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09/18/2019 Dale Feinberg, DPM
Welcome to the Future of Podiatry (Joseph Borreggine, DPM
Dr. Borreggine’s excellent analysis of the future of podiatry hit the nail right on the head. He had been prognosticating that the demise of private practice was coming and now he has put out the word that private practice is dead,
I started reading the tea leaves about seven years ago when the implementation of Obamacare started affecting my practice. Denial of payment for the medically necessary diabetic shoes was the opening shot in the war with Big Brother that we have unfortunately lost. Things have continued to go downhill every day and has now culminated with 90% of podiatrists feeling some level of burnout. I am not burned out, I’m bummed out!
I love our profession, but it is becoming harder and harder to stay afloat and I feel that I’m paying out-of-pocket to enjoy my hobby. Yes, a few of us are transitioning to newer models of employment but you’ll never know the level of freedom and joy that self employment brings.
I have recently been telling patients that when I retire my much needed podiatry skills would become a lost art. I recently had a patient present to my office for a new set of custom orthotics. When I inquired why he didn’t have these made back home he told me that no one makes them anymore. Another patient was so happy that I removed a painful callous as she had difficulty finding a Podiatrist to do it. A neighbor in California asked me to remove his painful heloma molle as his podiatrist had retired and it took six months to get a foot appointment at his health plan. Don’t even get me started on dystrophic mycotic nails. If you are in the front lines of private practice you know these things to be true. Supergroups and orthotic lab support at meetings will not save us.
In closing I am reminded of an op-ed article Dr. Bret Ribotsky wrote ten years ago comparing the reported average yearly DPM income to that of a school teacher. He made the argument that the two incomes were in fact equal when you took into account years of deferred income, educational costs, cost of loan repayment, malpractice insurance, and practice costs let alone no funded retirement, paid days off and a summer off from work.
I am counting the days until I get Medicare. My house is paid for and I have no kids in college. I will ride my Harley into the sunset and I wish you all the best of luck.
Dale Feinberg, DPM, Yuma, AZ
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