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Got that hospital job. My friends joke about me just moving around collecting signing bonuses.
Definitely agree with earlier sentiments about once in one hospital job seems easier to go to another. Can talk the talk etc. Have worked in close environment with other colleagues, etc. Also, can't discount the familiarity it breeds when talking to other doctors at the interview process.

Anyways see previous post about how to find hospitals.

260k base, 25k metrics and stuff easy to obtain. Only 10k signing, 10k moving. RVU bonus but don't know threshold or other Benny's.. so 285 plus bonus. No state income tax. 5k come yearly. 2.5k licensing. 5 year contract but I actually don't like that part. Ever hear of inflation bro? Will ask for 2 or 3. Building new ASC with ability to invest in.

Is this also rural?

 

[de Ribas]

I’m not. It would depend on ortho really. Which is unlikely, since a rural hospital is not going to have an ortho who cares at all about foot and ankle elective stuff or foot trauma. Worst case scenario is they keep the ankle fractures because they are usually easy and pay better (given the time in the OR and minimal follow up) than a lot of foot and ankle surgical pathology.

I meant would a rural hospital have all the necessary plates, instrument sets, ability to get grafts, ex fixes, necessary hardware to do most surgeries. If ones goes rural would they lose patients to nearby larger cities because smaller hospitals don't have everything. I am fine going rural, just don't want to be limited in what I can do or lose patients just because smaller hospitals can't get everything I would need. Just asking.

 

[air bud]

Is this also rural?

I meant would a rural hospital have all the necessary plates, instrument sets, ability to get grafts, ex fixes, necessary hardware to do most surgeries. If ones goes rural would they lose patients to nearby larger cities because smaller hospitals don't have everything. I am fine going rural, just don't want to be limited in what I can do or lose patients just because smaller hospitals can't get everything I would need. Just asking.

Rural has everything. Especially when it's truly a critical access hospital, money actually is less of an issue. My new place is not rural, it's in a smaller town but the definition of rural is you can drive 30 minutes to an hour and not come to any other further population center. Where I am at now is about an hour and a half to two hours outside of a large metro area and there's lots of small towns of 5 to 10,000 in between every 10 to 15 miles. I used to be 2 hours from anything more than a few hundred people that's rural.

The whole reason why these critical access hospitals are able to hire you is because of the reimbursement being different. And reps love critical access hospitals because they make more money too so they will make sure to be at your cases. I spent two years at a critical access hospital with only crnas. I only had one patient out of let's say 100 surgeries I did there that the CRNA did not feel comfortable with the patient due to health issues and had to have them shipped out. And I was 100% on board cuz that patient was a train wreck and I was looking for a reason not to operate. My next rural hospital had md's. Again none of the let's say 250 surgeries I did there did the patient need to be shipped out because they were too sick.

 

[dtrack22]

I meant would a rural hospital have all the necessary plates, instrument sets, ability to get grafts, ex fixes, necessary hardware to do most surgeries.

Not in my experience. But I could be an outlier. Critical access hospitals get better reimbursements on materials/costs as well as state/federal grant money for capital improvements. That’s on purpose to help keep rural facilities open.

A larger corporate outfit in our area is more likely to limit what you can use surgically than my hospital. We have a Mako joint robot and a new DaVinci robot. The big Providence hospital across the border doesn’t. We don’t have any vendor contracts that limit hardware. The big Providence hospital does. No Lapiplasty for those Podiatrists…

 

[de Ribas]

Not in my experience. But I could be an outlier. Critical access hospitals get better reimbursements on materials/costs as well as state/federal grant money for capital improvements. That’s on purpose to help keep rural facilities open.

A larger corporate outfit in our area is more likely to limit what you can use surgically than my hospital. We have a Mako joint robot and a new DaVinci robot. The big Providence hospital across the border doesn’t. We don’t have any vendor contracts that limit hardware. The big Providence hospital does. No Lapiplasty for those Podiatrists…

Rural has everything. Especially when it's truly a critical access hospital, money actually is less of an issue. My new place is not rural, it's in a smaller town but the definition of rural is you can drive 30 minutes to an hour and not come to any other further population center. Where I am at now is about an hour and a half to two hours outside of a large metro area and there's lots of small towns of 5 to 10,000 in between every 10 to 15 miles. I used to be 2 hours from anything more than a few hundred people that's rural.

The whole reason why these critical access hospitals are able to hire you is because of the reimbursement being different. And reps love critical access hospitals because they make more money too so they will make sure to be at your cases. I spent two years at a critical access hospital with only crnas. I only had one patient out of let's say 100 surgeries I did there that the CRNA did not feel comfortable with the patient due to health issues and had to have them shipped out. And I was 100% on board cuz that patient was a train wreck and I was looking for a reason not to operate. My next rural hospital had md's. Again none of the let's say 250 surgeries I did there did the patient need to be shipped out because they were too sick.

Thanks for your responses. That's good to know that rural hospitals are generally not limited in that respect.

 

[bloxxeeey]

It seems like you’re pretty much screwed in this field unless you want to go rural.

 

[AttackNME]

I’m an outlier, my hospital gig was 165k plus $250 per day for taking call. Was nice but I wasn’t getting numbers, eventually ended up in private practice at salary 165k plus bonus 35% of collections after paying my own salary (plus overhead for myself), now I’m partner taking home over 350k before taxes. Took me awhile to get there and I acknowledge contracts like mine are unfortunately rare

 

[diabeticfootdr]

Perhaps there is a selection bias on SDN. Those who come on the forum to complain are those who are unhappy with their present or past job opportunities.

I met an executive from HCA (a large hospital chain) this weekend who told me they can’t find enough limb salvage podiatrists to fill their hospital jobs. That seems to be a disconnect.

 

[heybrother]

I’m an outlier, my hospital gig was 165k plus $250 per day for taking call. Was nice but I wasn’t getting numbers, eventually ended up in private practice at salary 165k plus bonus 35% of collections after paying my own salary (plus overhead for myself), now I’m partner taking home over 350k before taxes. Took me awhile to get there and I acknowledge contracts like mine are unfortunately rare

So - what are you doing that actually makes money. I mean that as opened ended as you want to be.

-Are you doing DME ie. scanning/casting for CROW, custom braces, diabetic shoes?
-Do you have some sort of in office surgery suite?
-Heavy volume of outpatient surgery?
-Heavy in clinic grafting on Medicare patients?
-Just churn and burn on a lot of patients?
-A hodge podge of podiatry ancillaries that you see at conferences?

 

[Feeter]

Perhaps there is a selection bias on SDN. Those who come on the forum to complain are those who are unhappy with their present or past job opportunities.

I met an executive from HCA (a large hospital chain) this weekend who told me they can’t find enough limb salvage podiatrists to fill their hospital jobs. That seems to be a disconnect.

Of course there is a selection bias. Online forums can't really give you a full picture of our profession which is why I think it is a ridiculous to pick on this forum as a cause of decline in admissions. There are bigger issues in podiatry than someone complaining on an online forum.

I hope ABPM leadership at least acknowledges those issues. I don't think bigger issues at play will be solved with positive comments on this forum.

 

[AttackNME]

Mostly limb salvage, very efficient clinic, I see around 60-80 a week, lots of addons and sacrificing some weekends. Some in office procedures. I rarely use in-office grafts. Some elective type stuff. Whatever I bill I get to take home my portion of collections % including dispensing DME. I don’t do orthotics or casting braces. I think the bulk of my income is for in office management of wounds, lots of debridements, some high level e/m.

 

[malleolusman]

I’m an outlier, my hospital gig was 165k plus $250 per day for taking call. Was nice but I wasn’t getting numbers, eventually ended up in private practice at salary 165k plus bonus 35% of collections after paying my own salary (plus overhead for myself), now I’m partner taking home over 350k before taxes. Took me awhile to get there and I acknowledge contracts like mine are unfortunately rare

Ditto to what Heybrother said. What did it take for you in private practice to take home 350K… surgery center shares/frequent call and inpatient load/ancillaries such as MRI center investment?

Do you practice in rural or major metro or medium size city?

Good on you on getting a fair contract though, that’s awesome. Glad these exist.

 

[AttackNME]

Of course there is a selection bias. Online forums can't really give you a full picture of our profession which is why I think it is a ridiculous to pick on this forum as a cause of decline in admissions. There are bigger issues in podiatry than someone complaining on an online forum.

I hope ABPM leadership at least acknowledges those issues. I don't think bigger issues at play will be solved with positive comments on this forum.

I’m still a young practitioner but I’m probably gonna be staying in private practice forever. I’ve done VA and hospital and I dislike the politics and lack of control. I was naive to the terrible situations some people had, I guess I’m a bit of a hermit and don’t talk to my peers much about income, but this forum was helpful for me to understand the common issues. Moving forward it’ll be young podiatrists like myself who will have to make the change and treat associates fairly.

 

[diabeticfootdr]

Of course there is a selection bias. Online forums can't really give you a full picture of our profession which is why I think it is a ridiculous to pick on this forum as a cause of decline in admissions. There are bigger issues in podiatry than someone complaining on an online forum.

I hope ABPM leadership at least acknowledges those issues. I don't think bigger issues at play will be solved with positive comments on this forum.

It’s not about forcing positive comments. It’s about encouraging more people to post their experiences so there is a more accurate representation.

 

[Feeter]

Mostly limb salvage, very efficient clinic, I see around 60-80 a week, lots of addons and sacrificing some weekends. Some in office procedures. I rarely use in-office grafts. Some elective type stuff. Whatever I bill I get to take home my portion of collections % including dispensing DME. I don’t do orthotics or casting braces. I think the bulk of my income is for in office management of wounds, lots of debridements, some high level e/m.

How many hours per week would you say you work?

I'd say I work around 45 to 50 hours a week due to call and add ons and take home pre tax 325k at a hospital in metro area doing limb salvage and general podiatry.

 

[Feeter]

It’s not about forcing positive comments. It’s about encouraging more people to post their experiences so there is a more accurate representation.

I hope more people participate however I don't think it will increase student enrollment. It still will not be an accurate representation as it is just an online forum.

 

[AttackNME]

Ditto to what Heybrother said. What did it take for you in private practice to take home 350K… surgery center shares/frequent call and inpatient load/ancillaries such as MRI center investment?

Do you practice in rural or major metro or medium size city?

Good on you on getting a fair contract though, that’s awesome. Glad these exist.

Tbh I did learn a bit from @diabeticfootdr Dr Lee Rogers when he did a dinner talk for my program when I was a resident, he talked about how hospitals would beg for limb salvage podiatrists. I decided I was gonna specialize in limb salvage before his talk but that talk helped me go all in. I found it easy to plug my specialty skills into the state that I ended up settling in because no one wanted to do limb salvage. This city is sorta becoming saturated with podiatrists but most still don’t want to be on call more than the minimum required. I started taking as much call as I could and it easily got me to over $200k income my first year as an associate. I didn’t need my bosses to really funnel me patients, they didn’t do limb salvage so they gave me the few wounds they had. We spent no money on advertising my services. I simply opened the flood gates into clinic from my hospital work. Now I don’t do as much call but I’m still on call about 25% of the year as opposed to almost 50% (by choice). But I have such an established base of recurring wounds that I don’t need a high volume call schedule

 

[AttackNME]

How many hours per week would you say you work?

I'd say I work around 45 to 50 hours a week due to call and add ons and take home pre tax 325k at a hospital in metro area doing limb salvage and general podiatry.

Probably average 50-60 hours a week for the first year. A lot of it was just inefficient use of my time. I’ve become so much more efficient I can knock out the same amount of work in 40 or less hours

 

[diabeticfootdr]

Tbh I did learn a bit from @diabeticfootdr Dr Lee Rogers when he did a dinner talk for my program when I was a resident, he talked about how hospitals would beg for limb salvage podiatrists. I decided I was gonna specialize in limb salvage before his talk but that talk helped me go all in.

I’m glad I made a difference, in part.

It’s still true and even more hospitals are looking for a limb salvage podiatrist now.

The multidisciplinary alliances and meetings have helped this further.

Vascular surgeons want a podiatric surgery partner. Hospitals and wound centers have realized they need podiatry to prevent amputations (and make money).

The value is there. But you still have to work for it.

 

[dtrack22]

private practice at salary 165k plus bonus 35% of collections after paying my own salary (plus overhead for myself), now I’m partner taking home over 350k before taxes.

This should be a much more common story among podiatry associates (and therefore, new grads). How much did it cost you to partner?

I met an executive from HCA (a large hospital chain) this weekend who told me they can’t find enough limb salvage podiatrists to fill their hospital jobs.

HCA Podiatry Job Listings

Weird that a company with 1500+ active physician, NP, PA job listings, that is desperate for podiatrists doesn’t have a single listing for a Podiatrist on their website. Only a “fellowship” opportunity in San Antonio. Also, no HCA jobs on practicelink or any other popular physician job board.

Tell the executive they should try posting a free add on indeed.com for all of these positions. He/she would have plenty of applications. Having openings nobody can find probably makes the position hard to fill…

 

[deleted285117]

Vascular surgeons want a podiatric surgery partner. Hospitals and wound centers have realized they need podiatry to prevent amputations (and make money).

Most definitely... in fact, an old coresident of mine had a good gig with one before moving on to a major hospital group.

I’ve found there are also other large-group specialties open to podiatry (other than ortho): derm, ID, endocrine, FM, etc. Many specialties see the value of our care. But y’all got to remember, many of these gigs don’t post positions... it takes you contacting them to peak their interest in you!

I had an interview with both a derm and ID group before accepting my current MSG job. The thought of sending me all their venous stasis ulcers (and yes, nails, but you get more interesting pathology IMO in derm clinics) gave the docs tears of joy.

 

[air bud]

Not in my experience. But I could be an outlier. Critical access hospitals get better reimbursements on materials/costs as well as state/federal grant money for capital improvements. That’s on purpose to help keep rural facilities open.

A larger corporate outfit in our area is more likely to limit what you can use surgically than my hospital. We have a Mako joint robot and a new DaVinci robot. The big Providence hospital across the border doesn’t. We don’t have any vendor contracts that limit hardware. The big Providence hospital does. No Lapiplasty for those Podiatrists…

Exactly correct. Mine is not a critical access...no lapiplasty for me.

Other things of note that has bee

Perhaps there is a selection bias on SDN. Those who come on the forum to complain are those who are unhappy with their present or past job opportunities.

I met an executive from HCA (a large hospital chain) this weekend who told me they can’t find enough limb salvage podiatrists to fill their hospital jobs. That seems to be a disconnect.

HCA is finally coming around on podiatrists. My residency was associated with an HCA hospital but that was a few years back. Now they are on board and starting hire for sure. Other hospitals that compete with HCA are also sloooooowlu figuring it out. I know an are where HCA is paying 240-260 but RVU lowish at 47 or so.

 

[AttackNME]

I’m glad I made a difference, in part.

It’s still true and even more hospitals are looking for a limb salvage podiatrist now.

The multidisciplinary alliances and meetings have helped this further.

Vascular surgeons want a podiatric surgery partner. Hospitals and wound centers have realized they need podiatry to prevent amputations (and make money).

The value is there. But you still have to work for it.

Absolutely. You’re right about limb salvage.

I have a great relationship with all my vascular surgeons in town, we text and call freely to discuss patient care. My struggle is getting paid to cover call. Most podiatrists in my city do cover the minimum 3-4 weeks of call per year to maintain priviedges. We do it for free. I have no idea how to get them to pay us because this hospital system’s insurance cover >50% of the population. A battle for another day

 

[air bud]

It’s not about forcing positive comments. It’s about encouraging more people to post their experiences so there is a more accurate representation.

I think we have had some new people. I am going to encourage some friends to get on here and share their experiences.

 

[diabeticfootdr]

Only a “fellowship” opportunity in San Antonio.

That’s not us, BTW.

 

[air bud]

I’m glad I made a difference, in part.

It’s still true and even more hospitals are looking for a limb salvage podiatrist now.

The multidisciplinary alliances and meetings have helped this further.

Vascular surgeons want a podiatric surgery partner. Hospitals and wound centers have realized they need podiatry to prevent amputations (and make money).

The value is there. But you still have to work for it.

We like to bang on you here that is for sure ....but there is ZERO doubt we are better as individuals and a profession due to your knowledge, experience and contributions to the field. And now that I have a job again nobody can accuse me of sucking up to you.

 

[DYK343]

It seems like you’re pretty much screwed in this field unless you want to go rural.

Not necessarily. True -the more desirable the area the harder it is to get a job. But you can get a decent job in an urban/semi urban environment though much much harder fresh out of residency. Big cities have tons of people wanting that position and lots of competition. New grads wont beat out someone with 2+ years experience.

I just took a new hospital position and I am leaving the MSG gig. New job - city around 500k plus 2-300k in the surrounding areas that will feed in. Got tired of clipboard nurses running me down and lack of cross coverage at old position (it got ridiculous - see prior threads for backround on that...) . I could only take so many 80+hr weeks and lack of vacation/ER coverage.

300K guaranteed with benefits, 8% match, CME, 4 weeks vacation. I can go off guarentee at 1 year but stay on 2 years if I desire, Volume dependent wRVU $50-52 after off guarantee. Ill be taking a paycut my first 1-2 years on guarentee but its worth it for sanity reasons.

Fresh out of residency though... crapshoot on location and job quality. ABFAS/RRA certified really helped the job search.

 

[air bud]

The job that I just got was 100% created on need developing a limb salvage program which I know is sorely needed there. Yes they have a need for general podiatry and other stuff but one of the orthos in the group is already a foot and ankle guy doing total ankles and other stuff that is certainly covering a lot of the needs of the population. Doesn't like Achilles stuff or flat foot so there is certainly still room for me to do things electrically but I 100% got this job because of my ability to talk limb salvage, how it is beneficial to the hospital as well as the community. And again based on my past experience of dealing with IHS patients and a very sick patient population.

6 years out, board certified. I just want to make money make people happy have a good life no ego zero interest in doing trauma or total ankles or stuff like that. The other ortho in the group is trauma trained and does calc fractures and all that stuff. Yes I was doing that recently in previous ortho group but I don't enjoy it zero interest in it going forward

 

[dtrack22]

That’s not us, BTW.

I know, you guys aren’t an HCA facility. But I’m curious as to your thoughts on why a large, for profit, Hospital chain would have all of these podiatry openings they can’t fill without a single job posting? Anywhere. I mean, they took the time to post 1500 other physician and mid-level jobs.

I mean HCA has only recently changed their employment/physician relationship model so to speak. For a long time HCA was all about building medical office space adjacent to their hospital and then lease it out to physicians instead of employing them directly. They are slowly gobbling up more and more primary care and specialty groups, as well as making new hires. But that’s certainly no excuse to not have a single job posting for a podiatry opening, especially considering they are having so much trouble filling these positions…that don’t actually exist.

The executive was brown nosing. It was a lie. For now at least.

 

[DYK343]

The job that I just got was 100% created on need developing a limb salvage program which I know is sorely needed there. Yes they have a need for general podiatry and other stuff but one of the orthos in the group is already a foot and ankle guy doing total ankles and other stuff that is certainly covering a lot of the needs of the population. Doesn't like Achilles stuff or flat foot so there is certainly still room for me to do things electrically but I 100% got this job because of my ability to talk limb salvage, how it is beneficial to the hospital as well as the community. And again based on my past experience of dealing with IHS patients and a very sick patient population.

Legit question... besides wRVUs does anyone like doing flatfoot recons?

 

[AttackNME]

This should be a much more common story among podiatry associates (and therefore, new grads). How much did it cost you to partner?

I agree. I’m buying 20% at a 2.5mil valuation over the course of a decade. It’s a big clinic, the physical assets probably aren’t that much, but our group has a very good reputation among the community, so buying into the brand essentially.

 

[podwho]

There’s a grand total of 0 podiatry “limb salvage jobs” on hca. Must not be that hard to fill.

Having said that limb salvage is the future of podiatry in hospital networks. It’s where there is demand. Every major metro should have one on staff. Limb salvage is basically bread a butter podiatry. Unfortunately ever major metro does have coverage for this already and financially better to cover outpt docs than hire one on staff. Texas is one of the only areas where there is a massive shortage of doctors across the board.

 

[DYK343]

Someone (RN) recently told me that the VA where I went to college had an opening and "couldnt get a podiatrist no matter what - desperate need"

So I naturally looked online and no posted opening. I emailed the VA direclty and was kindly told to more or less piss off. lol.

What people say and what is reality are different things.

 

[AttackNME]

There’s a grand total of 0 podiatry “limb salvage jobs” on hca. Must not be that hard to fill.

Having said that limb salvage is the future of podiatry in hospital networks. It’s where there is demand. Every major metro should have one on staff. Limb salvage is basically bread a butter podiatry. Unfortunately ever major metro does have coverage for this already and financially better to cover outpt docs than hire one on staff. Texas is one of the only areas where there is a massive shortage of doctors across the board.

Could argue that limb salvage is the new bread and butter of podiatric surgery but to do it well takes a lot of time, experience, and rearranging your clinic and life to it. It’s hard to dabble in it. trying to do a full regular clinic, have block time and elective surgery, and then do addons afterwards will burn out most people including myself. When I’m on call, my clinic ends at noon so if I have addons I can do it when the hospital still have several teams available. Once it goes past 5pm they go down to a couple teams, then past 7ish it’s only the on call team, and that’s where people are always stuck doing emergent cases. Most of the time I’m done with addons by 7, and if I need to I’ll bump my own case to the next day. I do the hospital a favor by not making them stay late and they do me a solid by making sure my next day’s addon gets priority.

I see surgical podiatry could benefit from a split between those that do lots of addon type cases vs those that do lots of elective type cases. These 2 types of podiatrists can complement each other really well, as we do in my group.

 

[air bud]

Legit question... besides wRVUs does anyone like doing flatfoot recons?

Could argue that limb salvage is the new bread and butter of podiatric surgery but to do it well takes a lot of time, experience, and rearranging your clinic and life to it. It’s hard to dabble in it. trying to do a full regular clinic, have block time and elective surgery, and then do addons afterwards will burn out most people including myself. When I’m on call, my clinic ends at noon so if I have addons I can do it when the hospital still have several teams available. Once it goes past 5pm they go down to a couple teams, then past 7ish it’s only the on call team, and that’s where people are always stuck doing emergent cases. Most of the time I’m done with addons by 7, and if I need to I’ll bump my own case to the next day. I do the hospital a favor by not making them stay late and they do me a solid by making sure my next day’s addon gets priority.

I see surgical podiatry could benefit from a split between those that do lots of addon type cases vs those that do lots of elective type cases. These 2 types of podiatrists can complement each other really well, as we do in my group.

Agree 100%. Tremendous amount of friction created trying to educate anesthesia mostly on this. Time is tissue. At least in places where they are not used to podiatry and these types of cases and again what is interesting is look how many people come on here in private practice and say they don't do wound care cuz it's not worth their time. Well then what about these huge Metro areas that don't have anybody on staff who's doing the wound care who's providing good patient care, not podiatrists these are exactly the places that need to hire them

 

[diabeticfootdr]

These are not preexisting jobs. It’s not like it’s an opening that someone left and they have to fill. Hospitals create new centers around the right people - if they can find them. It’s why you have to be proactive.

 

[diabeticfootdr]

Having said that limb salvage is the future of podiatry in hospital networks. It’s where there is demand.

I just posted another 2 faculty positions in San Antonio and we just took 2 fellows. Diabetic foot is the driver, of course.

 

[diabeticfootdr]

Limb salvage is basically bread a butter podiatry.

Also, I appointed myself to the CPME 320 rewrite committee and tried to get wound care and vascular surgery as mandatory rotations for the PMSR. In the end, CPME proposed a 2 week vascular rotation (I recommended 4) and no mandatory WC rotation (although MAVs for WC).

 

[Pronation]

These are not preexisting jobs. It’s not like it’s an opening that someone left and they have to fill. Hospitals create new centers around the right people - if they can find them. It’s why you have to be proactive.

This is how you think you will get more pod school applicants from the mighty SDN forum? By telling them that after they accrue 300k debt in student loans over a 7 year period that they will have to claw and beg hospitals to hopefully open a new pod position for them? Otherwise they get to settle for a 100k private practice job?

 

[icebreaker32]

There are not that many good limb salvage jobs available for the taking. There are some, but those will likely go to fellows at a hospital associated with a medical school or someone that goes very rural. It is not like good jobs in this profession go unfilled because no one is willing to do limb salvage

In a typical PP setting doing a high volume of the more complex limb salvage cases is usually not profitable. Uninsured and underinsured non compliant patient base with lots of canceling clinic and after hours work. Plenty of non profit hospitals, even those with wound care centers, will fight you for every product more expensive than a 10 blade you use in the OR.

The typical diabetic toe amps etc on reasonably controlled and compliant diabetic patients are already done by podiatrists in the community.

You can be proactive and try to create your own job in limb salvage if that is your passion. That is something that has always been advised on here due to the job market is to be proactive.

 

[Weirdy]

Also, I appointed myself to the CPME 320 rewrite committee and tried to get wound care and vascular surgery as mandatory rotations for the PMSR. In the end, CPME proposed a 2 week vascular rotation (I recommended 4) and no mandatory WC rotation (although MAVs for WC).

I would be careful with the woundcare rotations being mandatory.

The wound care at the hospitals we cover are horrendous. We usually end up with their referrals for the ensuing infections, amputations or when they run out of ideas. Half of them are run by NPs with a wound care cert. We get their patients for the ensuing amputations or when they have spent 1 year trying to heal a small wound that should have taken 2-3 months with proper offloading.

 

[HaimFeldman]

Perhaps there is a selection bias on SDN. Those who come on the forum to complain are those who are unhappy with their present or past job opportunities.

I met an executive from HCA (a large hospital chain) this weekend who told me they can’t find enough limb salvage podiatrists to fill their hospital jobs. That seems to be a disconnect.

From my experience with HCA, I've been on staff at several HCA hospitals, they don't seem to hire podiatrists.

Looking at their website now, there's one job listing and it's for a fellowship. Maybe it's hospital and location dependent, but they utilized private practice in the area, pods that want surgical privileges at their facility, and consult out. Fresh out of residency I was taking a lot of call at one HCA hospital in particular. Unpaid call. Did it because I was fresh out, dumb, and wanted the surgical experience. They fed me a lot of medicaid and uninsured. I did get a lot of limb salvage surgical experience. I did it for about a year before I burnt myself out. I learned that another podiatry group in the area, that was working at their wound care center, had been taking call for them before me and demanded to be paid for call, and the hospital refused, so they stopped. They moved on from them and took advantage of me. All the docs at that wound care center, not on hospital staff, merely affiliated and contracted out.

HCA also collected a fat billion dollar government bailout during covid, gave their executives huge bonuses, and proceeded to lay off thousands of people.

Hospitals Got Bailouts and Furloughed Thousands While Paying C.E.O.s Millions (Published 2020)

Dozens of top recipients of government aid have laid off, furloughed or cut the pay of tens of thousands of employees.

www.nytimes.com

Maybe my experience is an exception with HCA, but I would take whatever that executive told you with a huge grain of salt.

 

[dtrack22]

These are not preexisting jobs. It’s not like it’s an opening that someone left and they have to fill. Hospitals create new centers around the right people - if they can find them. It’s why you have to be proactive.

As someone who works at a small hospital, who has expanded service lines since I’ve been employed, a preexisting job is not a requirement for an employer to put a job listing out to the world and/or on their website. We had several active physician job postings for 1-2 years before hiring, and only then did they create a new clinic/service line. If HCA wanted to hire their own podiatrists, they would have something posted online.

The reality with HCA is that the executive meant they can’t get community DPMs to come work on uninsured or underinsured wound patients, and can’t get community DPMs to come cover a wound clinic they would like to establish.

Maybe my experience is an exception with HCA

That was my experience. HCA had just hired a couple of orthos who were leasing space in their medical office building and then grew a small ortho group that covered 3-4 of their local hospitals. It was the first employed group these particular HCA hospitals had. No interest in hiring podiatry. I asked. They relied entirely on local DPMs to come take call for free and you only made what you could collect from the patient. This was in one of the larger metros in the country and was consistent across all (8-ish) of their hospitals in the area.

 

[HaimFeldman]

To add to my HCA experience, I made friends with a handful of their employed hospitalists during that time. None of them work for HCA anymore. There is huge turnover there. They treat their employees like crap too.

 

[PTPuser]

To add to my HCA experience, I made friends with a handful of their employed hospitalists during that time. None of them work for HCA anymore. There is huge turnover there. They treat their employees like crap too.

This is what I'm hearing from the MD/DO world too about residents and attendings. Just read the anesthesia and EM forum. They have been lamenting about it.

 

[HaimFeldman]

This is what I'm hearing from the MD/DO world too about residents and attendings. Just read the anesthesia and EM forum. They have been lamenting about it.

Granted these are MD/DOs... They have options.

An employee job at an HCA hospital for a podiatrist would be infinitely better than 99% of associate private practice gigs. If they do start hiring pods, that would be great for our profession. Hell, maybe we could even get to the point where we're thumbing our nose at HCA like our MD/DO colleagues!

 

[DYK343]

They relied entirely on local DPMs to come take call for free and you only made what you could collect from the patient.

There is absolutely no way I would sit around all day "on call" and not get paid.

Hospital employed its part of your contract - have to take ER coverage and is built into salary structure.

But private practice (or MSG/ortho) and taking call for free? No way. Hospital better be setting up a 1099 contract with DPMs to take call. If everyone in community banded together they would pay. Most hospitals/ERs really need and want podiatry service. I know from experience that they pay for call as long as the community of DPMs stops taking calls from ER/hospitalists.

 

[air bud]

Granted these are MD/DOs... They have options.

An employee job at an HCA hospital for a podiatrist would be infinitely better than 99% of associate private practice gigs. If they do start hiring pods, that would be great for our profession. Hell, maybe we could even get to the point where we're thumbing our nose at HCA like our MD/DO colleagues!

Paying like 47 per RVU.....

 

[HaimFeldman]

I know from experience that they pay for call as long as the community of DPMs stops taking calls from ER/hospitalists.

That's true... if the community of DPMs have the decency to communicate with each other, get organized, and tell the hospitals to shove it. There's too many desperate young, underpaid, pods that will jump at the "opportunity" to build up their name in the community and get cases. Hell, there's still a ton of experienced pods that jump at the opportunity to get whatever inpatient consults they can. After they learn their lesson, if they ever do, there's a new fresh batch coming out of residency. It's a never-ending cycle.

Edit: typo

 

[HaimFeldman]

O

Paying like 47 per RVU.....

Once you've been swindled as an associate pod, anything looks good.

Including bailing on your student loans and moving to some exotic country that doesn't extradite to the US.