You’ve been made, all 10 of you

[air bud]

As a recent grad I just want to voice my own opinion:

I accepted PP job which so far I enjoy, but my spouse makes 3x+ my salary (not in medicine) and we have zero debt. So my PP salary is more than enough to pay off our mortgage, car, and buy clothing. I have no real benefits through my job: I have no health insurance, no 401K, no life insurance and no disability insurance. Again, I am lucky that my spouse's job offers all that and I don't have to pay 2K per months for some crappy health insurance.

I graduated top of my class from podiatry school, and I hated most of the externships I did. Maybe it was the area, but attendings were nasty, residents would be mean and disrespectful, I heard sexual comments, etc...I end up in the decent residency, but again, RRA and ankle training was a joke. All ankle cases were with ortho who hated podiatry, so those "numbers" were not real. After 3 years of RRA residency, I don't feel confident doing any of it and honestly, I don't want to.

Also covid was a disaster. We were not considered "real doctors" until covid hits. We were first to be deployed. After covid ended, we were back to "just podiatrist". I didn't care much about the status, but it also corresponded how we were treated in the OR.

Reimbursement for bunions/hammertoes is a joke. Considering that you have to take time off you clinic day, and then see the patient after for free basically for the next 90 days. And then complications.

All my friends who finished recently got jobs, but unless you are in the hospital, I would not expect anything higher than 130K (again based on my and my friend's experience). If you in a high tax state like CA or NY, 130K is pretty low, considering that rent in those places 3K per months unless you want to live in a bad area, or in a studio. Do you want to live in a studio in your 30th?

Some private practice places would offer things like 130K, 6 days a week 8am-7 pm plus consults and 1 week vacation with no benefits. When my spouse saw those offers, he was terrified, his words were "they treat you like illegal immigrant, working in a kitchen and afraid to be deported". But unfortunately if you have 300K debt, kids and spouse who is not working/not making much, you might be forced to take that offer.

Hospital jobs exist but its very hard to get them unless you know someone, and many of these jobs are in the areas that are not desirable at all. Those jobs also require long hours, call and not much work life balance.

Also taking numerous board exam... We had to take 3 in the podiatry school and each was like 1K, then ABFAS 4 exams, then ABPM... At some point enough is enough... Seems like a money drain. And again if we would be making 500K like ortho, maybe, but requiring us to take so many exams, just unreasonable.

ABFAS gives you only 7 years to complete surgical numbers! After that, good luck. What if you have a health condition? What if you are pregnant 4 times ant taking time off? What if life happens? That's a very crazy requirement. Unless you are in the hospital job, first year you will not have many surgeries, it takes 3 months + just to get on a staff. If you have a child and take a reasonable 6 months off, you loose more time. Whoever invented 7 years rule, definitely didnt think about women and pregnancy/maternity leave. And I am not talking about a laughable passing rate for those exams. No other specialty has such a low passing rate, and we know its all on purpose to make more money.

To sum up, I personally do not think that podiatry is a good option, unless you can pay cash for your education, graduate zero debt and have job ready for you because your parent/relative owns a practice. I had a pretty good resume, publications, high GPA, recs letters, etc and it was not easy. I literally cold called places. I had several offers but none of them were amazing.

Sorry, going to disregard this post it's only anecdotal

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[Scrantonicity]

No one ever disputed that the information on this forum is anecdotal--it's a public internet forum, full of semi-anonymous posters. Half of these people could be truckers, for all we know.

If something came out funded by APMA and/or ACFAS stating what they have found to be typical salaries for podiatrists--I'd throw it in the trash. In this case, I think real people telling their experiences trumps "surveys" performed by APMA and ACFAS--who is gonna answer these surveys? Probably the top tier earners that are more than excited to share their $350K plus salaries with the world. The poor podiatrists making $85K are too busy going to the hospital to do that nail consult after office hours--they don't have the time or desire to fill out those things! It's much easier and more cathartic to get on SDN and talk about it--and warn others going into the field...

I think you're just gonna have to understand that this is a necessary evil.

 

[DYK343]

I have friends who work in the hospital and no, they do not make 350-400K and yes, they work until 9 pm and on call half of the months. Is it anecdotal? Yes, but, so is what you are saying. I am glad you had different experience, but its not experience of my friends.

Assume $50 a RVU (which is average, maybe even a little below average depending on latest MGMA salary).

$400,000/50 = 8,000 RVUs a year for salary 400k.

8,000/52 weeks = 154 RVU per week

154/5 days a week= 30.7 RVU a day.

30.7 RVUs a day is easy to achieve.

If youre hospital based you should be clearing 400k. Especially staying until 9PM every night.

 

[air bud]

Assume $50 a RVU (which is average, maybe even a little below average depending on latest MGMA salary).

$400,000/50 = 8,000 RVUs a year for salary 400k.

8,000/52 weeks = 154 RVU per week

154/5 days a week= 30.7 RVU a day.

30.7 RVUs a day is easy to achieve.

If youre hospital based you should be clearing 400k. Especially staying until 9PM every night.

Uh...maybe redo those numbers champ. Gotta take some vacation right? What are you a private practice owner?

 

[Boba Foot]

Can someone TLDR what the white paper/joint task force thing was all about? I must’ve missed that and I’m too lazy and disgruntled to look it up on my own.

 

[DYK343]

Uh...maybe redo those numbers champ. Gotta take some vacation right? What are you a private practice owner?

Whats a vacation?
And with 4 weeks vacation looks like its 33.3 RVU a day

 

[podwho]

I am baffled by the continued mis-representation and distortion of what I write which gets posted and then challenged. I never said there were good jobs ( although I think there are) and never said I had data. My point is that we do NOT have good data on the job opportunities and starting salaries available to new grads from residency training, nor do we have reliable data reflecting the true income of practicing podiatrists who are 5, 10, 15 and 20 years out. No, this is not realm of peer reviewed research for a medical journal but could be carried out by a qualified entity and funded by APMA and ACFAS. Until this is done, much of what we read in these posts regarding income potential for podiatrists must be recognized as anecdotal evidence at best.

“i aM BafFLeD” lol It’s all anecdotal. This is sdn not nature, people are not stupid. I’m glad you can admit you don’t have the data. So you know at best as much as I know about new graduate salaries.

 

[Hallux Flaccidus]

Assume $50 a RVU (which is average, maybe even a little below average depending on latest MGMA salary).

$400,000/50 = 8,000 RVUs a year for salary 400k.

8,000/52 weeks = 154 RVU per week

154/5 days a week= 30.7 RVU a day.

30.7 RVUs a day is easy to achieve.

If youre hospital based you should be clearing 400k. Especially staying until 9PM every night.

Since you have access to the latest MGMA data, please share with the group what it says about current podiatry salaries. The MGM data is the most accurate source available, although not inclusive of all podiatry practices. I saw the data for the years 2013 -2015. It showed that general podiatrists made about $237,000 per year ( median income) while surgical podiatrists made $279,000. By comparison Family Practice Physicians made $230,000 per year and Physician Assistant Ortho made $111,000. That was 7 years ago and the figures always trend upward.

 

[deleted664048]

Assume $50 a RVU (which is average, maybe even a little below average depending on latest MGMA salary).

$400,000/50 = 8,000 RVUs a year for salary 400k.

8,000/52 weeks = 154 RVU per week

154/5 days a week= 30.7 RVU a day.

30.7 RVUs a day is easy to achieve.

If youre hospital based you should be clearing 400k. Especially staying until 9PM every night.

There are other things you suppose to do as a doctor that you are not really getting paid for, like calling patients and their family, planning surgeries for the next day/week, discussing things with patients, going to the workshops/conferences, reading articles, fixing notes due to billing issues, learning how to bill properly, try to be up to date with new treatments, new requirements, etc

Obviously, no one is just seeing patient 8 am to 9 pm. It is not all about RVUs. Many hospital jobs also require you to teach, which also requires time and preparation.

If you require to do a complicated surgery, you need a good amount of time to review CT scan/MRI to plan everything and even go to cadaver lab.

If you have an "admin day" and see no patients, you still spend time doing other things.

 

[air bud]

Since you have access to the latest MGMA data, please share with the group what it says about current podiatry salaries. The MGM data is the most accurate source available, although not inclusive of all podiatry practices. I saw the data for the years 2013 -2015. It showed that general podiatrists made about $237,000 per year ( median income) while surgical podiatrists made $279,000. By comparison Family Practice Physicians made $230,000 per year and Physician Assistant Ortho made $111,000. That was 7 years ago and the figures always trend upward.

Lol

 

[air bud]

There are other things you suppose to do as a doctor that you are not really getting paid for, like calling patients and their family, planning surgeries for the next day/week, discussing things with patients, going to the workshops/conferences, reading articles, fixing notes due to billing issues, learning how to bill properly, try to be up to date with new treatments, new requirements, etc

Obviously, no one is just seeing patient 8 am to 9 pm. It is not all about RVUs. Many hospital jobs also require you to teach, which also requires time and preparation.

If you require to do a complicated surgery, you need a good amount of time to review CT scan/MRI to plan everything and even go to cadaver lab.

If you have an "admin day" and see no patients, you still spend time doing other things.

Rule number 1: it is ALWAYS about the RVU but yeah you are certainly bringing a whole new element into this. Based on the fact that you are talking about being pregnant, I am going to assume you have anatomical parts that allow for birthing of a human baby. Not sure how to word things these days just want to be as politically and anatomically correct as possible and not assume anything. Most of the posters on here I would assume do not have the ability to birth a child and can't relate to the additional problems that you are describing.

 

[DYK343]

There are other things you suppose to do as a doctor that you are not really getting paid for, like calling patients and their family, planning surgeries for the next day/week, discussing things with patients, going to the workshops/conferences, reading articles, fixing notes due to billing issues, learning how to bill properly, try to be up to date with new treatments, new requirements, etc

Obviously, no one is just seeing patient 8 am to 9 pm. It is not all about RVUs. Many hospital jobs also require you to teach, which also requires time and preparation.

If you require to do a complicated surgery, you need a good amount of time to review CT scan/MRI to plan everything and even go to cadaver lab.

If you have an "admin day" and see no patients, you still spend time doing other things.

OK but 150RVU a week should be pretty easy to hit. That was my point.

 

[DYK343]

Since you have access to the latest MGMA data, please share with the group what it says about current podiatry salaries. The MGM data is the most accurate source available, although not inclusive of all podiatry practices. I saw the data for the years 2013 -2015. It showed that general podiatrists made about $237,000 per year ( median income) while surgical podiatrists made $279,000. By comparison Family Practice Physicians made $230,000 per year and Physician Assistant Ortho made $111,000. That was 7 years ago and the figures always trend upward.

I dont have the newest. Mine is a few years old too.

Someone can correct me but 50 per wRVU is somewhere near the average for hospital employed..

 

[deleted664048]

OK but 150RVU a week should be pretty easy to hit. That was my point.

You are saying that anyone who works for the hospital makes at least 400K? LOL

 

[Hallux Flaccidus]

“i aM BafFLeD” lol It’s all anecdotal. This is sdn not nature, people are not stupid. I’m glad you can admit you don’t have the data. So you know at best as much as I know about new graduate salaries.

Contrary to your continued mis-representations,I never said I had data which would be helpful for new grads. And apparently you do not either. I am aware of MGMA data from several years ago and posted that just now.

 

[air bud]

Contrary to your continued mis-representations,I never said I had data which would be helpful for new grads. And apparently you do not either. I am aware of MGMA data from several years ago and posted that just now.

Sir, we are talking and have been talking about private practice. The reality for the large large majority of new graduates. No one is disputing these hospital jobs and salaries we are saying that they are unobtainable for the large large majority of graduating students.

 

[deleted1138023]

I wish I read this thread many years ago and didn't become a podiatrist.

 

[DYK343]

You are saying that anyone who works for the hospital makes at least 400K? LOL

I pulled in >30 wRVU a day last year and was paid accordingly at a MSG

30ish RVU a day is not that hard.

Maybe your friends are getting less than $50 an RVU. Or not seeing very many patients. I dunno.

 

[Feli]

View attachment 360129

Dr. Spinner is my hero. I would say the same thing but then my account on this sensitive site would be terminated.

Hmm, just saw this. Yeah, Spinner is legit. His program, depending on what somebody wants, is 1 or 1A in Florida and has been for years (Orlando probably overtook them, but Westside is very strong). I wasn't after Fla programs, but he has trained many solid surgical DPMs and matched well for decades. I stay in touch with a few alumni of his program.

That statement's probably more for the ABFAS/ABPM thread, but the full vendetta assault on ABFAS, gas onto the residency quality/shortage flame, SDN, Easter bunny, hospitals that want to protect pts, etc knows few bounds. What will next month bring?

...I am about done with this myself. Sometimes, if things are stupid at first glance, that's all the attention they need:
Make boards easier instead of make training better = not wise
Confuse the public in a way that could hurt people = no way
Add student seats when there aren't quality residency spots (or any spots) for grads = dangerous
Add grads when there aren't enough good-paying and good volume F&A surgery jobs and income to justify it = hurtful
Blame a discussion forum for lack of marketing, value, income for grads by profession/schools = huh???

 

[deleted664048]

I pulled in >30 wRVU a day last year and was paid accordingly at a MSG

30ish RVU a day is not that hard.

Maybe your friends are getting less than $50 an RVU. Or not seeing very many patients. I dunno.

Not just new grads, we asked attendings in my hospital before finishing residency and some of them barely made 230K after few years at the hospital and seeing 30+ people a day, with half days for surgery, etc.

I really think it depends on a hospital/location/contract/bonus structure.

Maybe they are making less than $50/RVU. Just because its your contract, does not mean its how everyone's contract is.

I really dont want some students reading and thinking "Let me get into 300K in debt, I will just easy make 400K after I graduate, and will work 9 to 5"

 

[deleted1138023]

just look at the APMA job postings...

Career Center | APMA

www.apma.org

there's a reason they don't post salaries. all these job are probably barely over 100k.

 

[malleolusman]

Sir, we are talking and have been talking about private practice. The reality for the large large majority of new graduates. No one is disputing these hospital jobs and salaries we are saying that they are unobtainable for the large large majority of graduating students.

Bingo. Dr Richie : MGMA reported income reports on HOSPITAL employed physicians, not private practice. The numbers you showed from MGMA are great , sadly - they are not available to most.

These numbers are unobtainable for a large majority of grads, and what is left for the majority - abusive private practice jobs - which no one from your cohort really wishes to dive into or write articles about.

I’ll add what I have seen since having left hospital based employment: with private equity getting into podiatry (pacesetter health, stride, ankle and foot centers etc) , podiatry will go the way of chiropractors.

If you are lucky, you will own/run/have a stake in an operation that is big enough to be acquired or be part of a group that treats you fairly ; otherwise - you will become another cog in corporate machinery. Lots of little chain chiropractor (podiatry) clinics. I hope I am wrong.

 

[111111194]

I graduated top of my class from podiatry school, and I hated most of the externships I did. Maybe it was the area, but attendings were nasty, residents would be mean and disrespectful, I heard sexual comments, etc...I end up in the decent residency, but again, RRA and ankle training was a joke. All ankle cases were with ortho who hated podiatry, so those "numbers" were not real. After 3 years of RRA residency, I don't feel confident doing any of it and honestly, I don't want to..

I had a similar experience. I came across some low life attendings and residents when I was a student. Losers with a massive inferiority complex who took out their bitterness on students because they don’t have power over anything else.

 

[icebreaker32]

Sir, we are talking and have been talking about private practice. The reality for the large large majority of new graduates. No one is disputing these hospital jobs and salaries we are saying that they are unobtainable for the large large majority of graduating students.

Yah that data sadly means very little for PP where the majority of jobs are.
The cold hard truth is it should be really, really hard to make less than 150K with good benefits as a newly trained podiatrist.....but truth is it is really, really easy to do so.

I wish those surveys meant something, but a podiatrist is not really a commodity with a going rate. Some places are willing to pay, but it is not like a young podiatrist can take those survey numbers and negotiate with them at a PP job offer.

A podiatrist will only become a commodity with a standard going rate (give or take) when the job market is not saturated.

 

[Scrantonicity]

I find it funny that we are indeed seeing some newcomers coming into SDN and posting their experiences...and these posts are eerily similar to the "bad eggs" that are speaking truth about our profession 😂 Good work, APMA!

 

[icebreaker32]

just look at the APMA job postings...

Career Center | APMA

www.apma.org

there's a reason they don't post salaries. all these job are probably barely over 100k.

.....the ones that do list salaries admit they exceed others at 120-150

Our compensation package will exceed other competitors as we establish a competitive-market base (range $120K-$150K)

 

[deleted1138023]

.....the ones that do admit they exceed others at 120-150 and that is a compensation package not salary

Our compensation package will exceed other competitors as we establish a competitive-market base (range $120K-$150K)

$120,000 is absolutely nothing. NOTHING. school loans, inflation, cost of living, WTF.

 

[shadesofgrey]

At least the apma job site has a ton of high paying hospital jobs listed… oh wait… never mind.

 

[wakaflocka88]

I have friends who work in the hospital and no, they do not make 350-400K and yes, they work until 9 pm and on call half of the months. Is it anecdotal? Yes, but, so is what you are saying. I am glad you had different experience, but its not experience of my friends.

Since you have access to the latest MGMA data, please share with the group what it says about current podiatry salaries. The MGM data is the most accurate source available, although not inclusive of all podiatry practices. I saw the data for the years 2013 -2015. It showed that general podiatrists made about $237,000 per year ( median income) while surgical podiatrists made $279,000. By comparison Family Practice Physicians made $230,000 per year and Physician Assistant Ortho made $111,000. That was 7 years ago and the figures always trend upward.

Dr. Richie - this is data for hospital/large group employed podiatrists. It does not account for the vast majority of PP podiatrists. Please refer to the “job offer thread” in this forum and there are numerous posts in there about the terrible job offers. And even some specific names of practices that are notorious for these offers year after year. These practices (many private groups) know new grads need jobs and they will eventually fill it no matter what because a new grad rather make $80k than $0

 

[PatchAdamsFan]

For those wondering, 2021 MGMA mean total compensation for a surgical podiatrist was $311,580, with a mean $53/wRVU. These numbers account for perhaps 5% of our profession as others mentioned above.

 

[DYK343]

Not just new grads, we asked attendings in my hospital before finishing residency and some of them barely made 230K after few years at the hospital and seeing 30+ people a day, with half days for surgery, etc.

I really think it depends on a hospital/location/contract/bonus structure.

Maybe they are making less than $50/RVU. Just because its your contract, does not mean its how everyone's contract is.

I really dont want some students reading and thinking "Let me get into 300K in debt, I will just easy make 400K after I graduate, and will work 9 to 5"

I work a lot more than 9-5. 60hrs a week is a good week hours wise and it can get far worse especially the weeks Im on call.

Most wont get a hospital/MSG contract (espeically right away) and work for a crummy 90k private practice associate until they start their own or join hospital/MSG/ortho.

Like I said above and many times in the past. Most podiatrists do make good money with time but a LOT of us get screwed the first 1-5 years out of residency.

 

[Poddy2Hotty]

Bingo. Dr Richie : MGMA reported income reports on HOSPITAL employed physicians, not private practice. The numbers you showed from MGMA are great , sadly - they are not available to most.

These numbers are unobtainable for a large majority of grads, and what is left for the majority - abusive private practice jobs - which no one from your cohort really wishes to dive into or write articles about.

I’ll add what I have seen since having left hospital based employment: with private equity getting into podiatry (pacesetter health, stride, ankle and foot centers etc) , podiatry will go the way of chiropractors.

If you are lucky, you will own/run/have a stake in an operation that is big enough to be acquired or be part of a group that treats you fairly ; otherwise - you will become another cog in corporate machinery. Lots of little chain chiropractor (podiatry) clinics. I hope I am wrong.

Larger groups have much more bargaining power with insurance companies but also more power in theory to control salaries. Economies of scale can allow them to cut costs (equipment, DME, etc) and secure referral pathways. This in theory would have the possibility to pressure solo pp out of business of force them to be acquired.

I googled large podiatry groups and several popped up:

stridecare
pacesetter-health
footandankle-usa
upperlinehealth

I know nothing about these groups and for all I know they are fantastic places to work. Would be interesting to see what the average salaries (base + production models and benefits) were for these mega groups vs MGMA data. The collective bargaining power and economies of scale may help them retain some autonomy against larger expanding hospital systems, but my gut tells me that benefits and pay would not be as competitive as a MSG/Hospital based practice with a wRVU model.

 

[air bud]

Larger groups have much more bargaining power with insurance companies but also more power in theory to control salaries. Economies of scale can allow them to cut costs (equipment, DME, etc) and secure referral pathways. This in theory would have the possibility to pressure solo pp out of business of force them to be acquired.

I googled large podiatry groups and several popped up:

stridecare
pacesetter-health
footandankle-usa
upperlinehealth

I know nothing about these groups and for all I know they are fantastic places to work. Would be interesting to see what the average salaries (base + production models and benefits) were for these mega groups vs MGMA data. The collective bargaining power and economies of scale may help them retain some autonomy against larger expanding hospital systems, but my gut tells me that benefits and pay would not be as competitive as a MSG/Hospital based practice with a wRVU model.

I am going to do a 6-month 1099 gig for a group with offices in multiple States. Honestly I don't know if private equity is involved or not I don't think so but with their model they are comfortable paying me 18K monthly salary guaranteed with the ability to bonus. It's going to be great, where it is in terms of the year, I have already maxed out employee side of payroll taxes, will basically put all of 2022 income into tax deferred accounts and then use all of the business expenses including Cobra which I have already been paying, my tail insurance from my last job as well as others and use that to offset my W-2 income. Then come 2023 will max out retirements accounts entirely as well. Honestly I think more people should be doing 1099 instead of W2.

 

[Hallux Flaccidus]

Sir, we are talking and have been talking about private practice. The reality for the large large majority of new graduates. No one is disputing these hospital jobs and salaries we are saying that they are unobtainable for the large large majority of graduating students.

Got it. So where is the accurate, verifiable data about the wage opportunities for new grads entering private practice? Are prospective applicants to rely upon stories told by a small group of podiatrists who are actually happy with their current situation but have dire warnings for those who may follow? For that matter, would any prospect care to hear my story of hiring 2 new grads in 2016, each of whom made over $250K in my private practice in their first year? This anecdotal data was generated by a subject group of n=1 Prospective applicants are not "stupid" and deserve access to honest, reliable and verifiable information in order to make a critical career decision.

 

[podwho]

Larger groups have much more bargaining power with insurance companies but also more power in theory to control salaries. Economies of scale can allow them to cut costs (equipment, DME, etc) and secure referral pathways. This in theory would have the possibility to pressure solo pp out of business of force them to be acquired.

I googled large podiatry groups and several popped up:

stridecare
pacesetter-health
footandankle-usa
upperlinehealth

I know nothing about these groups and for all I know they are fantastic places to work. Would be interesting to see what the average salaries (base + production models and benefits) were for these mega groups vs MGMA data. The collective bargaining power and economies of scale may help them retain some autonomy against larger expanding hospital systems, but my gut tells me that benefits and pay would not be as competitive as a MSG/Hospital based practice with a wRVU model.

If employees of those companies or even their leaders are on sdn it would be great information to share. No idea if they will because technically they are individual groups that merged but independently run so to maximize reimbursement so it’s again anecdotal but better than nothing. Everyone’s pay should have gone up in theory. I’d be very curious if they pay fairly to start or a good compensation structure.

 

[air bud]

Got it. So where is the accurate, verifiable data about the wage opportunities for new grads entering private practice? Are prospective applicants to rely upon stories told by a small group of podiatrists who are actually happy with their current situation but have dire warnings for those who may follow? For that matter, would any prospect care to hear my story of hiring 2 new grads in 2016, each of whom made over $250K in my private practice in their first year? This anecdotal data was generated by a subject group of n=1 Prospective applicants are not "stupid" and deserve access to honest, reliable and verifiable information in order to make a critical career decision.

I commend you for giving your associates an opportunity to earn a good living. Sadly this is not the reoccurring theme here on SDN, I promise. Stick around these parts and you will see him time. In the meantime, we certainly appreciate your unique perspective involving your distinguished career in Podiatry.

 

[Scrantonicity]

Here's my anecdotal take on the large groups (I have applied to a number of them, have interviewed with a couple, and talked to others that have): They do indeed offer a bit better salary/benefit package than typical podiatry PP owners do. Take into account that I am ABFAS Certified, with 10 years of experience, so this may not be accurate for new grads--the ranges I found were $160-170K base salary with bonus structure (30% after 500K-600K collected or something similar). Pretty decent health insurance plans to choose from (single or family). Some have 401K's. Again, I don't know what they offer to a new grad, just my experience.

Soo....definitely an upgrade from the abysmal PP scenarios we are talking about in this thread-if you do pretty well, these jobs are designed to get you into the $200K range--but still nothing to get overly excited about, especially when you look at MGMA data and your eyes glaze over.

These big super groups and private equity firms do seem to be the future of private practice in podiatry, and I kinda do hope they continue to swallow up all these dinky practices that screw new grads over...

I'm just happy to finally leave PP altogether. VA compensation will be similar to the big PP groups I feel (so yeah, not overly excited about the $$, but it's an upgrade!)--but with better benefits--and better work/life balance...

 

[Scrantonicity]

Got it. So where is the accurate, verifiable data about the wage opportunities for new grads entering private practice? Are prospective applicants to rely upon stories told by a small group of podiatrists who are actually happy with their current situation but have dire warnings for those who may follow? For that matter, would any prospect care to hear my story of hiring 2 new grads in 2016, each of whom made over $250K in my private practice in their first year? This anecdotal data was generated by a subject group of n=1 Prospective applicants are not "stupid" and deserve access to honest, reliable and verifiable information in order to make a critical career decision.

This is commendable--and we need more examples like this. Where were you when I was looking for a job out of residency haha

 

[AttackNME]

Got it. So where is the accurate, verifiable data about the wage opportunities for new grads entering private practice? Are prospective applicants to rely upon stories told by a small group of podiatrists who are actually happy with their current situation but have dire warnings for those who may follow? For that matter, would any prospect care to hear my story of hiring 2 new grads in 2016, each of whom made over $250K in my private practice in their first year? This anecdotal data was generated by a subject group of n=1 Prospective applicants are not "stupid" and deserve access to honest, reliable and verifiable information in order to make a critical career decision.

Private practice is a business. How is MGMA going to get data on what you offer your associates? Does anyone even know how they get their data? In fact, how is any organization going to get true data on every private practice? This cannot be mandated. Businesses are not required to disclose their financial information, including what their contracts are. You will never find the information you’re looking for. That’s why we have turned to sharing anecdotal evidence on SDN because that’s ALL you’re going to get

 

[dtrack22]

I know two foot and ankle ortho's. One has been in practice twenty years and might make that kind of money. The other does not.

Median MGMA compensation 3 years ago was $516k for F&A Ortho. They certainly are a lower earning ortho specialty but there are almost as many F&A ortho jobs listed on practicelink as there are fellowship programs. If you are an F&A ortho and not making $500k you are doing so by choice. Nothing wrong with that (shorter hours, or less call, or a desireable location for you/your family, or whatever the reason may be).

The MGM data is the most accurate source available, although not inclusive of all podiatry practices.

And as has been pointed out numerous times now, MGMA is hospital/large MSG employed positions which are a small minority of overall job openings at any given time.

Someone can correct me but 50 per wRVU is somewhere near the average for hospital employed..

It’s just north of that. My region was $54 two years ago when I signed.

I find it funny that we are indeed seeing some newcomers coming into SDN and posting their experiences...and these posts are eerily similar to the "bad eggs" that are speaking truth about our profession

Exactly. Essentially everyone here has the same story. Doing well now (for the most part) but ended up getting $100k base, 30% of collections after $350-400k offers or taking one of those jobs. The new posters have the same stories as the “regulars.” Still waiting for someone to come on and post their $180k first year salary with benefits, in a podiatry practice that they still work at and maybe even have partnered with. Several of my DO friends from school had pediatric practice jobs that paid that. That’s basically a compensation floor in the MD/DO world and we would be shocked to see it as a podiatry associate…

 

[Boba Foot]

I

the ranges I found were $160-170K base salary with bonus structure (30% after 500K-600K collected or something similar).

Honestly, this looks just as ****ty as most PP offers. It’s just a marginally higher base but the same 3x base collections and then 30% bull****. Ownership is still probably making about 20% of everything you see while paying you 30%, it’s just going to a venture capitalist group instead of a TFP.

 

[Scrantonicity]

I

Honestly, this looks just as ****ty as most PP offers. It’s just a marginally higher base but the same 3x base collections and then 30% bull****. Ownership is still probably making about 20% of everything you see while paying you 30%, it’s just going to a venture capitalist group instead of a TFP.

Pretty much Which is why it wasn't a big enough upgrade for me to bite.

 

[heybrother]

I

Honestly, this looks just as ****ty as most PP offers. It’s just a marginally higher base but the same 3x base collections and then 30% bull****. Ownership is still probably making about 20% of everything you see while paying you 30%, it’s just going to a venture capitalist group instead of a TFP.

I spoke to a PE group recently. The way they described the structure to me was different than classic PE buyouts that I read about online.

The group I spoke to claimed the following
-the only "must" point was you had to use their EHR
-its the same EHR I use and their rate is !1/2! mine. If I had their rate I'd save $30K.
-They have negotiated rates for supplies, equipment, DME, etc. You get health insurance through the company etc
-They claimed to have negotiated fee schedules with large insurance
-They own a micro lab / nail lab and there's some sort of vascular laboratory / wound healing center ownership in the mix also
-You sell to them. You get stock in the company and cash up front
-You are essentially selling an income stream to them (they didn't say how much) ie. a portion of your office cash flow goes to them permanently
-The company pays bonuses based on revenue acquired from the labs/vascular which you can acquire through quality metrics to make up for the income stream you surrendered
-You still run your office, your revenue is still based on what you produce in your office

How much of that is true - I cannot say. When I read about selling to PE online the set-up seemed different. The understanding I had from that was you essentially were paid some variation of a multiplier of your EBITDA. People arguing about it online described a large spectrum of what the multiplier could be. I had a friend who spoke to the group I spoke to above and the number he quoted me as the multiplier was less than other medical specialties were getting online.

There's probably a thousands questions I didn't ask. I can think of a million things that could go wrong. The biggest issue to me is - I still have to practice for another 20 years.

Amusingly my partner spoke to them a year ago but never followed up. If he had tried something when I wasn't a co-owner I'd have walked.

 

[newfeet]

I wish I read this thread many years ago and didn't become a podiatrist.

We shouldn't trust the anecdotal evidence... But me too!

 

[air bud]

We shouldn't trust the anecdotal evidence... But me too!

Me 3. Had stats for DO easy. Would have done ER med...or anything surgical but primary.

 

[podgod22]

Any benefit from using a "consultant" to help with a new practice set up? There's a couple a found and a few podiatry specific actually. It seems great what they provide. Just wondering if others have used these services and found them useful.

 

[blasthardcheese]

The practice I work for was sold to private equity last year. My contract changed very little, after we were sold. I stayed at 30 percent of collections, got a 5k base raise but they stopped paying 100 percent of my insurance premiums which in my case equated to a 10k pay cut.

They have made other changes too which has certainly made the practice more profitable, but none of those savings get passed down to the associates.

The worst part of working for PE is the loss of potential for partnership/ownership. You are encouraged to invest/buy shares in the PE company, but it pays no dividends and gives you no control over the company. You are just told your shares will be worth a lot more when PE sells the company in 5-10 years. I did not invest.

When I have more time, I'll do a new thread on working for PE.

 

[icebreaker32]

Me 3. Had stats for DO easy. Would have done ER med...or anything surgical but primary.

Right there with ya me 4

At the time I would have not done primary, but with hospitalists and solo practice becoming a dinosaur......the ability to work 32 hours with full benefits, a good salary and group call coverage (mainly telephone) the work/life balance seems enticing enough I would have done primary now also.

 

[newfeet]

Me 3. Had stats for DO easy. Would have done ER med...or anything surgical but primary.

Hmm... something where I can do telehealth while I'm on a Caribbean island. But I would have done primary care.

 

[Scrantonicity]

Meh we made our decisions, and we're doing the best with it--and most importantly we are supporting our families doing something more satisfying than standing in a hot factory all day wearing steel-toed boots like tons of my patients...

But yeah me 5, add me to the disgruntled list I guess--I also would have saved all the Bitcoin I mined in 2009 and now I wouldn't even have to work...so yeah.