Podiatrists and Surgery

[hawaiinchick]

I was wondering if someone could provide me with some insight into this.

I will be starting pod school in the fall. Although I still have a lot to learn in pod school and a lot of options to still explore, i believe right now I'm primarily interested in the surgical aspect of this field. I was wondering how heavily one can focus on surgery as a podiatrist? If I wanted to , could I JUST do surgery ? Or will you naturally be practicing (mandatorily) in other settings as well?

---

Members don't see this ad.

 

[OhEmGee]

No, if you just do surgery how will you find patients to do surgery on? I guess you can have some rare exception, that I am sure someone will point out, about some guy who is affiliated with some high volume residency program that just funnels cases to him and he does surgery 4-5 days a week...but that is not the norm. I would say most of the attendings I worked with at residency programs had one day a week that they did a majority of their cases. Occasionally they would have a second day or an add on when they were taking call.

 

[Comminuted]

And you'll come to realize that surgery doesn't make the money...it's what you do outside the OR that brings the $$.

 

[ManUnderFire]

From a Canadian perspective....Orthotics. They cost anywhere from $100-150 to manufacture, but you sell for $450-550. The entire process (initial consult: screening, testing, molding, and follow-up) takes about 1.5hrs, although I'm sure a seasoned Pod can do it under 1-hr. So, roughly a gain of 300 bones (per patient) not including consultation fees (varies widely from $80-120). They are usually good for 1-2 years...which means that although they generate a good rate of return, the real profit comes from bulk prescription. I recently visited a relatively low key practice (about 15 patients/day) on an 'average' volume day (so I was told). Pod prescribed 6 orthotics in the 4 hours I was there. Conservatively speaking, he made about $2280 (380/patient) that day from orthotics alone. And when done right, a custom orthotic can be the difference between walking in agony and running pain free. Podiatry isn't just correcting Lis-Franc displacements. I've heard biomech isn't a major part of the curriculum in the US, but it's something to look into. Food for thought.

 

[dyk343]

Can someone show me a REAL study that back orthotics for musculoskeletal pain?

 

[ManUnderFire]

Can someone show me a REAL study that back orthotics for musculoskeletal pain?

http://www.humankinetics.com/acucustom/sitename/Documents/DocumentItem/12015.pdf

Found this one. One of the few 'free' ones worth reading.

I will say, the literature seems divided on the issue. And with a relatively small number of quality studies (with a wide scope) on the subject, it would be difficult (and perhaps futile) to perform a meta-analysis. And yes, orthotics is not the solution for most LE injuries/pain but they still remain a viable option for some issues...hyperpronation of STJ, for example.

 

[heybrother]

That's feels like "expert opinion" masquerading as a study.

 

[ManUnderFire]

Found this. Feedback?

 

[Governor]

Can someone show me a REAL study that back orthotics for musculoskeletal pain?

Two that come to mind:

Woodburn J, Barker S, Helliwell PS. A randomized controlled trial of foot orthoses in rheumatoid arthritis. J Rheumatol. 2002 Jul;29(7):1377-83.

Burns J, Crosbie J, Ouvrier R, Hunt A. Effective orthotic therapy for the painful cavus foot: a randomized controlled trial. J Am Podiatr Med Assoc. 2006 May-Jun;96(3):205-11.

 

[g squared 23]

The busiest surgical Podiatrist I've seen operates five 1/2 days a week, and then all his clinic is post-ops and surgical consults. That particular doctor is in a Podiatry "mega-group" and gets consults from other members in the group who only do the basic operations (HAV/HTs). He states that he is actually one of the lowest producers in the group as far as revenue goes, but he enjoys the operating room and challenging himself with complex deformities.

This is an incredibly unique situation, the docs I've seen in an ortho group typically have 2 surgery days, and 3 clinic days. Most podiatrists I know have one dedicated OR day, and then an extra half day during the busy holiday rush.

So the odds of being a "primarily surgical" podiatrist are not fantastic, but there's always a possibility given you end up in the right situation.

 

[AttackNME]

I was wondering if someone could provide me with some insight into this.

I will be starting pod school in the fall. Although I still have a lot to learn in pod school and a lot of options to still explore, i believe right now I'm primarily interested in the surgical aspect of this field. I was wondering how heavily one can focus on surgery as a podiatrist? If I wanted to , could I JUST do surgery ? Or will you naturally be practicing (mandatorily) in other settings as well?

why don't you spend some time shadowing a doc who does have a high volume of surgery and see what it's like. you'll also get a better sense of this as you're doing externships on your 3rd and 4th year.