What would you do if you had to start over?

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SoleSucking said:
What about a podiatrist that also does pest control? That could be an interesting combo. Use the knowledge of killing maggots into another career. DPM/Pest control dual degree
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Podiatry isn’t that bad. Just destress and look for another job. Message me the area where you want to practice and I can send you leads on good jobs.
 
I can honestly say I'd never do hard labor.
There is a reason it pays good... forget that noise though.

I'm not young, not old... but I see waaaaaay too many people with sad issues.
It might be a bad back, major intra-artic fractures, crippling arthritis, hearing loss, MVA, sports injury or even just fall in the home, early dementia, other trauma or degenerative conditions at a fairly young age. Some even have tons of $$ but are too wheelchair bound or painful to enjoy travel - or even the gym or trails. It's sad.

That working oil rigs, scaffolds and ladders, driving at night, heavy equipment, etc stuff is not worth any price (to me).
You can always make money in many ways... but you only get one brain, spine, set of knees, etc.
About 1 in 5 people retires not because they want to or enough $$$... but because of disability.
And true, it's a fact of life that your mind or your body will fail at some point, but do jobs that tend to have the body fail early? Nope.
 
I did some plumbing work before going to undergrad. It's tough work even at a young age. On your hands and knees in awkward positions, working out side in the middle of winter digging trenches for underground pipes for new buildings etc... no thanks, wouldn't do it again. Electrician would probably be the route I'd go if it were trades related or mechanical/electrical maintenance like my brother does for a big manufacturing plant.
 
I'd get some form of engineering degree, just 4 years and I'm done and out. Minimal student loans and easily pay it back in no time, and can work my way up. My brother makes 180K with his engineering degree, but I'd be happy making around 100K.
 
DarkPathMedicine said:
I'd get some form of engineering degree, just 4 years and I'm done and out. Minimal student loans and easily pay it back in no time, and can work my way up. My brother makes 180K with his engineering degree, but I'd be happy making around 100K.
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Crazy. Just do PA 2 years then
 
Bluecollarmed said:
i envy 99% of CRNA/anesthesia life. Patient is sleeping and if you did a dodgy pop block guess who has to hear about it for the next week or two...not the anesthesia team.
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Anesthesia would be fine but the call would suck. General surgeons take general surgeon call. Ortho takes ortho call. Podiatry takes podiatry call. Anesthesia takes all call.

No thanks.

Thats why ER is king of medicine. 100% shift work. At 7pm when your shift is done you walk out that door. No follow up. Just treat and street or admit. Done. Bye. 300-400k job.
 
DYK343 said:
Anesthesia would be fine but the call would suck. General surgeons take general surgeon call. Ortho takes ortho call. Podiatry takes podiatry call. Anesthesia takes all call.

No thanks.

Thats why ER is king of medicine. 100% shift work. At 7pm when your shift is done you walk out that door. No follow up. Just treat and street or admit. Done. Bye. 300-400k job.
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The ER position you talk about sounds like a private practice podiatry job except I’m home by noon twice a week and 430 the other three days.

And I don’t work weekends or holidays and if my kids have an athletic/school event I want to go to I can just adjust my schedule.

Man podiatry seems great now.
 
DYK343 said:
...Thats why ER is king of medicine. 100% shift work. At 7pm when your shift is done you walk out that door. No follow up. Just treat and street or admit. Done. Bye. 300-400k job.
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ER's not bad, but they also have to do the flip side (overnight shifts) or even 24hr shifts in many places.
You get many days off (esp if you do those 24s), but it's very rough work after your 30s and certainly after 40s. If they work normal 8 or 10 or 12hr shifts, they don't have a ton of days off. There is little or no potential for ER to do private practice (very hard to make an urgent care getting higher than their good employ jobs as most ER/UC pts have crummy insurance).

They've had their fair share of VC groups or hospital systems that treat the ER docs like nurses - or even like burger flippers.

ER's not a bad specialty, but it's a grass is greener thing. It's average or below popularity in the match.

I honestly think that podiatry, if it were an MD specialty (so not saturated and higher paid), would be average or even more popular... look at ENT, ophtho, derm, uro, plastics, and other procedure/surg specialties that are basically banker hours. They are all above average competitive level in the match.
 
DYK343 said:
Anesthesia would be fine but the call would suck. General surgeons take general surgeon call. Ortho takes ortho call. Podiatry takes podiatry call. Anesthesia takes all call.

No thanks.

Thats why ER is king of medicine. 100% shift work. At 7pm when your shift is done you walk out that door. No follow up. Just treat and street or admit. Done. Bye. 300-400k job.
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You’re just missing the fact that you will undoubtedly do overnight shifts as an ED doc. Their pay isn’t great but I completely agree with the benefits of shift work, knowing what I know now. Honestly Hospitalist work looks better all the time. Same concept, depending on the setup, not drastically more work, and my experience is that overnight floor coverage is done by NPs at a lot of facilities. During the travel $ heyday post-covid we had a hospitalist that wouldn’t take a job unless he was paid $300/hr. And he got it.

Personally I would have gone into finance. Be a lending agent/loan officer at a bank out of college, move into management, and then executive level at a local credit union. Not a terribly difficult journey, we aren’t talking getting to that level at BOA or Chase. You’d start making $80-100k at 22 and be making closer to $200k with no debt by the time a DPM is getting out of residency.
 
DYK343 said:
Anesthesia would be fine but the call would suck. General surgeons take general surgeon call. Ortho takes ortho call. Podiatry takes podiatry call. Anesthesia takes all call.

No thanks.

Thats why ER is king of medicine. 100% shift work. At 7pm when your shift is done you walk out that door. No follow up. Just treat and street or admit. Done. Bye. 300-400k job.
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Anesthesia has mommy track jobs at ASCs. No calls, no nights, no OR or surgeons, and still make around 350k.

I agree ER is slept on. Their full time is 120 hours a month and they make 2x the base hourly rate as hospitalists at my hospital. They also don’t do as many nights as people think (2-3 a month) and they do it in a stretch so the flip isn’t as bad. Definitely gotta do weekends and holidays though.
 
caliking87 said:
Currently in practice, I want out. Any thing else outside of patient care/healthcare that would be worth looking into? With high income potential?
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High income is a must if I switch out because I still have some loans
 
Are you any good at basketball? See if the NBA teams are hiring. I hear they pay good.
 
caliking87 said:
Currently in practice, I want out. Any thing else outside of patient care/healthcare that would be worth looking into? With high income potential?
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How long have you been in practice? There likely isn't anything you will be able to do to earn more than you can as a podiatrist. I mean I would become a fellow of ACFAS if you aren't already. Their average income is 446k.
 
caliking87 said:
Currently in practice, I want out. Any thing else outside of patient care/healthcare that would be worth looking into? With high income potential?
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All you can really do is see patients, do what they need... and try to get well insured area.

If you want to "push the envelope" (and if such cashectomy-type things don't bother you), then you can try ipad "custom" braces, wound "grafts," balance braces, vein injects, ultrasound injects, cash nail laser, and many of the like will increase your collections.

We all know, regardless of wacky surveys where respondents can just put down whatever and only higher income DPMs tend to respond, the real income for pods is probably about 200k-300k VA/IHS and 300k-400k+ private hospitals for hospital pods, $200k or under for pod school profs and maybe $300k-400k+ for some univ profs, around $120k-200k for associates in supergroup/PP jobs, and highly variable but usually $200k-500k+ for PP owner/partners (a few nice tax advantages in that group, but they're somewhat overblown). But at the end of the day, you will be seeing patients in any of those. Pick the highest income spot you can get in a job setup you don't totally dislike (admins, location, path mix, etc). What other people make is trivia. The only thing that matters is one's own income... and how you use it.

I will tell you this, though: it's more how much you save / keep than simply how much you take in.
Paying down the student loans aggressively and doing backdoor Roth IRA (and then more in cash/401/etc once loans paid) works. It's not sexy. It's not flashy. It is not super fun. It'd be a lot more fun to buy more car or go to clubs or more travel or fancier house. But it works to save and invest... to pay down debt fast. MMM and other retirement/FIRE calcs call it your "savings rate." That's the not-so-complicated "secret" to early retire (well, the one that won't get you audited or have you hating the dude you see in the mirror). But yeah, that is what gets you picking up a golf club or fishing rod instead of a nail nipper or dictation mic at a younger age. Easier said than done. 🙂
Likewise, a pod who owns a PP with five associates all slapping on "grafts" for them or a pod who works 60hrs in hospital job maxxing Rvu bonus can still struggle if he's trying to drive a Ferrari and has a wife spending a ton and they travel 10wks domestic and 10wks international per year. True story: my bud from pod school was an associate right after residency for a sunshine state pod who lost his practice (I think it was 4 or 5 docs at the time) doing after-hours hookers and candy... no joke (my classmate broke off and did solo PP). It happens. Learn from other ppl's mistakes. Save as much as you can, and avoid the dumb wastes of money.
 
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caliking87 said:
Currently in practice, I want out. Any thing else outside of patient care/healthcare that would be worth looking into? With high income potential?
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I too want to transition out of this field and do something else once I'm done with my student loans, which is currently at 48K left to go. I've been paying since residency and during COVID, and I took advantage of the interest pause. The resumption of student loans interest on August 1st of this year really sucks, which was why I never trusted the government at all in this student loans debacle. It's a scam to keep you in debt like forever.

High income potential jobs are tough to find out there outside of the medical field, especially in this tough economy right now. At least in podiatry, you have a job. Just the pay really sucks compared to other medical fields. The best way is to open up your own business of your choice, but even with that there are risks and you need the money to start it. I'd stick with the job for now and pay your loans down as fast as possible while you work on the exit strategy, maybe save a bit of money, and then move on forward. I'm currently working on my exit strategy.
 
So here's a newsflash for @caliking87 and everyone else coming to the bitter reality of how much of outpatient podiatry is spent handling trivial low-paying nonsense. If there was a well-paying alternative to podiatry, everyone would be doing it, and there would be a crisis in the profession about how we're losing so many good doctors and what do we do to retain them. The only podiatrists I've heard of who transition out of podiatry are the ones who were really outside of the box. We make fun of Barry Block for being a dinosaur but what he did with PM News was groundbreaking for its time. Of course he got his degrees--plural--in the era of $5k/year tuition so go figure. I've had classmates and coresidents that started side projects that turned into moderately successful businesses too, so if you see a niche and want to take the risk, go for it. As always, there are no guarantees in life, the only certainties are death and toenails.

This is a point I keep harping on. Podiatry isn't that bad. If it was that bad, we'd all agree and the solutions would be obvious. Podiatry is just tolerable enough that as soon as you get in deep enough with tuition around P2 year, you really don't have any better alternatives. Once you start down the dark path, forever will it dominate your destiny.
 
For those of you who’ve started your own practice (or are thinking about it):
How did you approach your first website? Did you just throw something up quickly to have something online? Hire someone? Try to DIY it?
And how did you decide what to actually put on there?

I'm always curious how podiatrists figure this stuff out — especially when we're not trained in any of it during school or residency.
If you're early in the process, what are you stuck on or unsure about? And for those who’ve done it already, what do you wish you'd done differently?

Trying to learn from how others have navigated the early stages of private practice — both the wins and the "wouldn’t do that again" moments.
 
Dermato Fight Club said:
I've been extremely lucky with the profession so far. I really don't have too many complaints personally. I think there should be some pretty drastic changes to address some of the big concerns. Those mostly that are brought up on here.

Just for those pre-pods/students reading this, the consensus seems to be that after residency most will start out working as an associate (150k-250k?) and then eventually end up owning your own practice and doing very well (250k-400k?). Obviously these numbers could easily be larger/smaller but I would venture to guess that is about where 80% of practice owners are.

Anyway, my question goes to those current practice owners and current MSG/hospital podiatrists. Let's say you had to move across country due to a sick child/parent/spouse's job etc. How much of pay cut do you honestly think you would be taking? I'll go first and throw around a wild guess of atleast 150k. Of course, it would actually be a lot more because I would likely retire than have to work for another pod.

One of my pet peeves is the lack of job opportunities that seem to exist. A lot of people claim word of mouth but I just don't understand why anyone would not want to broadcast a job to receive as many candidates as possible. I went on gaswork.com and checked on CRNA job availability. Here is a screenshot of the 10th page (25 postings per page) ranked by highest minimum starting salary. You can see there are currently over 250 job postings that start over 300k. I wish our job market was as good as the CRNA market just in case I did have to pack up and move to a new area of the country.

So anyway, I would love to hear your thoughts and would definitely love to hear from some of the people that actually had to do this and how did it go?
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PA or NP pay well and have great latitude to practice. Podiatry limited and going down
 
Sybly said:
PA or NP pay well and have great latitude to practice. Podiatry limited and going down
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Don't be so bullish about NP and PA, they are having saturation pain as well. Far lower ceiling than us. Less debt, but not that much less. And in many situations resident forever. I am not sure the grass is greener over there. Situational of course.
 
Relative to the debt accrued, and time to making money I think NP/PA is better. Also pretty predictable what you will make with NP/PA, whereas with podiatry it’s highly variable.

Another thing I see with many NP/PA is they seem to have just a surface knowledge of most things since they didn’t go through residency.
 
mcdannald said:
For those of you who’ve started your own practice (or are thinking about it):
How did you approach your first website? Did you just throw something up quickly to have something online? Hire someone? Try to DIY it?
And how did you decide what to actually put on there?

I'm always curious how podiatrists figure this stuff out — especially when we're not trained in any of it during school or residency.
If you're early in the process, what are you stuck on or unsure about? And for those who’ve done it already, what do you wish you'd done differently?

Trying to learn from how others have navigated the early stages of private practice — both the wins and the "wouldn’t do that again" moments.
Click to expand...
I would just keep it cheap at first.
I did my own with the GoDaddy design tool (website tonight or whatever they call it now).... just a few titles, a few pics I'd taken with gf, some keywords, the website looked ok and was cheap. Anyone can do it.

I have a fancier website now (in my sig). Not amazing or super high cost, but professionally done and more professional photog pics... a bit neater looking and nicer.

In most places podiatrists work (vast majority), website doesn't matter a ton. The website is merely what people use to look you up and verify that you're good [passable?] once PCP/ER/UC has referred or their friend/fam/coworker told them to go to you (so spend far more time and money on PCP relationships than website). The website is not the net to catch patients... it's basically just for a patient to verify after they're already planning to see you. Those are the patients you want: already view your office as something of value and likely to have fair/good insurance as they were recommended to it by another doc or another patient who'd seen you.

As for the "do-it-yourself" patients looking through FB or searching Google themselves, you honestly don't want those people (imo). They will find you anyways, but they value appointments less, more demanding to get in soon, more likely to haggle on money or not have good insurance, less likely to know how healthcare works, probably already had a dissatisfaction with another podiatrist or other docs if they are searching themselves and aren't getting refer from PCP or similar. Ditto with UC/ER refer pts... you can take them, but they're absolutely more drama and a step below a PCP refer pt.

...if you are in a cutthroat area (major metro, esp pod school cities), then you can get a real fancy website, fancy photo sessions, SEO services, pro marketing on social, whatever. This is a bit of a waste for most places, but you need to have that big fancy flag flying in LA, NY, Chi, Miami, Houston, etc type markets. Those markets are dog eat dog (for any type of doc - quadruple that for DPMs), and you want any edge you can find with website pics airbrushed, AI, videos, whatever. Not the areas for me, but a lot of ppl do it obviously. You need a good website as the beacon to impress patients who have many other options in the area.
 
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