The AAOS and AOFAS agenda

[Pronation]

$350k + benefits + no call? Sounds like a dream job.

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[G0dFather]

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...

I fully understand this but this is not the norm... most of podiatry is in private practice

 

[G0dFather]

you think 25 patients a day is a heavy grind?

Yes... day in and day out for 5 - 6 days a week on a consistent basis it is ... unless they are all RFC and even then with all the notes and paperwork and headache.. come on now

 

[dtrack22]

I fully understand this but this is not the norm... most of podiatry is in private practice

but we aren’t talking about the Norm in podiatry. We are talking about one specific job that was mentioned in this thread.

 

[CutsWithFury]

Yes... day in and day out for 5 - 6 days a week on a consistent basis it is ... unless they are all RFC and even then with all the notes and paperwork and headache.. come on now

It's not a heavy grind.

I saw 98 patients last week and logged 10 procedures in the OR and saw 3-4 hospital consults.

Come on now

 

[G0dFather]

It's not a heavy grind.

I saw 98 patients last week and logged 10 procedures in the OR and saw 3-4 hospital consults.

Come on now

COME BABY!!! LETS GO!! LOL ... ok thats last week how long will you last doing that for the next decade and what will be you QOL ?

 

[DYK343]

25 is about the max for me in a day but I do almost no routine foot care.

I dont see how I could do anymore in an 8hr day. My biggest complaint already is I dont spend enough time with them.

I know a lot of people can see 40-50 patients a day but thats mostly going to be RFC or a wound healing center with a well trained staff.

 

[G0dFather]

but we aren’t talking about the Norm in podiatry. We are talking about one specific job that was mentioned in this thread.

Was that job real ? or was it just hesaid/shesaid ? .... Can someone please post a job that actually shows those kinds of number sx or non sx whenever they become available? ... when i ran those numbers from a priv practice stand point it shows it possible to actually pay someone that the patient load has to be there consistently and the office needs to be very well run and have little to no competition would also be a plus but none will ever give you something like that, one may GROW into a position like that overtime by take a bigger percentage ...

 

[G0dFather]

25 is about the max for me in a day but I do almost no routine foot care.

I dont see how I could do anymore in an 8hr day. My biggest complaint already is I dont spend enough time with them.

I know a lot of people can see 40-50 patients a day but thats mostly going to be RFC or a wound healing center with a well trained staff.

I agree with you .... since you dont see any RFC (being much quicker pts that move the schedule along and are very profitable) how involved are some of these other patients you see ? and what about the less involved ones, how long do they typically take you? ... if you take no lunch its about 3 an hour in 8 hrs... do you devote 20 mins to seeing them and doing notes/coding ?

 

[DYK343]

I agree with you .... since you dont see any RFC (being much quicker pts that move the schedule along and are very profitable) how involved are some of these other patients you see ? and what about the less involved ones, how long do they typically take you? ... if you take no lunch its about 3 an hour in 8 hrs... do you devote 20 mins to seeing them and doing notes/coding ?

My practice is about 25% plantar fasciitis, 10% ingrown toenail, <5% RFC, 40% surgical (20% pre/20% post), 20% non surgical arthritis/orthotics/tendinitis, etc etc.

Plantar fascial patients are usually 15min slots, ingrown nails 30min for consult/procedure with 15min follow ups, RFC 15min slots, surgical/MRI/Xray review 30min slots, the rest 15 min slots. Im usually double booked a few slots throughout the day.

I usually have 5-10 notes to complete at the end of the day because I didnt have time to do them during the day.

 

[G0dFather]

My practice is about 25% plantar fasciitis, 10% ingrown toenail, <5% RFC, 40% surgical (20% pre/20% post), 20% non surgical arthritis/orthotics/tendinitis, etc etc.

Plantar fascial patients are usually 15min slots, ingrown nails 30min for consult/procedure with 15min follow ups, RFC 15min slots, surgical/MRI/Xray review 30min slots, the rest 15 min slots. Im usually double booked a few slots throughout the day.

I usually have 5-10 notes to complete at the end of the day because I didnt have time to do them during the day.

i like this mix.. nice!

 

[air bud]

My practice is about 25% plantar fasciitis, 10% ingrown toenail, <5% RFC, 40% surgical (20% pre/20% post), 20% non surgical arthritis/orthotics/tendinitis, etc etc.

Plantar fascial patients are usually 15min slots, ingrown nails 30min for consult/procedure with 15min follow ups, RFC 15min slots, surgical/MRI/Xray review 30min slots, the rest 15 min slots. Im usually double booked a few slots throughout the day.

I usually have 5-10 notes to complete at the end of the day because I didnt have time to do them during the day.

You see ingrown follow-ups? What if healthy 13 year old kid? Do you think a level 2 is worth it for that time slot? I only see ingrown follow ups on people with comorbidities. I make it perfectly clear other healthy people are welcome to follow up with me, but tell them if they think they are fine then they don't need to.

 

[DYK343]

You see ingrown follow-ups? What if healthy 13 year old kid? Do you think a level 2 is worth it for that time slot? I only see ingrown follow ups on people with comorbidities. I make it perfectly clear other healthy people are welcome to follow up with me, but tell them if they think they are fine then they don't need to.

Nail avulsions I do not. Chemical procedures I do.. otherwise they go to the ER for "infection" (Had one go today actually...)

 

[dtrack22]

Do you think a level 2 is worth it for that time slot?

it’s not like you have anything else to do...

if you aren’t booked out several days, then I’m not sure there’s an argument to turning down $50-60 for a minute or two of your time

 

[air bud]

it’s not like you have anything else to do...

if you aren’t booked out several days, then I’m not sure there’s an argument to turning down $50-60 for a minute or two of your time

Clearly I do not have enought time....I actually njust feel bad for patient getting a charge for 2 mins of my time. And chemical I just tell them in 2 weeks of red but no pain, don't worry it is normal the chemical irritates the skin sometimes. No ER visits yet...but my n is smaller than your n

 

[CutsWithFury]

You see ingrown follow-ups? What if healthy 13 year old kid? Do you think a level 2 is worth it for that time slot? I only see ingrown follow ups on people with comorbidities. I make it perfectly clear other healthy people are welcome to follow up with me, but tell them if they think they are fine then they don't need to.

I always I see my ingrown toenail patient follow ups. Two week follow up visit. Double book with other EP or NP visits. Money in the bank


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[ExperiencedDPM]

I always I see my ingrown toenail patient follow ups. Two week follow up visit. Double book with other EP or NP visits. Money in the bank


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Money in the bank? No where in your reply did you state that you believe the follow up visit is medically necessary. Money in the bank? How about the factory worker who has a $45 copay for you to see a patient that likely doesn’t need to be seen?

Sorry, but I have done pretty well in this profession and to this day, never did a procedure, took an x-ray or had a patient return for follow up if it wasn’t medically necessary. I don’t treat wallets or insurance companies.

I’ll simply hope that you’re kidding and that you don’t simply have these patients return just to collect the fee.

 

[GreenHousePub]

How about the factory worker who has a $45 copay for you to see a patient that likely doesn’t need to be seen?

That same factory worker might have gone back to work same day at the hog poop company and having a latent infection that he thinks "is just fine." I always schedule follow ups after procedures, if the patient thinks it's unnecessary or can't afford the copay then they won't come in. That way it's on them for no-showing when it comes down to legal.

 

[ExperiencedDPM]

That same factory worker might have gone back to work same day at the hog poop company and having a latent infection that he thinks "is just fine." I always schedule follow ups after procedures, if the patient thinks it's unnecessary or can't afford the copay then they won't come in. That way it's on them for no-showing when it comes down to legal.

That’s fine if you are bringing them back because you feel it’s in the best interest of the patient. But if you’re bringing them back for no other reason than the money, it’s simply wrong.

 

[CutsWithFury]

That’s fine if you are bringing them back because you feel it’s in the best interest of the patient. But if you’re bringing them back for no other reason than the money, it’s simply wrong.

I always bring people back because it is in their best interest. People do stupid things. It's good medicine and avoids trouble but it is also a simple quick eval that is productive as well.

 

[king22]

I pretty much have everyone f/u If I've performed any procedure or dispensed DME (with the exception of a patient picking up their 4th pair of orthotics I've made). Patients for the most part aren't medical professions; they don't necessarily know what to look for.

 

[CutsWithFury]

AOFAS has no respect for us. Stop inviting these guys to our conferences and promoting there is a working relationship. There isn’t. There never will be.


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[JewOnThis]

But, our own are hiring us for 85k a year.
At least with ortho they will generally start you at 100+.

 

[dtrack22]

But, our own are hiring us for 85k a year.
At least with ortho they will generally start you at 100+.

They pay their PAs more than a podiatrist pays an associate. I bet they are starting around $200k and the ortho is still getting a good deal out of it...

 

[JewOnThis]

They pay their PAs more than a podiatrist pays an associate. I bet they are starting around $200k and the ortho is still getting a good deal out of it...

the ad says 115k. That’s still more than what the local pod associates are getting in that area

 

[dtrack22]

the ad says 115k. That’s still more than what the local pod associates are getting in that area

Ah, I didn’t actually read the ad. Is it just a flat salary or is that supposed to be a base with some production incentives?

What’s more insulting, an ortho paying you less than their PA? Who, mind you, is someone who cannot treat patients independently and therefore should be significantly less valuable. Or another podiatrist doing it?

I wish I was better with computers. I’d create a program/bot to spam these crap jobs with thousands of “applications” (emails) that have incredibly sarcastic cover letters/introductions, bogus CVs, etc.

 

[JewOnThis]

If it was me, I would take the ortho job for the pay and the benefits.

Being treated like a PA versus being treated like dirt? An easy one here, well at least for me.

 

[G0dFather]

If it was me, I would take the ortho job for the pay and the benefits.

Being treated like a PA versus being treated like dirt? An easy one here, well at least for me.
[/QUOTE




If anyone encounters an pod job that pays more than 175k+ anywhere in the country can they please post it for us to look at ... I've yet to see a legit listing like that

 

[CutsWithFury]

This is why AOFAS will prevail. Actively trying to train as many orthopedic residents they can to fill the ortho foot and ankle jobs which go unfilled and don’t want podiatrists.

It’s happening and you don’t even know it.


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[malleolusman]

Accurate. BUT HEY - we have hospital jobs so why listen to us?!

View attachment 299013

This is why AOFAS will prevail. Actively trying to train as many orthopedic residents they can to fill the ortho foot and ankle jobs which go unfilled and don’t want podiatrists.

It’s happening and you don’t even know it.


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[GreenHousePub]

This is why AOFAS will prevail. Actively trying to train as many orthopedic residents they can to fill the ortho foot and ankle jobs which go unfilled and don’t want podiatrists.

It’s happening and you don’t even know it.


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If anything it's getting far worse from what I've experienced. Everyone always harps on 'it's just the older guys who don't know about us' but from what I've seen it's nothing but the younger guys.

Who do you think trained the younger guys anyway?

 

[CutsWithFury]

AOFAS continues to disrespect us. Why are we respecting them? Stop inviting these people to our conferences.

 

[619]

Even at $115,000 a year, this position pays more than most associate position working for another podiatrist. This position most likely includes benefits (Health insurance, 401k, disability etc), which most podiatry associate positions do not have.

So I think we should point the finger at ourselves. Podiatrists should stop disrespecting their fellow podiatrists with low wages and no benefits.

 

[CutsWithFury]

Even at $115,000 a year, this position pays more than most associate position working for another podiatrist. This position most likely includes benefits (Health insurance, 401k, disability etc), which most podiatry associate positions do not have.

So I think we should point the finger at ourselves. Podiatrists should stop disrespecting their fellow podiatrists with low wages and no benefits.

100% true statement. Podiatry is tough. It could be so great if we didn’t continuously keep ourselves back.

Ortho is not dumb. They know the going rate for a DPM in private practice. Why not offer “a little” more to secure a well trained DPM and make a ton of money off of them.

Then at the same time this ortho group is doing “their part” to keep our profession back. This is the agenda.

 

[DYK343]

I disagree. No well trained DPM is going to take that job. They will get a below average candidate for a salary that maxes out at 110k. Private practice groups have incentive systems for their associates. They still suck and we all know my opinion on going the private associate route. But those private associates have the option to make more than 110k.

Though Austin is a cool town.

 

[Pronation]

I disagree. No well trained DPM is going to take that job. They will get a below average candidate for a salary that maxes out at 110k. Private practice groups have incentive systems for their associates. They still suck and we all know my opinion on going the private associate route. But those private associates have the option to make more than 110k.

Though Austin is a cool town.

I kind of agree. I would barely even trust the type of candidate they are going to attract to cut patients' toenails...

 

[ExperiencedDPM]

They will be using the DPM in the OR to allow the group to rip off the insurance and bill for an assistant fee. And the orthopod can leave and have the DPM close and apply dressings.

I know many Ortho groups who bill for assistants for bull****. You need an assistant to obtain a calcaneal graft using a trephine? You need an assistant to remove a dorsal exostosis? You need an assistant to perform a cheilectomy? They bill for assistants for these procedures all the time.

 

[CutsWithFury]

They will be using the DPM in the OR to allow the group to rip off the insurance and bill for an assistant fee. And the orthopod can leave and have the DPM close and apply dressings.

Correct. Fulfilling their agenda to keep podiatry down. If there was mutual respect between the ACFAS/APMA and AOFAS then these job offers would not exist. Every aspect of this job offer is offensive. Almost as offensive as a general or non F/A fellowship trained orthopedist trying to fix an ankle fracture (they did like 5-10 in residency) or balking at a chronically swollen ankle joint (secondary to previous sprains) because they have no idea how to scope an ankle joint or perform a brostrom. But they will make sure those "damn podiatrists shouldn't be fixing ankles...not in my hospital!"

 

[heybrother]

I'm not buying some of the above. They will have no trouble filling this position. They may even be able to get someone fellowship trained wink wink nudge nudge

There may or may not be incentives.
They will make more money than plenty of PP associates. You know that salary poll we did that started at $75K? I know someone taking less than that as a base.
This job will likely have benefits.
They'll tell their friends they work for an orthopedic group. They might not tell their friends what they do there...

They know our worth. Just as hospitals know our worth when 200 people apply for 1 job.

 

[CutsWithFury]

They know our worth. Just as hospitals know our worth when 200 people apply for 1 job.

THIS. I was talking to a recruiter for a job position that was originally posted for a foot and ankle ortho. Told me that it is "well known" within recruiting circles that podiatrists are "aggressive" when applying positions posted online. They know they are about to get hit up by 600 applications overnight once the job posting goes live.

He only called me back because they were having a hard time filling the position and they liked my application. We went through the initial conversation and told me somebody would follow up with me about the gig. No call back. Yup.

 

[deleted1061086]

A year ago I applied for a listed multi-specialty group position and found myself on the line with the recruiter. He had spoken to countless other applicants that week who had called his office. They ended up closing the slot and recruiting among the local pods. I don’t know why. At the time I thought it was maybe due to overwhelming applications.

 

[DYK343]

Almost as offensive as a general or non F/A fellowship trained orthopedist trying to fix an ankle fracture (they did like 5-10 in residency)

I tend to be pretty pro podiatry on here. But honestly, I think this is the reverse. Most ortho do a great job with ankle fxs. Many DPMs are in there with no idea in the world what they are doing and maybe did 5-10 in residency.

 

[deleted1061086]

I tend to be pretty pro podiatry on here. But honestly, I think this is the reverse. Most ortho do a great job with ankle fxs. Many DPMs are in there with no idea in the world what they are doing and maybe did 5-10 in residency.

Roadblocks To Hospital Credentialing: A New Practitioner’s Experience

I haven’t been able to blog as much lately due to my recent residency graduation and entry into private practice. I have learned many things while purchasing my practice and credentialing with insurance companies. Credentialing with insurance companies is certainly challenging but the main thing...

www.podiatrytoday.com

this reminds me of this article, where the author is rejected for privileges to do ankle fractures and scopes at the hospital he trained. He reports he did 10 ankle fractures and 7 scopes in his logs.

I also would feel very comfortable with most orthopedists doing my ankle fracture.

 

[air bud]

For the record the job is in Austin. I know an ortho who took a 150k pay cut to live in Austin. It's a pretty damn cool city (if you like people and I don't that's why I live in the middle of nowhere).

 

[air bud]

I tend to be pretty pro podiatry on here. But honestly, I think this is the reverse. Most ortho do a great job with ankle fxs. Many DPMs are in there with no idea in the world what they are doing and maybe did 5-10 in residency.

I agree. Anyone young ortho fixed a ton of ankle fx in residency. And did it themselves.

 

[CutsWithFury]

I tend to be pretty pro podiatry on here. But honestly, I think this is the reverse. Most ortho do a great job with ankle fxs. Many DPMs are in there with no idea in the world what they are doing and maybe did 5-10 in residency.

Must be regional because the general orthos and non F/A fellowship trained orthos in my state are not good at fixing ankle fractures and they have no idea how to fix their own complications. They just stick their head in the sand and tell the patient their fracture is healed and say goodbye.

 

[iceman55]

Correct. Fulfilling their agenda to keep podiatry down. If there was mutual respect between the ACFAS/APMA and AOFAS then these job offers would not exist. Every aspect of this job offer is offensive. Almost as offensive as a general or non F/A fellowship trained orthopedist trying to fix an ankle fracture (they did like 5-10 in residency) or balking at a chronically swollen ankle joint (secondary to previous sprains) because they have no idea how to scope an ankle joint or perform a brostrom. But they will make sure those "damn podiatrists shouldn't be fixing ankles...not in my hospital!"

Your comment about general orthopedic surgeons and ankle fractures is soo wrong, literally could not be further from the truth.

Trauma , upper and lower extremity fractures is such a big part of orthopedic surgery residency. Long bone fractures , shoulder, wrist, hip and ankle fractures are bread and butter orthopedics, what do you think we do in our five years of residency, which includes taking call all five years. In general, Fracture care is the basis of our education.

As a 3rd year ortho resident I have already logged about more than 30 ankle ORIFs and i haven’t even done my ortho trauma rotations yet. Those cases have all come just from being on call. After completing residency if I had to guess, i would say the average graduating ortho resident has logged at least 150 ankle ORIF.

Almost every weekend we’re on call, an ankle ORIF is almost guaranteed. and no it’s not getting sent to our F/A specialist, it’s taking care of that weekend by the on call attending, that may normally mostly do hand/spine, or if it’s during the weekday its added on for our ortho traum doc.

Also you forget about fellowship trained orthopedic trauma surgeons

Btw, I have a relatively recent interest in F/A and thinking about possibly pursuing a fellowship in it. Hence why I’ve ended up on this page.

Also, forgot to mention, yes we do an F/A rotation but that usually involves more complex trauma cases or elective recons , most of our ankle fx experience comes from call or our ortho trauma rotations

 

[CutsWithFury]

Your comment about general orthopedic surgeons and ankle fractures is soo wrong, literally could not be further from the truth.

Trauma , upper and lower extremity fractures is such a big part of orthopedic surgery residency. Long bone fractures , shoulder, wrist, hip and ankle fractures are bread and butter orthopedics, what do you think we do in our five years of residency, which includes taking call all five years. In general, Fracture care is the basis of our education.

As a 3rd year ortho resident I have already logged about more than 30 ankle ORIFs and i haven’t even done my ortho trauma rotations yet. Those cases have all come just from being on call. After completing residency if I had to guess, i would say the average graduating ortho resident has logged at least 150 ankle ORIF.

Almost every weekend we’re on call, an ankle ORIF is almost guaranteed. and no it’s not getting sent to our F/A specialist, it’s taking care of that weekend by the on call attending, that may normally mostly do hand/spine, or if it’s during the weekday its added on for our ortho traum doc.

Also you forget about fellowship trained orthopedic trauma surgeons

Btw, I have a relatively recent interest in F/A and thinking about possibly pursuing a fellowship in it. Hence why I’ve ended up on this page.

Also, forgot to mention, yes we do an F/A rotation but that usually involves more complex trauma cases or elective recons , most of our ankle fx experience comes from call or our ortho trauma rotations

I did over a 100 ankle fractures ORIFS in my 3 years of podiatry residency and over 50 total ankle replacements. Among many other types of foot and ankle reconstruction cases in residency.

Since graduation from residency I’ve done another 35 or so ankle fractures in a state that historically unfair to podiatrists. I get these opportunities from the orthopedists at my hospital who are general, sports medicine and/or total joint trained who want nothing to do with them unless it’s an isolated fibula fracture because there is no way they could screw that up (sometimes).

What happens when your patient has a missed torn syndesmosis or ATFL or OCD of the talar dome that was missed and complicated the recovery period? Your patient comes to you and complains of generalized ankle joint swelling and pain. At that point you might refer to your orthopedic F/A fellowship trained colleague but the patient has Medicaid and you don’t want to do that to your bro. So you repeatedly tell the patient the fracture is healed and you have no idea what’s wrong. Patient gets frustrated and they come to a podiatrist who accepts their insurance and helps the patient.

This scenario plays out almost on a weekly basis in my practice. Again it’s regional. Some areas of the country the foot and ankle ortho experience is stout in the ortho residency experience because these residents are exposed to attendings with foot and ankle practices. But there are a lot of ortho residencies where there are no attendings involved in ortho training with foot and ankle experience. These ortho residents only foot and ankle experience ends up being during their foot and ankle fellowship year. This is why the AOFAS has set up traveling residency experiences for ortho residents looking for foot and ankle exposure during their residency training. They know it’s a problem and have attempted to address it.

Lastly the amount of ankle fractures you have done so far in your ortho residency doesn’t display competence. Would love to have you come in here once you understand and have mastered the techniques of complex bunion correction, hammertoes, flatfoot correction, large OCD talar dome management, ankle arthroscopic ankle fusions, total ankle replacements, tendon transfers of the foot and ankle etc etc etc etc etc etc etc etc etc.

 

[DYK343]

I did over a 100 ankle fractures ORIFS in my 3 years of podiatry residency and over 50 total ankle replacements. Since graduation from residency I’ve done another 35 or so ankle fractures in a state that historically unfair to podiatrists. I get these opportunities from the orthopedists at my hospital who are general, sports medicine and/or total joint trained who want nothing to do with them unless it’s an isolated fibula fracture because there is no way they could screw that up (sometimes).

What happens when your patient has a missed torn syndesmosis or ATFL or OCD of the talar dome that was missed and complicated the recovery period? Your patient comes to you Mr. Awesome Orthopedic Real Doctor/Surgeon MD/DO and complains of generalized ankle joint swelling and pain. At that point you might refer to your orthopedic F/A fellowship trained colleague but the patient has Medicaid and you don’t want to do that to your bro. So you repeatedly tell the patient the fracture is healed and you have no idea what’s wrong. Patient gets frustrated and they come to a podiatrist who accepts their insurance and helps the patient.

This scenario plays out almost on a weekly basis in my practice. Again it’s regional. Some areas of the country the foot and ankle ortho experience is stout in the ortho residency experience because these residents are exposed to attendings with foot and ankle practices. But there are a lot of ortho residencies where there are no attendings involved in ortho training with foot and ankle experience. These ortho residents only foot and ankle experience ends up being during their foot and ankle fellowship year. This is why the AOFAS has set up traveling residency experiences for ortho residents looking for foot and ankle exposure during their residency training. They know it’s a problem and have attempted to address it.

Lastly, I do NOT care how many ankle fractures you have done so far in your ortho residency. You are still a crappy foot and ankle surgeon at this stage of your career. Come talk to me when you understand and have mastered the techniques of complex bunion correction, hammertoes, flatfoot correction, large OCD talar dome management, ankle arthroscopic ankle fusions, total ankle replacements, tendon transfers of the foot and ankle etc etc etc etc etc etc etc etc etc

Maybe want to tone it down a bit? The above ortho provider did not make personal attacks. You always come up with nick names for people who disagree with you. What was mine again? You had a good one. I forgot. I should find it and put it as my signature.

Edit found it!
Most podiometric Dr. DYK343 DPM, ACFOAM, ASPS, FACFAS, specialist in peripheral nerve surgery, CWS, I’m board certified via the ABPM

 

[CutsWithFury]

Maybe want to tone it down a bit? The above ortho provider did not make personal attacks. You always come up with nick names for people who disagree with you. What was mine again? You had a good one. I forgot. I should find it and put it as my signature.

Edited it