The future of podiatry

[AttackNME]

If hospitals want more reliable and consistent podiatry coverage, then they can start paying us like all other doctors

Very good point, for some of my local hospitals they get very infrequent podiatry patients so it makes no sense for them to figure out podiatry call. For those hospitals they won’t lose sleep if they have to ship out a podiatry patient every now and then if they can’t find a podiatrist willing to take the case. They still can find plenty of podiatrists willing to take call for free, I feel this problem is going to stay for a long time

negotiate for better payor contracts.

How do you do this? What leverage do you have?

My last employment I had paid call. It was enough to make it worth it.

How much? I’m wondering how much would most people feel is enough for them to take call. I think the university in my state pays their podiatrists $250 every day they do on-call cases or consults

There are already more applicants to UTRGV for next year’s class than all the other schools in the US combined.

That’s actually amazing, I however I hope UTRGV keeps class size small so they can increase average quality of their students

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[msion]

How do you do this? What leverage do you have?

Peer recommendations. As things move away from FFS, every insurance plan is a like a HMO in some sort. Participating in some managed care discussion for patients can be valuable. And podiatry sees a lot of at risk patients with CAD, PAD, ESRD, you name it. I receive mails from insurance companies notifying me that they are having a discussion about a patient on a specific date. Go to these. You will able to speak with the medical director, case worker and other doctors.

Of course by peer I mean MD/DO colleagues in vascular surgery/primary care or nephrologist. I will never be recommended by another peer DPM.

 

[DYK343]

Who are you referring to?

CPME? Because CPME can not consider anything other than a candidate schools ability to comply with the accreditation standards in the documents. If they did, it would be anti-competitive.

If someone wants to open a new school or 10 more schools, if they meet the standards, they must be accredited.

How were they able to ban opening new schools for x amount of years after western?

 

[DYK343]

How much? I’m wondering how much would most people feel is enough for them to take call. I think the university in my state pays their podiatrists $250 every day they do on-call cases or consults

$500 a day. Which is low when compared to ortho/gen surg stipend. Im not a 100% sure but I believe ortho got $1500 a day. I had far fewer middle of the night stuff than they did and as a DPM have limited area I can work on.

 

[NatCh]

You are correct. But how much did rate go up or down? Regardless I don't think can put a price on a good solid reliable employee.

Don't save pennies to lose a dollar. Post-covid, most folks don't want to work and hard to even find someone to show up to work.

It went up about $200/month IIRC. I don’t recall the exact number but it was enough to be noticeable. We hired her because she was a good candidate despite the increased cost. Totally agree with you there.

 

[AttackNME]

Peer recommendations. As things move away from FFS, every insurance plan is a like a HMO in some sort. Participating in some managed care discussion for patients can be valuable. And podiatry sees a lot of at risk patients with CAD, PAD, ESRD, you name it. I receive mails from insurance companies notifying me that they are having a discussion about a patient on a specific date. Go to these. You will able to speak with the medical director, case worker and other doctors.

Of course by peer I mean MD/DO colleagues in vascular surgery/primary care or nephrologist. I will never be recommended by another peer DPM.

how does showing up for these meetings make sense for insurance companies to pay you more?

$500 a day. Which is low when compared to ortho/gen surg stipend. Im not a 100% sure but I believe ortho got $1500 a day. I had far fewer middle of the night stuff than they did and as a DPM have limited area I can work on.

How do you protect this stipend from a new podiatrist coming in and undercutting everyone by offering to see consults for free to get more cases?

 

[Feli]

We have over 500 podiatrists graduating every year and they are worried about getting their surgery numbers for board certification. So this "problem" is never going to end with 2 new schools opening. Folks jumping over each other for surgery cases even if it is free work so you wonder why the $80k-$100k starting base salary are never going anywhere. The future of podiatry is not bright.

This is the bottom line right here.

With new schools and class sizes unregulated by anything aside from "meet the standards" and "qualified" applicants, there are just not enough surgical jobs and cases - or truly qualified students and residencies. It's unfortunate.

The idea of the dent model where a limited fraction of DPM grads get a high volume high quality surgical residency and those programs would have a high pass rate on the surgical boards needs to be seriously considered. Not every DDS goes on to be OMFS or endodontics, but those who do are generally in demand, well paid, and highly qualified. Those who do the basic training will also still have a good job and less debt, less call and stress.

If podiatry can't regulate and adjust for demand and training at admission and accreditation level as MDs do, it is problematic to just let it sort out at the attending level, as chiro or therapy schools seem to do.

I still can't believe they're doing this ****. When there isn't enough jobs to go around for the spots, but hey most people won't realize it until their 300k in debt and halfway through their 3rd year looking at a 80k job with the lovely $4700 a month salary and $2700 after student loans...

Yes.

 

[dtrack22]

Goodbye Dr. Ron

What did Dr. Ron do this time? I’m still waiting for the name of the hospital that has ortho on call without paying them. I mean, in his area it is very common after all…

 

[DYK343]

How do you protect this stipend from a new podiatrist coming in and undercutting everyone by offering to see consults for free to get more cases?

Anyone in town that had hospital privileges had option for paid call. Most didnt want it because you had to be able to handle all foot and some ankle trauma that came in. A lot of DPMs have zero interest in doing that work. There was also a lot of diabetic stuff which also a lot of DPMs dont want.

Honestly a lot of people want to spend time with their family on the weekends/evenings after work and didnt find the $500 a day worth it. It was hit or miss but typically a lot of hours.

We were taking free call right when I started and we all banded together (we were a close bunch) and stopped taking call unless they started paying us. Took 2-3 months of ortho caring for foot and gen surg caring for diabetic stuff before we had a contract in our hands.

Gen surg was the real push for us to get paid call. They were super busy and wanted nothing to do with DM feet. They asked my associate what the hell was going on and why we stopped seeing diabetic foot. My associate told them and then things started to change.

We basically unionized and got gen surg on board.

 

[DYK343]

To add to above I did a ton of call. If you recall prior posts I was working ~80hrs a week most weeks and just couldnt take the hours anymore. I built up a nice nest egg and left the job after 5ish years there. It was great money and I got a huge financial start in life but I just couldnt keep up with long hours anymore. Im ER'd out. So you can add me to the list of people who dont want the $500 a day. Its just not worth it. I did 32hrs of clinic a week in addition to all the ER madness. It was just too much. In addition I didnt have a lot of others in town who would take ER call so I was stuck always on call and managing my own patients even when I wasnt on call (because no one was listed as on call...).

It would have been easy to just stop taking call and keep the MSG job but they grew fond of the volume I was bringing into the MSG with my ER call. About 1/3 of my daily schedule was ER follow ups. I feel for the poor smuck who took the job after me. 4 years younger and money signs in his eyes. Curious how long he lasts.

 

[air bud]

I am going to get paid 350 a day. This is what was offered in the contract. This is after my 10 days required per contract. I am guessing it won't be a ton of actual call, still a pretty small town. But I want the money now. I reserve the right to change my mind. I am going to miss the west coast lifestyle of 4 day work weeks too

 

[DexterMorganSK]

This is not the meme thread. Please stay on topic. I will give out warnings to anyone else derailing.