1. What do you find most helpful? Give us your feedback on the 2019 SDN Member Survey to help further the SDN mission (and win prizes!)
    Dismiss Notice
  2. Dismiss Notice

Pros and cons of Podiatry

Discussion in 'Podiatric Residents & Physicians' started by coolguy53, Jul 11, 2018.

  1. air bud

    10+ Year Member

    Joined:
    Nov 11, 2008
    Messages:
    1,414
    Likes Received:
    354
    Status:
    Attending Physician
    I think everyday about how my life would take a complete 180 if I were to lose my job. If you are stuck in PP working for a 100k a year and top out at 140k with bonus...then honestly I would feel more confident about job security since you are already at the bottom and those jobs are a dime a dozen. Those of us lucky (not necessarily the best - just the luckiest) enough to have good paying/good benefits hospital MSG jobs know they would not find an equivalent job in their same area/state within 1 year. Hopefully they are making smart financial decisions - especially coming out of residency (see The White Coat Investor).

    All the "in demand crap" pushed by generic jobs websites that take BLS info are just making the problem with podiatry worse. There is extremely minimal (I had to change from ZERO) demand for good paying jobs. There is GREAT demand for jobs allowing PP owners to take advantage of new grads. There is INCREASING demand for "fellowships" where PP owners take advantage of 3rd year residents who have the wool pulled over their eyes by ACFAS and the incestuous nature of fellowships who believe it is their ticket to success in the field of Podiatry.

    As I have said many times on this forum, Podiatry is plagued by too many (ie the vast majority) of wanna be MDs who still want to be in the medical profession at the doctor level. They will justify and twist and turn the numbers and whatever they read online to fit their world view of podiatry being this great field with limitless opportunities and increasing demand blah blah blah. That ship has sailed. At this point podiatry is a TERRIBLE financial decision for anyone not in or just starting school. You will have 300k of debt that will take you at least a decade to pay off and will be a constant looming threat over your head that will dictate many life decisions in a bad way.

    For those of us who are already in this profession - the answer is clear - get a hospital job ( really only possible these days by having experience and having friends already in the system) or open up your own practice. While I would never in a million years open up my place, those that do are basically doubling down. I do know many opening up their own that are doing very well.

    At this point if I were to lose my hospital employed job, I would quit podiatry. My loans will soon be paid off, I will have no debt and some savings. I am smart and can leverage this into other types jobs.

    EDIT - I should also point out that this reality also has dictated how I practice - I don't do big complicated cases anymore. I live in a very small town. I don't need that case, I don't want that case. And most importantly if that case goes bad - my reputation and long term outlook is done. I am not going to jeopardize my great setup to be some Instagram hero and put up pics of some crazy deformity correction or huge trauma. If you live in a big city, you can afford to have some poor outcomes - they won't make or break you. Life in a small town is different. I have zero tolerance for a crazy patient or someone who is too big of a risk. These people are already used to driving 3 hours to the nearest big city and medical center for things related to their heart/kidneys/lungs etc - they are doing that for their pilon fracture/charcot recon/ cavus recon just like they did before I got here.
     
    #51 air bud, Mar 11, 2019
    Last edited: Mar 11, 2019
  2. de Ribas

    de Ribas Nobel Prize Recipient
    Gold Donor Verified Account 2+ Year Member

    Joined:
    Feb 4, 2017
    Messages:
    2,385
    Likes Received:
    1,803
    Status:
    Podiatry Student
    Going back, would you go into medicine at all, or you would go into other medical fields like MD/DO, PA, etc.
     
  3. air bud

    10+ Year Member

    Joined:
    Nov 11, 2008
    Messages:
    1,414
    Likes Received:
    354
    Status:
    Attending Physician
    It doesn't work like that. First of that was more than 10 years ago. I was at a different point in my life, mentally physically emotionally and most importantly maturity-wise. I was doing stupid things with my life, no money no food (spent most of my money going out an partying) didn't have health insurance or car insurance for 3 years. I reached rock bottom (relatively speaking) and so I decided to go back to school and take all the pre-med classes. The one thing I had going for me was I knew I was smart. I had a family willing to give me 1 more chance, 1 month at a time. I was motivated so I went back. Took me 1 semester to get back in the swing of things (some B's then the rest were A's). Finished all pre-med classes with 3.75gpa (didn't take any of them 1st time around since tested out of sciences and had another non-med major). Unfortunately all of my new class grades were averaged in with my first time in undergrad. Every computer would spit my application out and not look at the difference. So I couldn't do US MD (MCAT was 28 so low for MD anyways). Wouldn't do Caribbean, didn't want to do DO and risk doing PCP. So I did podiatry. School was easy, finished with a 3.7 something Pi Delta.

    If I could go back under same circumstances and had to do medicine - I would have done DO and gone for ER and then just done locums work and traveled ( assuming I couldn't get something else non-PCP/IM)

    If I could go back under same circumstances and not do medicine...I can't answer that. Medicine was my only focus. I had been lost for so many years that doing all the pre-reqs then school was so easy and so narrowly focused. Its like the military - someone tells you what your schedule is for you and where you need to be and what you need to do - it was what I needed at that point in my life.

    If I could go back knowing what I know now....I would have learned to code.

    If someone wanted my advice on going into medicine and could do anything they wanted? MD/DO

    If someone wanted my advice on going into medicine and couldn't get MD/DO? PA or nursing. PA is so tough to get into, so if couldn't get that I would do nursing. Might still choose nursing anyways. PA is going to top out most at 150k. Nurses can go NP/CRNA etc and make 300k. Rise to the top and SO many different ways to advance and focus and further your training and career.
     
    DexterMorganSK and de Ribas like this.
  4. CutsWithFury

    CutsWithFury I like to cut
    Podiatrist

    Joined:
    Feb 2, 2019
    Messages:
    90
    Likes Received:
    89
    Status:
    Podiatrist
    I agree with a lot of what air bud has said. I think podiatry is really only worth it if you are fortunate to land a hospital job, multi-specialty group or ortho group position. I feel ortho jobs are dwindling as they are more prone to take one of their own (foot and ankle ortho) to offload general ortho call and because they want to support the AOFAS. They owe nothing to podiatry.

    Private practice podiatry is a dead end. There are too many old podiatrists who make the buy ins incredibly high. There are PP podiatry jobs where you never become a partner and you are just an employee of the older podiatrist. There a lot of PP podiatry jobs where the older pod's practice is run by his wife which becomes incredibly biased when it comes to production/billing.

    Joining a private practice podiatry job is a dead end. Period. Sooner or later when you want more or think you deserve more the older podiatrist is going to tell you no or string you along long enough to make you want to quit and look for another job.

    Not everyone can be in an ortho group, MSG or hospital job. I do think there are plenty of hospital jobs to be had. You just need to create your own luck and pick up the phone and sell yourself. Thats how I did it. My current hospital job flat out told me "no" then two weeks later the HR department called me and said they reconsidered. The rest is history. I am now signing a new contract and will be here for awhile.

    If I lost my hospital job I would go solo. No doubt about that. Id rather make peanuts than be taken advantage of.

    The ACFAS fellowships are losing their luster. There is handful of programs that will really set you apart from your peers. All these new ones are just excuses for these private practice fellowships to use you out and still pay you a resident salary. Yes you get more surgical experience which is helpful but to be honest if you did a good residency program you should be good to go.

    I know many fellowship trained DPMs who have complications on their first cases. Just like I did coming out. But as you cut more the better you get. That is just how it works for any surgical specialty. No matter how much you know coming out you will always doubt yourself the first half of your career in the OR when there is no attending to remind you or hold your hand.

    I am almost two years out now and I've got several large elective recon cases scheduled this month such as a medial mal take down and repair of large OCD lesion at talus, triple arthrodesis, Tibial calcaneal fusion, multiple ankle scopes. No fellowship training here. I am doing the cases because I am confident in myself. I know I can do these cases.

    The only thing fellowship would have helped me with was that I probably could have done these big cases sooner in my career. By what though? By one year? Ok no big deal in the grand scheme of things.

    Again I think fellowship training is completely overrated.

    Podiatry is a redundant field. We are combination specialty (ortho + vascular + derm + general surgery). We do everything nobody else wants to do. Thats why we are here. Foot and ankle ortho can do the trauma and elective foot and ankle recon the problem is there are NOT enough of them. Why would an ortho want to specialize in foot and ankle? It’s one of the lowest paying specialities in ortho. Vascular surgery can manage all the patients with wounds and PVD but they hate that, they just want to bill the angioplasties and bypasses and have us do the wound care. Dermatology can treat all the warts and skin lesions we come across on the feet. General surgery was doing foot pus and amputations long before podiatry ever got into the hospital systems. Now that we are here these specialties have completed offload all the "crap" onto our profession. That is why there is a place for us in this medical world.

    As a podiatrist the majority of my complex recon cases are because foot and ankle ortho doesn't want it. Or because these would be revisions originally done by foot and ankle ortho. I also handle a lot of medicaid patients which is why ortho doesn't want them. It is all about money and not about patient care. These are the facts of life. You want good medical care? Get a job and get real insurance.

    I know I am rambling but being honest with everyone here. We still have a place here in this world but you have to understand we are not the experts in anything. We are just a blended profession that handles all the crap nobody else wants to deal with. That is how I really feel. You can be busy as hell if you are in the right set up. Or you could be fighting for scraps if you are in a large private practice podiatry group.
     
    #54 CutsWithFury, Mar 11, 2019
    Last edited: Mar 11, 2019
    DexterMorganSK and shadesofgrey like this.
  5. GypsyHummus

    7+ Year Member

    Joined:
    Jun 12, 2011
    Messages:
    4,162
    Likes Received:
    2,514
    Status:
    Pre-Health (Field Undecided)
    Thanks for the insight Airbud, I really appreciate it.

    I do think the PA vs NP has NPs in a better position. Their lobbying body is crazy big and they are pushing for more rights. Who knows, maybe you avoided a big primary care turf war by going into podiatry vs DO. No NP/PA is gonna want to deal with feet. I’m thinking PAs are gonna hit saturation soon, they opened up a ton a schools and it only takes 2 years to become a PA.

    For all of Podiatry’s faults, it seems to be the least bad of all the non MD/DO “doctoral” degrees. Optometry is dominated by commercial chains and Pharmacy is beyond saturation point. At least, that is what I am picking up from the practicing docs here. So you’ll have a job, it just might be lousy vs. having no job as a pharmacist.

    Never too late to code. Lot of boot camps that get you out in 12-14 months.

     
    DexterMorganSK likes this.
  6. air bud

    10+ Year Member

    Joined:
    Nov 11, 2008
    Messages:
    1,414
    Likes Received:
    354
    Status:
    Attending Physician
    THIS is the problem. Least bad is NOT GOOD
     
  7. dtrack22

    Podiatrist 10+ Year Member

    Joined:
    Apr 20, 2008
    Messages:
    2,025
    Likes Received:
    1,159
    Status:
    Podiatrist
    PAs and a majority of NPs defintiely have lower income ceilings. Low to mid $100k's. CRNA's do well, though there are certainly areas where anesthesia is trying hard to put that genie back in the bottle. I would never become a physician assistant, you could talk me into working towards becoming an NP I guess. If you didn't care about possibly doing surgery and/or really just want to be a doctor, I would certainly consider DO school. Plenty of specialists have DO degrees and if being able to work wherever you want for $200k and up is the worst that can happen? SIgn me up. And yes, I'm describing primary care physicians who can literally get a job anywhere and make double what most podiatrists are offered by other podiatrists out of residency.

    It is not hard to find a good job as a podiatrist IF you are open to multiple regions across the country or if you are willing to go a little more rural. If you are limited in geography and are set on one or two locations then its a crap shoot as to whether anything will be available the year you finish residency. All of the other degrees/specialties listed certainly make for easier job hunts and more consistent/predictable salary/compensation. But don't let a podiatrist tell you that being a PA or NP would be better for you financially. That's a load of crap.
     
  8. Nowehjose

    Joined:
    Mar 23, 2017
    Messages:
    215
    Likes Received:
    242
    Status:
    Pre-Podiatry
    You cannot put Pharm in the convo with MD/DO/PA/DDS/DPM. Podiatry and the others are hands on. Unfortunately now most hospitals have dispensers. In undergrad I worked at a Trauma 1 center in NYS and they were cutting back pharmacists to part-time, due to obvious tech advancements. DPM and other subspecialty surg. are going to be the last to go. Look at MD/DO hospital cut backs for ER/Family Med docs in cali with that robot conference call to tell a guy he is dying...

    I am less worried about podiatry being replaced compared to other small practice based professions. I'd be more scared being an MD/DO in regards to family practice, ortho all hiring a lot of PA/NP instead of docs for evaluations. I went to my Ortho and I only saw him 1x, the other 5x was my PA for injections(which he ****ed up 2x). I don't know if its 100% true everywhere but seems accurate to for downstate NY.
     
    #58 Nowehjose, Mar 11, 2019
    Last edited: Mar 11, 2019
  9. DYK343

    Joined:
    Jan 7, 2018
    Messages:
    20
    Likes Received:
    56
    Status:
    Podiatrist
    Lots of negativity on these forums.

    I am not going to say that everyone who reads this is going to get a great job, but I didnt have any troubles or find it particularily hard to get a well paying and fair job. I had multiple offers from hospitals and MSGs and chose what I thought was best for me.

    I did go to a upper tier residency so I am sure that helped my job search.

    I am still in the same job I started after residency which ended in 2017.

    I do work extremely hard for what I have and it can be frustrating at times, but podiatry is a great field in my opinion. I am very happy and would absolutely do it again.

    And I make more than my MD/DO friends in primary care. Almost double after my surgical income. PCPs do not get paid that well.
     
  10. GypsyHummus

    7+ Year Member

    Joined:
    Jun 12, 2011
    Messages:
    4,162
    Likes Received:
    2,514
    Status:
    Pre-Health (Field Undecided)
    also, PAs salary averages seem to be around the 90-100k mark, with the 90th%ile being 110-120k. (Payscale.com)

    Pods on the other hand have averages in the 125-150k and their 90th%ile is 220k+. Much better long term growth.
     
  11. dtrack22

    Podiatrist 10+ Year Member

    Joined:
    Apr 20, 2008
    Messages:
    2,025
    Likes Received:
    1,159
    Status:
    Podiatrist
    They get paid a lot better than most people think. They have the highest ratio of revenue to pay in a hospital system. They are even more valuable to a health network/hospital than you or I. There are multi-specialty physician owned groups where primary care docs are making $300-400k after ancillaries and profit sharing but before taxes. Virtually every PCP is going to make around double what an associate podiatrist in a podiatry practice will make for a few years. And unfortunately that is still where a majority of jobs are to be found.
     
    G0dFather likes this.
  12. de Ribas

    de Ribas Nobel Prize Recipient
    Gold Donor Verified Account 2+ Year Member

    Joined:
    Feb 4, 2017
    Messages:
    2,385
    Likes Received:
    1,803
    Status:
    Podiatry Student
    Though current medscape average for FM and Peds it is around 215K

    Just back in 2012-2013 Medscape shows PCP averages around 170-180k
     
  13. air bud

    10+ Year Member

    Joined:
    Nov 11, 2008
    Messages:
    1,414
    Likes Received:
    354
    Status:
    Attending Physician
    Have we not yet learned that all of that data is flawed in it's own way?
     
    Weirdy likes this.
  14. DYK343

    Joined:
    Jan 7, 2018
    Messages:
    20
    Likes Received:
    56
    Status:
    Podiatrist
    Some PCPs do better than average. As do some podiatrists. Several of my attendings in residency I know made >500k. There are always examples.

    And I make between 300-400k 1.5 yrs out. I have become very close friends with a pediatrician and a primary care provider in my MSG group. They have voluntarily shared salary info with me and it is half what I make. Of note, I do work nearly double the hours they do.

    Not everything in podiatry is easy. There are risks. But to walk away due to a couple people unhappy with their careers is a shame. I can assure OP that there are many very happy podiatrists practicing making a good income who do not post here. Get out and shadow.
     
    JKGarv, ldsrmdude, mavupcmu and 6 others like this.
  15. CutsWithFury

    CutsWithFury I like to cut
    Podiatrist

    Joined:
    Feb 2, 2019
    Messages:
    90
    Likes Received:
    89
    Status:
    Podiatrist
    You wouldn’t be so cheerful if you were stuck in a dead end associate position making 75k base salary. Get real.
     
    G0dFather and air bud like this.
  16. air bud

    10+ Year Member

    Joined:
    Nov 11, 2008
    Messages:
    1,414
    Likes Received:
    354
    Status:
    Attending Physician
    I agree. @DYK343 is an outlier. I am happy for his/her early success. I have coresidents in similar situations. But it is giving false hope to too many bad candidates grasping at straws trying to become a doctor.
     
  17. ldsrmdude

    ldsrmdude Back in the saddle again
    Staff Member Administrator Podiatrist Faculty Verified Expert 10+ Year Member

    Joined:
    Feb 20, 2007
    Messages:
    1,882
    Likes Received:
    760
    Status:
    Podiatrist
    Of course not, but that doesn’t make what @DYK343 is saying any less valid. None of us would be happy stuck in a dead end job, and that applies to all professions. As someone who started out in one of those awful associate positions, I can say without a doubt I’m happier now than when I started. But that doesn’t mean podiatry is a bad profession. Or that there are no good jobs. There are lots of happy podiatrists (including me) and lots of unhappy ones. It’s a shame that there are so many crappy jobs and so many graduating residents get taken advantage of and there aren’t high-paying MSG or ortho groups for everyone.
    I don’t keep up with all of my classmates regularly. Or my co-residents even. But the classmates and co-residents I do keep up with are all reasonably happy. Some have their own practices, some even have an associate working under them, some in ortho groups, some as partners or associates in small groups. I’m hospital-employed and have classmates in similar situations.
    I’m not saying it’s all sunshine and rainbows. But it’s not all dark clouds and thunderstorms either. I enjoy my job, and if I lost my job, I’d be able to find another. I enjoy what I do. Maybe that’s why I don’t see any need to be pessimistic. I agree that @DYK343 is an outlier in terms of salary so early in practice. But I don’t think he’s an outlier just because he is happy with his job. As mentioned, there are lots of happy podiatrists
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
    #67 ldsrmdude, Mar 13, 2019 at 12:06 PM
    Last edited: Mar 13, 2019 at 9:31 PM
  18. dtrack22

    Podiatrist 10+ Year Member

    Joined:
    Apr 20, 2008
    Messages:
    2,025
    Likes Received:
    1,159
    Status:
    Podiatrist
    I'm (fingers crossed) 3 months away from at least being happier. Should be joining an Ortho group getting 50% of collections in my first year with the ability to tap into ancillary revenue streams whenever I want. Pathology will also be much different as that is just what comes with falling under the Orthopedic clinic umbrella. Hopefully I didn't just jinx myself as it is not yet finalized. I would literally double my income if I did the exact same volume/revenue. Realistically I would be somewhere in the neighborhood of $300k before taxes in my first year.
     
  19. AttackNME

    AttackNME Podiatrist
    Podiatrist 10+ Year Member

    Joined:
    Feb 22, 2007
    Messages:
    427
    Likes Received:
    283
    A lot of people change jobs after their first couple years out including me. You tend to meet people and make connections, and with your added experience, makes it easier to find better opportunities. To put things in perspective, consider it an extension of residency, Ortho does 5 years and then a fellowship before they start making big money, so when I graduated my mindset was to look for the job with the best opportunity to be busy
     
    de Ribas likes this.
  20. med2345

    2+ Year Member

    Joined:
    Oct 16, 2015
    Messages:
    330
    Likes Received:
    260
    Status:
    Pre-Medical
    I remember you being unhappy with your current.. congrats! what do you recommend as far as making connections for a better job?
     
  21. heybrother

    Podiatrist 7+ Year Member

    Joined:
    Oct 17, 2011
    Messages:
    705
    Likes Received:
    473
    Status:
    Resident [Any Field]
    If that doesn't work out dtrack I know of a podiatrist near you trying to sell their practice for near a mil. :rolleyes: Its an amazing opportunity! :laugh:
     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  22. de Ribas

    de Ribas Nobel Prize Recipient
    Gold Donor Verified Account 2+ Year Member

    Joined:
    Feb 4, 2017
    Messages:
    2,385
    Likes Received:
    1,803
    Status:
    Podiatry Student
    If only he'd be a realtor. That would be an opportunity for a realtor to sell.
     
  23. hematosis

    hematosis Slappin Da Bass
    7+ Year Member

    Joined:
    Jul 27, 2009
    Messages:
    442
    Likes Received:
    151
    Status:
    Fellow [Any Field]
    congrats to dtrack22.

    Here is a great example of why you should NEVER work for another podiatrist. I read this PMNews garbage once in a while and just look at this terrible offer i saw the other day.

    "30 year established surgical practice in rural East Central Illinois. Re-locating. Turn-key operation with 3 treatment rooms and surgical suite. Certified EHR. Generates $450K, asking $300K. Call **** or email"

    Anyone stupid enough to buy this guys practice for 300k deserves to go bankrupt. I'd rather drive for uber than work for these scum bag old Podiatrist looking to dump their practice on new graduates or, worse, hiring them for 80k salary and crap bonus structure...:bang:

     
    Stop hovering to collapse... Click to collapse... Hover to expand... Click to expand...
  24. DYK343

    Joined:
    Jan 7, 2018
    Messages:
    20
    Likes Received:
    56
    Status:
    Podiatrist
    There are good jobs out there. MGMA data is fair for hospital/MSG and easy to argue.
    Maybe I am super lucky... but then so are my close friends.
    My co residents are all doing well too.
    Im happy. I really like what I do and I would absolutely do it again.
    Ive said it before on here and i'll say it again... My dad's best advice "Hang with the smart kids who dont complain a lot".
    That advice apparently has taken me far.
     
  25. Utvolsdpm

    Joined:
    Nov 9, 2017
    Messages:
    26
    Likes Received:
    23
    I was sitting at a conference this past weekend and overheard a humorous conversation - this older podiatrist was complaining about how her friend can’t retire because nobody will buy his practice. She went on to say kids today don’t want to work and they have no work ethic because they were handed everything growing up.

    It’s amazing how out of touch with reality some people are.
     
    air bud likes this.
  26. JohnnyFootball2016

    2+ Year Member

    Joined:
    Apr 5, 2015
    Messages:
    5
    Likes Received:
    5
    I wonder what her student loans were when she graduated?

    Older generation pods will never understand the devastating cost of education. Even if you have no debt from your undergraduate (more and more rare), you easily can rack up over $250,000 in podiatry school. Very few podiatrists graduating in the 80's or even 90's had anywhere near that debt
     
  27. dtrack22

    Podiatrist 10+ Year Member

    Joined:
    Apr 20, 2008
    Messages:
    2,025
    Likes Received:
    1,159
    Status:
    Podiatrist
    And they practiced in a time of $100 deductibles, $1000 bunions, nobody paid less than Medicare, custom orthotics were regularly covered, fewer diabetics, paper charts and no MIPS, etc.
     

Share This Page