podiatry job..

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I don't think newankle has to only hire I DPM if his state allows him to hire a NP. It's not his fault the state allows NPs to do the same thing a DPM can do. I don't think it's a big deal what the pod does, especially of he tells you up front.

Kidsfeet, your post about the hired pod getting jealous of the employers "sexy" work seems silly because he knew what he was hired for. Maybe your a pod that does like to do surgery. Maybe you know you suck at surgery so you just wanna do nails from 9-5. I don't have less respect for this type of podiatrist, even if a DNP can do these same things. If someone paid me 130k a year to clip nails, wound care, and fit inserts, and I wasn't all that into surgery, you better believe I'd be excited about it.
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MaxillofacialMN said:
It's not his fault the state allows NPs to do the same thing a DPM can do.
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The state allows NPs to work under the direct supervision of a Doctor. So Newankle can be in the office seeing his post ops while the NP is cutting toenails in the room next to his "under his supervision", even though he is not technically performing the treatment BUT can bill for it. NPs can not function independently on their own. This can be VERY much abused. I've seen it. See the difference here?
 
MaxillofacialMN said:
Maybe you know you suck at surgery so you just wanna do nails from 9-5. I don't have less respect for this type of podiatrist, even if a DNP can do these same things.
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So why go through all that school and incur all that debt? Study to be an NP and work for a Podiatrist.
 
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Kidsfeet said:
So why go through all that school and incur all that debt? Study to be an NP and work for a Podiatrist.
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You might have to actually work as a NP. As a NP, the odds of finding a gig of getting paid 100k to clip toenails is probably pretty rare. As a podiatrist, working in a nursing home making ~100k cutting toenails probably wouldn't be all that unheard of.

A friend of mine went to pharm school so that he could work about 30 hours a week, make a fairly decent living, and pursue his real passion: music. He knew he could never have a great lifestyle as a jazz clarinetist (and drummer), but working 30 hours a week as a pharmacist provided it. He wasn't interested in doing anything profound with pharmacy and pharmacy wasn't his passion.

I guess all I'm saying is that I don't look down upon podiatrists who use podiatry as a job, and are not trying to become leaders or open wildly successful practices. For some people podiatry might just be a means to an end.

That's not me though. Look for my name as APMA president in about 30 years. :laugh::laugh:
 
Kidsfeet said:
The state allows NPs to work under the direct supervision of a Doctor. So Newankle can be in the office seeing his post ops while the NP is cutting toenails in the room next to his "under his supervision", even though he is not technically performing the treatment BUT can bill for it. NPs can not function independently on their own. This can be VERY much abused. I've seen it. See the difference here?
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Yeah I see the difference, but I am usually a fan of loopholes and bending the rules. If you are going to put all these regulations on the way I practice, you better believe I'm going to look for a loophole to exploit the system. ;)
 
MaxillofacialMN said:
Kidsfeet, your post about the hired pod getting jealous of the employers "sexy" work seems silly because he knew what he was hired for. Maybe your a pod that does like to do surgery. Maybe you know you suck at surgery so you just wanna do nails from 9-5. I don't have less respect for this type of podiatrist, even if a DNP can do these same things. If someone paid me 130k a year to clip nails, wound care, and fit inserts, and I wasn't all that into surgery, you better believe I'd be excited about it.
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:thumbup:
 
MaxillofacialMN said:
If someone paid me 130k a year to clip nails, wound care, and fit inserts, and I wasn't all that into surgery, you better believe I'd be excited about it.
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Sorry to burst your bubble, but no one in their right mind would pay you that much to ONLY do those things. Look around. You'll see. I don't care what Newankle thinks he can pay you.
 
MaxillofacialMN said:
I don't think newankle has to only hire I DPM if his state allows him to hire a NP. It's not his fault the state allows NPs to do the same thing a DPM can do. I don't think it's a big deal what the pod does, especially of he tells you up front.

Kidsfeet, your post about the hired pod getting jealous of the employers "sexy" work seems silly because he knew what he was hired for. Maybe your a pod that does like to do surgery. Maybe you know you suck at surgery so you just wanna do nails from 9-5. I don't have less respect for this type of podiatrist, even if a DNP can do these same things. If someone paid me 130k a year to clip nails, wound care, and fit inserts, and I wasn't all that into surgery, you better believe I'd be excited about it.
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:love:
 
Kidsfeet said:
Sorry to burst your bubble, but no one in their right mind would pay you that much to ONLY do those things. Look around. You'll see. I don't care what Newankle thinks he can pay you.
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You are wrong. A former classmate of mine was offered a little over $120k out west to do exactly that in a larger than average pod group.
 
You're right. Never mind.

I'm giddy when I think about all of you entering into the job market with your expectations. Good luck.
 
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Talk about fulfilling! That's the sort of stuff I dream of, when I see all the external/internal fixation lectures, and trauma lectures, and while practicing suturing.

I really just wanna get paid the big bucks to clip some big ol' nasty yellow toenails.

If only they would let me disimpact some bowels while I was at it, that would be the dream job.
 
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I'm confused... Is this sarcasm bob? :D Kidsfeet, lighten up bro! You may be Canadian, but that doesn't ALWAYS mean you have the answers lol. Other people have opinions too. Heck, if you can deal with me, you SURELY have the moxie to agree dtrack has a lot of valid points.
 
dtrack22 said:
How come you can't accept or respond like an adult when someone has an experience different than your own?
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How come you don't realize that just because you know ONE guy who did something different, you think it will happen to you?

I've been around dtrack, and speak from experience which neither you nor Rocky have. You expect me to take what you say at face value because you heard of some guy who...please.

How many people do you know in this profession who are in a position to do the hiring? I know many, and NONE of them can offer what Rocky says this guy is making "out west".

I wonder if that dude that Rocky knows getting $120K lives in Cali and if he or she is actually making a living on that pay?

Like I said, I'm done with the "pissing match". Believe what you want. I'm happy and comfortable and making out just fine thank you very much. You can't convince me you're right just like I can't seem to convince you that my experience has more value than your "one guy who..."
 
SuperFeisty said:
I'm confused... Is this sarcasm bob? :D Kidsfeet, lighten up bro! You may be Canadian, but that doesn't ALWAYS mean you have the answers lol. Other people have opinions too. Heck, if you can deal with me, you SURELY have the moxie to agree dtrack has a lot of valid points.
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See my above comment. If you look at both dtrack and Rocky's track record THEY seem to think they have the answers even though they haven't had any real world life experience in this realm. They talk about "some guy I knew who...", which doesn't add any validity in my eyes.

The other thing that really peeves me is that I've also added some valuable content, but both of them (and not just in this thread) start nit picking and DON'T respond to some of the things that they say that are challenged. They deflect when they are wrong and then go on and on about their "one guy who..." Play devil's advocate all you want guys. When it slaps you in the face maybe you'll hear me in the background laughing, pointing and screaming "I told you so!". (Immature I know, right?).

Reminds me of my damn kids...
 
Kidsfeet said:
If you look at both dtrack and Rocky's track record
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You'll be hard pressed to find anyone with a cleaner track record than dtrack22. A few others that come into mind are RockyIV, Feli, Jonwill, and Podfather.
 
Kidsfeet, it's not your responsibility to help everyone make the "right" choices. All you can do is calmly provide your opinion. Whether or not they choose to accept it or dtrack and rocky's advice should be up to them. I can only say you would be a fool to not thoroughly research the position. This is not an "i told you so because I know more than you" forum. It's the OP's decision. He/she would also be stupid to completely ignore an attending with years of experience. But he/she would also be stupid to only listen to 1 source on an anonymous forum.
 
bobdolerson said:
Talk about fulfilling! That's the sort of stuff I dream of, when I see all the external/internal fixation lectures, and trauma lectures, and while practicing suturing.

I really just wanna get paid the big bucks to clip some big ol' nasty yellow toenails.

If only they would let me disimpact some bowels while I was at it, that would be the dream job.
Click to expand...

I guess I'm in the minority I never pictured myself as a big time surgeon. I went to podiatry school to prevent amputations and treat diabetics. I don't see a job like that as insulting. I would love to find a job I'm primarily doing wound care and primary podiatry with a little surgery. :love:
 
Kidsfeet said:
I wonder if that dude that Rocky knows getting $120K lives in Cali and if he or she is actually making a living on that pay?
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Oregon. And she's a she. Wanted the hours for her child and for some crazy reason likes wound care.

The point that you continue to miss is that most of your posts are in absolutes. Look no further than your post about nail and wound care salary. You stated "nobody", i simply provided "somebody" who did. If your limited experience is different than someone with even less experience then they are obviously wrong and you are clearly right. I simply provide equally real examples that contradict yours, because lets be honest, there are few to no attendings LEFT on this site who will do it. If people were only able to read your opinion, especially regarding our current education, training, and job opportunities for new grads, I'm afraid they would be getting short changed. Most of my experience in these areas in particular, are much more recent than yours and because of that probably more accurate.

In most cases I could provide numerous examples of my "stories"/"experiences", but that has never mattered to you anyways. And don't get me started on "selectively" answering questions. You did it multiple times in this thread alone.

As for the "pissing match", you will never be done with it because there has never been a thread on these forums where you havent gotten the last word.
 
Now it's time for me to chime in on this subject.

I have no problem with newankle delegating any responsibilities or duties to a new associate, especially if they are duties new ankle presently isn't performing. It is an opportunity for him to grow the practice in another direction, and offer services not previously offered.

However, I do have an issue with saying that duties can be performed by a new DPM or CRNP. I find that slightly insulting and don't personally believe that a DPM with residency training is on the same playing field as a CRNP.

I also don't believe the nursing home jobs you see advertised and new ankles hypothetical job is really a valid comparison. Those signing up for these mega-nursing home companies, have to realize that they will be treating patients in facilities, and not performing surgery, not going to the hospital, not performing consults, not seeing patients in the office, etc.

These companies pay very well and offer great benefits, because they are billing HUGE numbers, and billing very aggressively per visit. The new hire will be required to see as many patients that can be scheduled daily as possible, and the new hire is expected to do more than just palliative care. These companies aggressively perform non invasive vascular studies, ultrasounds, recommend expensive bracing (Richie Braces/Arizona Ankles, etc.) and as a result, bring in big bucks. They "justify" their existence by routinely recommending and performing vascular studies to "prove" these patients have PVD, therefore necessitating palliative care routinely. These jobs 'ain't about just clippin' nails. They are VERY aggressive with procedures and billing.

So I have no problem with newankle's proposal, as long as it involves hiring a DPM, because I don't believe hiring a CRNP will replace any quality DPM. They simply are not the same.

And one last note. I've GOT to bust Kidsfeet's balls just a little. I had a long day today, with barely enough time to grab some food during my 10 hour day. I saw quite a few patients, and 14 new patients today, and that's why I didn't have time to "relax".

Yet I see that Kidsfeet posted at: 9:23. 9:40, 10:50, 11:37, 12:30, 1:26, 2:29, 3:02, 3:03, 3:04, 3:13, 3:26, 3:36, 4:02, 4:18, 4:17 and finally at 6:44 (I guess he was home by then).

I'm a little envious that Kidsfeet has THAT much time during the day to dedicate to posting on this site.......I wonder what his employers would think of that much online "action"????????????????
 
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PADPM said:
Now it's time for me to chime in on this subject.

I have no problem with newankle delegating any responsibilities or duties to a new associate, especially if they are duties new ankle presently isn't performing. It is an opportunity for him to grow the practice in another direction, and offer services not previously offered.

However, I do have an issue with saying that duties can be performed by a new DPM or CRNP. I find that slightly insulting and don't personally believe that a DPM with residency training is on the same playing field as a CRNP.

I also don't believe the nursing home jobs you see advertised and new ankles hypothetical job is really a valid comparison. Those signing up for these mega-nursing home companies, have to realize that they will be treating patients in facilities, and not performing surgery, not going to the hospital, not performing consults, not seeing patients in the office, etc.

These companies pay very well and offer great benefits, because they are billing HUGE numbers, and billing very aggressively per visit. The new hire will be required to see as many patients that can be scheduled daily as possible, and the new hire is expected to do more than just palliative care. These companies aggressively perform non invasive vascular studies, ultrasounds, recommend expensive bracing (Richie Braces/Arizona Ankles, etc.) and as a result, bring in big bucks. They "justify" their existence by routinely recommending and performing vascular studies to "prove" these patients have PVD, therefore necessitating palliative care routinely. These jobs 'ain't about just clippin' nails. They are VERY aggressive with procedures and billing.

So I have no problem with newankle's proposal, as long as it involves hiring a DPM, because I don't believe hiring a CRNP will replace any quality DPM. They simply are not the same.

And one last note. I've GOT to bust Kidsfeet's balls just a little. I had a long day today, with barely enough time to grab some food during my 10 hour day. I saw quite a few patients, and 14 new patients today, and that's why I didn't have time to "relax".

Yet I see that Kidsfeet posted at: 9:23. 9:40, 10:50, 11:37, 12:30, 1:26, 2:29, 3:02, 3:03, 3:04, 3:13, 3:26, 3:36, 4:02, 4:18, 4:17 and finally at 6:44 (I guess he was home by then).

I'm a little envious that Kidsfeet has THAT much time during the day to dedicate to posting on this site.......I wonder what his employers would think of that much online "action"????????????????
Click to expand...


Yes, yes, yes... I was amazed to see just now that there have been over 50 posts since my comments just before I started seeing patients this morning. I understand that students and maybe residents have time during the day to post but damn Kidsfeet... It's not like you just sat down and busted out a bunch of replies in rapid fire but you had an online battle ALL DAY! I hope you're on vacation or at a conference this week with all that free time. I was so busy seeing patients today I didn't even have time to eat lunch, or my young as you imply. And all this talk about this proposed job you have assumed refers to me hiring someone just out of residency but I never stated that. There are many podiatrists looking for jobs that are not right out of residency.
 
PADPM said:
However, I do have an issue with saying that duties can be performed by a new DPM or CRNP. I find that slightly insulting and don't personally believe that a DPM with residency training is on the same playing field as a CRNP
Click to expand...

Ok, serious question. Would you have the same issue if CRNP was replaced with PA? I guess I'm trying to understand wether the issue is with NP's being able to performs these duties or with someone hiring a DPM to only perform these duties (like its a waste of training) or both? And what about a Pod who doesn't have training to do anything other than what newankle was asking about? I know you know of a few of those. I shadowed "one" but that no longer means anything, however, I think we all know they exist. Would you have the same objection if the employer was looking to hire a DPM who had little to no training and is not or cannot be ABPS cert? Like I said, just trying to understand the objection.

I guess I've never thought of the post as saying that a CRNP is on the same playing field with a DPM grad, rather that the duties he's asking to be covered could be performed by both and he's looking for any way he can add these services to his practice (and presumably make $). I equated it to a Dermatologist hiring a PA to take care of all of his mole/wart removal, punch biopsies, topical skin treatments, etc. I wouldn't think it would be as big of a deal as some people on here have made it out to be. But I could be missing something or incorrectly equating it to the scenarios I'm picturing in my head.
 
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PADPM said:
Now it's time for me to chime in on this subject.

I have no problem with newankle delegating any responsibilities or duties to a new associate, especially if they are duties new ankle presently isn't performing. It is an opportunity for him to grow the practice in another direction, and offer services not previously offered.

However, I do have an issue with saying that duties can be performed by a new DPM or CRNP. I find that slightly insulting and don't personally believe that a DPM with residency training is on the same playing field as a CRNP.

I also don't believe the nursing home jobs you see advertised and new ankles hypothetical job is really a valid comparison. Those signing up for these mega-nursing home companies, have to realize that they will be treating patients in facilities, and not performing surgery, not going to the hospital, not performing consults, not seeing patients in the office, etc.

These companies pay very well and offer great benefits, because they are billing HUGE numbers, and billing very aggressively per visit. The new hire will be required to see as many patients that can be scheduled daily as possible, and the new hire is expected to do more than just palliative care. These companies aggressively perform non invasive vascular studies, ultrasounds, recommend expensive bracing (Richie Braces/Arizona Ankles, etc.) and as a result, bring in big bucks. They "justify" their existence by routinely recommending and performing vascular studies to "prove" these patients have PVD, therefore necessitating palliative care routinely. These jobs 'ain't about just clippin' nails. They are VERY aggressive with procedures and billing.

So I have no problem with newankle's proposal, as long as it involves hiring a DPM, because I don't believe hiring a CRNP will replace any quality DPM. They simply are not the same.

And one last note. I've GOT to bust Kidsfeet's balls just a little. I had a long day today, with barely enough time to grab some food during my 10 hour day. I saw quite a few patients, and 14 new patients today, and that's why I didn't have time to "relax".

Yet I see that Kidsfeet posted at: 9:23. 9:40, 10:50, 11:37, 12:30, 1:26, 2:29, 3:02, 3:03, 3:04, 3:13, 3:26, 3:36, 4:02, 4:18, 4:17 and finally at 6:44 (I guess he was home by then).

I'm a little envious that Kidsfeet has THAT much time during the day to dedicate to posting on this site.......I wonder what his employers would think of that much online "action"????????????????
Click to expand...
I guess this is why I want to either own my own practice or be a partner...everywhere I look and it seems all the people I shadow at some point bring up how much their urged to sell sell sell and bill bill bill.

I got enough of that crap with morning pep talks at Best Buy, and it would be nice to be in a place where the patient comes first (haha, I'm so naive, I know, I'm laughing to myself a little bit), or at the very least the guy in charge isn't pushing me to perform procedures/tests that aren't necessary.

Can some of you practicing folks chime in here, is that something I'm going to face anywhere if I'm not the one in charge? Is that something I'm going to have to do as the guy in charge to stay solvent? I'm all for jerking the government around and getting back my tax dollars, but not at the patients expense, ya' know?
 
RockyIV said:
As for the "pissing match", you will never be done with it because there has never been a thread on these forums where you havent gotten the last word.
Click to expand...

That was a good one!
:laugh::eek:
 
dtrack22 said:
Ok, serious question. Would you have the same issue if CRNP was replaced with PA? I guess I'm trying to understand wether the issue is with NP's being able to performs these duties or with someone hiring a DPM to only perform these duties (like its a waste of training) or both? And what about a Pod who doesn't have training to do anything other than what newankle was asking about? I know you know of a few of those. I shadowed "one" but that no longer means anything, however, I think we all know they exist. Would you have the same objection if the employer was looking to hire a DPM who had little to no training and is not or cannot be ABPS cert? Like I said, just trying to understand the objection.

I guess I've never thought of the post as saying that a CRNP is on the same playing field with a DPM grad, rather that the duties he's asking to be covered could be performed by both and he's looking for any way he can add these services to his practice (and presumably make $). I equated it to a Dermatologist hiring a PA to take care of all of his mole/wart removal, punch biopsies, topical skin treatments, etc. I wouldn't think it would be as big of a deal as some people on here have made it out to be. But I could be missing something or incorrectly equating it to the scenarios I'm picturing in my head.
Click to expand...

I personally believe we are going down a slippery slope when we start delegating traditional "podiatric" duties to an NP, PA or anyone else. Part of what even well trained DPM's do on a regular basis involves these duties. I know of no PA or NP who really has training in the foot/ankle. What has always made our profession unique is the wide range of services we offer our patients.

I assure you, I am more than busy, yet have trimmed nails on a patient and have performed major reconstructive surgery on that patient's spouse. Part of the way I build my portion of the practice is referrals from ALL types of patients. That ingrown nail patient can often refer that rearfoot surgery patient, etc., etc.

Our profession is also unique that there are presently different levels of practitioners. Those who "do it all", those with surgical training who now are predomintely surgeons and those who perform more palliative care via choice or via lack of training. These docs still have a 4 year podiatric background as well as residency, and I believe hiring these docs is the wiser choice and is ultimately better for the patient. Yes, you can teach a monkey to cut nails, or execute a surgical procedure, but that doesn't mean the monkey understands what's really going on. Now I'm not attempting to insult a PA or NP, but their background simply does not allow them to have the same knowledge of the foot and ankle as a DPM. And the value of that degree is the understanding that a dark nail may not be a subungual hematoma, but may be a subungual melanoma. That "wart" that isn't healing or resolving may be a squamous cell carcinoma, etc.

I believe when we begin delegating too much to "others" we trivialize the importance of the basics of our profession. And to understand the complicated, you first have to understand the basics.
 
FiveOVicryl said:
You'll be hard pressed to find anyone with a cleaner track record than dtrack22. A few others that come into mind are RockyIV, Feli, Jonwill, and Podfather.
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slow down bro. dtrack is not that cool. That is some rare air there, dtrack still has his training wheels.
 
He's okay. I mean...he's no bobdolerson....now that guy....he knows his stuff.

You'd be hard pressed to find a first year that knows more about interviewing at DMU last year in early November than that guy.
 
Who? This is the land of anonymity and free expression without consequence. Easy on the name drops :)
 
I had a "slow" day and "only" saw about 25 patients yesterday (along with helping to see one of the other associates in the practices' patients) and spent time with each and every one of them to their satisfaction. I also did rounds and scheduled a rather interesting case of a patient I did a sesamoidectomy on a few months ago, due to a chronic submet ulcer and fractured his toe over the week and developed septic arthritis.

I type and think quickly. Sue me.

That being said, I hope I've given all of you things to think about over the last couple of years with my postings, but I'm done here. As PADPM pointed out, I think my employers would rather I DON'T spend anytime here, especially since some of you are so fond of "outing" those that are honestly trying to stay anonymous and helpful. I have MUCH better things to do with my time both during my day at the office and at home with my family.

Adieu.
 
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Hey Kidsfeet, people gang up on me all the time with some of the crazy things I say on here, you just gotta move forward! I'm sure none of us should be on here - we all have things that we could be doing to make us better, but like strip-clubs, SDN is a guilty pleasure.

As for knowing who you are, I also tried googling searching you using select phrases knowing a lot about your school, background etc, and i couldn't find you either, so... You might want to reconsider the whole, "everyone knows who I am" schtick and therefore can contact me if they want. I consider myself pretty adept at google and an extremely proficient Internet creep, and if I couldn't select you with 100% certainty, there won't be many who can.

In other words, sit back in your chair, put some ones on the stage and continue to get the sweet lap-dance that SDN provides.
 
MaxillofacialMN said:
Hey Kidsfeet, people gang up on me all the time with some of the crazy things I say on here, you just gotta move forward! I'm sure none of us should be on here - we all have things that we could be doing to make us better, but like strip-clubs, SDN is a guilty pleasure.

As for knowing who you are, I also tried googling searching you using select phrases knowing a lot about your school, background etc, and i couldn't find you either, so... You might want to reconsider the whole, "everyone knows who I am" schtick and therefore can contact me if they want. I consider myself pretty adept at google and an extremely proficient Internet creep, and if I couldn't select you with 100% certainty, there won't be many who can.

In other words, sit back in your chair, put some ones on the stage and continue to get the sweet lap-dance that SDN provides.
Click to expand...

Actually, if I were him, I would very much consider resigning from this place and if he so desires to come back, to do so under a different name and perhaps an entirely different "persona".

From the person who so carelessly posted a name, previous location and current location, I easily found his practice, his former practice, his profile, and his picture. The internet is a terrifying place.

That wasn't cool at all.

Anyway, to Mr. Whoever you are, good luck in your endeavors, and I hope the years are kind to you as a DPM. I appreciate the advice of anyone who gives it, and you were no exception.
 
MaxillofacialMN said:
I consider myself pretty adept at google and an extremely proficient Internet creep, and if I couldn't select you with 100% certainty, there won't be many who can.
Click to expand...

Once you get into the nest (you know, the trust tree) you will figure out who most of the people posting on here are. Most of the pod students and residents know who one another are, and know who the attendings are. That being said, when you do find out who somebody is, be a normal human being and don't "out" them and drive them off the forums. That's just not cool (well, in most cases it's not cool...sometimes it's awesome).

There is one though...very elusive...nobody has figured it out...yet
 
Wow guys, i was trying to be nice and encouraging to KF....
 
Nonono, I don't mean as far as someone spending time here; I would appreciate it if he would stay, and welcome the advice and guidance of people in positions farther down the line than I in this path.

I simply mean that sometimes when you're outed, it's better to leave that name in the dust and start anew.

I thought the strip club analogy was good.
 
especially since some of you are so fond of "outing" those that are honestly trying to stay anonymous and helpful.
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i
 
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