Truth Hurts

I have gone full circle: student, resident, and practitioner while occasionally lurking, and posting once or twice.

The second year in podiatry school I started to learn about the residency game and soon after how there were limited desirable job opportunities.

Initially it inspired me I guess you could say. I figured that I was past the point of no return and had to focus on making podiatry work. In retrospect I would have gone to osteopathic school or offshore medical school if I had to do it over again in healthcare. I ended up with a 3 year residency so things could have been worse, right?

Now that I am in the real world I am fighting to survive. I am friends with all of the other doctors and get referrals mainly for diabetic toenail care and not enough of those. The wound care mainly goes to general surgery, physical therapy, or wound care nurses and most of the other stuff goes to ortho, general, or vascular surgery (in some parts of the country it even goes to plastic surgery). Family practice does avulsions, warts, and usually tries to treat heel pain. These are not the only specialties or healthcare providers we compete with either. There are not that many bunions, hammertoes, and neuromas walking through my doors either. Do not fool yourself that is most of what we do. To those of you who do much more, good for you, and good for our profession, but you are still the exception, regardless of your training.

I keep in touch with more peers than most and very few are doing really well (yes one or two are doing really well, and a similar number have even left podiatry). These are the generalizations that I have found to be true:

You can struggle as an employee (the jobs are hard to find) and make around 35K base and have productivity incentives. Try to buy a house or pay your loans on that. You may be able to make around 70k if you are aggressive and have the opportunity to work nursing homes, and do consults. No 40 hour work week here, try around 60-80. No real job security either until you are a partner. Partner also means taking out a loan to buy into the practice. There are a few that really enter great associate relationships that lead to partnership, but even the most promising often fail.

You can start you own practice, but not everyone has family with a large bankroll and a wife that can support you the first few years while you are building your practice. Why should you have to take this kind of risk? There is a high failure rate, and if you declare bankruptcy you can not discharge your student loans. Certainly those that make it will eventually have a nice lifestyle. Those that have ownership in a surgery center, or have other podiatrists working their clinics or nursing homes may even become very wealthy.

Those really great jobs are out there. The only problem is that there are only a handful of them. They might not be in the part of the country you want to live in, and there are only about 100 hundred other people applying for each of these jobs anyways.

Mainstream medicine may not be what it used to, but at least there are always pages full of jobs in any specialty that pay 6 figures, with signing bonus and benefits. Even the foreign or offshore doctors in primary care have job opportunities that are almost unheard of in podiatry.

You can try to make yourself feel better by saying chiropractors and lawyers who go to bottom tier law schools often struggle. Hey veterinarians often do not make that much either. This does not do the trick for me. The cost of a podiatry education is tremendous, and the time investment is huge. The training is becoming better, and more available, but the average salary and job market have not improved much, despite smaller recent graduating classes.

Prospective students please do not be fooled by what the schools tell you, some average salary, or report ranking podiatry as a top profession. Do not be memorized by the successful podiatrist in your hometown either, unless it is your father. There are some really great fellow podiatrists out there for sure, but unfortunately it will more often be your fellow podiatrist not the orthopod trying to restrict you ability to get hospital or surgical privileges.

There is no perfect profession, but podiatry has too many problems for me to recommend to anyone. In fact I feel the need to make this post in the hopes that potential students really take a hard look at podiatry. Current podiatrists or naive students please do not argue the facts. It is hard to make a case for podiatry when you consider the cost and the length of the education, the job market, and healthcare in general. Podiatry does not make very much sense as a profession. There are better ways to support a family and have a noble profession. If you are already in podiatry school than it may be worth staying, and trying to make it work like the rest of us. Podiatry is a profession of haves and too many of us who have very little. There are far to many podiatrists that leave the profession altogether, and it is not because they have made their millions and are disgusted with insurance companies telling them how treat patients or the government threatening to throw them in jail. We do not post here because we are rich podiatrists that do not want competition. Most of us are genuine and sincere (some more sarcastic, bitter, and angry than others) and wish we found a website like this before we entered podiatry school.