Part Time Hospital Employed - Just Ask

[air bud]

So an update on my situation, as well as some advice for those looking for employed work.

I am currently full time employed by a hospital. I make good income (more than 200k although capped due to production) and see maybe 35 patients a week in busy week. I work 4 days a week, every monday off. Lets say I do 3-5 surgeries a month. Like all good things, this is coming to and end. However, it is of my choosing. To a certain degree I am just getting ahead of the situation. I have been told if I were to leave they would replace me, but there is instability and insecurity in knowing that you can't work harder and make more money and if they were to eliminate your position you would have to leave town as private practice wouldn't work. Also, at some point your skills begin to atrophy as a result of seeing so little pathology.

So what have I done? I asked my hospital to go part time hours full time benefits. They have said yes. On one hand, I am the idiot since I am going to now do all the same work I am doing now....but for half the money. This gets me 2 things though. I get to live in a different town 2 hours away (out here that is nothing I drive further than that to go to Target), I get to live in a much cooler town and location, I get to join another group and see more patients and make more money. Of course I will actually have to work for this paycheck....

So what is the point of this? Contact your rural hospitals. Contact your community hospital. Maybe they have never considered a part time podiatrist. A critical access hospital makes money on surgery and outpatient facility fees. You, as a surgical subspecialist, make them SIGNIFICANT money. You don't make them as much money if you are just a visiting provider at their outpatient clinic. If you are employed by them, you make them much more money. Even if no benefits, employing you one day a week gives you a guaranteed paycheck and makes them money. Yes there are pros and cons to w2 vs 1099. I have actually talked to another hospital 2 hours in the other direction from my new location that is willing to bring me on as a part time employee with full time benefits. I would join the ortho dept and have a PA. I may take that option eventually, but for now I will take the stability of my current job for part time work. I will probably play these two offers against each other at some point. This other hospital has never had a surgical podiatrist, just some TFP who comes to town 2 days a month and sees inmates at the nail jail set up in the visiting provider clinic. Probably pays 100 bucks a day in rent. However the CEO has experience in other locations with podiatrists and knows their value. But he is in a small rural location and knows a full time would never work. When I initially discussed doing some outreach there and then broached the subject of part time employment because it would make them more money and give me some guaranteed income as I transition to production work with my ortho group, I could sense the wheels in his brain spinning- holy crap I never thought about getting or that I could get a part time podiatrist.

Moral of the story - pick up the phone and call a hospital. You never know. Just ask. Hell, even if I only did my current gig part time at my new salary and full benefits it is better than 50 percent of associates will make in their first year out and that is working 2 days a week. You have value, it may just take some work on your part convicing someone of this.

The rest of the story - I will join an ortho group and do all foot and ankle. They will do ankle fx they get when they are on call. I will get some ankle fx, as well as all other trauma. Ortho gets to dump all the diabetic stuff on me. The plan is to build a surgery center in a year or two when I join full time as a partner. There are no other ortho in town, no podiatrist in town. It is 3x the size of my current coverage area. I will now have about 60k people all to myself. The best part is, a F/A ortho was coming to town and renting from them. I got to kick this guy out and throw him under the bus by convincing (although they already knew) them that he was taking knees, hips etc from them. Also, he would never join the ASC because he is employed by an ortho group 3 hours away with their own ASC. Guess how I got this job? I picked up the phone and called them. If the ortho group didn't hire me, the medical group in town was going to. Guess what, I cold called the CEO one day and explained my value to them. They had never employed a podiatrist before either (there was a pod there 4 or 5 years ago but left). While I have been negotiating all this ortho has actually told the hospital to not hire their own FA ortho and also strongly discouraged 2 pods from coming there and setting up shop since it isn't big enough for 2.

tldr: know your value, be open to different options, pick up the GD phone and call. And keep calling these CEOs are incredibly frustrating and take forever to get around to things when you want stuff done ASAP.

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[malleolusman]

So an update on my situation, as well as some advice for those looking for employed work.

I am currently full time employed by a hospital. I make good income (more than 200k although capped due to production) and see maybe 35 patients a week in busy week. I work 4 days a week, every monday off. Lets say I do 3-5 surgeries a month. Like all good things, this is coming to and end. However, it is of my choosing. To a certain degree I am just getting ahead of the situation. I have been told if I were to leave they would replace me, but there is instability and insecurity in knowing that you can't work harder and make more money and if they were to eliminate your position you would have to leave town as private practice wouldn't work. Also, at some point your skills begin to atrophy as a result of seeing so little pathology.

So what have I done? I asked my hospital to go part time hours full time benefits. They have said yes. On one hand, I am the idiot since I am going to now do all the same work I am doing now....but for half the money. This gets me 2 things though. I get to live in a different town 2 hours away (out here that is nothing I drive further than that to go to Target), I get to live in a much cooler town and location, I get to join another group and see more patients and make more money. Of course I will actually have to work for this paycheck....

So what is the point of this? Contact your rural hospitals. Contact your community hospital. Maybe they have never considered a part time podiatrist. A critical access hospital makes money on surgery and outpatient facility fees. You, as a surgical subspecialist, make them SIGNIFICANT money. You don't make them as much money if you are just a visiting provider at their outpatient clinic. If you are employed by them, you make them much more money. Even if no benefits, employing you one day a week gives you a guaranteed paycheck and makes them money. Yes there are pros and cons to w2 vs 1099. I have actually talked to another hospital 2 hours in the other direction from my new location that is willing to bring me on as a part time employee with full time benefits. I would join the ortho dept and have a PA. I may take that option eventually, but for now I will take the stability of my current job for part time work. I will probably play these two offers against each other at some point. This other hospital has never had a surgical podiatrist, just some TFP who comes to town 2 days a month and sees inmates at the nail jail set up in the visiting provider clinic. Probably pays 100 bucks a day in rent. However the CEO has experience in other locations with podiatrists and knows their value. But he is in a small rural location and knows a full time would never work. When I initially discussed doing some outreach there and then broached the subject of part time employment because it would make them more money and give me some guaranteed income as I transition to production work with my ortho group, I could sense the wheels in his brain spinning- holy crap I never thought about getting or that I could get a part time podiatrist.

Moral of the story - pick up the phone and call a hospital. You never know. Just ask. Hell, even if I only did my current gig part time at my new salary and full benefits it is better than 50 percent of associates will make in their first year out and that is working 2 days a week. You have value, it may just take some work on your part convicing someone of this.

The rest of the story - I will join an ortho group and do all foot and ankle. They will do ankle fx they get when they are on call. I will get some ankle fx, as well as all other trauma. Ortho gets to dump all the diabetic stuff on me. The plan is to build a surgery center in a year or two when I join full time as a partner. There are no other ortho in town, no podiatrist in town. It is 3x the size of my current coverage area. I will now have about 60k people all to myself. The best part is, a F/A ortho was coming to town and renting from them. I got to kick this guy out and throw him under the bus by convincing (although they already knew) them that he was taking knees, hips etc from them. Also, he would never join the ASC because he is employed by an ortho group 3 hours away with their own ASC. Guess how I got this job? I picked up the phone and called them. If the ortho group didn't hire me, the medical group in town was going to. Guess what, I cold called the CEO one day and explained my value to them. They had never employed a podiatrist before either (there was a pod there 4 or 5 years ago but left). While I have been negotiating all this ortho has actually told the hospital to not hire their own FA ortho and also strongly discouraged 2 pods from coming there and setting up shop since it isn't big enough for 2.

tldr: know your value, be open to different options, pick up the GD phone and call. And keep calling these CEOs are incredibly frustrating and take forever to get around to things when you want stuff done ASAP.

fantastic advice. Happy for you Airbud. Most of the pods on this forum really do make it easier being a podiatrist by knowing that not everyone in our profession isn’t scummy.

Progress never follows a straight line, it zigs and zags, but eventually helps move everyone forward in the right direction.

 

[air bud]

fantastic advice. Happy for you Airbud. Most of the pods on this forum really do make it easier being a podiatrist by knowing that not everyone in our profession isn’t scummy.

Progress never follows a straight line, it zigs and zags, but eventually helps move everyone forward in the right direction.

Yes. Progress is also proportional to your effort and work. But also its luck. Lots of luck.

Also, for the record, ortho is proposing a Revenue less overhead model. They keep infrastructure revenue like x-ray. I am in clinic 2.5 days a week there. They are in clinic 2.5 days a week. 2 locations nobody same location same time. So rent, practice manager, MAs, front office cost we split. It makes sense for them. They have someone to send foot/ankle to and keep local people happy, they reduce most overhead from 50 to 33 percent, dont' have to do any I&Ds. Win win. And guess what - they are not like PODS who think they deserve a cut of my production....

They don't have any risk in this. I really don't either. I have benefits from w2 employment that I can live on. I get their good name and good will, no upfront heavy costs, no committment either. I will get my own 1 year occurence insurance policy- like 8k for part time work. I will pay for medical staff dues. I will pay for some advertising - my name and pic on their billboard with their pics and names. Then in a year become a partner and we build an ASC.

Let me take the time do re-iterate my position on what new associates should do - your employer will offer you a claims made malpractice policy. Do yourself a favor and negotiate they give you that money, and you buy your own occurrence policy. You pay a few k extra, but it protects you from spending 15k on tail coverage in 3 years when you leave because you hate them. Don't budge. They know this is a factor in you not leaving.


Edit I made the same mistake. Switched up claims made and occurrence. Fixed.

 

[SouthPod7]

Let me take the time do re-iterate my position on what new associates should do - your employer will offer you an occurrence malpractice policy. Do yourself a favor and negotiate they give you that money, and you buy your own claims made policy. You pay a few k extra, but it protects you from spending 15k on tail coverage in 3 years when you leave because you hate them. Don't budge. They know this is a factor in you not leaving.

Excellent point. None of my attendings who reviewed my contract said anything about Claims Made vs. Occurrence. Nobody mentioned anything about Tail coverage. They just said make sure it's PICA and make sure it's a 1mil/3mil policy (1 million max per claim and 3 million max total). My contract specifically states that I am responsible for paying for Tail coverage if and when I choose to leave (likely this will be my first and last year at this practice depending on how some leads I'm pursuing turn out).

For new grads/residents/students reading this, let me break it down how it works a bit because nobody taught me this and I didn't learn this until it was too late (and any more senior attendings here please feel free to jump in and correct me if needed):

Malpractice insurance comes in occurrence and claims made policy. Claims Made is cheaper because it only covers claims made against you during a specific period of time (usually a year at a time). After that year, if you choose to leave, you aren't covered by an Claims Made policy for claims that patients make against you that you treated during that time period. Claims Made policies literally just cover you from Time A -> Time B, they don't cover you if a patient decides to sue you after the policy has expired. Occurrence policies are comprehensive (and hence more expensive). They cover you completely from all patients that you treat during a specified time period, including when/if patient's sue you after your policy term has concluded. Tail coverage is essentially closing the "gap" between Occurrence and Claims Made, I don't know how much it costs but if I had to guess it's likely in the thousands, probably more expensive than if you had just bought the Occurrence policy to begin with. PICA gives you an insurance discount your first year. Don't let your practice take advantage of it by getting you an even cheaper Claims Made policy. Ask for the money up front and use the discount to get yourself a Occurrence Policy which won't bite you in the ass when you inevitably decide to leave for greener pastures.

Edit: Got Claims Made and Occurrence backwards. Should be correct now.

 

[NatCh]

Congrats Air Bud. May everything fall into place.

I've been in private practice from the beginning and intend to stay this way until the lights go out so I'm asking purely out of curiosity -- when you guys "call the hospital to discuss employment," which person do you ask for?

[ring ring]

"St. Nowhere Medical Center, how may we help you?"

"Hello, may I please speak with __________________?"

 

[air bud]

Congrats Air Bud. May everything fall into place.

I've been in private practice from the beginning and intend to stay this way until the lights go out so I'm asking purely out of curiosity -- when you guys "call the hospital to discuss employment," which person do you ask for?

[ring ring]

"St. Nowhere Medical Center, how may we help you?"

"Hello, may I please speak with __________________?"

Honestly it's easier talking to head of medical staff at a hospital or head of the outreach clinic. But I have had luck directly with CEO from the start. The most recent one that I will probably decline I started with outreach coordinator. My current position was initially due to leaving message for the CEO directly.

And I am not saying Hospital employment is amazing and awesome. This Ortho group is private practice. It's just 2 hours away where I don't have a base. So I want some income guarantee and benefits stability as I transition. Hopefully in a year I am busy enough in my new location and can tell the hospital to f*** off and I will just come back one day a week as private person instead of being there two days a week and having to be away from my wife and child for a night each week. If the hospital would have said no, and I didn't have a different Hospital willing to give me a similar setup and I was forced to go 100 percent private - I ultimately would have been fine. Some more stress and financial insecurity but more freedom.

When myself and others talk about Hospital employment, it is really focused on new grads. You have loans, lack of security, lack of knowledge etc. That is who this is ideal for. Gets your loans paid off, get board cert, get some experience. Then do PP. Honestly there is zero chance I would stay employed if given the chance with near equal income/take home pay vs being in PP.

So if you really want to live in amazing city X in California because that is where you were born and raised and that is where your family is and you can go work as an associate and make 150 a year with high cost of living and take 15 years to pay off your loans...don't do it. Figure out how to go to dumpy city Y in northwest North Dakota where they will pay you 300k a year, you get board cert and low cost of living and loans paid off in 2 years living like a resident. Then go back to city X with no loans and some freedom. Short term sacrifice.

 

[air bud]

Excellent point. None of my attendings who reviewed my contract said anything about Claims Made vs. Occurrence. Nobody mentioned anything about Tail coverage. They just said make sure it's PICA and make sure it's a 1mil/3mil policy (1 million max per claim and 3 million max total). My contract specifically states that I am responsible for paying for Tail coverage if and when I choose to leave (likely this will be my first and last year at this practice depending on how some leads I'm pursuing turn out).

For new grads/residents/students reading this, let me break it down how it works a bit because nobody taught me this and I didn't learn this until it was too late (and any more senior attendings here please feel free to jump in and correct me if needed):

Malpractice insurance comes in occurrence and claims made policy. Claims Made is cheaper because it only covers claims made against you during a specific period of time (usually a year at a time). After that year, if you choose to leave, you aren't covered by an Claims Made policy for claims that patients make against you that you treated during that time period. Claims Made policies literally just cover you from Time A -> Time B, they don't cover you if a patient decides to sue you after the policy has expired. Occurrence policies are comprehensive (and hence more expensive). They cover you completely from all patients that you treat during a specified time period, including when/if patient's sue you after your policy term has concluded. Tail coverage is essentially closing the "gap" between Occurrence and Claims Made, I don't know how much it costs but if I had to guess it's likely in the thousands, probably more expensive than if you had just bought the Occurrence policy to begin with. PICA gives you an insurance discount your first year. Don't let your practice take advantage of it by getting you an even cheaper Claims Made policy. Ask for the money up front and use the discount to get yourself a Occurrence Policy which won't bite you in the ass when you inevitably decide to leave for greener pastures.

Edit: Got Claims Made and Occurrence backwards. Should be correct now.

Also PICA is a rip-off. Medpro and others. It's just that PICA advertises everywhere and we thing we are getting a deal because they are podiatry friendly. I have never seen a situation where PICA was cheaper for tail coverage.

 

[NatCh]

Also PICA is a rip-off. Medpro and others. It's just that PICA advertises everywhere and we thing we are getting a deal because they are podiatry friendly. I have never seen a situation where PICA was cheaper for tail coverage.

We're with The Doctors Company. When I first got to town I was told that I should use whichever company everyone else in the group uses, since if there is ever a lawsuit everyone gets a finger pointed at them and it's better if the malpractice company is consistent between providers so you don't have competing legal teams. Since everyone else here uses The Doctors Company so have I. They have a part-time rate adjustment too, so if you're only working half time or 3/4 time then they reduce your premiums accordingly. If any of you are just getting started in private practice and are only seeing enough patients to count as part time then it might be worth asking for a rate adjustment.

 

[air bud]

We're with The Doctors Company. When I first got to town I was told that I should use whichever company everyone else in the group uses, since if there is ever a lawsuit everyone gets a finger pointed at them and it's better if the malpractice company is consistent between providers so you don't have competing legal teams. Since everyone else here uses The Doctors Company so have I. They have a part-time rate adjustment too, so if you're only working half time or 3/4 time then they reduce your premiums accordingly. If any of you are just getting started in private practice and are only seeing enough patients to count as part time then it might be worth asking for a rate adjustment.

Yes med pro does a .5 part time adjustment. Probably knocks a few k off a year.

 

[air bud]

Here is an example of a quote for me. A few years out of residency for reference.

This for part time. I think only 2 or 3k less than full time.

Pretty crazy right? Now you know why they are offering associates a claims made policy. They are not responsible for the tail. F you if you leave not my problem.

Here is full-time

 

[SouthPod7]

Wow, I had no idea Tail was THAT expensive. If you choose to purchase Tail coverage do you have to buy it from the same company that insured you? Or could you shop around for the best rate?

 

[air bud]

Wow, I had no idea Tail was THAT expensive. If you choose to purchase Tail coverage do you have to buy it from the same company that insured you? Or could you shop around for the best rate?

As a general rule you get from the company that issued the original policy.

Has been discussed in other threads but there some states that have a state fund that cover your tail coverage. My first job I did not have to pay a 15k tail because of this state fund. Maybe this is an example where @dtrack22 would be pro government...

Also tails increase the first 5 years out and then plateau. Probably start around 10k first year. So that 24k would be my fifth year out. That is the reason for the jump and then plateau.

 

[NatCh]

That tail coverage is insane. I don't know what mine is and now I'm afraid to ask. I think they do have a policy for docs retiring who don't intend to ever return to practice so maybe that'll be less expensive? When I left OUM 20 years ago their tail coverage was 100% of my annual premium, not triple.

 

[air bud]

That tail coverage is insane. I don't know what mine is and now I'm afraid to ask. I think they do have a policy for docs retiring who don't intend to ever return to practice so maybe that'll be less expensive? When I left OUM 20 years ago their tail coverage was 100% of my annual premium, not triple.

this is obviously just one company. But I have a friend who left a private practice job after 3 years of being out of residency and he paid 17K with pica

 

[air bud]

But now you see what I'm talking about with the difference between policies. If you are going to a chop shop and there's a good chance you're not going to be there in 3 years then getting an occurrence versus a claims made is basically buying Insurance on your insurance. Would you rather spend an extra 5K now to save 15K or 10K later. In my case I am going to be 1099 for one year with the ortho group and then will be on their policy as a partner so it makes sense for me to just get a one year no strings attached policy and pay more

 

[dtrack22]

We're with The Doctors Company.

I think you stumbled upon a good choice

They were the cheapest in this area and offered similar benefits to PICA in terms of how they handle your coverage into retirement if you've been with them long enough. I have a claims made policy because the only way I'm changing malpractice carriers is if someone buys out my practice and forces me into a policy with the medical groups/hospital/etc. In that case they will be paying for any tail I would need. Doesn't make much sense to get an occurance policy once you are your own boss.

Oh, and the tail policy $ figures above are incredibly high. Mine was $5k from the podiatry associate job I left last year (through a random insurance broker). PICA had the highest quote at ~$10k. The $ above are probably for tail policies that last forever. Even though you pay one lump sum up front, and the tail policy only covers prior work, it still has its own expiration date. That's what PICA will sell you even though most states only allow patients to file a malpractice claim within 2-3 years of the procedure/event. You may have to pay attention to kids since they have until 18 typically, but nobody needs a tail policy that is active for 20 years.

 

[air bud]

I will check out doctors company.

Edit: oh this awesome company you are talking about? Just went to website to get a quote - like many many many companies....podiatry is not a choice in the drop down menu for chosen specialty. It required a specialty to get a quote, so I went with aerospace medicine.

 

[Naviculosity]

Hello everyone, I'm new-is here. Lurked a long time, you all have been really helpful over the years. This thread piqued my interest, I am graduating in July from residency. I'm currently in a large city but would love to be able to go to a more rural location as my city is very saturated. I'm debating opening my own practice vs cold calling Hospitals like you suggested Air Bud. So my questions are: these hospitals you are calling, are they owned by larger hospital systems? Seems even the rural ones here are owned by one of the large systems. If so do I call the recruiter/CEO/whoever for that specific location?

I'd also like to hear about any downsides to working for a Hospital other than the obvious production doesn't always equal $$$. COVID hit this area/state hard so I am a little worried about job opportunities going forward.

Thank you again to you all for posting, it really does help answer a lot of questions.

 

[deleted690619]

During the call to the CEO or CMO what are you saying during that initial call? Are we talking collection cabalities? Why podiatry is dandy etc or? What’s causing the employers to take further action?

 

[PikminOC]

I learned alot from this. 200k and benefits is more than some physicians make. And your mp insurance is expensive!

 

[air bud]

I learned alot from this. 200k and benefits is more than some physicians make. And your mp insurance is expensive!

That was just one quote. Working on some others. That was more instructive to show difference between claims made and occurrence. Welcome!

 

[air bud]

During the call to the CEO or CMO what are you saying during that initial call? Are we talking collection cabalities? Why podiatry is dandy etc or? What’s causing the employers to take further action?

A lot of it is literally just education. Again, nobody has any idea what we do. Remember the key is critical access Hospitals that is where and surgical specialty is very very valuable. You will run into a few scenarios.

1. I have been at other Hospitals before and podiatry was very profitable for the hospital and he/she was very busy.
-A: we have though about employing one but haven't looked into it yet
Great I am interested in being that podiatrist for your community.
B: we have thought about it but do t think we are busy enough to support one full time.
Have you thought about having someone part time that would be able to provide all the services your community needs in a few days a week?

2. I am not familiar with podiatry
- great. I am trained to do everything from fixing bunions and hammertoes to ankle surgery and flatfoot correction. I can take care of all the lower extremity wounds that are probably being done in your physical therapy dept. ( PT does a lot of wound care in rural locations). A lot of those need different surgical procedures to prevent amputations and significant disability. I also do nail care and callous care for at risk individuals that are probably being done by community health right now and could be better served by a specialist who can prevent infections and complications within the community. I am also trained to do lower extremity trauma, which I am sure overlaps with your orthopedic specialist, but we are able to work together to provide the best care for the local community AND CAN USUALLY PREVENT ANYONE FROM HAVING TO BE SHIPPED OUT TO A LARGER HOSPITAL.

3. we don't need a podiatrist.
- see number two plus add in stuff about facility fees for outpatient visits and surgery

Still don't need a podiatrist
- see 1B


You don't win them all. There is a government website that lists all critical access hospitals.in the US.

Each state has a Hospital association that lists all hospitals in the state. Start there. Pick up the phone.

 

[air bud]

Repeat nobody has any idea what we do. Not everyone grew up on Long Island and had an Uncle Murray that was a podiatrist. Education. In theory our professional organizations would do this...
Think of all the states in flyover country that have no schools and no residencies. How are they being exposed to podiatry? They are not. Not every city is like Detroit or Miami or Philadelphia with a pod on every corner.

 

[Weirdy]

A lot of it is literally just education. Again, nobody has any idea what we do. Remember the key is critical access Hospitals that is where and surgical specialty is very very valuable. You will run into a few scenarios.

1. I have been at other Hospitals before and podiatry was very profitable for the hospital and he/she was very busy.
-A: we have though about employing one but haven't looked into it yet
Great I am interested in being that podiatrist for your community.
B: we have thought about it but do t think we are busy enough to support one full time.
Have you thought about having someone part time that would be able to provide all the services your community needs in a few days a week?

2. I am not familiar with podiatry
- great. I am trained to do everything from fixing bunions and hammertoes to ankle surgery and flatfoot correction. I can take care of all the lower extremity wounds that are probably being done in your physical therapy dept. ( PT does a lot of wound care in rural locations). A lot of those need different surgical procedures to prevent amputations and significant disability. I also do nail care and callous care for at risk individuals that are probably being done by community health right now and could be better served by a specialist who can prevent infections and complications within the community. I am also trained to do lower extremity trauma, which I am sure overlaps with your orthopedic specialist, but we are able to work together to provide the best care for the local community AND CAN USUALLY PREVENT ANYONE FROM HAVING TO BE SHIPPED OUT TO A LARGER HOSPITAL.

3. we don't need a podiatrist.
- see number two plus add in stuff about facility fees for outpatient visits and surgery

Still don't need a podiatrist
- see 1B


You don't win them all. There is a government website that lists all critical access hospitals.in the US.

Each state has a Hospital association that lists all hospitals in the state. Start there. Pick up the phone.

I'm surprised you're sharing the good stuff and even spelling it out for us sir.

Most people would sit on this until their death bed.

 

[air bud]

I'm surprised you're sharing the good stuff and even spelling it out for us sir.

Most people would sit on this until their death bed.

Don't come near my territory I will bury you.

 

[air bud]

In the case of 1B . A night or two away from the family and a long drive is what happens. But it's not a big deal in some areas of the country. I drive 3 hours just to go to Target. I will jump in the car Tuesday morning, drive 2 hours, stay overnight probably either a call room or hotel, don't really want to share a room at the hospital owned houses that anesthesia uses. See patients again Wednesday then turn around a drive back. I can do that. Might do this other gig one day a week on a Friday as well while I build up with ortho. Then. In 6 months can decide who I want to keep. Do I want to drive multie days of the week forever? No, but it what has to be done when dealing with rural medicine.

Hell even our ortho has multiple locations that are three hours away. Of course he just flys to each one...

 

[CutsWithFury]

I'm surprised you're sharing the good stuff and even spelling it out for us sir.

Most people would sit on this until their death bed.

Doesn’t matter. Most residency grads will still screw it up.

Secondly a lot of these hospital gigs want DPMs with experience. If they are going to create a new position and take a chance they want someone who doesn’t need their hand held with billing, performing surgery, coordinating care and who is able to professionally communicate with other doctors. Those are the pillars of any good hospital practice. If you can’t do one or more you ultimately won’t be getting a new contract and in the grand scheme of things the hospital “failed” in getting the right podiatrist. Every time one doctor leaves and another doctor gets onboarded there will be a block of time where the hospital is not making any money. Then it takes awhile for the new doctor to ramp up in terms of business.

 

[air bud]

Doesn’t matter. Most residency grads will still screw it up.

Secondly a lot of these hospital gigs want DPMs with experience. If they are going to create a new position and take a chance they want someone who doesn’t need their hand held with billing, performing surgery, coordinating care and who is able to professionally communicate with other doctors. Those are the pillars of any good hospital practice. If you can’t do one or more you ultimately won’t be getting a new contract and in the grand scheme of things the hospital “failed” in getting the right podiatrist. Every time one doctor leaves and another doctor gets onboarded there will be a block of time where the hospital is not making any money. Then it takes awhile for the new doctor to ramp up in terms of business.

This. Experience as in running a clinic, knowing basics of coding, how to keep patients happy. You don't need to be gods gift to podiatry, just a few years of experience of cutting on people and not being sued.

Also number one is having ties to a region. I know not everyone was born in northwest North Dakota, but if you love to fish and hunt and off-road....great that is enough for them to think you will stick around.

 

[air bud]

Doesn’t matter. Most residency grads will still screw it up.

Secondly a lot of these hospital gigs want DPMs with experience. If they are going to create a new position and take a chance they want someone who doesn’t need their hand held with billing, performing surgery, coordinating care and who is able to professionally communicate with other doctors. Those are the pillars of any good hospital practice. If you can’t do one or more you ultimately won’t be getting a new contract and in the grand scheme of things the hospital “failed” in getting the right podiatrist. Every time one doctor leaves and another doctor gets onboarded there will be a block of time where the hospital is not making any money. Then it takes awhile for the new doctor to ramp up in terms of business.

And you don't even need to do all 4 really well. @CutsWithFury only does 3 out of those 4

 

[CutsWithFury]

And you don't even need to do all 4 really well. @CutsWithFury only does 3 out of those 4

He’s not wrong.

 

[NatCh]

Uncle Murray! Haha.

 

[PikminOC]

That was just one quote. Working on some others. That was more instructive to show difference between claims made and occurrence. Welcome!

I pay for occurrence

 

[air bud]

I pay for occurrence

Care to explain you reason for doing so? I think this stuff is instructive especy to the rather young crowd on this forum

 

[air bud]

We're with The Doctors Company. When I first got to town I was told that I should use whichever company everyone else in the group uses, since if there is ever a lawsuit everyone gets a finger pointed at them and it's better if the malpractice company is consistent between providers so you don't have competing legal teams. Since everyone else here uses The Doctors Company so have I. They have a part-time rate adjustment too, so if you're only working half time or 3/4 time then they reduce your premiums accordingly. If any of you are just getting started in private practice and are only seeing enough patients to count as part time then it might be worth asking for a rate adjustment.

Changing lives @NatCh , changing lives.

Got a quote for them and it's like 2k no tail for part time.

 

[NatCh]

Changing lives @NatCh , changing lives.

Got a quote for them and it's like 2k no tail for part time.

AWESOME!