Forum Members Official: Job Offer Thread

[dtrack22]

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My partnership track in my MSG is 2 years.

Also common in the world of real doctors.

It’s clear Wolverine is taking this job no matter what. Might be a good job, but the more I think about how awful this contract is…

I would certainly ask for the partner track to be shortened to 3 years. I would also ask why I only get 10 cents of every dollar I bring in after I cover my overhead? And then after whatever BS answer I got, I would ask, “so what incentive is there for me to collect more than $400k?” Or, “why would my effective compensation rate (% of collections you get) continuously go down as I bring in more money?”

I mean think of it this way, your base is essentially 37% of collections at $400k. When you collect $500k your pay comes out to 32% collections. Bring in $700k and you’re getting 25% of collections. At $1 million…21% of collections.

I’m glad this is where Wolverine wants to live and is really happy. But it’s super depressing how excited a new grad gets with an offer like this. How many more examples of awful contracts do we need before even the most optimistic finally admit the job market is not good? At least not good relative to virtually every other position within all of healthcare…

 

[TrueWolverine]

But it’s super depressing how excited a new grad gets with an offer like this. How many more examples of awful contracts do we need before even the most optimistic finally admit the job market is not good? At least not good relative to virtually every other position within all of healthcare…

Am I allowed to agree with this even though it's about me? Lol It does kill me that after 4 years of post-grad training a bazillion dollars in debt we have to seemingly compromise either location or pay. Of course I'd love the better contract AND get to live where we want but seems hard to come by in our field (yes yes I know it's not unheard of....). Got a buddy who's got a $200k base, makes partner after he collects his salary, part of a large orthopedic group where they get a cut of everything (imaging, surgery center, other income ventures of the group, etc), BUT he has to live in the middle of nowhere.

 

[dtrack22]

BUT he has to live in the middle of nowhere.

Meh, at least he’s being treated like a doctor when it comes to compensation. Not to mention, “middle of nowhere” is what many here call anything that isn’t a major metropolitan area. The second largest city in the state of Washington was referred to as middle of nowhere. I doubt he’s actually in the middle of nowhere. And @airbud is the only reputable source on actual middle of nowhere, USA

 

[Scrantonicity]

It was a private group for a long time that was purchased by the university healthcare system. They are now under the umbrella of the system and have all the resources, but still have all the say and control like in the practice (for example I didn't meet with anyone from "corporate," the docs were the ones who had the say in bringing me on). Maybe there's a better way to say it but it feels like sort of a mix of private and hospital based.

Group is 4 partners (one retiring) and 2 associates (both grads within the last couple years). They've only had one guy leave the practice and he was a partner (and he went to a group in another area if I remember correctly.

Obviously I'm not oblivious to the fact that it's really a bad bonus structure. I'm not banking on it but I do believe there will be some opportunity for renegotiation in the future.

Note- I haven't signed with them yet but contract is in the works so I do appreciate the input and maybe there will be some leeway for a better bonus.

Meh it's not amazing, but it's not anywhere close to the worst offers out there. The no hospital call and somehow becoming a partner with no buy in is what does it for me...wish I had started out with a contract like this (only cause my first 10 years out of training were way worse than this, sadly)--I think I'd take it if I was just starting out and there wasn't a hospital employed job offer on the table.

The big private equity firm associate contracts are similar to your's (maybe a bit better with bonus structures), but without the path to ownership

 

[deleted285117]

My partnership track in my MSG is 2 years.

Same here. Worth every penny.

 

[Pronation]

Got (and accepted!) this offer. Working on contract negotiation but probably won't be much because it's a big hospital system.

Private practice group part of a large university healthcare network
Base is $150k
Bonus 10% after 400k
Partnership after 5th year with no buy in or other stipulations (partners all making $500k+)
Will be filling in the spot of a retiring partner so hope to be busy pretty quickly
No hospital call
All CME, malpractice, overhead covered
Larger, mostly suburban city

It's basically my dream setup in our number one area to live so overall couldn't be more excited. I wish the bonus structure was better (and I've wrestled a lot with it) but there's no buy in to make partner so I'm just trying to focus on the long term reward. Decent pay/base right out the gate but I feel like I'll be wishing for more growth in years 3-5. Good chance for me to have a solid initial contract and prove my worth I guess.

This is a pretty bad contract, but at least it’s a bit better than the crappy 100k PP offers. If I were you, I would take my sweet time with every patient so that they limit you to low 20s per day (because beyond that they are exploiting you with their typical podiatry predatory bonus structure) … and also start an exit plan on day 1…

 

[icebreaker32]

It is a good first job for podiatry, especially if it is in your preferred location. It seems most make partner. Whether it is good forever job is TBD, but it sounds promising.

I would want to know what the partners contract looks like that they are making over 500K. It sure is not on a 10% bonus structure. Make sure they were not grandfathered in to a situation that they receive ancillary income sources not be available to you when you become a partner.

You mentioned 4 years of postgraduate training so just to be clear you did a fellowship correct?

Note to others we can argue about good versus great jobs. It is becoming increasingly common if you want anything better than a mediocre job, completing a fellowship is becoming almost necessary. It you are board certified by ABFAS RRA with a few years experience that also separates one from the stacks of CVs jobs like this get.

Lets be clear this forum may call out podiatry's lies and shortcomings, but they are as a whole very well trained and doing very well financially.

Most will not get a first job anything like this, especially in their desired location from just going to podiatry school and doing a typical 3 year residency without some very serious connections.

 

[Adam Smasher]

If you truly can be made a partner on the basis of "sweat equity" alone, that's a great thing. Hopefully the owners are trustworthy, because (and my attorney advised me of this way back when) partnership clauses in an employment contract are totally unenforceable.

 

[TrueWolverine]

It is a good first job for podiatry, especially if it is in your preferred location. It seems most make partner. Whether it is good forever job is TBD, but it sounds promising.

I would want to know what the partners contract looks like that they are making over 500K. It sure is not on a 10% bonus structure. Make sure they were not grandfathered in to a situation that they receive ancillary income sources not be available to you when you become a partner.

You mentioned 4 years of postgraduate training so just to be clear you did a fellowship correct?

Yeah partners are definitely not on 10% bonus structure lol I believe they are on a collection based model of some sort. That’s a good point about other income sources that may or may not be available to me. I’ll have to ask them. They seem like a good group of guys who want people invested in the area and are willing to mentor a lot initially.

Sorry I realized misspoke there. Just meant 4 years of med school. 3 years of residency with no fellowship (turned down a fellowship in favor of this job).

 

[air bud]

It is easy to get a job when you have a job. You can potentially get a job exactly where you want to live. This is a temporary job that is all. Get started networking. Understand your non compete. If you are potentially buying a house then do that in an area outside of any potential non-compete (hopefully those get struck down...). You are gone in 2 years and either a part of a different group or on your own. Make no mistake, you are not working harder than 400-500kish and you are a networking machine.

Edit - I have plenty of friends that have leveraged a crappy PP job into a MSG job just by being in the community and networking. Location is important for your happiness I know. If that is your priority then figure out how to make the rest work.

 

[icebreaker32]

Yeah partners are definitely not on 10% bonus structure lol I believe they are on a collection based model of some sort. That’s a good point about other income sources that may or may not be available to me. I’ll have to ask them. They seem like a good group of guys who want people invested in the area and are willing to mentor a lot initially.

Sorry I realized misspoke there. Just meant 4 years of med school. 3 years of residency with no fellowship (turned down a fellowship in favor of this job).

Not a bad idea (for podiatry at least)....look for jobs and fellowships, if nothing good works out with jobs then do the fellowship.

 

[air bud]

 

[619]

MD and DPM are different degrees. Trying to compare the income of apples to oranges. Mayne the top 20% DPM earners can be compared to MDs.

The average DPM does not even earn close to NP/PA/CRNA let alone the bottom 20% who earn less than a nurse.

 

[air bud]

MD and DPM are different degrees. Trying to compare the income of apples to oranges. Mayne the top 20% DPM earners can be compared to MDs.

The average DPM does not even earn close to NP/PA/CRNA let alone the bottom 20% who earn less than a nurse.

Yeah well employed salaries/Benny's are right in line with average MD. If only there were more... average hospital employed pod is higher than PCP.

 

[DYK343]

Yeah well employed salaries/Benny's are right in line with average MD. If only there were more... average hospital employed pod is higher than PCP.

In my last job I was the highest paid provider on staff and there were a lot of PCPs (Probably 50 plus or minus).

 

[619]

There is no doubt that a podiatrist will generate more income than a PCP simply because we do a lot of office procedures. That's what I don't understand. The reason new grad podiatrist make less income is because of bad contract. We have the same CPT codes as every one else except in the special situation of practices with special insurance negotiated IPAs.

I am solo and I do a lot of office procedures. Literally everything. I don't let any $$ work out the door. Maybe it comes down to training and confidence. I am 100% confident in all aspect of podiatry. Lots of RVUs or collections to to be made from office procedures. Just don't be lazy and let things walk out the door.

Podiatry is meant to be the hidden germ in medicine but unfortunately it is not.

 

[DYK343]

There is no doubt that a podiatrist will generate more income than a PCP simply because we do a lot of office procedures. That's what I don't understand. The reason new grad podiatrist make less income is because of bad contract. We have the same CPT codes as every one else except in the special situation of practices with special insurance negotiated IPAs.

I am solo and I do a lot of office procedures. Literally everything. I don't let any $$ work out the door. Maybe it comes down to training and confidence. I am 100% confident in all aspect of podiatry. Lots of RVUs or collections to to be made from office procedures. Just don't be lazy and let things walk out the door.

Podiatry is meant to be the hidden germ in medicine but unfortunately it is not.

It really doesnt make any sense. DPMs eat their young. Always have. That saying has been said forever and its still going strong.

This has been discussed over and over on here, but luckily hospitals and MSGs are catching on. Quite a few hospitals are starting to hire DPMs because of all the small procedures we do/wRVUs we generate in addition to MRIs, CTs, Xrays, PT orders, inpatient hospital management, electice quick surgeries, etc..

Weird ortho usually isnt hired by hospital directly. I assume thats because they get a good deal joining the local large ortho group. They tend to really band together and form supergroups. DPMs do not. We just fight each other.

 

[Feli]

Bill a million in collections and make $210k (base + 10% of 600k)? Yikes. Maybe I’m missing something, but I fail to see the reason for such excitement. Someone with a straight 20% gig that bills a million would make the same, and that’s not a good offer.

You have to realize that ppl, esp younger DPMs... but many with exp also, put a ridiculous value on base salary as a guaranteed floor.
They want to know they can pay their loans, pay bills, and have a bit left over.

That is why most hospital/MSG jobs are on such a pedestal even if the call is bad or the RVU/collect bonus is little/none.
That's why even a legit PP job in a high payer area, good track record, can get you BUSY immediately is written off anyways if its base is 100 or 120.

I say it all the time, but if ppl want decent base salary without a lot of call or fighting tooth and nail for interviews for a hospital/govt jobs (that still have call and admin headaches), working for a pod large or supergroup PP is a legit option. There are hundreds of large groups (5+ DPMs, multiple offices) and dozens of supergroup (~10+ offices, 15+ DPMs) with base usually 150-200k or more. They exist in basically any major city and some other places also; some have 100+ podiatrists. The call is little to none, the pay is good, you have the tools to pump collections that most small groups don't... but you are expected to handle a fairly full schedule and produce large collections. It won't be the VA job where you can play games and do 2 or 3 surgery cases or see only 10-15 clinic patients in a day. Another obvious downside is that very few large/super groups offer any partner/owner path... you are capped at producing a bunch and getting a % of that.

...At the end of the day, never trust the nonsense that the owner, the partners, the senior docs, etc are doing well, driving nice cars, multi-mil houses, etc. Just because some or all of them have that does NOT mean a new associate ever will sniff that stuff. They want the associate to take a piece of collections from, to lighten or remove their call, and to (sometimes) dump the underperforming clinic location and/or lesser payers on. We've all gotta start somewhere, but you can never make decisions off of ideas many years away or how senior docs [say they] are doing.

...It's basically my dream setup in our number one area to live so overall ...

It's good you like the job idea and area, but be a bit careful with this if it's a state where non-competes are enforceable.
Airbud was the only one to mention this... in many areas, it matters more than compensation in the grand scheme.
You could very likely be out of town (or at least far across town) for years if it doesn't work out. GL

Congrats, can’t hurt to accept the job, work, and still be on the look for something better. At least you gain experience. ...

I would normally agree, but if it's the area he likes best and non-competes are enforced, it is almost better to start on the opposite/outskirts while learning so that he can take other better options or solo in that desired area later on.

 

[bloxxeeey]

Another offer I received 65k with benefits. Bonus earnings after what they deem acceptable. In a metro area.

 

[Feli]

One of my co-residents in NMex metro practice is hiring associate to partner.
Cool person, well trained, ABFAS cert, full scope practice... wants well trained in surgery/office.
...Anyone can PM me if interested to be put in touch. Not wide-posted as yet due to networking first.

...This one is done... other small group NMex I posted is still available.

 

[GreenHousePub]

Another offer I received 65k with benefits. Bonus earnings after what they deem acceptable. In a metro area.

 

[deleted285117]

Another offer I received 65k with benefits. Bonus earnings after what they deem acceptable. In a metro area.

The mustache is strong in this one

 

[de Ribas]

Another offer I received 65k with benefits. Bonus earnings after what they deem acceptable. In a metro area.

Fellowship trained?

 

[icebreaker32]

Another offer I received 65k with benefits. Bonus earnings after what they deem acceptable. In a metro area.

……you have received a few offers now, so obviously there is unmet demand and we need more schools

I have a feeling podiatry will eventually work out for you. Your wife is doing well.
If you can not find a good first job, you will not keep a bad job forever out of desperation and can keep looking for a better job or eventually open your own practice.

 

[bloxxeeey]

……you have received a few offers now, so obviously there is unmet demand and we need more schools

I have a feeling podiatry will eventually work out for you. Your wife is doing well.
If you can not find a good first job, you will not keep a bad job forever out of desperation and can keep looking for a better job or eventually open your own practice.

I think one of my co-residents is leaning towards taking it. He needs/wants to stay in the area. Maybe it will but I'm ontop of my game and started earlier, I also made a name for myself in a good way so far during residency.

Fellowship trained?

Considering the job offers I'm getting, fellowship training might be "worth it"? To be completely honest though, I give up another year to hopefully make 100k a year? I mean people strive for better jobs with fellowship training but if you want to stay in an area with more than 10,000 people fellowship training or not you're max salary will be 150k coming out and to be completely honest that is an amazing salary for us coming out.

 

[deleted1138023]

Another offer I received 65k with benefits. Bonus earnings after what they deem acceptable. In a metro area.

You should quit and work at chipotle

 

[shadesofgrey]

I saw an article on CNN about that chipolte salary a few years ago. I want to say they claimed the average time from just hired to manager with 100k salary was 3.5 years, obviously this would depend on you excelling at your position. I could never do food service again. I did it during college, and honestly people would get more angry about how long it would take to get their food than with postop bunion complications. However, it does hammer home the point about ROI and podiatry.

 

[dtrack22]

I saw an article on CNN about that chipolte salary a few years ago. I want to say they claimed the average time from just hired to manager with 100k salary was 3.5 years, obviously this would depend on you excelling at your position.

Sounds reasonable. My wife went from server to General Manager of a restaurant chain in 4-5 years. I’m with you, the work sucks, but it really just takes a work ethic to move up. It’s what minimum wage type employees generally lack, and they are your competition. She was making around $120k after bonuses before we left Iowa. And you could have been in that job as a 23 year old who graduated high school and went to work. Any ways, back on topic before I get cutswithfury’d…

 

[Sweatshirt]

I think one of my co-residents is leaning towards taking it. He needs/wants to stay in the area. Maybe it will but I'm ontop of my game and started earlier, I also made a name for myself in a good way so far during residency.



Considering the job offers I'm getting, fellowship training might be "worth it"? To be completely honest though, I give up another year to hopefully make 100k a year? I mean people strive for better jobs with fellowship training but if you want to stay in an area with more than 10,000 people fellowship training or not you're max salary will be 150k coming out and to be completely honest that is an amazing salary for us coming out.

I can hear your frustrations and I'm sorry for what you are going through. Not sure of your location restrictions but if you have none, look rural. I'm starting at $250,000 in a city of 8,000. Surrounding towns puts it at less than 30,000. I know your wife has a great salary so money may not be a big issue. I think doing a fellowship would be a waste of time for you if you are still going to job search in the same area. You sound well trained, so if you like the area you are in now don't waste a year working for someone again

 

[deleted285117]

I can hear your frustrations and I'm sorry for what you are going through. Not sure of your location restrictions but if you have none, look rural. I'm starting at $250,000 in a city of 8,000. Surrounding towns puts it at less than 30,000. I know your wife has a great salary so money may not be a big issue. I think doing a fellowship would be a waste of time for you if you are still going to job search in the same area. You sound well trained, so if you like the area you are in now don't waste a year working for someone again

Agree 100%. Go rural for job and live closer to civilization (reasonable commute).

 

[underwood]

Most likely signing this job. Keep in mind it is a PP job, did the best I could.
120k base. Quarterly “collections bonus” of 30% above 90k. Well run busy practice, ancillary services, many MA’s to speed up patient encounters. On call one week at a time every few weeks, not too busy however. Few weeks PTO, health insurance, 401k.

 

[dtrack22]

Quarterly “collections bonus” of 30% above 90k.

You are essentially bonusing at $360k in collections. I guess determining that quarterly is good from the standpoint of a more consistent stream of increased income above base, compared to a lump sum check at the end of the year. But this is still a normal podiatry contract….

$120k base, 30% of collections at 3x your base. Just like many of us have experienced, you get to take a pay cut on your “bonus” pay. You get 33% of collections in base pay (assuming you collect $360k) and then you “bonus” at only 30% of collections. You cover your cost to the practice and then they start reimbursing you LESS per $ you bring in. How very Podiatry of them.

 

[underwood]

You are essentially bonusing at $360k in collections. I guess determining that quarterly is good from the standpoint of a more consistent stream of increased income above base, compared to a lump sum check at the end of the year. But this is still a normal podiatry contract….

$120k base, 30% of collections at 3x your base. Just like many of us have experienced, you get to take a pay cut on your “bonus” pay. You get 33% of collections in base pay (assuming you collect $360k) and then you “bonus” at only 30% of collections. You cover your cost to the practice and then they start reimbursing you LESS per $ you bring in. How very Podiatry of them.

Completely agree. I’m yet to see a contract where the % collections increases after covering the threshold. I did ask for collections after 300k, or 75k per quarter. So if that does happen, then it would be 2.5x base. But still, it would be 40% until 300k then 30% after that….. maybe next year if I like the practice could ask for higher %.

 

[Feli]

You are essentially bonusing at $360k in collections. I guess determining that quarterly is good from the standpoint of a more consistent stream of increased income above base, compared to a lump sum check at the end of the year. But this is still a normal podiatry contract….

$120k base, 30% of collections at 3x your base. Just like many of us have experienced, you get to take a pay cut on your “bonus” pay. You get 33% of collections in base pay (assuming you collect $360k) and then you “bonus” at only 30% of collections. You cover your cost to the practice and then they start reimbursing you LESS per $ you bring in. How very Podiatry of them.

Don't forget "paid" time off won't bonus.
401k may start only after a year or may be measly 2,3,4% etc.

The real TFP/moustache podiatry contract doozies are that some DME/OTC stuff won't count at all for bonus or that you only get 30% of the profit margin on orthotics, grafts, etc... not 30% of the total purchase/reimburse price. Joy.

 

[underwood]

Don't forget "paid" time off won't bonus.
401k may start only after a year or may be measly 2,3,4% etc.

The real TFP/moustache podiatry contract doozies are that some DME/OTC stuff won't count at all for bonus or that you only get 30% of the profit margin on orthotics, grafts, etc... not 30% of the total purchase/reimburse price. Joy.

Here’s a follow up question that I was thinking about. For example, let’s say a DME costs practice $50 and is reimbursed at $100. What should count towards associate collections? 50 or 100?
Thanks

 

[air bud]

Most likely signing this job. Keep in mind it is a PP job, did the best I could.
120k base. Quarterly “collections bonus” of 30% above 90k. Well run busy practice, ancillary services, many MA’s to speed up patient encounters. On call one week at a time every few weeks, not too busy however. Few weeks PTO, health insurance, 401k.

Lets go into this more for a teaching exercise.

Let's start with 401k. Is there a match? Who will service it? Is there a self directed amount? Are you allowed to make Roth contributions? Are you allowed to make short term withdrawals?

Is this going to change you taking the job no, but still important to know.

For those that may not know, it is common to not be able to contribute until after 1 year. An employer may or may not offer a match. The may use a servicer that only has like 20 fund options and all have high fees associated with them. For example I had a job that used fidelity. I had the option to self direct what I wanted to invest (still plan limitations could only do mutual funds). My current employer uses Voya. I have a bunch of target date funds and then lots of actively managed funds. It sucks. I wish I could just use a simple SPY or similar fund but I can't.


They offer health insurance - are they covering any of the premium? Is there an HSA option? What is the deductible?

 

[619]

Here’s a follow up question that I was thinking about. For example, let’s say a DME costs practice $50 and is reimbursed at $100. What should count towards associate collections? 50 or 100?
Thanks

Depends on if they want to nickel and dime you. For most DMEs such as CAM boots, night splint that cost less, they may not deduct the DME cost of the practice. For example CAM boots can cost the practice $20 or $30 and reimburses upwards of $250 to $300. Most practices will not bother to deduct the $20.
However for grafts that cost upwards of $5k per application and reimburses about $7k therefore $2k profit. All practices will deduct the cost of the original graft. No way a practice will eat up the cost of the graft especially when you apply multiple grafts per patient. Think about when you have many patients on grafts. And you bet if they ever claw back the cost of the graft in the future, it will come out of your collections. Once again, a practice is not going to eat up the cost of the grafts.

 

[Feli]

Here’s a follow up question that I was thinking about. For example, let’s say a DME costs practice $50 and is reimbursed at $100. What should count towards associate collections? 50 or 100?
Thanks

It is up to the practice (and associates who sign up). All jobs are learning exp.

The most common thing is cash pay stuff like arch supports or orthotics... eg, $425 orthotics or $60 arch supports... cost the office maybe $100 fee plus $25 shipping on orthotics or $15 arch supports, so they consider $300 or $45 margin for bonus calc and give you 30% aka $90 orthotic or $13.50 arch supports for associate.

Another fun one is they won't count the OTC lotions and potions and pads at all for associate bonus("different system").

Yet another one to watch for is putting most/all copays under the owner doc ("forgot to change it") even if associates saw those pts. Same can be done with OTC... put most under owner doc.

As 619 said, the only thing you will almost certainly get your 30% of is the actual insurance collections, and even those could be fudged if they like... how would you know what went to deductible and wasn't paid, what was rejected, etc? Unless you have access to the billing side of EMR and time to check it, you won't. And yeah, insurance-paid DME (night splints, CAMs, ankle braces) will usually be gross not the net amount, but never underestimate greed.

Now, it is entirely possible to get an ethical and productive practice that wants to get good DPMs, get them busy, retain them as fairly paid employees or partners eventually. I know a few (one is the one I mentioned above). In reality tho, it is much more likely a DPM employer wants to skim and skim and "miscalculate" to arrive at the rock bottom pay the associate(s) will accept. They might do a few less miscalcs for productive associates versus minimally productive or less likable ones. Time will tell in your case.

 

[underwood]

Yeah I mean as a new grad there’s only so many questions I can ask. They confidently told me ‘Everything counts such as DME and grafts etc’ but how they calculate or if they’re going to mess with the numbers or mess with the copay I have no way of knowing…. And maybe I’ll never know.

 

[Adam Smasher]

The real problem is that so much of the routine complaints in podiatry clinic is brainless work. So why would a practice owner pay top dollar for someone with a brain?

My dream: stop churning out 600 new foot and ankle surgeons/year, create economic pressure to legitimize nail techs to grind keratin and dpms don't, just like hygenists scrape teeth and dentists don't, dpms can devote their careers to being doctors and not dremels, dpms command salaries in line with the complexity of the medical decisions they now spend most of their day making

 

[thefootfixer]

It is up to the practice (and associates who sign up). All jobs are learning exp.

The most common thing is cash pay stuff like arch supports or orthotics... eg, $425 orthotics or $60 arch supports... cost the office maybe $100 fee plus $25 shipping on orthotics or $15 arch supports, so they consider $300 or $45 margin for bonus calc and give you 30% aka $90 orthotic or $13.50 arch supports for associate.

Another fun one is they won't count the OTC lotions and potions and pads at all for associate bonus("different system").

Yet another one to watch for is putting most/all copays under the owner doc ("forgot to change it") even if associates saw those pts. Same can be done with OTC... put most under owner doc.

As 619 said, the only thing you will almost certainly get your 30% of is the actual insurance collections, and even those could be fudged if they like... how would you know what went to deductible and wasn't paid, what was rejected, etc? Unless you have access to the billing side of EMR and time to check it, you won't. And yeah, insurance-paid DME (night splints, CAMs, ankle braces) will usually be gross not the net amount, but never underestimate greed.

Now, it is entirely possible to get an ethical and productive practice that wants to get good DPMs, get them busy, retain them as fairly paid employees or partners eventually. I know a few (one is the one I mentioned above). In reality tho, it is much more likely a DPM employer wants to skim and skim and "miscalculate" to arrive at the rock bottom pay the associate(s) will accept. They might do a few less miscalcs for productive associates versus minimally productive or less likable ones. Time will tell in your case.

This is very true.

I just spoke to a colleague not too long ago who got offered a flat 80k salary at a local practice. Relatively busy with pathology and surgery. Few locations I think. But that was it. 80k and malpractices coverage. There was some deal of bonuses I can’t remember the figures.

Same colleague got offered a mobile job, 50% collections. Massive patient volume (as they usually are). Plus the advantage ihere are the write offs , solo 401k etc. So while the job itself is meh the advantages are greater, at least in the short term.

The private practice gig seemed like a pretty raw deal imo

 

[619]

Same colleague got offered a mobile job, 50% collections. Massive patient volume (as they usually are). Plus the advantage ihere are the write offs , solo 401k etc. So while the job itself is meh the advantages are greater, at least in the short term.

There is zero advantage in doing nursing or mobile work after going to school for over 10 years. Better to be working as an associate for low pay because at least you are sharpening your clinic skills after residency, getting surgery cases, learning billing and coding etc.
The only advantage of doing mobile podiatry is you are currently opening your own practice and you need a few coins to get by until practice is up and running. After the practice is set up, quit the mobile podiatry and you are better off going door to door to meet PCPs and introduce yourself for referrals.

 

[619]

Yeah I mean as a new grad there’s only so many questions I can ask. They confidently told me ‘Everything counts such as DME and grafts etc’ but how they calculate or if they’re going to mess with the numbers or mess with the copay I have no way of knowing…. And maybe I’ll never know.

As I said, they will never eat up the cost for the grafts. "Everything counts" is a nothing burger.

Another fun one is they won't count the OTC lotions and potions and pads at all for associate bonus("different system").

So true, the sale of OTC lotions, portions, spices and pads goes into the general office cookie jar. The free candy jar at the staff lunch station have to be paid for somehow.

 

[thefootfixer]

There is zero advantage in doing nursing or mobile work after going to school for over 10 years. Better to be working as an associate for low pay because at least you are sharpening your clinic skills after residency, getting surgery cases, learning billing and coding etc.
The only advantage of doing mobile podiatry is you are currently opening your own practice and you need a few coins to get by until practice is up and running. After the practice is set up, quit the mobile podiatry and you are better off going door to door to meet PCPs and introduce yourself for referrals.

I respectfully disagree . Going to school for 10 years then coming out to a PP gig making 60-80k? That’s truly ridiculous. A lot of these older pods and maybe even newer pod owners know how to play the game. They have their fair share of desperate pod applicants. Might as well hustle grind it out for a few years do some mobile work to make 120k. Max out all possible self employment rietiremenr accounts save some money and open your own gig . While there is an advantage to being in a practice (learning coding etc), you can still take courses on these , chat with colleagues etc and figure out the best way to move forward.

The atrocity here is that the normal expected pod salary is 80k. 100 k and you’re a rich man or woman. Nurses make more than this.

We all have to be true to ourselves and ADMIT we have been fooled, and the expectation of “attending salary” doesn’t exist in the DPM world. Use that fact to drive your own destiny.

 

[HardRoadPaved]

Going to school for 10 years then coming out to a PP gig making 60-80k? That’s truly ridiculous.

Agreed. I collect anywhere from 750k-1m/yr in solo PP. No BS like lasers and dumb wound dressings. (and def not EMG/NCS)

To only bring home 10% is criminal. Never will work for a DPM again.

 

[Boba Foot]

Yeah I mean as a new grad there’s only so many questions I can ask. They confidently told me ‘Everything counts such as DME and grafts etc’ but how they calculate or if they’re going to mess with the numbers or mess with the copay I have no way of knowing…. And maybe I’ll never know.

For the most part, you should be able to judge the owners character through your interactions during this process. Not every PP owner is going to screw you, despite the popular opinion around here. I’m 6 months into mine and don’t have any major complaints so far. I’m hoping for a higher ceiling within a few years from now, but while being fresh out of residency I feel I like I’m being treated fairly and with respect. Just do your research on your prospective employer.

 

[DYK343]

For the most part, you should be able to judge the owners character through your interactions during this process. Not every PP owner is going to screw you, despite the popular opinion around here. I’m 6 months into mine and don’t have any major complaints so far. I’m hoping for a higher ceiling within a few years from now, but while being fresh out of residency I feel I like I’m being treated fairly and with respect. Just do your research on your prospective employer.

I concur that I know some success stories of friends joining PP.

 

[thefootfixer]

For the most part, you should be able to judge the owners character through your interactions during this process. Not every PP owner is going to screw you, despite the popular opinion around here. I’m 6 months into mine and don’t have any major complaints so far. I’m hoping for a higher ceiling within a few years from now, but while being fresh out of residency I feel I like I’m being treated fairly and with respect. Just do your research on your prospective employer.

6 months isn’t much time at all.

For the most part, you should be able to judge the owners character through your interactions during this process. Not every PP owner is going to screw you, despite the popular opinion around here. I’m 6 months into mine and don’t have any major complaints so far. I’m hoping for a higher ceiling within a few years from now, but while being fresh out of residency I feel I like I’m being treated fairly and with respect. Just do your research on your prospective employer.

again all due respect, but 6 months is the “honeymoon phase”…especially for fresh grads getting used to life outside of residency. Give it 1-2 years. Start planning NOW for the eventual difficult convos of raises (which almost certainly there will be a lifetime cap), buy in (could probably buy into your own work if you’re not careful with this), or buy -out (mustache pods think their practices are worth more than gold). I’m not saying to not enjoy your job and the people u work for or with. But know at the end of the day, the owner will looks out for the corporation above all else. If all you can offer is 200k to buy the place but the next guy offers $300k , the next guy will get it 9/10 times. Play your cards right, plant your seeds and look out for #1…yourself

 

[HardRoadPaved]

Not every PP owner is going to screw you, despite the popular opinion around here. I’m 6 months into mine and don’t have any major complaints so far. I’m hoping for a higher ceiling within a few years from now, but while being fresh out of residency I feel I like I’m being treated fairly and with respect.

Haha just wait until you realize you're bringing in real dough and your boss shows up in a fancy new whip. Get your exit plan ASAP as you're making pennies on the dollar.

 

[619]

respectfully disagree . Going to school for 10 years then coming out to a PP gig making 60-80k? That’s truly ridiculous. A lot of these older pods and maybe even newer pod owners know how to play the game. They have their fair share of desperate pod applicants. Might as well hustle grind it out for a few years do some mobile work to make 120k. Max out all possible self employment rietiremenr accounts save some money and open your own gig . While there is an advantage to being in a practice (learning coding etc), you can still take courses on these , chat with colleagues etc and figure out the best way to move forward.

The atrocity here is that the normal expected pod salary is 80k. 100 k and you’re a rich man or woman. Nurses make more than this.

We all have to be true to ourselves and ADMIT we have been fooled, and the expectation of “attending salary” doesn’t exist in the DPM world. Use that fact to drive your own destiny.

You made an assumption that you will earn $120k doing mobile/nurs work. I have done mobile/nursing home work and I can tell you from first hand experience that very unlikely you will make $120k regardless of the false advertisement you see on job postings. Nails pays like $20 lol. Calculate how many nails you will trim (to make $120k) and remember you get about 40% of the collections assuming you work for one of those organizations. At best you get beer money from nursing home work.

Max out all possible self employment rietiremenr accounts save some money and open your own gig

Making $120k , after paying the 2 ends of social taxes and rest of taxes, then gas and car maintenance etc, you will not be maxing out any retirement account let alone save money to "open you own gig". We are talking about $120k in 2023 dollars not $120k in 1923.

We all have to be true to ourselves and ADMIT we have been fooled, and the expectation of “attending salary” doesn’t exist in the DPM world. Use that fact to drive your own destiny.

This is 100% correct.