The AAOS and AOFAS agenda

[CutsWithFury]

Listen ladies and gents. Our profession is losing. Bigger and bigger hospitals that are well respected are now hiring podiatrists but for one specific purpose. To do all the things that no one else wants to do.

Job postings like this tells us what the AAOS and AOFAS really think about our profession and our training/education.

Well experienced non-fellowship DPMs can't even apply for this job!

The sad part is some of our fellowship trained podiatrists will actually consider this job opportunity an “opportunity” because the job prospects out there across the nation are poor.

Who the hell wants to work for another podiatrist for 75k/100k starting salary?!?

“swallow my pride and advanced training to work for an orthopedic group that will just feed me crap? I have no other choice. At least I will be part of a prestigious university medical center.”

The first fellowship trained DPM who accepts this job sets us back. It sets the whole profession back. This is exactly what the AAOS and AOFAS want.

They want to stifle the ever-growing DPM fellowship training model by offering jobs only to fellowship trained DPMs to do just foot surgery. The more fellowship trained DPMs who accept these jobs will do great damage to the ACFAS and their fellowship training programs.

It will set the precedent to the medical community, across all professions, that a fellowship trained DPM can only handle foot surgery.

Wake up people. Open your eyes. Our own profession is letting everything we have gained slip through our fingers. The annual ACFAS podium lecturers don’t care because they are already entrenched in their careers and consulting deals.

I AM TALKING TO THE PODIATRISTS WITH 5 YEARS OR LESS PRACTICE EXPERIENCE. WE ARE THE FUTURE. WE AS A PROFESSION WE CAN NOT ACCEPT THESE JOBS.

The AAOS and AOFAS are winning.

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[AttackNME]

Looks like they’re looking for someone to do limb salvage and research with Dr Armstrong and are looking for fellows from limb salvage programs. There are podiatrists that focus on this type of work who would take this job and have become very successful. Would you rather limb salvage be taken over by nurse practitioners, physical therapists, or anyone else?

 

[CutsWithFury]

Looks like they’re looking for someone to do limb salvage and research with Dr Armstrong and are looking for fellows from limb salvage programs. There are podiatrists that focus on this type of work who would take this job and have become very successful. Would you rather limb salvage be taken over by nurse practitioners, physical therapists, or anyone else?

Putting on dressings to treat wounds is one thing. Cutting to save a limb is another. NPs and physical therapists are not a direct threat. They will never cut.

Vascular/general surgery are not interested except for angioplasties and bypasses.

I do a ton of wound care and surgery for limb salvage.

 

[hematosis]

I don't see any specifics on this job. How do you know its only foot surgery? it looks like their department already has one DPM who practices full scope Podiatry. If they are able to practice within their scope and training, then i don't see why this job posting is an insult to Podiatrist.

 

[CutsWithFury]

I don't see any specifics on this job. How do you know its only foot surgery? it looks like their department already has one DPM who practices full scope Podiatry. If they are able to practice within their scope and training, then i don't see why this job posting is an insult to Podiatrist.

Most university hospital jobs that have been posted in the past were only for DPMs to do foot surgery. Do a search. University of Colorado had one. University of West Virginia had one. Kaiser Permanente Washington medical group is doing the same.

Who is the podiatrist at USC that practices full spectrum podiatry (toenails to total ankle replacements)?

 

[josebiwasabi]

James Chun Wang, DPM - Beverly Hills, CA - Foot and Ankle Surgery, Podiatry - Request Appointment

Specialties
Foot and Ankle Surgery
Podiatry

Specializing In
Injuries and Deformities of the Foot and Ankle, Reconstructive and Traumatological Surgery of the Foot and Ankle, Minimally Invasive Techniques for Bunion Correction, Metatarsal Lengthening in Congenital Short Metatarsals

 

[CutsWithFury]

Well well another garbage agenda driven research study to trash our profession. If JBJS prints it must be true.

First they printed that podiatrists fixing ankle fractures lead to poorer outcomes with their biased methodology and now they doing the same thing with TARs and Ankle fusions

Study Asserts Higher Costs And Longer Hospital Stays When DPMs Perform Ankle Arthroplasty And Ankle Arthrodesis Procedures

 

[CutsWithFury]

here's another crappy job for everyone in denial. Wounds and toe amps only.

Podiatrist for Duke Orthopaedics in Raleigh, NC Area job with Duke Health | 252999

 

[dorsiflexor]

here's another crappy job for everyone in denial. Wounds and toe amps only.

Podiatrist for Duke Orthopaedics in Raleigh, NC Area job with Duke Health | 252999

Think this is probably a very good indication of what the duke podiatry fellowship entails. What a joke.

 

[ExperiencedDPM]

Although the quality of the program may be questionable, it may open doors. The orthopedic community knows and cares very little about podiatry. The majority of Podiatric residency programs are not at well known, major university hospitals. Of course I know there are programs at well known institutions, but those are not the majority.

There are also fellowships associated with some Podiatric practices and groups. These fellowships may be amazing but there may be no name recognition to the allopathic world.

I work with orthopedic surgeons in my current position, and I am very aware of what they know about podiatry.

If someone is applying for a position with an ortho group or multi specialty group and you come out of a small hospital or come out of a fellowship sponsored by someone they don’t know, and you are up against someone who did a residency at Yale (which is not a super strong program) and someone who did a fellowship at Duke, the orthopods will jump on the Yale and Duke candidate.

Although we as DPMs may know better, to the MD world it’s all name recognition.

 

[Carbon13]

Although we as DPMs may know better, to the MD world it’s all name recognition.

I'm Bonafide

 

[StressRisers]

here's another crappy job for everyone in denial. Wounds and toe amps only.

Podiatrist for Duke Orthopaedics in Raleigh, NC Area job with Duke Health | 252999

Funny, this job is still available. I interviewed for this position more than a year ago. The job posting at that time did not specify the different level of amps and who they go to. I remember the chief telling me that they want their ortho residents to get ALL the amps because they needed the numbers. Maybe they changed it because no one was taking the job...

 

[AttackNME]

Funny, this job is still available. I interviewed for this position more than a year ago. The job posting at that time did not specify the different level of amps and who they go to. I remember the chief telling me that they want their ortho residents to get ALL the amps because they needed the numbers. Maybe they changed it because no one was taking the job...

What exactly did they want the podiatrist to do then?

 

[Scrantonicity]

What exactly did they want the podiatrist to do then?

It says you'll run a regular clinic, right? Probably not all in one place though--a few locations around the county (and take all your surgeries to their OR) Also having a time slot at their wound care center... seems like a normal hospital podiatry job to me. If you don't have to do all the amps yourself, even better! Also nice to be able to turf your Charcot recons to someone else. Not sure what's so bad about this job posting unless I'm reading it wrong...

 

[CutsWithFury]

It says you'll run a regular clinic, right? Probably not all in one place though--a few locations around the county (and take all your surgeries to their OR) Also having a time slot at their wound care center... seems like a normal hospital podiatry job to me. If you don't have to do all the amps yourself, even better! Also nice to be able to turf your Charcot recons to someone else. Not sure what's so bad about this job posting unless I'm reading it wrong...

How about showing some spine and demonstrating that WE (podiatrists) are competent foot and ankle surgeons and can handle more than this crappy job offers. Jobs like these are what ortho wants us to take. They don't like it when podiatrists are doing foot and ankle surgery in ortho groups and in hospital based MSGs.

 

[Scrantonicity]

How about showing some spine and demonstrating that WE (podiatrists) are competent foot and ankle surgeons and can handle more than this crappy job offers. Jobs like these are what ortho wants us to take. They don't like it when podiatrists are doing foot and ankle surgery in ortho groups and in hospital based MSGs.

This looks like a hospital based MSG, was my point. Nowhere does it say you'll only do amputations and wound care.

I do agree I was a bit rankled about the wording--where it says the more "complex" Charcot cases will go to ortho--but I personally HATE doing anything on Charcot patients besides the ol' plantar exostectomy w/ TAL. Anyways, my spine is intact thanks.

 

[StressRisers]

What exactly did they want the podiatrist to do then?

The job posting at the time didn't indicate that it was non-surgical, but that's what it was.

It says you'll run a regular clinic, right? Probably not all in one place though--a few locations around the county (and take all your surgeries to their OR) Also having a time slot at their wound care center... seems like a normal hospital podiatry job to me. If you don't have to do all the amps yourself, even better! Also nice to be able to turf your Charcot recons to someone else. Not sure what's so bad about this job posting unless I'm reading it wrong...

I can't remember it to that detail now, but it did sound like it was at 2 different clinics. No surgeries at all so no OR. Lots of academic meetings that you're required to attend. Sounds like they wanted some research studies conducted there as well.

 

[Scrantonicity]

The job posting at the time didn't indicate that it was non-surgical, but that's what it was.




I can't remember it to that detail now, but it did sound like it was at 2 different clinics. No surgeries at all so no OR. Lots of academic meetings that you're required to attend. Sounds like they wanted some research studies conducted there as well.

Huh...well...that's pretty lame then. Sure didn't get that impression reading the post. And it looks like they already have 5 podiatrists there in that big group...guess they all just see patients and send their surgeries off to the F&A orthopods...
I see now why you gave it a pass.
In that case, I agree with CutsWithFury and dorsiflexor--what a freakin' joke.

 

[CutsWithFury]

Here’s another gem position posted on the AOFAS website

Podiatrist Job Opening in Colorado - American Orthopaedic Foot & Ankle Society (AOFAS)

A new Podiatrist job is available in Colorado. Check it out on American Orthopaedic Foot & Ankle Society (AOFAS).

careers.aofas.org

 

[CutsWithFury]

Here’s another gem position posted on the AOFAS website

Podiatrist Job Opening in Colorado - American Orthopaedic Foot & Ankle Society (AOFAS)

A new Podiatrist job is available in Colorado. Check it out on American Orthopaedic Foot & Ankle Society (AOFAS).

careers.aofas.org

View attachment 268201

They want a fellowship trained podiatrist to do basic diabetic at risk foot care and wounds...........

 

[PatchAdamsFan]

It is telling that these 'Orthopaedic group' positions likely pay significantly more than the majority of pod associate positions do. Not defending the position (frankly it is purposefully demeaning to our profession), but can be a goldmine for grads with poor training/no interest in surgery.

 

[CutsWithFury]

It is telling that these 'Orthopaedic group' positions likely pay significantly more than the majority of pod associate positions do. Not defending the position (frankly it is purposefully demeaning to our profession), but can be a goldmine for grads with poor training/no interest in surgery.

There will always be poorly trained podiatrists taking these jobs. This job will pay more than any podiatry associate job.

 

[StressRisers]

It is telling that these 'Orthopaedic group' positions likely pay significantly more than the majority of pod associate positions do. Not defending the position (frankly it is purposefully demeaning to our profession), but can be a goldmine for grads with poor training/no interest in surgery.

Actually, they are expecting a double-board certified pod with fellowship training, so those poorly trained pods wouldn't get their foot in the door while the qualified pods would find this position beneath them. What a world.

 

[CutsWithFury]

Actually, they are expecting a double-board certified pod with fellowship training, so those poorly trained pods wouldn't get their foot in the door while the qualified pods would find this position beneath them. What a world.

You nailed it. I don’t understand why nobody cares to talk about these things going on. AOFAS is basically telling us to our face that they have no respect via jobs and the recent published articles.

 

[ExperiencedDPM]

I see it differently. It’s an option that you can take or not take. But for some of the younger, “gung ho” pods out there, after a few years your ideas may change.

Big cases also can mean big problems and it’s not always a smooth ride. All the associates I’ve hired have strong training and all wanted to do big cases. After 1-2 years they ALL backed off since these cases can get difficult.

Prior to the associates and prior to me providing them with surgical patients, I was the number one “surgeon” in our practice. One of the older docs who saw a large volume and no surgery, out-produced me.

I work with orthopedic surgeons daily and one of my colleagues does 500 total knee replacements a year and makes less than one of the non surgical docs. Medicare pays about 1200 for a total knee.

The job offer stated that the new hire will do about 100-150 cases a year. With the security of the job and it’s benefits, in the LONG run this may be a great opportunity. I’m sure the salary is also pretty decent. Just the thoughts of someone who has “been there and done that”.

 

[CutsWithFury]

This job offer is insulting to our profession. Join a primary care group and get 50 routine diabetic foot care patients dumped on you daily and get paid straight 100k-125k salary for it in one of the most expensive counties in NJ let alone the United States.

BUT someone in this profession will take this job because this is actually a better offer than a lot of private practice podiatry associate gigs.

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[deleted1003403]

11 years of education if you include undergrad just to make $100,000 with $250,000 in loans.that’s a starvation wage. podiatry is losing

 

[G0dFather]

This job offer is insulting to our profession. Join a primary care group and get 50 routine diabetic foot care patients dumped on you daily and get paid straight 100k-125k salary for it in one of the most expensive counties in NJ let alone the United States.

BUT someone in this profession will take this job because this is actually a better offer than a lot of private practice podiatry associate gigs.

View attachment 288160


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YEAH.. so that is what im talking about .... in this area these are the kind of gigs that exist, i know everyone slams working for pods in this area but working for these MSG and ortho groups in this region is not that much better yeah you may make an extra 20K but they will slam you with a ton more work like you said above ... all while making a fortune off you ( 50 pt a day is serious money!)

 

[G0dFather]

Medicare pays about 1200 for a total knee.

Wow all those years of training and expertise for that amount per case .... guess we shouldn't be complaining about the HT and HAV reimbursement given how much quicker and less involved those cases are compared to a TKA

 

[JewOnThis]

I will bet you that NJ gig will have 100+ applicants . Keep in mind that it’s probably the older pods telling these msgs and orthos how much they should pay us.

 

[Dochopeful13]

YEAH.. so that is what im talking about .... in this area these are the kind of gigs that exist, i know everyone slams working for pods in this area but working for these MSG and ortho groups in this region is not that much better yeah you may make an extra 20K but they will slam you with a ton more work like you said above ... all while making a fortune off you ( 50 pt a day is serious money!)

What areas/ states pay the best?

 

[JewOnThis]

There was a job in Iowa or somewhere around that area that had a base salary of 375k. It was filled by a grad from UPMC .

 

[CutsWithFury]

There was a job in Iowa or somewhere around that area that had a base salary of 375k. It was filled by a grad from UPMC .

Hospital or ortho?


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[JewOnThis]

Hospital

 

[CutsWithFury]

I think DeHeer reads this thread. Guy knows what’s up.

Could A Recent ‘Emergency Resolution’ From AOFAS Sabotage Progress With Podiatry Scope Of Practice Efforts?

“I’m as mad as hell and I’m not going to take this anymore!” - Peter Finch as Howard Beale in the 1976 movie Network. The aforementioned scene comes to mind when I recall learning that a so-called “emergency resolution” was to be introduced by the American Orthopedic Foot and Ankle Society...

www.podiatrytoday.com

AOFAS and AAOS has no respect for us and wants to minimize our profession as non surgical providers to feed ortho foot and ankle cases.

I am seeing this nationally with ortho groups wanting to hire DPMs purely for non surgical work up of foot and ankle pathology.

The AOFAS dedicates lectures at their national conference on “how to deal with podiatry”

Orthos lecturing stating how they are willing to “pay more” for DPMs because they know how bad the private practice market is for us.

Would you rather be used and abused by the old school DPM owner as an associate (sometimes with no pay way or opportunity to partner) or make 2-2.5x your base salary and get benefits working for an Ortho group but become purely non surgical?

They are winning




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[air bud]

I think DeHeer reads this thread. Guy knows what’s up.

Could A Recent ‘Emergency Resolution’ From AOFAS Sabotage Progress With Podiatry Scope Of Practice Efforts?

“I’m as mad as hell and I’m not going to take this anymore!” - Peter Finch as Howard Beale in the 1976 movie Network. The aforementioned scene comes to mind when I recall learning that a so-called “emergency resolution” was to be introduced by the American Orthopedic Foot and Ankle Society...

www.podiatrytoday.com

AOFAS and AAOS has no respect for us and wants to minimize our profession as non surgical providers to feed ortho foot and ankle cases.

I am seeing this nationally with ortho groups wanting to hire DPMs purely for non surgical work up of foot and ankle pathology.

The AOFAS dedicates lectures at their national conference on “how to deal with podiatry”

Orthos lecturing stating how they are willing to “pay more” for DPMs because they know how bad the private practice market is for us.

Would you rather be used and abused by the old school DPM owner as an associate (sometimes with no pay way or opportunity to partner) or make 2-2.5x your base salary and get benefits working for an Ortho group but become purely non surgical?

They are winning




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Would rather be non surgical and make 350 with no call and great Benny's. No question, would hand over my scalpel tomorrow.

But then again you already know this.

 

[CutsWithFury]

Would rather be non surgical and make 350 with no call and great Benny's. No question, would hand over my scalpel tomorrow.

But then again you already know this.

Exactly

Says the guy who sees like 5 patients a month

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[heybrother]

My problem with being non-surgical would be that presumably I'd have to see post-ops for other people and in general following the foot surgery of others is an exercise in stoic faces and weak apologies and what not. Had to follow an Austin the other day that should have been a 1st MPJ fusion. My bunion seems to still be there. Hrm, we'll just have to see how it goes.

 

[JewOnThis]

Podiatry is a crap show. As long as we get rid of these old timers who control the more prominent organizations we will be okay.

 

[G0dFather]

Podiatry is a crap show. As long as we get rid of these old timers who control the more prominent organizations we will be okay.

They will just be replaced by the same

 

[JewOnThis]

They will just be replaced by the same

You are absolutely right.

 

[air bud]

My problem with being non-surgical would be that presumably I'd have to see post-ops for other people and in general following the foot surgery of others is an exercise in stoic faces and weak apologies and what not. Had to follow an Austin the other day that should have been a 1st MPJ fusion. My bunion seems to still be there. Hrm, we'll just have to see how it goes.

I have a friend that is non surgical. He took the money. He does not see post ops of other guys in practice. He is not a PA. He just seems patients that don't need surgery

 

[dtrack22]

I’d be non surgical for a $375k base and benefits. Wouldn’t hesitate. I’d do the bare minimum, collect my paycheck and live life. Hang out with family. Do fun crap

 

[G0dFather]

I’d be non surgical for a $375k base and benefits. Wouldn’t hesitate. I’d do the bare minimum, collect my paycheck and live life. Hang out with family. Do fun crap

Ok lets talk logistics here ... so plus bene's your base compensation would be about lets say $400K... for anyone to realistically pay you that you would have to bring in at least 800k-900k gross right? .... at the in-network compensations rate that im seeing that would mean you'd have to be seeing at least 130 pts per week averaging $125 per patient... a solid 25 pts per day 5 days a week ... doable actually but itll be a heavy grind

 

[CutsWithFury]

Ok lets talk logistics here ... so plus bene's your base compensation would be about lets say $400K... for anyone to realistically pay you that you would have to bring in at least 800k-900k gross right? .... at the in-network compensations rate that im seeing that would mean you'd have to be seeing at least 130 pts per week averaging $125 per patient... a solid 25 pts per day 5 days a week ... doable actually but itll be a heavy grind

you think 25 patients a day is a heavy grind?

 

[air bud]

you think 25 patients a day is a heavy grind?

oh boy....

 

[dtrack22]

for anyone to realistically pay you that you would have to bring in at least 800k-900k gross right?

at the in-network compensations rate that im seeing that would mean you'd have to be seeing at least 130 pts per week averaging $125 per patient

you’re thinking about this like someone who works private/group practice in an outpatient clinic setting. Which is wrong.

An outpatient clinic, attached to a hospital, could be charging those 130 patients a $75 facility fee. Which means each week, without counting a single e/m or CPT code billed, you generated over $9,000 in revenue. That alone is over $400k per year. Just in facility fees. That doesn’t include revenue that your employer gets from every CT or MRI you order. EMG/NCVS, ABI, PT referral, etc.

For YOU to pay someone $400k they would have to bring in the $ you’re talking about. A hospital can pay a podiatrist that even if their collections from e/m and CPT codes total, let’s say, $500-600k. Now tell me how many patients I’d have to see...

 

[air bud]

you’re thinking about this like someone who works private/group practice in an outpatient clinic setting. Which is wrong.

An outpatient clinic, attached to a hospital, could be charging those 130 patients a $75 facility fee. Which means each week, without counting a single e/m or CPT code billed, you generated over $9,000 in revenue. That alone is over $400k per year. Just in facility fees. That doesn’t include revenue that your employer gets from every CT or MRI you order. EMG/NCVS, ABI, PT referral, etc.

For YOU to pay someone $400k they would have to bring in the $ you’re talking about. A hospital can pay a podiatrist that even if their collections from e/m and CPT codes total, let’s say, $500-600k. Now tell me how many patients I’d have to see...

So is this why I have a job??

 

[CutsWithFury]

you’re thinking about this like someone who works private/group practice in an outpatient clinic setting. Which is wrong.

An outpatient clinic, attached to a hospital, could be charging those 130 patients a $75 facility fee. Which means each week, without counting a single e/m or CPT code billed, you generated over $9,000 in revenue. That alone is over $400k per year. Just in facility fees. That doesn’t include revenue that your employer gets from every CT or MRI you order. EMG/NCVS, ABI, PT referral, etc.

For YOU to pay someone $400k they would have to bring in the $ you’re talking about. A hospital can pay a podiatrist that even if their collections from e/m and CPT codes total, let’s say, $500-600k. Now tell me how many patients I’d have to see...

Facility fees is where the hospital makes a lot of money off of providers but it’s never talked about in contract negotiations.

Providers who work for hospitals need to understand their worth and what they literally bring to the table.The problem being a DPM negotiating with a hospital is that it’s very challenging to go out and get “another hospital job” if you don’t like your contract. There are just not a lot of jobs out there. Most settle and take the low ball offer when they are actually worth so much more. Why? Because they would rather accept that paycheck then work in private practice podiatry.

It’s hard being us. Ortho can jump hospitals whenever they want.


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[air bud]

Facility fees are even higher for rural medicine. I want to say something like 125 bucks for so