So we all know that it's basically a rite of passage for new grads to get used and abused as they enter the job market.
Just curious how things change after 5 years in practice? 10 years? I know of many classmates who have fabulous incomes. I also have seen CVs of people who job-hop associate gigs. I know of people who scale down bigtime after only a few years on the job, maybe spouse has a good income, maybe they just don't want to work full time because they discovered they don't like podiatry. I've known two docs who work 2-3 part time gigs concurrently as opposed to being full time with any one business. One guy did that for something like 40 years!
Is bottom-tier income a feature of this profession for your entire career? Or is it just this profession's way of hazing residency grads before it eventually gets better?
I don't see it getting a whole better...
The debt is not getting lower.
The significant DPM saturation will get worse with more schools/grads.
Lending is still tough, credit is obliterated by the student loans.
A lot of the larger PPs that had some decent partner or even high(ish) earner associate jobs have gone to venture cap supergroups.
Hospital jobs are more prevalent than ever, but very few of them are full scope jobs (and most of those have 100 DPMs waiting to steal the job).
The limb salvage + "general podiatry" hospital jobs are there, but VA/IHS hospitals etc are opening much lower rate than DPMs, and the % who are "surgical" DPMs are increasing.
Just as it is now, the basic options for
amazing DPM income are:
1 Own an office, make many more, have very many underpaid associates and/or sell out to VC.
2 Get a director title or similar and parlay it into as many industry payments for hawking industry implant products, grafts, lectures, fuzzy research for said products, lecture fees as you can.
Options for
good income are:
1 Buy out or start a practice.
2 Get - and do not burn out at - one of the rare good DPM hospital jobs (very rare if you want to use full scope training).
3 Marry someone rich and then do whatever want for podiatry career (owner, employed, retire).
The
medium income DPM options are:
1 Govt/small hospital work or pod school faculty work.
2 Find a rare ethical PP pod/MSG/ortho office that'll offer partner or high income and not stagnate your pay or dump you for a newer cheaper doc a few years in.
3 Try to politic your way to "admin" roles in a pod supergroup, MSG, hospital, etc (this could attain good hours... even be good income).
The
low income are the ones DPMs know too well and the majority of DPMs (all ages) are doing on Monday:
1 Worker bee associate in podiatry or MSG group, supergroup, etc.
2 Mobile and nursing home podiatry.
...so, short answer = yes. An even higher % will be in the bottom lower income category. Many will bounce associate jobs their whole career. Quite a few already do. Awhile ago, I think the DPM owner/solo % was a lot higher (since loans were available, hospital jobs were rare and not as good).
Right now, this is the heyday of DPM hospital jobs with the highest % of DPMs in them (sad but true, since those jobs aren't too common)... hospitals will continue to wise to our saturation and lower the pay on those and/or reduce open positions as they disappear further into basically networking-only, as many would say they basically are now. Hospital employ DPMs might only be 15% today, but it might be 12% and with same/lower pay/benefits in ten years with more supply of DPMs who want them. As tough as it is to say, the podiatry MGMA will likely stagnate... it already plateaued a lot lower than MD surgeons. Hospitals won't overpay if they don't have to; they see the applications numbers. Supply and demand rules... ask hospital PharmDs or read their forums... they opened up hospital jobs, pay improved, then basically faceplanted due to saturation of grads and applicants (be an appli-can!).
The new DPM grads will keep coming, and they have to go to work somewhere to pay the loans... worker bee associate, esp VC supergroup, is a common landing spot and will continue to be.
The avg DPM now entering the job market is looking at ~$200-250k in today's dollars for their whole career. That's salary = half student debt (if they're lucky), which is generally the worst ratio deemed potentially acceptable. And when is the last time tuitions decreased? They go up much faster than salaries. And, of course, some outkick the avg... so many many are going to fall below the average.
The way to break the cycle and "beat the system" is obviously to do the employ thing, save up and be very frugal despite the massive loan payments, and start or buy your own. Some will do that... we did. Eventually getting those 1/10 hospital jobs (maybe 1/5 or 1/3 if good enough training or network) can also work. That solo office is getting hard to do, though. Metros were always saturated with DPM offices; supergroups made it even tougher. Now, suburbs and even some rural places are hard to break into. Even starting solo now takes a bit of a dice roll going into a saturated area, going more rural than one intended, or lucking out and taking a retiring doc's area/pts (a lot more DPMs graduating than retiring). It is still feasible to do solo, but it's no given that the DPM will do it anytime soon after training or have their pick of viable locations.
