Forum Members Official: Job Offer Thread

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Jay Seidel said:
but there really is no limit to earning potential if dr is willing to hustle.
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The job offer seems as good of an associate job as anyone is going to get. Especially in a NE metro area. That being said, I really hate this line above. There is a limit to earning potential. Even if Dr is willing to hustle. You can only see so many patients and collect so much money, especially without ownership of ancillary revenue streams. Such a cliche, TFP thing to say to new grads/potential associates

Jay Seidel said:
most offices run at ~50-60% overhead.
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Even orthopedic offices with salaried PA’s who bring in little to no revenue don’t run at 60% overhead. Podiatrists are notorious for being overstaffed and overstocked with useless people and products.

If you are a potential associate and they can’t offer 40% of collections because their overhead is over 50% you’ll never get enough of the money you bring in to make it worthwhile. You will become disenfranchised and leave several years later 100% of the time.

As has been said, there are some really dumb replies to the job posting. An associate position that would pay you 40% collections and is set up for you to get busy and be collecting $600-700k in your second year (not unreasonable with 80-100 patient encounters weekly and getting a % of everything you bring in) means $240-280k. That’s more than some “hospital employed” DPMs are making. They are totally getting screwed by the hospital, but it happens more than people here would probably like to admit. I would never take an associate job like this ever again, but beggars can’t be choosers. It sounds like a perfectly reasonable associate contract. Even though overhead is high and your % won’t be fantastic as the owner alluded to. Better than $100k (or less) with bonus that you’ll never get to.
 
See job postings at UT. For more information or to apply, click here.


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Jay Seidel said:
and as far as me sharing the 'owner's perspective', have you tried to run a business? most offices run at ~50-60% overhead. giving 35% to an associate and keeping 5% isnt exactly what i would call 'making money on an associate'. again, im talking gross figures, not net, so a 5-10% return on running all of the business aspects of a practice seems pretty reasonable to me
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Thank you for sharing a different perspective on here and interacting. As has been said by a couple others you seem like a better than typical owner to work for and this seems like a better than typical associate job. It one wants to do better they can open their own office or apply for organizational jobs with long odds. For someone that wants to live in the area with a high earning spouse this might be more than a better than typical associate job and a great longterm opportunity with at least what sounds like a chance for a buy in.

Situations like this as an owner or an associate are still what is most common in this profession.

Opening a solo office may not be as common as it was in the past, but it is still common in this profession and is still the most common path I have seen for one being able to eventually live the doctor's lifestyle.....large house in the suburbs, nicer than typical or at least newer than typical SUVs and nice vacations etc.

The thing that I personally feel is not emphasized enough is that opening an office is not for everyone. It is not a guaranteed way to riches. What is does is at lest give one a chance to have a good ROI, job stability, the ability to practice how they want and the ability to pick the location they want to live. The down side is if the business is not doing well or was once doing well and the business is down and you are used to the lifestyle etc is tempt many to get into situations that involve a lot more than risk of paybacks and that could lead to loss of license and jail time. There is a lot on the line with owning an office when you can not just get an organizational job across the street.

I do not think enough that go into this profession deeply consider the pros and cons of being a small business owner/solo doctor. Being an owner eventually either solo or with a couple other podiatrists is still the most common way to practice in this profession.
 
The "hustling" crap is an entirely legitimate concern.

We were all externs once, we all had lazy co-externs. We all have seen lazy co-residents. I personally know about lazy attendings. When I started in practice, I replaced a guy who had awful charts and undertreated most of his patients. Lazy doctors DO exist.
 
Here's a scenario someone mentioned that they are considering in a major city:

Job #1: Straight 40% collections (including off profit margins from DME, office products, grafts). Minimal immediate clinic volume to start, have to build up at a new location (which is not saturated and potentially has room for quick growth with a few referral sources in place), do a bunch of inpatient/wound care center work to begin with (no overhead so percentage is not very enticing for the work), requires a lot of driving to different parts of the city. 1099 structure so no benefits though they pay for supplies/MA/rent/online marketing. Supposedly a lot of growth potential if the person follows a similar growth trajectory as the practice owner has. Potential to partner if the person collects enough and is productive.

Job #2: $120k base, 30% after 300k collections. Relatively standard PP contract but also relatively busy to begin with, associates do reach bonus threshold by year 2 and is doable to collect 500-700k+ once busy. Requires a decent amount of driving and rotating call/regular consults at 2 hospitals. Benefits are offered (health insurance, malpractice, licensing/organizational dues). Partnership buy-in will be significant though if offered after a few years, or practice might be sold to a supergroup due to the high price.

Doing the math, it seems Job #1 is only the better option once you clear the $500k collections threshold (or even more) and likely a higher ceiling but doesn't offer the stability of job #2, as well as being 1099 and technically making less without consideration for benefits.

How much of a negative is being a 1099 straight percentage contractor vs being a W2 employee when considering these situations?
 
HR91 said:
How much of a negative is being a 1099 straight percentage contractor vs being a W2 employee when considering these situations?
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If the job seeker is looking to buy a house in the area then W2 is far more advantageous. Banks likely won't give you a mortgage if you're 1099 aka self-employed (LOL) without at least 2 years of tax returns showing profitability of the business.
 
HR91 said:
$120k base, 30% after 300k collections.
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Podiatry might be the dumbest profession in all of healthcare when it comes to contracts. And by “might be” I mean definitely. Assuming these are real, you need to ask this owner a question:

“Dr. Mustache. I see that my base ($120k) is 40% of my ‘bonus’ threshold of $300,000. So why after I’ve theoretically covered the cost of my base salary, do I only get 30% of every dollar I bring in? When I’m getting 40% of every dollar I bring in up to $300k?”

So, so, so dumb. And you see it in virtually every podiatry associate contract. Maybe some of our practice owners can explain this to me, as I’m just a (currently) employed podiatrist who obviously doesn’t understand the nuances of private practice…even though I’ve owned one.

HR91 said:
How much of a negative is being a 1099 straight percentage contractor vs being a W2 employee when considering these situations?
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The situation described is one where 1099 isn’t as beneficial as most folks are going to assume. You have to pay both ends of employment taxes. You won’t be able to take a significant amount of money and pay it out as a dividend when your income is low. And as an associate (not the business owner with the legitimate expenses) your deductions aren’t as great as you’d think. Your work/business related expenses will be pretty minimal when the things you mentioned are being covered by the practice.
Jummy Biffett said:
If the job seeker is looking to buy a house in the area then W2 is far more advantageous. Banks likely won't give you a mortgage if you're 1099 aka self-employed (LOL) without at least 2 years of tax returns showing profitability of the business.
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Very good point. Ran into this when doing locums work between jobs and buying a house where we are now. Even the doctor mortgage programs wouldn’t accept 1099 money without years of steady 1099 income.
 
dtrack22 said:
Podiatry might be the dumbest profession in all of healthcare when it comes to contracts. And by “might be” I mean definitely. Assuming these are real, you need to ask this owner a question:

“Dr. Mustache. I see that my base ($120k) is 40% of my ‘bonus’ threshold of $300,000. So why after I’ve theoretically covered the cost of my base salary, do I only get 30% of every dollar I bring in? When I’m getting 40% of every dollar I bring in up to $300k?”

So, so, so dumb. And you see it in virtually every podiatry associate contract. Maybe some of our practice owners can explain this to me, as I’m just a (currently) employed podiatrist who obviously doesn’t understand the nuances of private practice…even though I’ve owned one.


The situation described is one where 1099 isn’t as beneficial as most folks are going to assume. You have to pay both ends of employment taxes. You won’t be able to take a significant amount of money and pay it out as a dividend when your income is low. And as an associate (not the business owner with the legitimate expenses) your deductions aren’t as great as you’d think. Your work/business related expenses will be pretty minimal when the things you mentioned are being covered by the practice.

Very good point. Ran into this when doing locums work between jobs and buying a house where we are now. Even the doctor mortgage programs wouldn’t accept 1099 money without years of steady 1099 income.
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I agree completely D Track about the base with percent after x collections. It’s like you get punished for hitting your “bonus”.

Unless it means if you hit 300k collections you get paid 36k as a bonus. But…I don’t think that’s the case lol
 
#1 -
-A 1099 is a independent contractor. They work where and when they want. If you work for 1 employer who dictates your schedule you are not an IC. There are websites devoted to explaining the difference - you should read about this thoroughly so that you know your rights. 40% is probably still not enough though you'll be hard pressed to go over this amount.

-As dtrack noted - ICs pay both sides of social security and Medicare - that's worth thousands of dollars. See below.


-A generous podiatry practice will pay for your health insurance though they won't pay for your family. You might be able to get a subsidy for a marketplace plan your first year, but you'll likely be paying for yourself without subsidies once income ramps up. Health insurance for an individual now runs about $6000/year based on the numbers I was given by brokers and surveying the marketplace. It will not be a good plan. There's some savings to be had on high deductible HSA eligible plans but you'd be shocked by how high a deductible can go (and you might not have the money to maximize the HSA).

-As dtrack noted, the classic 1099 benefit that emergency rooms doctors, hospitalists, etc maximize is the self-401k which allows you to put money aside as both the employer and the employee. You have to have higher income to maximize the "employer" side. You are starting from scratch.

-You will be essentially building a practice from scratch, paying almost all of your own costs, driving around town, keeping 40% of services performed in facilities where the reimbursement will be lower and then will still be expected to have some sort of bull**** partnership track.

-Who will pay for mileage and gas?

You should look into (hire a lawyer) whether a non-compete can be enforced against a 1099 in the state in question.

#2 - is pretty classic podiatry. People seem to be regularly posting offers that are worth less than this. You should consider spending 1 year there and then leaving to start your own practice. As is described above, they literally are capable of paying you 40% up to $300K but won't pay you that once you've covered your overhead.
 
diabeticfootdr said:
For the limb salvage positions it’s preferred and for the Sports Med a must.

Adult recon is residency + experience.
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Why do you need to be fellowship trained in sports medicine podiatry?

This is essentially brostroms, ankle scopes, OCD repair of talus, peroneal tendon repairs, achilles work, etc etc.

This is basic stuff.

Separating recon/trauma from sports med doesn’t make any sense and for anyone who accepts these jobs…are you really going to limit your earning to potential to a handful of procedures? I don’t get it.

I do all three disciplines in my hospital based practice and that’s why I am productive. Why would anyone want to separate these things and compromise their ability to bonus?
 
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Qualifications
•Amarillo, TX 79119: Reliably commute or planning to relocate before starting work (Required)
•Medical License (Required)
Benefits
•Reasonable paid call schedule and lots of opportunities for growth!
Pay: From $165,000.00 per year
•Health insurance
•Paid time off
•Professional development assistance
•Relocation assistance
•Monday to Friday
•Bonus pay
•Signing bonus
Job description
Growing practice has immediate opening for a full-time or part-time associate in the Texas panhandle. We are centrally located with easy access to a variety of different locations. Within 4-5 hours you can be to the New Mexico mountains, take a visit to Oklahoma, head to Colorful Colorado, Kansas, or take a weekend getaway to Dallas for a Broadway show or visit to the "big city". We serve patients from five states and there is a lot of opportunity to grow the patient base. Our clinic is well-rounded clinic and we traditionally deal with diabetic wound care, elective surgeries, and general podiatry (planter fasciitis, neuromas, warts, etc). Family friendly work hours and environment. Office building is only a few years old and in a nice area of town. Reasonable paid call schedule and lots of opportunities for growth! Applicant must be surgically trained as they will have hospital privileges at both local hospitals and the surgery centers. IF YOU ARE INTERESTED IN APPLYING, please send your CV and a short paragraph explaining why you are interested in joining our practice.
Job Types: Full-time, Part-time
Pay: From $165,000.00 per year Benefits:
• Health insurance
• Paid time off
• Professional development assistance
• Relocation assistance Schedule:
• 4 hour shift
• 8 hour shift
• Day shift
• Monday to Friday Supplemental pay types:
• Bonus pay
• Signing bonus Ability to commute/relocate:
• Amarillo, TX 79119: Reliably commute or planning to relocate before starting work (Required) Application Question(s):
• Have you researched the area to see if it is somewhere you would be happy living?
 
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Physician - Podiatry - Fort Smith​

Mercy
7301 Rogers Avenue, Fort Smith, AR 72903

Mercy​

Benefits
Pulled from the full job description
  • Dental insurance
  • Health insurance
  • Loan forgiveness
  • Relocation assistance
  • Retirement plan
  • Vision insurance

Mercy Podiatry is currently seeking a board certified or board eligible physician to join our practice in Fort Smith, AR. Our Mercy Podiatry team consists of 2 physicians, and an engaged support staff focused on quality patient care.

This Position Offers:
  • Integrated health system with a competitive income guarantee and productivity-based model to follow
  • Flexible, significant recruitment incentives tailored to your needs including sign-on/commencement bonus, resident/fellow stipends, etc.
  • Comprehensive, day one benefits including health, dental, vision and CME
  • Retirement plans available with employer contribution and matching options
  • Relocation package and professional liability coverage provided
  • As a not-for-profit system, Mercy qualifies for Public Service Loan Forgiveness (PSLF)
Welcome to Fort Smith

Fort Smith offers historic sites and a scenic riverfront downtown, while being located on the Arkansas River in the northwest quadrant of Arkansas - right on the border of Oklahoma. Ozark National Forest and 5 area lakes provide plenty of opportunities for various outdoor activities, including rafting, boating, hiking , golfing, and biking - whatever you could imagine doing outdoors, Arkansas can provide the setting. As far as entertainment, Fort Smith is home to an array of arts - with museums, theatres, live music and a plenty of restaurants displaying our southern hospitality - both locally owned and national chains.

Your life is our life's work

Mercy physicians are pioneering a new model of care. As part of one of the largest Catholic health care systems in the U.S., this physician-led and professionally managed multi-specialty group is the foundation of care and well-being of our patients in seven states, delivered cohesively through 43 hospitals, 900 physician practices and outpatient facilities, and our robust virtual care platform. Working with Mercy provides all the advantages of a large organization balanced by an uncompromising commitment to engage physicians in leading and designing patient- and consumer-centric care. You'll discover a friendly and collaborative environment rooted in the belief that everyone deserves the most personalized experience we can deliver. What sets us apart is our unique approach, beginning with physician leadership at the senior most roles within our organization and continuing into our care locations, where physicians and co-workers share leadership responsibility and embrace new thinking and the most recent clinical and hospital innovations to get health care right for everyone we serve.

It is a continuing goal to advance diversity and inclusion within our Mercy ministry. We cherish each person as created in the image of God and believe it is our responsibility to strive for excellence in establishing an environment of dignity for all.

Find us at:

Facebook | LinkedIn | Instagram | mercy.net | Mercy Careers

For more information, contact:

Sarah Wilson, FASPR | Senior Physician Recruiter

479-314-7466 | fax: 479-314-1190

[email protected] | mercy.net

EOE/AA/Minorities/Females/Disabled/Veterans Employer
 
Now just to be clear the opportunity above seems to be an income gurantee.

Beggars can not be choosers but salaries are better than income gurantees.

Income guarantees are forgivable loans after you stay a certain amount of years. They have potential land mines.


You could be let go for any number of reasons that have nothing to with the care you provide. You think no big deal......but they can let you go and you still have to practice in that community for a few years or you owe them a very large sum of money, like maybe potentially equal to your student loans amount in some cases. Try to get a clause you do not owe unless let go with cause.

One more thing is many try to have loans forgiven in pro rated month amounts and not years. So if you need to move for new job over summer etc for kids and school or there is a hard start date deadline with your new job you can takes a hit for a month of payback if necessary versus a whole year.

I know organizational job talk is not as common in our profession, but it is still something important to know.


One thing to be aware of in private practice or super groups etc. As far as non competes in private practice. You also want those to be void unless let go with cause. Some of those can potentially hold up in some states even if they let you go. Some states are slowly doing away with these but the ones already under contract are generally still valid even if the law changes.

Reasons above and more are why a good attorney is worth their money when looking over a contract.
 
I'm going to get esoteric here so bear with me. In a biological system, there is a drive to reproduce as well as a drive to maintain itself. Once you've reproduced--evolutionarily speaking--you're no longer useful to the species so not much point in maintaining the system. That's why we get old and our bodies deteriorate (I'm oversimplifying). Some organisms, like Homo sapiens, are very complex systems, and we're pretty long-lived as far as animals go. We have kids 1-2 at a time and that's gotten us along just fine for the past 300000 years. Other organisms like insects are very simple, they have short lifespans but have broods in the thousands to millions. They turnover generations rapidly and that also has enabled them to occupy many diverse ecological niches.

What's this got to do with the podiatry job market?

We can see a small number of high complexity jobs. The employer in these positions has every incentive to maintain this person in recognition that their work might be difficult to replace. So they hold those positions for a while. (Except at the VA where everyone is paid according to government fiat.) I like to hope practice owners would be looking for this kind of person and offer a high wage because they want to keep them and develop them because theoretically it's good for business to have this type of person on board.

We also see a large number of low complexity lobster jobs. Literally anyone who can get a license can do this work. So the pay is terrible. People work them a few years until they find their "forever" position described in the previous paragraph. In the process, they turnover quickly. Associates who can leave self-select out of these roles, and employers just find another lobster to do it. Due to the high turnover, these positions will resurface on jobs boards frequently. Meaning these will always be the majority of all job postings!!!

That's the simple answer to @dtrack22 's question above about quirky base/bonus structures. Call it greed, call it rational self interest. Everyone responds to market forces. I guarantee you no one in private practice was involved with the decision to start new colleges of podiatry, but if CPME or whoever thinks it's fine to flood the job market, then the market will respond accordingly.
 
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The thing is there a lot of jobs that pay well that don't require an advanced level of training. It is plug and okay. You just need the volume and the payment structure. Whoever gets the job will produce within a certain level. Sure, someone more talented may be able to do an extra 1k RVUs via certain procedures, but at some point 100 patients per week at 2.x RVUs per encounter and 50+ Per RVU = great money for a pod . Person X got the chance, person Y never did. It sucks. That's podiatry.
 
diabeticfootdr said:
The difference is that I’m not just looking for someone to come in and do a job. I’m looking for a professor at the top of their game who can be an NBA podiatrist. So yes, a fellowship is necessary.
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Interesting statement. Being that podiatry fellowships have not been around for too long are you taking someone with no work experience who is fellowship trained or are you looking for a minimal amount of work experience who happens to be fellowship trained? Because if you hire a new fellowship grad and say they are the best the the profession has to offer I would beg to differ.
 
Retrograde_Nail said:
Interesting statement. Being that podiatry fellowships have not been around for too long are you taking someone with no work experience who is fellowship trained or are you looking for a minimal amount of work experience who happens to be fellowship trained? Because if you hire a new fellowship grad and say they are the best the the profession has to offer I would beg to differ.
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Good thing this isn’t “hire-by-SDN-committee.”

Meanwhile, we have 2 new pods starting Sept 1.

A 3rd, Graham Hamilton, starting as residency director on 11/1.

And I have 4 openings.
 
diabeticfootdr said:
Good thing this isn’t “hire-by-SDN-committee.”

Meanwhile, we have 2 new pods starting Sept 1.

A 3rd, Graham Hamilton, starting as residency director on 11/1.

And I have 4 openings.
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How many podiatrists do you have total at this point? Pretty awesome that the division has been grown that much.

Would be cool to see other academic medical centers doing this across the country.
 
diabeticfootdr said:
The difference is that I’m not just looking for someone to come in and do a job. I’m looking for a professor at the top of their game who can be an NBA podiatrist. So yes, a fellowship is necessary.
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I know many pods whom never did a fellowship
diabeticfootdr said:
Good thing this isn’t “hire-by-SDN-committee.”

Meanwhile, we have 2 new pods starting Sept 1.

A 3rd, Graham Hamilton, starting as residency director on 11/1.

And I have 4 openings.
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is there enough volume to sustain the elective/trauma stuff for all the new pods that are not doing limb salvage?
 
Podstar said:
Worth it at all for 2024 residency new grads to apply?
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If you’re interested in one of the fellowship spots, email me or Collin Pehde. Our fellows all do well and get placed either here or we help find good positions for them in a geography they desire. I get 1-2 emails a week looking for DPMs. Many from universities/hospitals.

For faculty positions, we’re looking for people that can teach, interested in research/publishing. Usually those are people with more experience and/or fellowship.

I already put in 2 more faculty positions for the budget next year (starting 9/1/24).
 
diabeticfootdr said:
If you’re interested in one of the fellowship spots, email me or Collin Pehde. Our fellows all do well and get placed either here or we help find good positions for them in a geography they desire. I get 1-2 emails a week looking for DPMs. Many from universities/hospitals.

For faculty positions, we’re looking for people that can teach, interested in research/publishing. Usually those are people with more experience and/or fellowship.

I already put in 2 more faculty positions for the budget next year (starting 9/1/24).
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So will you tell us how many applications you’re getting? Go ahead and put this “saturated market” discussion to rest.
 
podwho said:
So will you tell us how many applications you’re getting? Go ahead and put this “saturated market” discussion to rest.
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Sure, I’ll tell you. So far only a few apps came in unsolicited.

I sent an email out to 200+ residency directors this week in addition to posting on LinkedIn and sending out via AAPSM.

I also asked people I trust who they would recommend. I got about 6 for the 2 limb salvage spots and 5 for the Sports Med. But I solicited them to apply. Not all have sent in their apps yet. We won’t interview until Sept and try to make offers in Oct for start dates in Jan-Feb.
 
Susitna said:
Thanks Feli, you paint a broad stroke and not all fellowships are a waste of time for the reasons I stated above. These fellowships are relatively new. What I said about opportunities is true. Give it a few years.

I agree that 3 years of top notch training is sufficient but, as in the past, there aren’t enough of them to go around.
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You're asking students with 250k+ loans to sit on it for a few years, while it compounds, with no guarantees that it'll lead to a 250k-300k job.

Have you lived on a compounding 250k debt on a 100k base salary? Maybe you can share that experience so the applicants have a head-start on how to prepare for a fellowship
 
Why don’t we point the finger more at the schools hiking costs rather than what jobs pay? Honestly if our schools had costs in line with inflation compared to what they were 30 years ago it would still be significantly cheaper than what it is now, and less people would be getting upset over jobs.

The problem was when podiatry made a push for mandatory residency (which should be irrelevant when factoring in student loan cost for pod school) it gave these schools the idea they should charge the equivalent as an MD or DO education
 
Hybrocure said:
Why don’t we point the finger more at the schools hiking costs rather than what jobs pay? Honestly if our schools had costs in line with inflation compared to what they were 30 years ago it would still be significantly cheaper than what it is now, and less people would be getting upset over jobs.

The problem was when podiatry made a push for mandatory residency (which should be irrelevant when factoring in student loan cost for pod school) it gave these schools the idea they should charge the equivalent as an MD or DO education
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Why blame the schools when reject med students who are desperate would pay anything to be a “doctor”? The market is the market
 
JustAPedicurist said:
Why blame the schools when reject med students who are desperate would pay anything to be a “doctor”? The market is the market
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Well that’s easy. Because we are stuck reaping the consequences. For the last 5 years there has been zero reason for reject med students to pursue podiatry with NP and PA being as strong as it is, yet podiatry school tuition only keeps climbing despite having those empty seats.
 
Susitna said:
Thanks Feli, you paint a broad stroke and not all fellowships are a waste of time for the reasons I stated above. These fellowships are relatively new. What I said about opportunities is true. Give it a few years.

I agree that 3 years of top notch training is sufficient but, as in the past, there aren’t enough of them to go around.
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where are you in your training? Are you a resident? Or are you still a student?
 
Pronation said:
I didn’t ask. I would never bother asking you this loaded question because I already know your agenda and associated deceitful practices. I will, however, point out some obvious BS. Any of us that have applied for jobs in the past few years know what the reality is. I’m happy to post some screenshots from recruiters at hospitals in the middle of nowhere with responses indicating an overwhelming amount of apps all shortly after the job posting went live.
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Yes this is my experience as well. I was even involved with the hiring of a non surgical DPM position at a previous hospital job and we got 50 applications for a non surgical DPM position. Guess who applied? Fellowship trained DPMs, DPMs who completed high powered residencies, etc. Very few of the candidates were actually non surgical DPM material. A lot of the applicants were foot and rearfoot/ankle certified by the ABFAS. I am not making this up. This really happened.
 
Hybrocure said:
Why don’t we point the finger more at the schools hiking costs rather than what jobs pay?
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So while I agree that schools are raising tuition way too quickly and drastically, the big difference between now and say, 40-50 years ago, is that higher ed funding has been cut bigly. States used to help subsidize tuitions to keep them more affordable. At one time before Reagan destroyed the country, Cali had free college tuition. Basically since then, states have eliminated most higher ed funding, and the end result is that students have to take it all in the form of absurd student loans with no limits.
 
Boba Foot said:
So while I agree that schools are raising tuition way too quickly and drastically, the big difference between now and say, 40-50 years ago, is that higher ed funding has been cut bigly. States used to help subsidize tuitions to keep them more affordable. At one time before Reagan destroyed the country, Cali had free college tuition. Basically since then, states have eliminated most higher ed funding, and the end result is that students have to take it all in the form of absurd student loans with no limits.
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I also thank Obummer for removing all professional subsidized loans in 2011/12. Maybe things have changed since then, but many were screwed into getting the abysmal grad PLUS loans
 
I have deleted and even reposted content to appropriate thread.

Please stay on topic.

No, we are not closing this thread.
No, I am not spam deleting comments to serve an agenda.
 
Susitna said:
I don’t understand why SDN “attendings” are so against Fellowships. Fellowships give you an opportunity to do research, write papers, work with leading docs, develop mentors, give lectures, become a better surgeon, be an expert in something. You’re going to have a 30 year career and the trajectory of that career could be significantly enhanced with a 1 year fellowship opportunity.
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Not against them in theory.

We probably need a fraction of what we have.

If one has a better chance of getting a better job even if the additional training was potentially not needed in many instances and it was really just the networking or adding to CV that got the job and not the actual training then that is what is arguably bad for the profession.

You take a profession that currently has a poor ROI as far as initial jobs due to few organizational jobs and primarily poor paying associate jobs with poor benefits as associates and residents will chase fellowships in the hopes that job prospects will be better. Which fellowship will be worth the ROI and which ones are not and make the ROI even worse.

For the profession as a whole it lowers the already questionable ROI even more if there are too many fellowships. It is saying 7 years beyond college most likely gets you a 100K associate job with poor benefits, but a fellowship might get you a 200K plus organizational job with good benefits.

We can pretend podiatry is great and we are advancing the profession with fellowships, but if the typical young podiatrist faces a horrible job market we need to address that. We need to cut enrollment in half if not more. There is not unmet demand for our specialty and there is saturation. Cut enrollment and then the poor residencies go away. Will all get organizational jobs even then? No, but the percentage of reasonable associate jobs will increase with more opportunities for partnership. Less will have to Dremel nails in nursing homes and assisted living centers for a living also. There is nothing inherently wrong with private practice and it is not going away. In this day and age most expect reasonable paying jobs wether organizational or private practice when they finish residency. It is not the 80s anymore where everyone just assumes you go solo or buy out a retiring podiatrist. Healthcare has changed and saturation is holding podiatry back even though we do have more organizational jobs than in the past.

It says something sad about our profession that so many have to open their own solo office to have a chance at doing well. It should be more mutually advantageous and more economically affective for there to be mainly group jobs that pay fair versus the amount of solo offices there are in this profession. It should be less risky for a young doctor also to step into an established practice, but all too often the real risk is being stuck with a poor ROI job. There is nothing wrong with opening solo, but one should not have to to be paid fair.

Saturation...existing podiatrists are not busy enough to hire and pay well or they choose no to create a business model to underpay an associate due to....saturation to profit and grow their associate mill.

Even many of the podiatrists that are busy enough to pay well and may eventually offer a track to partnership often pay low initially like it is some rite of passage to pay low and prove one's self like they did many years ago instead of start a relationship paying one a respectable salary....because saturation and because podiatry.
 
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icebreaker32 said:
Jennifer Spector, DPM: So what drew each of you to private practice, independent of the type that you actually have right now versus an employed practice. I know both of you have sort of mentioned, possibly past experiences not being a great fit. What made you think that private practice was the way to go for you?

Tea Nguyen, DPM: Oh, yeah, my tagline is I'm unemployable there.

Click to expand...

That interview was just depressing.
 
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