I gotta say that I've read and heard some very disturbing things from both current pods and people familiar with the field.
I was speaking to my neighbor who is a dermatologist a few days ago - his son went to pod school and then a 3 year residency at Kaiser. He was offered several jobs out of school and everyone of them turned out to be garbage.
Red tape at the hospitals didnt allow him to do rear foot work since there was a MD who specialized in it. His admitting privelages were very limited at another hospital.
So I started a little more research and my general concerns are as such -
1) Pods have no universal scope of practice;
2) very difficult times getting on insurance panels;
3) only are allowed to do certain procedures in certain hospitals;
4) have no govt loan forgivness (as MD/DO/DDS do);
5) schools take anyone with a pulse and can sign the loan docs;
6) have a very very high loan default rate;
7) are second to MD and DOs;
8) residency training although is getting better has no standardization and can be very subpar;
9) no board certification without a 36 mo. residency;
10) very little referrals and surgical calls from MD and DO;
11) schools have approx. 700 seats to fill yet they can only fill 50%;
12) reimbursements are at an all time low for podiatry procedures. In fact, some insurance companies wont even cover podiatric care; and
13) nurses, PTs, chiropractors, and other health care professionals are doing orthotics and wound care and other basic podiatry procedures.
This is a list of just a few of the crappy comments I found by talking to my neighbors son and reading some literature.
Are all of these thoughts unsupported because it seems like everyone here is gung-ho! for podiatry school.
Your thoughts?
Hello there, To answer your questions i have to say that I'm not very familiar with your neighbour's son situation and to tell you the truth it seems a bit far fetched to have someone coming out of Kaiser's residency and not be able to land a stable career - unless of course, your neighbour's son is a difficult person to work with. I will tell you from my experience with other colleagues, friends, and family - I have yet to meet or experience what you mentioned above - I will answer your concerns to the best that i can:
1) Pods have no universal scope of practice;
-That is true, the scope of practice will vary from state to state - and this is something being addressed by the APMA. they set a goal to have this problem completely solved by 2015. However, that does not mean that you can't practice podiatry in all states - some states will vary, so it depends on what you want to do as a professional.
2) very difficult times getting on insurance panels;
-Not true at all. Maybe that was the case a decade ago when the training was mostly inconsistent but with today's standard of training - this is becoming less of an issue.
3) only are allowed to do certain procedures in certain hospitals;
-Some hopsitals are run with alot of politics. However, if the state allows for a certain advances scope, and the podiatrist is trained with board certification, then the hospitals usually will grant him the previlidges.
4) have no govt loan forgivness (as MD/DO/DDS do);
I'm not too familiar with that issue so I won't comment. However, I have yet to meet a podiatrist who struggled to repay his loans
🙂.
5) schools take anyone with a pulse and can sign the loan docs;
Not all schools do that. However, the schools that do that tend to weed out the weaker students by the end of the 2nd year. Do I think it is unethical to do so? Absolutely. However, we have to understand that some podiatry schools are businesses and need to insure tuition money in the bank.
6) have a very very high loan default rate;
Not true. I would imagine you heard this from a disgrunted or older podiatrist with no training whatsoever - but last time i checked, all my podiatrist collegues are making a very very comfortable living.
7) are second to MD and DOs;
I don't understand what you mean by second? We are not MD's or DO's. We are DPM's. Do you mean we get treated like "second class citizens"? Not true at all. On the contrary, we are very respected for our knoweldge and expertise in the lower extremity. This is something our senior members can testify for as they have done hospital rotations and residencies. From my experience, I've experienced nothing but respect from both types of professions.
8) residency training although is getting better has no standardization and can be very subpar;
It is in the process of standardization and in fact by 2009 all residency will be PM&S24 or 36.
9) no board certification without a 36 mo. residency;
Not true, you can get board certification for forefoot surgery after 24 mo. residency and with an ABPS certification you can get hospital previlidges. However, you can not get a rearfoot or reconstructive surgery certification which makes sense i think. More training = more certifications for more procedures. I think thats fair, don't you?
10) very little referrals and surgical calls from MD and DO;
Again, very subjective. Where are you getting this from? All DPM students do hospital rotations and residencies now so we work with many MD's and DO's. I'm not saying that EVERY podiatrist will get referrals from MD's and DO's but if you are good, well trained, and are very pleasant to work with - you will get referrals - business ethics i guess.
11) schools have approx. 700 seats to fill yet they can only fill 50%;
-there are more than 350 podiatry students at the 8 colleges of podiatric medicine. Many of the schools are placing a limit on how many seats to fill - so again, outdated information.
12) reimbursements are at an all time low for podiatry procedures. In fact, some insurance companies wont even cover podiatric care; and
-reimbursements are at a low for many surgical procedures at the moment. However, podiatry procedures are still covered and podiatrists are still getting paid. This is a problem in the health care in general not just podiatry.
13) nurses, PTs, chiropractors, and other health care professionals are doing orthotics and wound care and other basic podiatry procedures.
-So? Foot and ankle Orthopoedic surgeons do great Foot and ankle procedures as well. Whats new with that? Many professionals do different aspects of foot and ankle treatments. However, name me one professional who can do ALL procedures and treatments.
I appreciate your concerns and they are valid. However, you probably should understand that these questions are not new despite the fact that profession is continuing to progress forward. I'm sorry for your neighbour's son's experience but if I was to do research about this field, I would ask more recent PM&S 36 grads. In fact, I would probably call up some of the residency programs and speak with the residents directly and ask them very openly about their job offers and job market because they probably have the most accurate picture of the current state of the profession.
Hope that helps and good luck with your endeavours