or not. How is the lumify immune from similar cord issues? They use thicker plastics in their cord?

Last I saw the lumify probe was around $8k and data storage was over $2k per year if you signed up for a year (a little cheaper if you agreed to more months). Total cost to own of the lumify over 5 years was about $17,000. Butterfly storage would cost you around $2k over that time so you could buy 7 butterfly probes in your first 5 years and still come out ahead financially. Though butterfly recently had lifetime cloud storage for $999 for new users who bought a probe. I thought I was getting a great deal before they ran that promo when I got 6 months of cloud storage free lol

 

[HardRoadPaved]

Though butterfly recently had lifetime cloud storage for $999 for new users who bought a probe. I thought I was getting a great deal before they ran that promo when I got 6 months of cloud storage free lol

Handheld portable ultrasound machine | Butterfly iQ+

store.butterflynetwork.com

 

[G0dFather]

Never had that issue though I used the case and only had the probe for a month or so before the iQ+ came out and butterfly let me trade out my unit for the new one. The new model has a different cord probe interface. Cords are now replaceable. Not sure if that will make a difference or not. How is the lumify immune from similar cord issues? They use thicker plastics in their cord?

Last I saw the lumify probe was around $8k and data storage was over $2k per year if you signed up for a year (a little cheaper if you agreed to more months). Total cost to own of the lumify over 5 years was about $17,000. Butterfly storage would cost you around $2k over that time so you could buy 7 butterfly probes in your first 5 years and still come out ahead financially. Though butterfly recently had lifetime cloud storage for $999 for new users who bought a probe. I thought I was getting a great deal before they ran that promo when I got 6 months of cloud storage free lol

wow all of this you wrote .... call phillips and buy it direct its costs 6k to own outright not the crazy stuff you wrote... also one can just save straight to EMR no need to pay anything extra after that .... but in classic dtrack fashion you have to go on and on with speculation and fluff that amounts to ZERO.... also you get what you pay for

 

[Startingover123]

wow all of this you wrote .... call phillips and buy it direct its costs 6k to own outright not the crazy stuff you wrote... also one can just save straight to EMR no need to pay anything extra after that .... but in classic dtrack fashion you have to go on and on with speculation and fluff that amounts to ZERO.... also you get what you pay for

Lol I’m starting to think you don’t like Dtrack.

 

[air bud]

Classic dtrack

 

[dtrack22]

wow all of this you wrote .... call phillips and buy it direct its costs 6k to own outright not the crazy stuff you wrote... also one can just save straight to EMR no need to pay anything extra after that .... but in classic dtrack fashion you have to go on and on with speculation and fluff that amounts to ZERO.... also you get what you pay for

i looked at the lumify. The price when I was looking was $8 to buy outright and $7k if you signed up for a “subscription.” Amazon. Or has it for $7k. Their subscription prices could have fallen a little as well but not more than 6 months ago, all of that info came straight from Phillips. And yeah, when I’m looking at products I compare apples to apples. Not cloud storage with one product vs another product without the same storage option. You could certainly take an image off of any portable ultrasound app and move it into the patients chart. What is your workflow like to get those images into your EHR? And you never answered what Phillips did to the cord that makes it worth 3x the price of the iQ+? I mean let’s say the butterfly cord breaks every year. At $49 for a new cord, you could replace it every year for 81 years before you get to the price of the lumify.
Are you the NY podiatrist who wrote in to PMnews today suggesting someone use google drive as their EHR?

 

[G0dFather]

81 years before you get to the price of the lumify.
Are you the NY podiatrist who wrote in to PMnews today suggesting someone use google drive as their EHR?

Perhaps that was YOU because im certainly not the one trying to spend 2k penny pinching on an Ultrasound, HAAAAA!!! ( GOT EMMMM!!)

Im that NY POD that makes it rain in the club EASY !!

Its also SAD that you will have to work for 81 years, at least you could do a 99212 for another replacement cord after your ONE year warranty expires

 

[G0dFather]

To the OP ... I really apologize for high-jacking the thread like this .... i promise not to entertain this fiasco anymore

 

[619]

Back to the OP ....... which job offer should he take??? Let us not argue anymore about how he is getting screwed. We all know and that horse have been beaten to death.

The answer is which job offer will screw him the least while giving him an opportunity in the long term to have a prosperous career. Whichever he picks, the plan is to be there for 2-3 years max and bounce to open your own shop. That's my 0.02 cents

 

[Startingover123]

Back to the OP ....... which job offer should he take??? Let us not argue anymore about how he is getting screwed. We all know and that horse have been beaten to death.

The answer is which job offer will screw him the least while giving him an opportunity in the long term to have a prosperous career. Whichever he picks, the plan is to be there for 2-3 years max and bounce to open your own shop. That's my 0.02 cents

Would you mind PMing me? I have a few podiatry questions.

 

[HardRoadPaved]

Back to the OP ....... which job offer should he take???

I think an assumption that should be discussed is that "everyone needs/wants to be an owner." Running a business is like no other. Does the OP want to get called when a new PPP program sets up and sit on the phone trying to find a bank to process their application, source PPE in the middle of a pandemic, or deal with an employee that wants to quit without 2 weeks notice? Residency does not prepare you for the real world. There are business minded people that do set up right outside of residency but if you are going to do the 2-3 year be an associate then you have to learn the game. You have to treat that crappy PP job like you already are the owner. Got to take an interest and cozy up with the office manager. One day you will be wearing a lot of hats from learning real estate to human resources to supply chain management.

 

[G0dFather]

deal with an employee that wants to quit without 2 weeks notice?

This is a real issue.... which is why you need to know how to do everything your self and keep a floater on board ... but it also depends on how busy you are

One day you will be wearing a lot of hats from learning real estate to human resources to supply chain management.

This is LIFE of PP !