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Your mouth to God's ears
Forum Members Official: Job Offer Thread
Started by DexterMorganSK
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May we get an Old Testament vengeful Lord then
*also if you’ve never looked up the rent is too damn high party, this meme is totally worth looking up
Sir this meme has been done.... By myself of course
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All my love, still trying to win more than the regular season title. Should be deep diving the old school stuff for inspiration
It does seem logical... common need, low overhead, a lot of "foot" traffic.
I had the lady who does senior center nail care weekly quit... now those patients [trying to] flow to me (apparently new nail tech going there charges more).
Really You need to start at day one. It was a magical time. And actually some of the original ones got deleted when an official thread got moved I think it all started in an ABFAS versus ABPM thread. I was in between jobs interviewing and let's just say there was a lot of free time and a lot of alcohol involved. You should get yourself a bottle of peach schnapps and devote a Saturday night and just start on page one.
Costco hot dogs > free hospital food
I bet a small foot pain injection booth in Disneyland or Disney world would make a killing
And lymphedema wraps…
USA USA USA!!!!
If Florida was a jpeg....And lymphedema wraps…
Current job market is HORRENDOUS. $350K+interest, 7 years of school/residency, nonstop networking just for $185K to only be wanted for diabetic nail and callus is reality
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deleted1235332
In a high cost of living area probably
That can't be right. There's a second year student who assures us we're only graduating surgeons.
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Sorry but you are seriously mistaken so I decided to chime in. Yes you are mainly wanted for nails and calluses but rest assured that the pay is NOT 185k, it’s like 145k if you work as an associate.
185K offers from atleast 3 diff places in 3 diff states for associate positions. 145K is what I’ve seen from colleagues that weren’t geographically open, last minute, or didn’t send out a trillion emails
Yeah, you should be able to get $180k or 200k job from the many many VC supergroups... but then they pull the base after 1yr, and you are on straight 30-35% after that (to kinda trap the associate, discourage vacation, encourage overbilling). You also can expect the max non-compete allowed by state law and zero chance of ownership.
Small and large doc-owned PPs will be more variable on base pay... but more potential to not get as screwed as bad on the % and usually more learning, less non-compete, small partner/buyout chance. It's a better bet if your long term plan is to run your own office (you won't own DME and vasc lab and stuff like supergroups do). The regular PPs can be anywhere terrible to pretty good; it depends much on who you work for/with.
...Cold calling hospitals is the best bet (to get your numbers for ABFAS board cert and pay off loans), but that is also nearly every new grad's plan. Nearly any grad wants highest money and most surgery they can find. It worked much better years ago... exceedingly difficult now. The wells are mostly dried up. Even some of the VA and IHS jobs are tougher than ever to get. And it's not as if hospital jobs aren't without problems also... admins, call schedule, scope, staffing, politics, all that.
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This is true in many cases... especially if not very flexible on locations. It's sometimes less... just look at pod classifieds.
But it's important for grads not to take it personally.
It is a real letdown after all the years, loans, training.
That first job search near finishing residency (or now fellowship) is a bit depressing for 90% of DPMs...
Then, they take the best job they can find and decide "it's just for now, it will get better soon."
I think the real letdown, for most, comes a few years out of training... when it's not much better.
They realize they won't be doing much surgery despite all the training,
won't make as much as hoped despite all the debt (really sets in once you do attending budget),
won't be able to make very good money - or sometimes even find a job at all - in their target area,
get burnt out of the call and the politics of hospital job ... and see MD/DO surgeons making much more,
or all of those things.
It's just key to not internalize it. It's not as is any of us are low worth or not good enough.
It's simply a function of there being WAY too many podiatrists, a glut of "foot and ankle surgeon."
And it's also highly important to keep trying for ABFAS, searching and applying for better jobs, expanding areas, all that.
It only takes one breakthrough (hospital job, better area, start own PP, etc) to make it much better ROI on the debt.
Sometimes that breakthrough finally comes when willing to go to Alaska or North Dakota or take a non-op hosital job or lobster PP...
But it'll come for most eventually for most.
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Well said - “It only takes one breakthrough (hospital job, better area, start own PP, etc) to make it much better ROI on the debt…..
But it'll come for most eventually for most.”
But it'll come for most eventually for most.”
We can trust that this is how you explain the future to your students?
Yes, look for the right opportunity in the right place. Working in a private practice as an associate or for PE isn’t the answer.
So you tell your students 70 plus percent of you will not be working in a good opportunity?
Or you just keep pumping out feel good stories? (See propaganda)
Airbud, I’m not going to sit here and argue with you. Come on my podcast and we’ll have the discussion.
It's much better idea to have a second year student on who can tell you about the undiscovered gem of podiatry.
majority of new grads including fellows are struggling to find a job currently
Many will never land a fair paying job
Please stop assuming your podcast of well known pods somehow represents a profession of 20k
Hey BRO, Go on his podcast to discuss
the pathetic reality of our profession. i see my current graduating residents accepting job offers of 100k base with hopes of landing a hospital gig when they have enough surgical numbers...newsflash is that they'll be making someone else rich for several years before realizing the well has seriously dried up and the only opportunity left on the table is starting on your own in an area without sufficient coverage (which is hard to find these days in any major metropolitan area). thats what the truth that students really need to be told
Perfect ploy to try and silence people by stripping them of anonymity and opening them up to retaliation from unfortunate leadership in our profession.
"You may eventually find or create a great job, but after years of being underpaid and barely being able to service your massive student debt."
What a great selling point. Maybe that can be APMA's next Facebook campaign.
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Yep, better to complain anonymously on SDN. Carry on!
Is it the anonymity that actually bothers you or is the dissent to the “party line”?
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deleted1235332
Podiatry is a scam. I was sold on the “best kept secret in medicine” and “work-life balance” just to find out that is hilariously wrong.
Let’s start with the schooling and the debt. Anyone who doesn’t have parent support is ending up at minimum 250k-300k in debt at a majority of the schools. Some students even more. For that you lock in seven more years of your life (4 years already wasted to undergrad) before you can benefit in anyway. Podiatry school may be easier than medical school but it’s not “easy”. Where I went to pod school we had plenty of people fail out. Exam weeks were brutal. There was a lot of stress. I grinded those four years. I wasn’t at Barry going out on a boat every weekend. APMLE exams, not everyone passes those either. Yes if you work hard you should but also we all know those exams are written poorly. I remember being in what felt like a cave for three months studying for APMLE part 1. So even if you pass the classes you have to pass the exams. I would say what 15% or more of students don’t make it out of school with passing the classes and exams? That’s a risk. A $300k+ debt risk.
Then let’s move on to residency. Everyone’s experience is going to differ here. Maybe you sucked up enough on clerkship or was good looking enough to get a good program. But we know there are truly only a handful of good programs. A lot of programs use residents for free labor. In fact, that is why most of them are even started. It’s not to “give back to the profession”. It’s so someone can take your call at the hospital to help you get paid. Majority of everyone who starts residency finishes (maybe they shouldn’t), so that’s not so much a risk.. but your ability out of residency to do what you think you were signing up for is a big risk. And that’s why there’s so many fellowships. But fellowships are started for the same reason residencies are started… Free/Reduced labor costs.
Then let’s go to being an attending. You’re finally an attending. Yes! You’re finally at the end of those seven years. You can finally reap the rewards and that “work life balance” you were sold… wait. Free call? I’m always on call? If I’m not always on call I’m in private practice and I’m only cutting nails? But I did seven years of training and even a non mandatory fellowship why am I stuck here? And I’m working for private equity and people I’ve never even met are making money off me. My financial advisor says the only way I can pay off my loans is to get on a PSLF plan. Maybe me and my wife can buy a house in five or so years. Oh podiatry…
It is no guarantee and it’s no “best kept secret”. There’s a reason why enrollment is going down. It’s called ROI. It’s terrible for podiatry.
Let’s start with the schooling and the debt. Anyone who doesn’t have parent support is ending up at minimum 250k-300k in debt at a majority of the schools. Some students even more. For that you lock in seven more years of your life (4 years already wasted to undergrad) before you can benefit in anyway. Podiatry school may be easier than medical school but it’s not “easy”. Where I went to pod school we had plenty of people fail out. Exam weeks were brutal. There was a lot of stress. I grinded those four years. I wasn’t at Barry going out on a boat every weekend. APMLE exams, not everyone passes those either. Yes if you work hard you should but also we all know those exams are written poorly. I remember being in what felt like a cave for three months studying for APMLE part 1. So even if you pass the classes you have to pass the exams. I would say what 15% or more of students don’t make it out of school with passing the classes and exams? That’s a risk. A $300k+ debt risk.
Then let’s move on to residency. Everyone’s experience is going to differ here. Maybe you sucked up enough on clerkship or was good looking enough to get a good program. But we know there are truly only a handful of good programs. A lot of programs use residents for free labor. In fact, that is why most of them are even started. It’s not to “give back to the profession”. It’s so someone can take your call at the hospital to help you get paid. Majority of everyone who starts residency finishes (maybe they shouldn’t), so that’s not so much a risk.. but your ability out of residency to do what you think you were signing up for is a big risk. And that’s why there’s so many fellowships. But fellowships are started for the same reason residencies are started… Free/Reduced labor costs.
Then let’s go to being an attending. You’re finally an attending. Yes! You’re finally at the end of those seven years. You can finally reap the rewards and that “work life balance” you were sold… wait. Free call? I’m always on call? If I’m not always on call I’m in private practice and I’m only cutting nails? But I did seven years of training and even a non mandatory fellowship why am I stuck here? And I’m working for private equity and people I’ve never even met are making money off me. My financial advisor says the only way I can pay off my loans is to get on a PSLF plan. Maybe me and my wife can buy a house in five or so years. Oh podiatry…
It is no guarantee and it’s no “best kept secret”. There’s a reason why enrollment is going down. It’s called ROI. It’s terrible for podiatry.
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deleted1235332
I’m not sure where I read this idea from but it came from someone on here. In fact, sdn has a lot of great ideas but they’re never taken seriously.
Why is apma not taking those member fees and going to every hospital system in America and trying to get the system to hire a podiatrist? Podiatry makes a ton of money for hospitals and it’s how we gain respect as a profession. Hospitalists love us. Vascular loves us. Infectious disease loves us. It’s through limb salvage. And it’s really what most of us are best at. A lot of our training is this. It’s not trying to be ortho of the foot (don’t get mad at me orif bros it’s still great to be able to do recon)
But that is how we make the job market better for new grads and how we get the most respect in the medical community. Unfortunately abfas thought leaders think limb salvage is below them. If there’s not 12 screws and plates in there or whatever new system Stryker has paid them to talk about it’s not worth their time.
Stop letting private equity and industry control the narrative. Help out the new grads. Make a push for employment at every hospital and revisit what acgme wanted to talk about. But that got shut down way too quick without even a real conversation.
I’d rather podiatry be in the hospital doing what we’re best at instead of being controlled by PE in private practice telling us what to do. Just my thoughts.
Why is apma not taking those member fees and going to every hospital system in America and trying to get the system to hire a podiatrist? Podiatry makes a ton of money for hospitals and it’s how we gain respect as a profession. Hospitalists love us. Vascular loves us. Infectious disease loves us. It’s through limb salvage. And it’s really what most of us are best at. A lot of our training is this. It’s not trying to be ortho of the foot (don’t get mad at me orif bros it’s still great to be able to do recon)
But that is how we make the job market better for new grads and how we get the most respect in the medical community. Unfortunately abfas thought leaders think limb salvage is below them. If there’s not 12 screws and plates in there or whatever new system Stryker has paid them to talk about it’s not worth their time.
Stop letting private equity and industry control the narrative. Help out the new grads. Make a push for employment at every hospital and revisit what acgme wanted to talk about. But that got shut down way too quick without even a real conversation.
I’d rather podiatry be in the hospital doing what we’re best at instead of being controlled by PE in private practice telling us what to do. Just my thoughts.
Dean said SDN has calmed down a bit from a few years ago. I think it's because we've said all the things that need saying and have run out of new topics. All we've got now are new posters (CAMBoot) coming to the same conclusions we've already reached. And there's the difference: Dean seeks out the podiatry enthusiasts, whereas we don't need to search for podiatry skeptics--the podiatry skeptics FIND US.
Instead of arguing with Dean's chat people should start dissecting the ACFAS 2025 salary survey and comparing it to the 2021 survey. All the boosters are holding this out like a shield - which I get. They are selling an indescribably expensive product. The survey is weird to me though.
-With salaries as high as it claims I expected to see a mostly hospital based population, but its only 35% RVU based.
-It claims young people (30-39) make in the $400s and it reports this both in age and years in practice (0-5).
-It claims associates makes in the $400s which is fascinating knowing general trends in reimbursement.
-It claims increasing income is associated with increasing surgical volume which is fascinating because simultaneously - doing more is worth more, but surgery routinely isn't worth anything. I could understand this if the population was heavy RVU, but they aren't. And only a trivial portion of the reporting claims they receive ancillary income from a surgery center ie. ancillary services were 5.1% of compensation so that isn't the driver.
-It reports you can expect income of $280K which was the 25% percentile reported.
-They obviously prefer to report the mean rather than the median - there's a big difference between these values.
Its really just a fascinating survey to me because the values are just so dang high for everyone. Higher than any other survvey out there - or am I wrong? I don't have more time to put into this, but my memory is the ACFAS 2025 survey is just way higher than anything else you'll see out there. Could compare it to MGMA but this is 65% non-RVU.
-With salaries as high as it claims I expected to see a mostly hospital based population, but its only 35% RVU based.
-It claims young people (30-39) make in the $400s and it reports this both in age and years in practice (0-5).
-It claims associates makes in the $400s which is fascinating knowing general trends in reimbursement.
-It claims increasing income is associated with increasing surgical volume which is fascinating because simultaneously - doing more is worth more, but surgery routinely isn't worth anything. I could understand this if the population was heavy RVU, but they aren't. And only a trivial portion of the reporting claims they receive ancillary income from a surgery center ie. ancillary services were 5.1% of compensation so that isn't the driver.
-It reports you can expect income of $280K which was the 25% percentile reported.
-They obviously prefer to report the mean rather than the median - there's a big difference between these values.
Its really just a fascinating survey to me because the values are just so dang high for everyone. Higher than any other survvey out there - or am I wrong? I don't have more time to put into this, but my memory is the ACFAS 2025 survey is just way higher than anything else you'll see out there. Could compare it to MGMA but this is 65% non-RVU.
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deleted1235332
ACFAS website has a job search section they advertise. and they routinely advertise orthopedic foot and ankle jobs so... if we make $400k plus why aren't those jobs listed? they're all ortho jobs. quick job searches dismiss outlier surveys.
also everyone ignore the $170,000-500,000 podiatry job listings. anyone can make $500k in private practice as an associate if they see 55 patients a day.
ACFAS - Job Seekers
devsd.acfas.org
APMA leaders are the PE.. they need more cheap new graduates associate.
There is a post on LinkedIn where a resident was offered a rural hospital job in his hometown. The resident decided to pursue a fellowship instead. When he was about to graduate, the hospital withdrew the offer and moved on. He is now jobless, and the fellowship director is trying to help him find a job.
It highlights how saturated podiatry is and how most hospitals view podiatry. This applies regardless of whether you are a podiatrist or a “fellowship-trained foot and ankle surgeon.”
It highlights how saturated podiatry is and how most hospitals view podiatry. This applies regardless of whether you are a podiatrist or a “fellowship-trained foot and ankle surgeon.”
Until that contract is signed you got nothing. I saw that. The quote was wanted to be ready for anything that walked through the door.
But now he is outside the door 😬
That resident’s LinkedIn states he has done over 2,000 foot and ankle cases and over 50 TARs in residency, but still did not feel ready?
I know of people who had crappy associate jobs, could not find anything else, did a fellowship (after being in practice for 1-4 years), and then still came out with a crappy job in the middle of nowhere hahah.
IDK why anyone defends this field and why students keep applying. It sucks. That is the end all, be all. Podiatry sucks. At least for anyone that graduated after 2020ish.
that's why this @Dean’s Chat is such nonsense!!!!
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deleted1235332
I respect what he does for the profession. And respect that he reads concerns on here. His podcast has been useful for me on certain topics. let’s not scare him off. We need someone who disagrees with us.
But my opinion (and won’t change) is that podiatry is not worth the ROI. The risk vs reward is severely out of whack. There’s just no chance I would tell a pre pod to do podiatry. The only way I would tell them to consider it is: no or very minimum loans, and maybe some family connection/nepotism waiting on them on the other side. And even if you have no loans I don’t think the 7 years (11 if you count undergrad) is worth it if you want my truthful answer.
Everyone underestimates how long that time commitment is. All of healthcare could be totally different by the time you practice and we know it’s likely not going to be for the better. And it’s not like podiatry school/residency is easy. It would strain a marriage for sure. You’re grinding your life away (maybe in actuality if you’re cutting nails) for little reward.
Also I’m sure there’s plenty of MD’s telling pre meds not to do med school. This isn’t unique to podiatry (although ROI is def worse). In general medicine is becoming not worth it
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it’s easier to get in to podiatry school than allopathic medical school, but has higher risks, lower ROI, less opportunity to pivot. That’s the nature of the game. There are some thriving but many just floating along, some drowning. But same with MDs, it’s not all sunshine and rainbows, some hate their specialty or quit altogether. Doesn’t mean podiatry or allopathic medical school sucks and no one should apply.
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What are the thoughts on 1099 positions without any benefits paid (of course)? What do you think is a fair percentage collections? Does any of them ever pay your malpractice? I know some of the MSGs where the MDs/DOs are independent contractors but it is podiatry and anything bad is always possible 🙂 I like the idea of setting my own hours and controlling my schedule instead of seeing patients till 7pm as an associate.
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deleted1235332
Non-competes don’t apply to 1099 employees. So that’s a benefit at least.
This is what AI spits out. I have a feeling you've asked this before and the simple answer for most podiatrists is that 1099 is a lie. You aren't really a contractor if you are working at the same private pracice podiary clinic every day. Keep in mind that you'll be paying for your own health insurance and your own malpractice. Even crappy $200/600K malpractice is $10,000 after a few years.
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For a 1099 physician without RVUs, you should generally ask for 45% to 60% of net collections. The exact target depends heavily on who covers your overhead and malpractice. The split dictates how much you take home after the clinic extracts its share for staffing, billing, and rent. [1, 2, 3, 4, 5]
High-Overhead Settings (40% - 50% of Collections)
- What's included: The practice provides the physical office space, front office/nursing staff, billing and coding services, EHR infrastructure, and typically malpractice insurance.
- Best for: Outpatient clinics, high-volume specialties, and locations with heavy equipment or clinical staff overhead.
- Note: Because 1099 independent contractors do not receive W-2 benefits (like PTO, 401k match, or health insurance), aim for the higher end of this bracket. [1, 2, 4, 5]
Low-Overhead / Locums Settings (50% - 65% of Collections)
- What's included: You are acting as a heavier independent contractor, potentially bringing your own staff, utilizing hospital-provided resources, or operating in a heavily virtual/telemedicine capacity.
- Best for: Locum tenens, telemedicine, and consulting models. [1, 2]
Essential Contract Clauses to Negotiate
To protect your income, ensure your contract clearly specifies these stipulations:
- Net Collections vs. Gross Billed: Your percentage must be based on net collections (what the practice actually gets paid after insurance adjustments), never on gross charges.
- Billing Transparency: Because your pay depends entirely on the clinic's billing efficiency, require monthly reports on Net Collection Rates (industry standard is 95% or higher). If their rate drops, your pay drops through no fault of your own.
- Tail Coverage: Clarify who pays for your malpractice tail coverage (if claims-made) when the contract ends. [1, 2, 3, 4, 5]
I feel like none of them would cover malpractice, forget about tail lol So it seems like we should be asking for a higher net percentage, potentially over 50%.
as a 1099 it needs to be over 50% of net collection. Realistically it should be something more like 65%. The person contracting your services is paying $0 in employment taxes, $0 in benefits, $0 for licensing/CME/malpractice. Your cost to a group/practice as a contractor is some small % of rent, staffing, and disposable supplies. That’s it, a few grand per month.
