Surgery time

[Breno58]

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I am interested in obtaing a surgical residency if I was to choose podiatric school, can anyone tell me how much time is spent in an office setting v.s surgery time. Is there alot of surgery, or mostly office visits? Anyone that has shadowed or knows the answer would help me out alot! Thanks....

 

[FC Omar]

I am interested in obtaing a surgical residency if I was to choose podiatric school, can anyone tell me how much time is spent in an office setting v.s surgery time. Is there alot of surgery, or mostly office visits? Anyone that has shadowed or knows the answer would help me out alot! Thanks....

that is up to you. the pod i shadowed always dedicated 1 day a week to surgery. i applied to pod school b/c you are still a surgeon. and from what ive seen/heard, you can do a **** load of surgery. but that is not all the type of stuff you do, and not always what you want to jump into doing.

ask PADPM, or Kidsfeet, or any of the practicing DPMs on here. but from what ive heard seen (keep in mind, im only a 1st year), you can do a lot of surgery, if you want it.

 

[javajava]

I am interested in obtaing a surgical residency if I was to choose podiatric school, can anyone tell me how much time is spent in an office setting v.s surgery time. Is there alot of surgery, or mostly office visits? Anyone that has shadowed or knows the answer would help me out alot! Thanks....

Im quoting Feli, a resident

Yes, it's still good info. There was also a repeat of that study by the APMA in 2007.

I think that maybe the best study was the 2005 study of ACFAS members (therefore, people who passed ABPS boards and joined the college, not just all DPMs regardless of residency training, etc):
-86% private pod practice (of those 46% solo/54% group), 9% multispec clinic, 5% other (hospital employed, industry, etc)
-Avg is 44hrs/wk... 115 office pt/wk (15% new pts)
-In an avg month for an the avg member time was spent 68% seeing pts, 15% surgery, 10% admin, 3% consults, 4% other (research, etc)

... The AAPPM has some of the best studies on income. These studies are all interesting, and they are all discussed in the practice management class during Barry 4th year. I would post some of these PDF files, but they're too large and I think they contain some info that's supposed to be restricted access. These "what comes after residency" topics are VERY good things to think about, though. 👍
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I think surgery is gonna be once a week for most

 

[Breno58]

Wonder how this compares to Orthopedic surgeons? Im hoping for alot of surgery! The surgery is really the main reason for me wanting to become a podiatrist and of course the patients...👍

 

[javajava]

Wonder how this compares to Orthopedic surgeons? Im hoping for alot of surgery! The surgery is really the main reason for me wanting to become a podiatrist and of course the patients...👍

I think orthos would do more

dont worry youll be doing alot of surgery, but even more non surgical procedures jkjk jk

 

[NoStress]

The podiatrist I shadowed had a surgery at least once a week ranging from the pretty common bunionectomy to complex ankle reconstructions. He told me, if he wanted to, he could book surgeries 3-5 times a week, but he didn't want to be that busy. He owned his own practice along with one other podiatrist, and they seemed pretty well off in terms of the variety of patients they encountered during the short time I've been observing.

 

[Breno58]

Thanks for the information everyone! It helped alot.....The 3-5 days sounds pretty nice 🙂

 

[347932]

Thanks for the information everyone! It helped alot.....The 3-5 days sounds pretty nice 🙂

...until you realize that doing surgery all the time is not going to pay your bills. Patient per patient you can make A LOT more money doing mostly office based care in podiatry.

Surgery is great, but the fact of the matter is, the more surgery you do, the less money you make. At least for us mere mortals.

 

[PADPM]

Thanks for the information everyone! It helped alot.....The 3-5 days sounds pretty nice 🙂

Let's all be mature and let's all be realistic. If you are performing surgery 5 days a week, when do you propose that you will be treating patients in your office to GENERATE these surgical patients? If you are performing surgery 5 days a week, when do you propose you will be seeing these patients post operatively? When you are performing surgery 5 days a week, when do you propose you will be doing hospital consultations or visiting your in house patients?? When you are performing surgery 5 days a week, when do you propose you will be treating patients who may actually want to see you for an ankle sprain, metatarsal fracture, or G-d forbid a lowly ingrown nail?

Now is when the cold water gets splashed in your face. This is NOT a specialty that lends itself to being "primarily surgery" for the VAST majority of DPMs. Yes, there are always, yes always exceptions. But I've been in this business for many years and in the 3 surrounding states where I practice, I can count the number of practices who perform surgery more than 2 days a week on a regular basis on one hand.

Not every patient who enters your office needs, wants or requires surgical correction.

I'm a partner in a very busy multi-doctor practice with several locations. I treat about 200 patients a week and spend one day in surgery for elective cases, and often another afternoon performing emergency cases. And I do VERY little routine foot care, just ask Kidsfeet. He was actually in my office today observing as he was passing through the area.

I treated 46 patients today, and 3 were "routine" care. Yes, I booked 3 surgical cases, but as a general rule, the overwhelming majority of my patients were treated and very happy without surgical intervention.

I keep reading about all the pre-medical/pre-podiatry students who "just want to do surgery". If that's truly the case, you may want to reconsider and enter a specialty like general surgery or trauma surgery.

Even the orthopedic surgeons I know average time in the O.R. about 1-2 days weekly. They treat a lot of injuries, fractures, sprains, etc., and don't spend all their time in the O.R. That's a myth.

Once again, there are ALWAYS exceptions, but I'm not going to waste my time speaking about those....I'm speaking of the great majority.

I'm on staff at SIX hospitals, and most BUSY DPM's are performing cases once a week, and many aren't performing cases that often.

 

[347932]

I'm a partner in a very busy multi-doctor practice with several locations. I treat about 200 patients a week and spend one day in surgery for elective cases, and often another afternoon performing emergency cases. And I do VERY little routine foot care, just ask Kidsfeet. He was actually in my office today observing as he was passing through the area.

I treated 46 patients today, and 3 were "routine" care. Yes, I booked 3 surgical cases, but as a general rule, the overwhelming majority of my patients were treated and very happy without surgical intervention.

I'm on staff at SIX hospitals, and most BUSY DPM's are performing cases once a week, and many aren't performing cases that often.

Yep.

 

[amaprez]

Is there ever a concern than there might be potential for surgical skills to atrophy given that you only use them 1 day out of the week? I know general surgeons in the military are commonly griping about their skills atrophying due to low case volumes. Or is this not really applicable to podiatry?

 

[347932]

Is there ever a concern than there might be potential for surgical skills to atrophy given that you only use them 1 day out of the week? I know general surgeons in the military are commonly griping about their skills atrophying due to low case volumes. Or is this not really applicable to podiatry?

Good question.

My take on it is that if you are a skilled surgeon, you are a skilled surgeon.

I can tell you that the best you will ever be, hands wise, is the day you graduate from your residency, however surgery encompasses much more than just how good you are with your hands. The experience you glean over time and the care with which you take of your patients makes you a much better physician AND surgeon over the long run.

If you don't do anything with your hands for months and months, you may get "rusty", but it's amazing how quickly things return to you once you get busy again. It is somewhat like riding a bike, so to speak.

I wouldn't worry about losing skill if one week you don't have any cases. It just doesn't happen imo. If it does concern you though, there are plenty of fine motor skills you can practice without ever setting foot in an OR.

 

[amaprez]

If it does concern you though, there are plenty of fine motor skills you can practice without ever setting foot in an OR.

*Rushes out to buy video games* Jk. I'm the kind of person who forgets things quickly if I haven't used it in a while. It's good to know that hand skills are like riding a bike...if only that were true for my basic science knowledge 🙂

 

[PADPM]

I can tell you that the best you will ever be, hands wise, is the day you graduate from your residency

Sorry my friend, I could not disagree more. Just as with any other skill, with experience comes improvement. I believe I learn something everytime I go into the O.R., and although that does not necessarily mean my "hands are better", I sincerely believe that my hands and skills have improved over the years, and so have the majority of grads I've had the good fortune of observing.

And no, your skills certainly don't get rusty by performing surgery "only" once a week. I had a friend who for personal reasons didn't perform surgery for about 2 years. When he returned, he had to be observed and it was if he never took a leave of absence. Certain skills become "set", and although I would definitely want someone with experience on a regular basis, taking off a week, several weeks or even a month or two should not make a well trained surgeon "rusty".

 

[347932]

Sorry my friend, I could not disagree more. Just as with any other skill, with experience comes improvement. I believe I learn something everytime I go into the O.R., and although that does not necessarily mean my "hands are better", I sincerely believe that my hands and skills have improved over the years, and so have the majority of grads I've had the good fortune of observing.

My take on that is that in three years, I did about 2500 cases in residency and all I did was surgery, every morning, 5-6 days a week. I agree that skills improve with experience, but I would say that pure hand skills alone are at the peak.

I too learn something every time I do a case, which improves my over all "skill" as a surgeon. I can't argue with that one bit.

 

[347932]

*Rushes out to buy video games* Jk. I'm the kind of person who forgets things quickly if I haven't used it in a while. It's good to know that hand skills are like riding a bike...if only that were true for my basic science knowledge 🙂

Want to try something cool?

Go out and get Super Mario Galaxy on the Wii. One of the levels requires you to use the motion controller to control Mario walking on a large ball. See if you can make him move slowly, medium, fast, side to side, forward and backwards without him falling off the ledge. The controller is VERY sensitive and it's not that easy to do well. And it teaches you to not look at your hands while controlling Mario. That's how I keep my arthroscopy skills sharp between cases. No, I'm not kidding. I was thinking about incorporating that into the next round of residency interviews!😀

 

[PADPM]

Want to try something cool?

Go out and get Super Mario Galaxy on the Wii. One of the levels requires you to use the motion controller to control Mario walking on a large ball. See if you can make him move slowly, medium, fast, side to side, forward and backwards without him falling off the ledge. The controller is VERY sensitive and it's not that easy to do well. And it teaches you to not look at your hands while controlling Mario. That's how I keep my arthroscopy skills sharp between cases. No, I'm not kidding. I was thinking about incorporating that into the next round of residency interviews!😀

Please don't tell this to your next arthroscopy patient.😱

 

[347932]

Please don't tell this to your next arthroscopy patient.😱

Practice makes perfect!😛