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deleted1162946
That person is going to work their ass off I bet
Forum Members Official: Job Offer Thread
- Thread starter DexterMorganSK
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Bennies.
I think I get myself a good Benny this weekend after the gym... Canadian bacon, heart attack sauce, all that.
Even tho I'm not a podiatry associate who gets $25 Denny gift cards for XMas anymore, that still sounds dope.
That's pretty much it. ^^
For podiatry, any 'academic' place usually has ortho and other training programs, so podiatry gets the scraps. Usually the more 'academic' or 'prestigious' the medical center, the more limited the scope (for podiatry). That was sure my experience on clerkships.
It seems the key to maxing those podiatry jobs at 'academic' places is to have a residency and/or fellowship program there to get more rVUs and do 'research' that way. But we all know it's usually a lot more gas and Charcot and pus than and flat foot recons and SER-4s and ankle scopes.
The places to get the better ortho/sports stuff for DPMs are usually areas with less action (small/medium community hospitals or structure a PP that way). Sometimes big hospitals like county general type trauma ones can work ok if you don't drown in the medicaid.
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You are probably talking about Tucson Medical Center. That one has a residency and I did not rotate there.
Banner is associated with University of Arizona. Separate hospital system.
I was considering working for them upon graduation. They pay MGMA if you include bonuses
You were 'considering' a MGMA job... yet took a PP associate job where you are trying to grow the practice? Ok.
I think you may have not learned very much reading SDN?
Oh, and I 'considered' dating Scar Jo and Paige Spirinac. 🙂
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That was my favorite thread ever. I laughed so hard.
The one where they're marketing someone elses practice as an associate, rep dinners, taking out google ads with their own money for someone else's place.
I laughed so hard making these memes:
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It was a good thread.
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What hospital do you work for? Asking for a friend 😉(in all seriousness, do not leave that job. It's rough out there)
I held my NC license for over 10yrs.... looked for pod jobs from time to time. I basically found 3 kinds:
-hospital jobs without residents where pay was good but you work HARD with call, rounds, clinic, etc (basically residency workload forever)
-hospital jobs where you were very limited fore/midfoot scope (and still usually much pus bus call)
-PP jobs where you make about half what you do now (possible "bonus" or buy-in for more, but who knows)
-large/super group or MSG type pod jobs where they expect mostly clinical podiatry and pay is again far from stellar
NC was pretty good as it was growing and not a ton of pods there. Now, a lot more pods there.
I never found the right fit (closest were a couple overpriced PP buy in/out options, hospital job where DPMs burnt out every 2-3yrs seemingly). I hope you can do better.
If it's just your wife looking to go there, I would explain that your pay is likely to go way down. Probably get NC license (takes awhile) and pay off your loans and finish your ABFAS cert before you go? ... not a ton of RRA going to podiatry in NC (besides DM stuff). Definitely a cool place overall. GL
You can do that. Creating / cold calling is how I made my best job leads there.
I would absolutely get your state license there asap. It's a hard one to get, and it can take awhile. Most won't even want to talk until you have it. You will probably get at least a couple job listing letters when you get the license also.
Consider paying off your loans hard with the better GA job. Unless you are getting worked to death, that level of income is just not something easy to replace as a DPM (without going to Minot, ND or doing fraud or something).
The difference betweek 360k and 200k is massive. If you assume 40k for loans, 50k taxes... $200k gross is really little left for living, retirement, overpay loans, etc these days. A lot also depends if your spouse/partner is financially competent or not so much. Your call.
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OrthoCarolina grads just keep dominating there.
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Am I ridiculous for suggesting you focus hard on saving $100,000 in cash and then you start your own practice? It won't be the same practice, but it will be yours.
Lol... if you have a $300k+ job as a podiatrist that lets you "focus on my kids," you are winning the game.
Nearly any job like that for DPMs is taking call, long hours office, doing both etc.
Well, that's cool... call some hospital physician recruiters/HR and some office managers for pod/msg groups?
My general impression was that Novant works DPMs they employ pretty hard (no residents, active call, inpatients, etc) but they get some good stuff (mostly DM stuff, tho), most other hospitals in NC (Baptist, Duke, UNC Health, etc) are basically just wounds/forefoot for podiatry and Ortho gets almost anything good. The supergroups/msg FASMA etc (job types most DPMs there seem to work, esp younger pods) I saw are also fairly limited scope simply by nature of refer types they get (and don't get). The PPs I visited are ok but did not pay super well, and many have been bought out by hospitals and are now mostly or totally hospital-run. It depends what you want to do I guess. Most of the ones I saw did inpatient and wound center work.
Ortho is just very powerful in NC, and while DPMs were relatively few and successful in PP there even a decade or two ago (RFC and TFP stuff and basic office stuff)... not rare anymore. The licensing/exam got more lax, a lot of new grads have gone there, and supergroups and hospitals gobbled up and expanded many PPs to press on the remaining private podiatry PPs. You have a lot of pods - not so much relative to the population, but it's all in a reasonably limited scope state. The people (and PCPs) in most of NC just don't really call podiatry for ankle, Achilles, deformities, etc.
The hospital pod jobs are probably your best bet if you don't want to run a biz... but most will be limited scope, some fairly hard hours. I don't think you will find the same $ unless you want approx q3 call and generate a fair amout of rvu.
Supergroup might be ok if your spouse can do more of the heavy lifting on earings. Never too fun when you are a cog in the wheel and your career has basically no upside, though.
I let my license there expire.... hope you can find much better tho. Cool place, no doubt.
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How did you get the 100k figure
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Completely arbitrary. There are people posting here stating they can start an office for dramatically less, but there are also people saying you don't need to have x-ray when you start. That feels like the old expression - "dress for the job you want to have". I want a job that requires x-ray.
My x-ray decadence aside, I'm mostly of the opinion that 619 had the right idea starting off an office and pushing frugality. New offices have lots of issues and uncertainty, but ideally they should allow you to control costs from the get go as opposed to being stuck with Athena or some other legacy cost. Keeping overhead low from the get go can be more valuable than increasing collections.
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Don’t leave your job. NC sucks. The licensing process is excessive and hard because it’s just podiatry trying to gatekeep other podiatrists from entering the state.
Keep stacking your RVUs
Keep stacking your RVUs
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100% correct. I opened my practice in Oct 2020 with just one staff. I was doing everything at the back myself from cleaning the rooms to autoclaving my instruments to taking x-ray. Nothing was beneath me when I was seeing 7-10 patients a day. A year later I added a second staff up front. I trained the second staff how to take x-rays and clean rooms so that gave me some relief. A year later I hired 2 new staffs within a month bringing my total staff to 4. I promoted my original staff to office manger (she did my billing and basically trained everyone upfront) so I was very confident to put her on straight salary with a generous raise.
Now I have 4 staff but I don't still have a dedicated MA. I thought about it many times but I don't still need an MA. When I hired 2 at the same month, one was meant to be my MA but she loves being in front with the other girls and taking phone calls. Everyone upfront knows how to clean the room, set up for procedures, take x-rays, auto clave instruments etc. Their main job is to work up front, take phone calls and get new patients on the schedule. They know their number one job is to pick up every phone call and put them on the schedule same day, next day or same week. The schedule is never too full for an "ingrown nail, heel pain, sprain, warts etc". I genuinely love ingrown nails. Like taking out infected tooth for a dentist. It's gratifying.
I run my practice like an urgent care for foot/ankle. I am not trying to be a revolving door for diabetic nail/calluses. Yes I do nails and calluses but most of them I tell them to call me back in 3 months when they are ready. I am in what you call a saturated area outside a top 10 metro area. I have 2 super group and a few other solo docs within 5 mile radius from me. My office is next to trauma 2 busy hospital ( I don't take call) so very well within the medical community. Still I not afraid to keep my schedule open. Next week, I have about 14 patients/day on the schedule but I am very confident that I will easily pick up 5-7 new patients same day that are looking to be seen. The secret is having good google reviews (because patients just google for a podiatrist near me) and picking up the phone. I have 4 staffs ready to pick up the phone and put new patients on the schedule.
20 patients a day is good for me with half of them new patients. New same day or next day patients are not worried about their co-pay, co-insurance or deductible. They are very grateful that I am able to get them in quickly. These are working busy patients who want to be seen, treated, get better and move on with their lives.
desertpod8
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That’s a great setup. I’m an associate so I don’t have much say in how our practice is ran. Our patients’ main complaint is no one picks up the phone, we spend a lot of time responding to voicemails so it’s quite inefficient. Also an ingrown toenail patient may take weeks to get in, when I think it should be added on same or next day.
I’ve had thoughts of opening my own practice but current owners ingrained in us how hard and expensive it is to run a practice. As a solo doc, what’s your overhead like (percentage wise) for having 4 staff members?
You can run an office as expensive or as lean as you like. I use one front, one MA... see typically 16-20+ per day.
I have total opposite model of @619 in that I am booked out awhile, barely any "walk in" spots, fill cancels with waitlist new pts. Cancels are rare; I take less than one walk in per day (typically just if a PCP calls me and has a wound or injury or etc). I find the scheduled patients to be less drama, less flaky, and more likely to have good payer and pay their bill if they are PCP refers ...versus just found the office on social or Google or whatever. The nearby associate mill probably gets a lot of new pts who called my office, didn't like the wait, and go there. No prob. It just shows you the difference to compete/thrive in a metro versus semi-rural... saturated area versus less so. All biz models can work fine.
One idea is to get an answering service in addition to front desk employee (catch calls after hours, at lunch, while on other calls, etc). I use a service that's about $250 per month that forwards after a couple rings (answers, emails us the message, will call through to me if it's ER/doc/urgent call). An actual employee can cost roughly that same money per day.
If you want to start your own office, do it. Don't let anyone tell you that you can't. It can be done. 👍
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First, to answer your question, things tend to end up around 50-60% overhead. Any higher and you'll start to look at ways to increase revenues and decrease costs. Any lower and you might have an attractive profit margin but you might have a very small scale business that could be more profitable if you invested a little more, or you're just doing too much yourself, like spending your evenings/weekends on the ledger.
You have to think along the margin, will this extra employee make the doctor more productive or not? In other words can you increase the practice income by working more because you have the personnel offloading tasks from you? What kind of fringe benefits do you give your employees? If you want to build a bigger team, that becomes more important.
Another question to figure out on your own is what do you do yourself vs what do you outsource? Obvious examples: payroll/bookkeeping, HR, cleaning crew. Are you going to hire a biller in your practice or contract with a company to do it for you? And lots and lots of other little things.
And there we have it, this is
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Correct, overhead is about 50%-60%. Major things are rent and payroll. Phone/internet/EHR etc are pennies to the dollar. Everything is on autopay to capital one biz credit card so I get free points. The rest is supplies (also on cap one biz credit card) which commensurate to how many patients you treat.
What happens when one person calls out sick?
I can also see 16-20 patients a day with 2 staffs.I have four because every now and then someone calls out sick or request a day off (I have a rule that 2 people can't request the same day off). More than a few times 2 of them have called out sick same day so I only have one person upfront and I run the back myself. My office manager has her own separate office so she can focus on billing/claims denial appeal/insurance verification for new patients and also schedule new patients.
My office manager is my rock. She has never called out sick or miss a day of work for any reason since I opened in Oct 2020. It is so unbelievable. Even though I tell her many times that she can take her vacation whenever, she only wants to take her vacation when I am on vacation so I make sure to tell her way ahead of time. I am truly blessed for having her.
So just like feli, you can run a very god clinic with just 2 staff. I have 4 staff (3 upfront and one office manager) because it just works out that way. It also gives me rest of mind when someone calls out sick or takes a day off for whatever reason or take a vacation (I give 7 days PTO plus 7 paid public holidays).
My 3 staffs working upfront all get along except the occasional girl fight/drama and I have my office manager take care of that. The 3 are between ages 22-27 while my office manager is over 50 y/o so she keeps the girls in check and make sure they do their work. In my clinic, my staffs know I don't like to micro manage anybody. On the slow days or when we have down time, they can be on their phones or watching a show. I don't care about that once they get their tasks done and make sure to answer every call.
I agree with the PCP refers are reliable patients but I am also a big fan of google. I have very good google reviews and patients that find me on google are also very reliable, show up to their appointment and pay their bills at check out. They also want to be seen same day/next day or same week. I want to get those types in including self-pay patients.
Overhead is really hard to get a handle on.
If you just take what is claimed on taxes, sure... it's 50%, 55%, 60%, 65%... whatever.
But it's usually significantly less in reality.
Nearly all pod PPs are structured as S-corps (or LLC taxed as S-corp, based on state), so a lot of things suddenly become deductible. You get into the "company car," your meals, all your clothes become "uniforms," a family member might become an "employee," etc etc etc... a whole lot of things you buy anyways can just (voila!) become work expenses, etc. It's basically a game to deduct whatever you reasonably can when you're owner... doesn't make the stuff free, but it's tax-shielded.
That is why being a w2 employee sucks so much: you have little/no say in the biz, and you have almost no tax deductions.
Bottom line: it's not nearly as hard or expensive to start a PP as you probably think... and it's a lot more profitable than you think.
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Boomers, and to be fair anyone who has done it....often want to claim super hard to both discourage others and pay themselves in the back. It's human nature. And again, to become a doctor ...it is NOT entrepreneurial in nature...docs tend to be risk averse.
You can do quite well even early on in some of those NC supergroups (source: i know a guy). As with any PP/group its a lower base with decent bonus. I have heard the process of getting a NC license is ridiculous with limited seats and only twice per year for the exam and all the case submission requirements etc. I suspect that most recent NC "fellowship trained" posting is more of a formality posting...
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deleted1162946
Case submission requirements? TfYou can do quite well even early on in some of those NC supergroups (source: i know a guy). As with any PP/group its a lower base with decent bonus. I have heard the process of getting a NC license is ridiculous with limited seats and only twice per year for the exam and all the case submission requirements etc. I suspect that most recent NC "fellowship trained" posting is more of a formality posting...
Case logs from residency for privileges. All paper submissions, highlight all your toe amps and let us know which colors are for what kinda thing for amp credentialling.
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deleted1162946
Sounds unnecessary, in my state I just sent a screenshot of my logs. You ready for balloonerism?
Yeah I had some friends go through the process recently and it sounded like hell. I wait in eager anticipation. Have a nice long drive friday to visit some friends so I'll be locked in to it in the car.
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The hell...
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deleted1162946
We need more schools
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Hiring freeze 😢
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Are there that many jobs online? No.
Are there a few decent associate jobs online that actually have a hard time finding someone? I have heard yes, but only if they are in a very small city. Obviously it can be socially and culturally difficult to move to a random small city for an associate job. Anything organizational anywhere or a good associate job online that might have partnership potential in a large city is competitive.
Is podiatry just such a small profession that it has enough unadvertised good jobs for everyone? Absolutely not.
Typical career path…..start at a typical associate job. Most of these are unadvertised as they are near residencies or created by networking/connections in one’s hometown or where they are certain they want to live.
Is it all doom and gloom? No, as many do well enough eventually….wether it is being open geographically for a better job, an opportunity due to connections, a local opportunity that presents itself or opening your own office.
Is it depressing if one thinks they deserve the starting salaries, benefits, choice of geographic locations and being recruited like most mainstream healthcare professions with the amount of training we have? Absolutely
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I have heard from other specialists that they typically don’t have many job postings listed either and it’s mostly word of mouth or just create your own. However, they don’t have any problem getting paid appropriately
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We need to open more schools so that there is more teaching jobs
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Found my hospital job online.
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Found my 2nd ex-wife online
desertpod8
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Saw this on PMNews. An associate position that sounds fair and with benefits.
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They are going to make you use grafts...
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Monterey yes.
Watsonville........................
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Fellowship preferred
chsrecruiting.applytojob.com
Full-Time Podiatrist - Outpatient + Surgeries - CHS Recruiting - Career Page
Podiatrist needed in Thibodaux, LA.
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There is no comparison between someone who is fellowship trained right out of fellowship vs a candidate who has experience and has worked in a hospital before who is also ABFAS certified. Nothing trumps experience. Nothing trumps experience working in a hospital. Fellowship trained candidate right out of fellowship should not be considered over someone who is already certified by ABFAS. It is really that simple.Fellowship preferred
Full-Time Podiatrist - Outpatient + Surgeries - CHS Recruiting - Career Page
Podiatrist needed in Thibodaux, LA.
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Agree....they also say no practice experience required. Mainly a way of saying fellowship preferred if no experience.
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No experience required = **** job anyways.
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Some **** is better than others.
Maybe $ per RVU is a bit lower than some organizational jobs and location is less desirable. Might be **** for a new MD grad, but gold for a new pod.
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Was it hard finding a hospital job? My dream job would be hospital based and not really private practice. Do hospital jobs usually pay 365? or does it vary dramatically?
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