JoeNamaMD

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I heard there used to be some shorter post graduate training programs for Podiatrists, such as one and two year programs. From what I hear that now, all Podiatry students enter three year surgical residencies, is this true? My research suggests the six figure jobs that go to Podiatrists go to those who only completed the full three years of residency. Is this correct?
 

Feli

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You are right: all podiatrists entering residency today get surgical exposure and training in residency. There are only two models...
http://www.casprcrip.org/html/residencies/rp_programs.asp

In the past, there were other residency models with 1yr programs, non-surgical, pyramid programs (accepts maybe 6 residents for first year of primary podiatry care training, and only the top 2 of them will go on to a second year of surgical training), etc. Also, in the more distant past, some grads didn't even get any residency at all.

As you can see, there are vast differences in training between podiatrists out in practice today. That is where the general misconceptions of the profession and the ambiguity about what DPMs can and are qualified to do stems from. 30yrs ago, a DPM might have gotten 4yrs of school and then opened an office or jumped right into practice, but today, a grad may do a 3yr residency program followed by a 1yr fellowship.

As for income, it's a complicated subject. Surgically trained pods surely have a higher income on average, but it's as much about business sense as it is skill when you get out in the market. If you have a big patient/referral base, have good business sense, know how to advertise and bill, and are on a lot of insurance plans, you could probably make a very fine living doing purely non-surgical practice or minimal sugery. Orthotics, nail care, skin care, etc are needed by many many more patients than surgery. A lot of pods do just that. Not every patient who walks in the door is going to have a heel fracture - or even a hammertoe that absolutely needs surgery. Even though you'll learn a lot of the surgical treatments with today's training, you still certainly want to know the basics and how to make a living off of them. A lot of the best pods will tell you that surgery is just for enjoyment, a last resort for treatment in most patients, and icing on the income cake. Podiatry began as non-surgical profession, and its roots and the bulk of the insurance/medicare payments are still there.

Maybe NatCh will find this thread if you're lucky. He'd have great insight on the salary and billing issues...
http://forums.studentdoctor.net/showthread.php?t=396294&highlight=ingrown
 

NatCh

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Six-figure jobs are likely to go only to 3-year-trained podiatrists right out of Residency (and they deserve it), but again, there's a difference between "having a job" working for someone else versus being your own employer. If you are a practice owner (which can mean either solo or being Partnered in a group) you stand to take home much more than you would as an employed podiatrist once you get up to speed. You also stand to take it in the shorts if your business tanks, so it's a double-edged sword.

Pretty much any podiatrist I've ever met makes six-figures as an owner. As an employee, not so much. One of my former Partners made around $300K-$400K per year. Another made a bit more than that. Both had only one year of Surgical Residency. I had two years, so twice as much as they, but I work part-time hours (by choice) and so I make less than they. I still make more than average because my practice consists of a lot of high-return work (surgery, ingowns, heel pain, neuromas, verruca) and I control my expenses where I can (EMR, no transcription, reduced support staffing, shared office costs).

Feli's getting the picture pretty well. Business decisions will control your income more than your medical training, but you definitely want to be as well-trained as possible.

By the way, when docs start making money they tend to look for sources of income other than just their practice. Real estate investment, surgery centers, side businesses, etc. It's like a snowball heading down a hill. It's easier to do those things as an owner than as an employee since you have more say in what you do with your schedule. Some employment contracts also forbid you from having any side businesses that may distract you from your primary commitment to your employer.
 
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busupshot83

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Six-figure jobs are likely to go only to 3-year-trained podiatrists right out of Residency (and they deserve it), but again, there's a difference between "having a job" working for someone else versus being your own employer. If you are a practice owner (which can mean either solo or being Partnered in a group) you stand to take home much more than you would as an employed podiatrist once you get up to speed. You also stand to take it in the shorts if your business tanks, so it's a double-edged sword.

Pretty much any podiatrist I've ever met makes six-figures as an owner. As an employee, not so much. One of my former Partners made around $300K-$400K per year. Another made a bit more than that. Both had only one year of Surgical Residency. I had two years, so twice as much as they, but I work part-time hours (by choice) and so I make less than they. I still make more than average because my practice consists of a lot of high-return work (surgery, ingowns, heel pain, neuromas, verruca) and I control my expenses where I can (EMR, no transcription, reduced support staffing, shared office costs).

Feli's getting the picture pretty well. Business decisions will control your income more than your medical training, but you definitely want to be as well-trained as possible.

By the way, when docs start making money they tend to look for sources of income other than just their practice. Real estate investment, surgery centers, side businesses, etc. It's like a snowball heading down a hill. It's easier to do those things as an owner than as an employee since you have more say in what you do with your schedule. Some employment contracts also forbid you from having any side businesses that may distract you from your primary commitment to your employer.
Awesome post... good info!
 
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