How many people in private practice are taking 350K+ home, currently? I can tell you all of my partners in my group are taking at least 275k home ,working less hours, and dealing with less stress than PP. I understand every situation is different, and I did work in PP at one point so I do know a little here and there. Even with this pandemic, I’m still looking at the same salary versus the previous year.
Salary poll to help prospects and current pod students
- Thread starter Treaty of Dorsi
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How many people in private practice are taking 350K+ home, currently? I can tell you all of my partners in my group are taking at least 275k home ,working less hours, and dealing with less stress than PP. I understand every situation is different, and I did work in PP at one point so I do know a little here and there. Even with this pandemic, I’m still looking at the same salary versus the previous year.
Ok ... i would say that the average PP should see about 20-25 patients a day ( spaced out over 8 hours that is hardly work) on 4 - 5 days a week ( again that is hardly time .... there are offices that do it in 3 days and then 3-4 days off ) this will generate 550-650K gross ( give or take) ... most offices with reasonable rents and a few (2-3) of staff members run a 40- 50% overhead ( 50 is honestly on the high side, one just needs to manage well, other than rent, staff, malpractice there arent overly high ticket expenses in podiatry, everything else is JOKE) ... so if you look at those numbers the average "struggling" pod is netting 250-300k ( but they will "pay" themselves a "reasonable" salary of say 120K or so "wink wink") .... now that is based on AVERAGE/MEDIAN .... how about those that are above it ? (also when you are at that point an extra 20 pts more a week makes a significant diff in gross/net income) and even lets just say good majority maybe below the above amount seeing 70 pts a week ( very slow practice btw, not much action) not working much and grossing 400K ( which they could be easily netting 250-275k at that point as they would need very little overhead to run an operation like that ) .... What do you think most people in PP take home ???!!!
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If this is the case EVERYONE needs to be opening their own practice to ride the gravy train
“ideally “ pods should be making that much in PP. I know some that do 10-15 pairs of custom inserts a week. I know some that make really good money selling hydro gels, shoes, and all those other good stuff.
I was in private practice and I know the numbers. I really do hope PP docs can generate 250k a year for our profession sake. I really do.
From experience and talking to multiple colleagues, I can tell you as of now with today’s economy, netting 300k for most is a far far reach.
Ahhhh yes they are .... the majority of jobs and the money IS in PP.... thats why you have to cold call places to get a hosp/msg job ... that is the premise of this entire forum ... please use the search function LOL
So what are the majority of these people you have been talking to netting in PP since 300k is "far far" reach ? ( note today's economy only started 4 months ago )
Most have told me they are making half of what they used to make. A friend of mine used to net 80k by himself, but his practice couldn’t thrive and joined another practice recently. That’s just an example, but understand everyone’s situation is different.
My former partner closed down his practice about 2-3 years ago and signed with another practice as an associate.
I have another friend who joined a hospital 6
Months ago. His practice was grossing 300k a year before the pandemic.
Months ago. His practice was grossing 300k a year before the pandemic.
it isn’t that hard to figure out about how busy someone is based off of their collections. Let’s take your friend’s $300k gross revenue. If he/she had 3 weeks of vacation throughout the year and otherwise worked M-F, weekly gross revenue is $6100. Thats $1200 per day. Let’s say you have a low ppv and you’re averaging $100 per visit. That’s 12 patients per day...max.
Of course someone seeing 12 patients per day isn’t making much money. That being said, depending on rent prices in the area, with volume that low it would be easy to keep overhead down around $10k per month (not counting the owners draw). Which means $120k in expenses before $300k in revenue and $180k left for the owner to do whatever he/she wants with. Even a very slow PP doc can make $180k. That’s $80k more than I have ever made in a year, working for another podiatrist.
What’s happening in some of these posts is people are confusing private practice podiatry owner with private practice podiatry associate. From an income standpoint, these two groups have disparities that mirror PP associates and hospital/msg employed podiatrists. When discussing salaries PP associates and PP owners/partners need to be distinguished. One group gets around 30% of what they bring in and the other (should) double that and get something closer to 60% of what they bring in. And that is entirely a podiatry thing. You don’t see contracts like that very often in the rest of medicine.
A full clinic with around 120 weekly encounters shouldn’t have any issues grossing $700k. The overhead for that clinic shouldn’t top $300k-$350k. That’s easily $350k before taxes. An associate with a typical podiatry contract, collecting $700k, won’t do much better than $200k of gross W-2 income. You’re paying a lot of money as an associate for the owner(s) to handle management decisions and the risk they took on by hiring you. The only way that “fee” or increased overhead you have as an associate makes any sense at all, is if you do absolutely nothing other than show up and see patients. If the owner(s) takes care of all of the marketing for you, and staff does everything non-procedural for you in clinic, and you have a scribe to do most of your documentation...then 30% of collections or that $100-150k managerial fee you are essentially paying is reasonable, fair, worthwhile. Since that is rarely the case in podiatry practices, an associate contract is rarely reasonable, fair, worthwhile. And it’s the reason turnover is so high.
Since I’ve been out of residency (about 3 years), between the jobs I’ve been offered and the ones I’ve taken, 8 different podiatry practices have had 7-8 associates come and go. Not counting myself. The owners are all still doing just fine and continue to advertise for new associates. PP owners/partners do just fine financially.
I am sure some PP owners do very well. It still doesn’t negate the fact that the majority of podiatrists are looking to join a MSG, Hospitals, or Ortho group if given the opportunity. I do still believe that most podiatrists who open up their own are the ones that have been denied from the opportunities mentioned above.
Yes ... i commend him for that he should go somewhere else, this was clearly not working for him .. its not for everyone ... he could also have been making 120K+ driving a Mr Softee !!
This person was seeing innetwork 40-50 pts a WEEK ( to many people in the PP world 80-100 pts per week in an innetwork office is considered slow-average), a totally DEAD and faltering practice ( whats really SAD is when people try to sell something like this to others that have no clue !!! but thats a whole other story for another time).... and even with this he could have been netting close to the average doctor salary working half as much !!!
probably the majority that already made their money in private practice and now wants to wind down and still collect a pay check... i know many like this ... at the end of the day a busy PP is still a GRIND and after youve already stacked up this is a good way to slow down, especially taking a job at the VA.... but i find it hard to see that someone being paid 300k+ from a hospital/msg wont be grinding it out ( your probably generating 1 mill for them), they will work your *** off, if you dont produce your not worth your weight and on to the next
THIS!!
Bottom line .... there is no comparison to PP vs other things in podiatry .... again it is not for everyone but that being said, there are so many pros it doesnt even come close, as shown above even with a FAILING practice it still may outclass these other options, just from the flexibility you have with the money that comes in and the amount of work you would have to put in
If you're getting paid $300k a year at a hospital, I promise you're making them way more than a million dollars a year
Most def .... this only proves the point further ... i guess now you cant really fault the guys offering an associate 30% of what they make?! .... hahaha just kidding
seems like the better metric students should look at is annual collections, then they can extrapolate net income based on different circumstances, contracts and overheads etc
Either way you look at it, every student or resident should know that working as an associate for another podiatrist is the worst part about being a podiatrist. They say the "old eat the young". I can tell you that the "young are now eating their fellow young". A lot PP owner who are maybe 5-10 years out practicing, and are in their mid 40s, are hiring new grads and offering the same ****ty contract of $80k-$110K base with 20%-30% bonus after 3x collection (with no 401K or Health insurance).
So this is no longer the fault of "older pods" , this is the new reality with the new generation of podiatrist. We are in a capitalistic society and this is a business like any other. You look for the cheapest labour willing to work and make your profit.
How can a human being hire another doctor (after +10 years of school) to work for a low wage and not even offer health insurance. This is the saddest part about our profession.
These are market forces in action. Basic economics. Over saturation of a skill drives wages down. Professions that fail to control their markets suffer. The wide disparity in residency training, which varies from excellent to very bad, also contributes to wage stagnation. Employers are not sure what they are getting, so they use that to justify their reasoning for low investment on newer hires. They may not directly use that as an excuse, but I think it contributes to the job market confusion.
Just to add a real life example to this thread. I just started into private practice and have had a very different experience than what is on these forums. My salary is basically eat what you kill with different levels of % of compensation ranging from 30-38%. Would have to bill about $4000/day to hit the highest tier. The bonus is calculated on what I bill monthly. I work 4 days a week but have only been doing a half day on Friday until I get some more volume. In my first half month I hit my lowest tier easily and am averaging seeing 17 patients a day. I have 1-2 surgeries scheduled every week an example of surgeries that I have done or are schedule include (lisfranc ligament rupture, austin/tailor bunionectomy, calc slide and deltoid reconstruction for eventual TAR, triple arthrodesis, AT tendon rupture, hammertoe correction, and Lapidus/Brostrom with possible anterior/lateral compartment fasciotomy).
The practice is so well run it is awesome! The MA's do pretty much everything but procedures. There is a scribe in the room with every patient (I spend like 20 min a day on notes.) There is a nurse that takes calls from patients after hours. Call is optional. We do go to like 4 nursing homes once every 9 weeks and to a wound center for a couple of hours a week. Overall it is such a relaxed schedule and stark contrast to my residency which is one of the top in nation. I haven't had to do anything for marketing since the practice has gone above and beyond with that and my schedule is getting more full everyday!
I do not have a clear path into partnership but honestly as long as I make a decent living doing this I don't really care. I am just enjoying life (and my family) and not having to deal with all the crap that running a business would bring. The other thing that has surprised me are all the opportunities that you have to invest in when you get out. The investment opportunities for podiatry have been sketchy and I am staying far away from all of that. (If someone says "we don't take government funded insurances so we won't break any rules" in their pitch run like your livelihood depends on it!!!). But the investments outside of podiatry should pad the bank account quite a bit.
In summary, there may be bad associate gigs but there are really good ones out there too!
The practice is so well run it is awesome! The MA's do pretty much everything but procedures. There is a scribe in the room with every patient (I spend like 20 min a day on notes.) There is a nurse that takes calls from patients after hours. Call is optional. We do go to like 4 nursing homes once every 9 weeks and to a wound center for a couple of hours a week. Overall it is such a relaxed schedule and stark contrast to my residency which is one of the top in nation. I haven't had to do anything for marketing since the practice has gone above and beyond with that and my schedule is getting more full everyday!
I do not have a clear path into partnership but honestly as long as I make a decent living doing this I don't really care. I am just enjoying life (and my family) and not having to deal with all the crap that running a business would bring. The other thing that has surprised me are all the opportunities that you have to invest in when you get out. The investment opportunities for podiatry have been sketchy and I am staying far away from all of that. (If someone says "we don't take government funded insurances so we won't break any rules" in their pitch run like your livelihood depends on it!!!). But the investments outside of podiatry should pad the bank account quite a bit.
In summary, there may be bad associate gigs but there are really good ones out there too!
That sounds like a good setup! I think someone mentioned something like this a few posts up in the thread...
I think Halux’s situation really highlights how bad the majority of associates are getting screwed. A practice can afford to pay an associate 30-38% while providing all of the above mentioned benefits. So when you apply for some job in Southlake, TX where the base salary is $85k and you bonus 20% at $350k-450k and 25% at $450-600k and top out at 30% of each dollar above $600k; and you have to do all of your own notes and you have to do a good amount of your own marketing and you are forced to take call...just know that practice is either incredibly poorly run or the owner is making a killing off of you if you stick around for more than 6-12 months.
If podiatry practices hired new associates once they were busy enough to actually need them, and if they paid straight 40-45% of collections (or A little less if you get a scribe, physician liaison/marketing person to set up meetings for you, etc.), and didn’t force MSO hardware/services and compounding pharmacy crap down your throat, you wouldn’t see half of the posts you do here ****ting on working for other podiatrists. But they don’t, so here we are
This how things should be. You have a good set and I am happy for you. Every student or Resident reading this should be looking for this kind of set up. Most podiatry practices don't have % of compensation ranging from 30-38%.
#2 A new associate starts in a practice with about 3-5 patients a day for many months. They expect you to market yourself and "build your own patient base" . So very hard to make bonus first year seeing 3-5 patient for the first few months. They say it takes a year to build your name and patient base which is ridiculous. A well run and busy practice should fill up your schedule from the first month like @Halux
#3 Most podiatry practices don't have a scribe
Lastly, most podiatry practices don't have a marketing plan (besides a website), the office managers job is to order supplies and take care of cat fights between the MA. A new associate have to go door to door to other doctors like a snake oil sales man handing out his own fliers and cards.
Or more like a high school graduate with optional 2 years associate degree initially hired as a front desk coordinator/Medical assistant, does occasional billing and coding, then patient scheduler, then turned surgery scheduler and ordering office supplies and finally metamorphose into the office manager.
So as a new associate, this is your handler who will be controlling your life
I was going to try and write a comical comparison to halux's experience - describing how quickly "we just want you to be happy" became spending 2 months asking for a $100 bottle of Cantharone or how "Dragon is too expensive", but it just reinforces the fact that I need to leave with a side of why haven't you left yet. Eh, can't stop myself. I think this has been a pretty good discussion of the ups and downs. I had a friend who is hospital employed tell me they hired some PP people who may have been owners and they said they were making more hospital employed than in their prior businesses. That said - as someone who is part of a dysfunctional practice - its totally possible to work really hard and make no money. Like see 30ish patients 4 days a week, 3-5 surgeries a week and barely break $400K in collections (and have high overhead too).
-Instead of offering profitable DME - spend your time cutting felt foot pads for people and encourage them to come back regularly to have their orthotics adjusted for free.
-Not diabetic? Bill a level 2 E&M for nails and calluses to a MA plan that pays 65% of Medicare - so like $20. A beautiful double whammy. Technically fraud and you made no money.
-Cut out a plantar wart and if it comes back - have 3-4 free visits and then refer to dermatology.
-Routinely debride wounds and then bill it as a level 3 instead of a wound code... perhaps for the best because none of the notes would ever pass an audit since they have no measurements...
-Never review your contracts, have no idea what anything pays. Accept a bunch of well-below-Medicare rates. Cry that everything pays poorly. Other docs in town try to get you to join IPO to negotiate better rates on health insurance for employees, pay rates, etc, but you say no.
-Have an office manager who never actually goes through the books - turns out thousands of dollars of "paid" money was sitting in limbo waiting to be put into the bank account if only someone would have clicked a button.
-Have difficulty with prior authorizations or some sort of issue with Tricare - announce you'll just see Tricare people for free rather than doing whatever paperwork
-Also unlimited post-op dressing change visits. Lots of them.
-Full sterile prep for matrixectomies with sheets and prep and sterile gloves.
-Gather no information ahead of time from patients about their insurance so people regularly show up for visits with insurance/Medicaid you don't accept and get turned away at the door. Hell awkward. Gather no information on if patient will have referral ahead of time.
-Try to make plans to do inpatient care, but you aren't going to add Medicaid/any new insurance plans ...who do you think ends up in a hospital needing podiatry care?
-Since you didn't gather any insurance information you also can't get deductible information ahead of time.
-Since you have no idea what anything pays - if people call asking for a quote on an office surgery just quote them the entire fee schedule price and then say ...well your insurance may reduce it somewhat.
-Quote cash pay patients full price and not have any set system in place for a price reduction - then haggle with them the day of, if they show up.
-Routinely let cash pay patients back into the office without noticing they don't have insurance so the doctor gets to have the money conversation.
-Don't like making customs because you hand cast so set the price really high to scare people off.
-Keep old EHR on expensive server you pay expensive IT company to maintain
Anyway. Looking forward to my own thing even if I never match the hospital game. I probably would be a bad hospital employee anyway since I don't need an MRI to treat 99% of MSK issues. I do order a lot of PT and vascular testing.
Things I'm planning.
-Hard focus on overhead. Evaluate inefficiencies, big and small. Cheap rent. avoid paying thousands of dollars a year for a basic, zero frills website, overpriced local companies for cleaning and 401ks and day to day crap like - 50 page faxes for a toenail referral printing on the machine. Should have been turned into an email by the machine....
-No paper charts - no huge bins of old crap. Everything gets scanned. Yeah, I get it. Its work. I don't want to pay for a storage facility to hold old charts.
-Actually negotiate/explore health insurance instead of just saying "all I care about is a PPO" and picking the first plan that comes along.
-I will optimize my fee schedule to stop scaring off cash pay patients. I will know the price of everything that happens in the office. Fee schedule for cash pay on website.
-Get their insurance information ahead of time. I've literally heard people crying when they found out they waited 3 weeks to get in and we don't accept Medicaid.
-No desperate conversations telling people they need surgery for benign podiatry conditions that will resolve.
-Make my own video marketing materials for things like ingrown nails, plantar warts, and bunions and winner - not having to care that someone else would be butthurt about it.
-Marketing - both real, online, in person, but also the GD appearance of the office. Sterile. Clean well lit. Not depressing. Fresh paint. No f^&*ing nails littering the hallway. No grubby, old, little bottles of lotions and potions sitting on counters.
-Get a partner in 2 years and don't screw them so they stay.
-DME. But like the sort of DME people might need like an affordable CAM boot or a nice orthotic - not some BS brace that DeHeer's people are trying to push in place of a CAM boot... I'm not selling anything I can't tell a patient the price of.
-Instead of offering profitable DME - spend your time cutting felt foot pads for people and encourage them to come back regularly to have their orthotics adjusted for free.
-Not diabetic? Bill a level 2 E&M for nails and calluses to a MA plan that pays 65% of Medicare - so like $20. A beautiful double whammy. Technically fraud and you made no money.
-Cut out a plantar wart and if it comes back - have 3-4 free visits and then refer to dermatology.
-Routinely debride wounds and then bill it as a level 3 instead of a wound code... perhaps for the best because none of the notes would ever pass an audit since they have no measurements...
-Never review your contracts, have no idea what anything pays. Accept a bunch of well-below-Medicare rates. Cry that everything pays poorly. Other docs in town try to get you to join IPO to negotiate better rates on health insurance for employees, pay rates, etc, but you say no.
-Have an office manager who never actually goes through the books - turns out thousands of dollars of "paid" money was sitting in limbo waiting to be put into the bank account if only someone would have clicked a button.
-Have difficulty with prior authorizations or some sort of issue with Tricare - announce you'll just see Tricare people for free rather than doing whatever paperwork
-Also unlimited post-op dressing change visits. Lots of them.
-Full sterile prep for matrixectomies with sheets and prep and sterile gloves.
-Gather no information ahead of time from patients about their insurance so people regularly show up for visits with insurance/Medicaid you don't accept and get turned away at the door. Hell awkward. Gather no information on if patient will have referral ahead of time.
-Try to make plans to do inpatient care, but you aren't going to add Medicaid/any new insurance plans ...who do you think ends up in a hospital needing podiatry care?
-Since you didn't gather any insurance information you also can't get deductible information ahead of time.
-Since you have no idea what anything pays - if people call asking for a quote on an office surgery just quote them the entire fee schedule price and then say ...well your insurance may reduce it somewhat.
-Quote cash pay patients full price and not have any set system in place for a price reduction - then haggle with them the day of, if they show up.
-Routinely let cash pay patients back into the office without noticing they don't have insurance so the doctor gets to have the money conversation.
-Don't like making customs because you hand cast so set the price really high to scare people off.
-Keep old EHR on expensive server you pay expensive IT company to maintain
Anyway. Looking forward to my own thing even if I never match the hospital game. I probably would be a bad hospital employee anyway since I don't need an MRI to treat 99% of MSK issues. I do order a lot of PT and vascular testing.
Things I'm planning.
-Hard focus on overhead. Evaluate inefficiencies, big and small. Cheap rent. avoid paying thousands of dollars a year for a basic, zero frills website, overpriced local companies for cleaning and 401ks and day to day crap like - 50 page faxes for a toenail referral printing on the machine. Should have been turned into an email by the machine....
-No paper charts - no huge bins of old crap. Everything gets scanned. Yeah, I get it. Its work. I don't want to pay for a storage facility to hold old charts.
-Actually negotiate/explore health insurance instead of just saying "all I care about is a PPO" and picking the first plan that comes along.
-I will optimize my fee schedule to stop scaring off cash pay patients. I will know the price of everything that happens in the office. Fee schedule for cash pay on website.
-Get their insurance information ahead of time. I've literally heard people crying when they found out they waited 3 weeks to get in and we don't accept Medicaid.
-No desperate conversations telling people they need surgery for benign podiatry conditions that will resolve.
-Make my own video marketing materials for things like ingrown nails, plantar warts, and bunions and winner - not having to care that someone else would be butthurt about it.
-Marketing - both real, online, in person, but also the GD appearance of the office. Sterile. Clean well lit. Not depressing. Fresh paint. No f^&*ing nails littering the hallway. No grubby, old, little bottles of lotions and potions sitting on counters.
-Get a partner in 2 years and don't screw them so they stay.
-DME. But like the sort of DME people might need like an affordable CAM boot or a nice orthotic - not some BS brace that DeHeer's people are trying to push in place of a CAM boot... I'm not selling anything I can't tell a patient the price of.
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WOW.... yes you are doing ALOT for free but even so if your getting paid on 25 pts and half of these sxs you should be in the 550k ball park... maybe that "office manager" has 150K floating around somewhere ? This is a very depressing situation that the office is in i would have lasted more than 4 months, there is extreme waste.. you have literally listed everything not to do, you are ready whenever you go out on your own
You're starting to make too much sense there sir.
The higher ups might come after you and twist your arm.
Do you guys recommend hiring a credentialing company to get on insurance panels vs doing all the leg work yourself?
Also, can I get started with credentialing midway through my PGY3 year or do I have to wait until I graduate from residency?
Is board qualification REQUIRED for credentialing?
Also, can I get started with credentialing midway through my PGY3 year or do I have to wait until I graduate from residency?
Is board qualification REQUIRED for credentialing?
Credentialing is something I would outsource but you have to follow up with them regularly to make sure they are checking on the application progress regularly.
You need an active state license to start credentialing which most residents do not have until graduation. You also need type 2 NPI if you’re opening up shop, which requires you to have your business registered with the state and an EIN from the feds.
Long story short, there are a lot of things you can start in terms of opening your own practice. But the credentialing can’t start for most people until after graduation from residency. You do not need to be board qualified or certified to start credentialing in my experience.
A friend was just offered a job in a rural area of a populous state. Hospital employed, a few orthos who do no foot/ankle. 360 base plus bonus, bennys, loan assistance, golf club membership. He thinks can get 400k to start. Likely 500k in 2 years. Fellowship trained, family friend knew CEO. Debating if wants to move family, currently in home state and in PP.
Podiatry is profitable for hospitals, you either need them to know it already or convince them
Podiatry is profitable for hospitals, you either need them to know it already or convince them
Question is how many years is the $360k base contract guaranteed for? We often hear of rural hospitals luring new grads into a small town initially then slashing the pay the following year (after of course you have a big mortgage, car payment and kids are in school system). This happens to all specialty and not just podiatry specific. Healthcare is a business.
#2 - A lot of things can happen after joining a rural hospital. The hospital can go bankrupt; the hospital can be bought by a bigger health care system and we know what usually happens afterwards, The hospital CEO and management can change, etc etc
Depending on his situation and flight distance, you can advise him if he can leave his family in the home state (fly home on the weekends) and see how the first year goes at the rural area hospital gig. Make good money the first year ($360K), save a lot of cash, and if the hospital decides to play games for the 2nd year contract, then he can move back to his home state and open his own PP.
After leaving his home state/city for a year, his non compete clause should be over. Open shop next door.
If I was in PP, I would take it. I actually got a similar offer from a hospital I talked to many many years ago. I wonder if it’s the same one. The offer I received was 350+k. Guarantee for 2 years.
I feel like this is talked about much more than it actually happens. I'm in year 4 at a relatively rural, but good sized hospital that is part of a large system. I frequently speak with 6 or so others that graduated on or around my year who are suburban/rural hospital employed and none have seen or experienced this. Not to say it can't happen and it is important to understand the implications of the contract you're signing especially when moving your family.
I started out of residency at 200k base +quality incentive bonus +production bonus +student loan stipend. The base was guaranteed 2 years and then switched to production based in year 3. Student loan stipend guaranteed for 3 years. At year 3 my production from year 2 raised my base to 235ish. Renegotiated new contract moving into year 4 and although I was a bit disappointed based on a few things I asked for, my base increased to 265k, student loan stipend ended, but RVU value increased to match the money I would lose from student loan stipend based on my previous year production. Overall I have been able to make 330-375k each year I've been here and they're happy to have me. Unfortunately, I graduated with a boatload of student loans and should pay them off in this next year. We rented the first year here and then bought a house that costs less that we make in a year. Have updated some things and now have ~100k equity in it. Just have to be smart and not dive in head first...In the end, I dont totally love where I live and will likely move on after my loans are paid, but it has been a good 1st job for sure.
Your #2 is definitely something that happens though and something I've seen happen at local community hospitals. The transition does not always have to be doom and gloom, but i do caution people of this who are taking rural hospital jobs hoping to take advantage of PSLF....If you have 300k in loans and go on REPAYE hoping for forgiveness in 10 years and your hospital suddenly stops being a 501(3)(c), youre going to have a bad time with your now 500k in student debt.
I’m glad to be doing my residency in an extremely rural area so that I can see, now, that I would much rather live and practice in the suburbs of a metropolitan area. As a student I always thought that I would gun for a non PP employed gig w/high base salary in the boonies if need be but now I know better.
Although the thought of raking in a lot of cash and paying off my student loans quicker is an attractive option, I figure it would be better to set up shop where I know I would want to live long term and climb the ladder from there as early as possible. To many, it doesn’t matter. Lucky you’s
I do know of Chief in the NE who got a hospital employed gig not too far from the big city with a $200K starting base so it’s not impossible but certainly more difficult I would imagine. It makes me wonder about the location of people who frequent these forums with large H/MSG/Ortho employed contracts.
Although the thought of raking in a lot of cash and paying off my student loans quicker is an attractive option, I figure it would be better to set up shop where I know I would want to live long term and climb the ladder from there as early as possible. To many, it doesn’t matter. Lucky you’s
I do know of Chief in the NE who got a hospital employed gig not too far from the big city with a $200K starting base so it’s not impossible but certainly more difficult I would imagine. It makes me wonder about the location of people who frequent these forums with large H/MSG/Ortho employed contracts.
Good insights. Thank you for your honest first hand experience. I am happy it is working out well for you.
I also never even thought of a hospital being bought out and then the hospital suddenly stops being a 501(3)(c). That is a big one too.
LOL at golf membership !
This sounds more in line with what ive been hearing in very high quality hospital gigs .... not all are like this, the less rual you go the less they pay
Random small thing. If you buy a doctor house in a small enough town the only person who can buy the house after you leave is another doctor.
Median compensation for podiatrists (foot and ankle surgery) that work in hospital/msg settings is $306k (MGMA). 25th %ile is $242k. It’s not as if $300k+ in yearly pay is some rural job phenomenon. And there is not a single rural job where you have the ability to make what a DPM in a bigger city/health system can. The rural job is paying you more per encounter (so a salary which on the outside seems inflated compared to the volume you see), but they can never pay as much as a big city where someone can crank out 11,000 wRVU each year. The volume isn’t there for rural to pay more overall, so they get you with larger salary guarantees and try to keep you with lifestyle perks (more paid time off, lighter clinic schedules, less call, etc.).
And I haven’t heard of any rural hospital/msg lowering pay in year 2 or 3, let alone “slashing” it. It doesn’t make sense from a financial standpoint which is probably why it rarely (if ever) happens.
Agree totally. Most of these contracts evergreen if not able to negotiate higher.
And yes, these rural contracts don't provide the upside that other larger cities may. That is one of the reasons I am leaving my job.
Sad that is the case when comparing the same MGMA data to foot and ankle ortho ( and dont tell me its due to call situation ) ... Again .... whats the sample size for this data ? how many listings are available in the US as of today for jobs like this ? Can you please send links ... come on now .... if this was the norm pod schools wouldnt be begging for applicants !! lets be real and stop trying to make this the normal ( dont get me wrong i would love for this to be the norm)
and Big cities dont pay as high as rural because they have alot of demand for the job... please find me big cities that pay 300K +
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read my post again. Every point in your post is either based on something I didn’t say, or just plain wrong.
I said it’s NOT as if it’s some rural phenomenon. MGMA data is based on hospital employed/msg data and it is total compensation, not base salary. I don’t know anyone in a big city, employed by a hospital or MSG who does not make over $300k with production incentives.
Nobody ever said these jobs were the norm, but for these types of jobs (of which there are more in big cities than there are in rural areas), median compensation is over $300k now. This isn’t skewed upward by rural data. It can’t be.
Rural jobs with high base salaries, excellent benefits (also part of the compensation package), and/or high $ per wRVU production incentives are common when those positions open up. Those things are more likely to be true of a rural msg job than one in a bigger city. But $300k base with a 5,400 wRVU threshold or $65 per wRVU sound great, until you realize that you only have the volume to do around 4600 wRVU. Compare that to a big city system with a $240k base, 5,400 wRVU threshold or $50 per wRVU where you can do 8,000 wRVU.
In the end, the person doing more volume generally makes more money. That is true across all practice settings. Bigger city health systems generally have more volume than rural systems can provide. They generally make more money because of it. I’m not sure what is even debatable about what I said...
off the top of my head?
Minneapolis/St. Paul, Pittsburgh, Dallas, Fort Worth, Portland, San Fransisco, Oakland, San Diego, Los Angeles, Detroit, Denver, Louisville, Baltimore, Virginia Beach...
those are just cities where I personally know someone working for a hospital/MSG, at or above MGMA median compensation. Obviously I’m missing a whole lot of jobs in a whole lot of cities. And, since my last post wasn’t clear enough, I’m not saying these jobs are more common than working for other podiatrists, they aren’t.
What are you even saying at this point man, i ask questions in my post ?!! guess its WRONG to ask questions ... its pointless
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Great that you know 14 friends there ....Where are these job listings which show total comp of 300k+ ?
You asked which cities do employed podiatrists make over $300k. I gave you plenty of big cities with big healthcare systems (like Kaiser) where podiatrists get paid over $300k, but you dismissed it because I didn’t list enough?
And you understand that total compensation is rarely listed on job posts? And that most jobs (even podiatry group jobs) aren’t ever listed on a job board, right?
If a majority of hospital/msg jobs paid less then $300k, it would be very difficult for any well done survey to show a median income of $306k. Really, it would be impossible. You keep moving the goalposts, which has to be pretty obvious for others following along at this point.
Coming right out of residency its going to be hard to get a job at a hospital system in a large city unless you are a graduate of their residency program
More established DPMs who have made a name for themselves have more options.
Plenty of DPMs work for hospital systems in large cities. Many are associated with residency programs.
I got an offer in a catholic health hospital in a large city a couple months ago. They contacted me. I declined as I am happy in my current situation and compensation would have been about the same - probably a little more but higher cost of living.
The jobs exist but someone fresh out of residency with no experience in the real world with board qualified status is going to have a hard time landing their dream job in the heart of Chicago.
More established DPMs who have made a name for themselves have more options.
Plenty of DPMs work for hospital systems in large cities. Many are associated with residency programs.
I got an offer in a catholic health hospital in a large city a couple months ago. They contacted me. I declined as I am happy in my current situation and compensation would have been about the same - probably a little more but higher cost of living.
The jobs exist but someone fresh out of residency with no experience in the real world with board qualified status is going to have a hard time landing their dream job in the heart of Chicago.
I can confirm that Kaiser in certain parts of California starts their podiatry “surgeons” at 375k base.
I agree. Documented experience and being able to produce your productivity and patient satisfaction score data along with sending your CV is a stronger application than someone fresh out of residency or even fellowship training.
Residents who have a real connection to the geographic area (grew up there or trained there) are typically stronger candidates for hospital jobs in those areas. Recruiters want to know they are getting someone with ties who will not leave after 1-2 years.
DPMs who are currently practicing in the state are theoretically stronger candidates for hospital gigs because they have an established presence in the area.
This is not 100% of the time. There are exceptions. Sometimes hospitals are not actively looking until someone knocks on their door and they realize they could make a lot of money having someone on staff rather than letting the pathology go into the community.
This is a fact. But cost of living is astronomical in California. Kaiser employed DPMs are not getting the typical RVU incentive bonuses that one would see being employed at a non Kaiser hospital. If you blow it out of the water you can make some serious money with your bonuses. More money then you could ever earn at Kaiser.
The Chicago situation above (who gets hired first) made me wonder about this.
You're an established doctor in whatever city. Somewhere not east or west coast. Let's say you own a private practice. You do 5 elective surgeries a week at the hospital that you booked from your PP clinic - with more than 1/2 being Blue Cross and the rest being Medicare. You refer them your MRIs. You refer to their vascular team/cardiology and to their PT/neurology. Maybe you even come in to do an amp occasionally or do a 1/2 day in their WHC (which exists let's be honest - solely to feed hyperbarics).
Isn't the hospital already getting the best of it? Is there a "why buy the cow when the milk is free" to this? You're feeding their most profitable services without even being an employee?
You're an established doctor in whatever city. Somewhere not east or west coast. Let's say you own a private practice. You do 5 elective surgeries a week at the hospital that you booked from your PP clinic - with more than 1/2 being Blue Cross and the rest being Medicare. You refer them your MRIs. You refer to their vascular team/cardiology and to their PT/neurology. Maybe you even come in to do an amp occasionally or do a 1/2 day in their WHC (which exists let's be honest - solely to feed hyperbarics).
Isn't the hospital already getting the best of it? Is there a "why buy the cow when the milk is free" to this? You're feeding their most profitable services without even being an employee?
