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08/23/2022
PODIATRISTS AND STUDENT DEBT
From: Daniel Chaskin, DPM
Podiatric medical colleges, the APMA, and state societies that send representatives to educate potential applicants to our profession have a fiduciary responsibility to give full disclosure of the possibility of uncontrolled student debt, and that the statistics for how much podiatrists earn include some struggling self-employed podiatrists. Furthermore, podiatry may be a better choice for those who have a spouse or family member able and willing to support a podiatry practice until it becomes profitiable. Lastly, they should be told that although currently 100% of graduates were able to secure a residency position, there is no guarantee that upon graduation that they will be able to secure a residency position, which is required for licensure.
Daniel Chaskin, DPM, Flushing, NY
Other messages in this thread:
08/30/2022
RESPONSES/COMMENTS (PODIATRISTS AND STUDENT DEBT) - PART 1A
From: Richard A Simmons DPM
I would say that many who enter into any field of medicine should no longer think they will work until they are 65 and retire. Not just podiatrists, but everyone. If I were a generalist/family practitioner MD, I would be very concerned about my job being taken over by a nurse practitioner or PA. It seems that many in my generation are either still working in podiatry or working in some other endeavor, such as podiatry lecturer, property management, stock trading, etc. Many have simply taken off one hat and replaced it with another. The best advice I have for young practitioners: pace yourself. For most, it’s a long, steady course. Make it enjoyable.
Richard A. Simmons, DPM, Rockledge, FL
08/30/2022
RESPONSES/COMMENTS (PODIATRISTS AND STUDENT DEBT) - PART 1B
From: Ivar E. Roth DPM, MPH
I would like to opine on this pathetic case of owing nearly a million dollars in student debt as a podiatrist. Many of you will ask, "How could this happen?" The shocking truth is that a percent or two of each graduating class should not have been passed on to graduate from podiatry school.
Unfortunately, I have interviewed some of these candidates over my career who have come by requesting a job at my office. The sad fact is they actually believe they have something to offer when the reality is they are either socially inept and unable to properly communicate with a patient, or are on the slow side and just do not catch on and have terrible to little clinical acumen. I personally feel sorry for these podiatrists and the fact that the schools did not properly flunk them out but rather allowed them to pass through. While this may not be the case here, I can say that this situation does unfortunately exist.
Ivar E. Roth DPM, MPH, Newport Beach, CA
08/29/2022
RESPONSES/COMMENTS (PODIATRISTS AND STUDENT DEBT)
From: Michael M. Rosenblatt, DPM
I would like to thank both Drs. Kesselman and Kornfeld for responding to my letter comparing various choices for the profession, among them music, with podiatry. A recent article decrying lower Medicare payments to physicians just appeared on Medscape. The article questions: “how low will it drop?” So we are certainly not alone. The average income for podiatrists in NV is $109,560. This is certainly not as high as I would have hoped, although the 75% percentile is quite a bit higher. The average salary for cocktail pianists is about $20,000, and that is difficult to reach, even for Vegas.
I never looked at podiatry as my ONLY source for retirement income. However, I did write an accreditation manual and got my office certified as a Medicare Certified ASC. I owned the building I got certified in and built rental units on it. This provided rental income and facility fees along with...
Editor's note: Dr. Rosenblatt's extended-length letter can be read here.
08/25/2022
RESPONSES/COMMENTS (PODIATRISTS AND STUDENT DEBT)
From: Robert Kornfeld, DPM
Comparing podiatry to music does not address the problem of high student debt and potentially low income. I graduated NYCPM 42 years ago. When I went into private practice, podiatry was a very lucrative field. We worked hard but we were paid very well. And our student debt was not even close to overwhelming or insurmountable. The problem is that in the early ‘90s, insurance companies created managed care (managed fees) and our then leadership pushed very hard to get podiatry covered under these plans.
Now, this many years later, tuitions have risen dramatically, managed care’s fees are a fraction of what they once were, and podiatrists still do not have parity with MDs and DOs. To run a practice, you must see an enormous amount of patients, which means...
Editor's note: Dr. Kornfeld's extended-length letter can be read here.
08/25/2022
RESPONSES/COMMENTS) PODIATRISTS AND STUDENT DEBT - PART 1A
From: Paul Kesselman, DPM
I have to agree with Dr. Rosenblatt and disagree with Dr. Chaskin's use of the word "fiduciary". Dr. Rosenblatt's reference to his experiences rang a familiar ear to me as I too was headed towards a musical career. However, I too realized that either you were one of tens of thousands of gifted musicians who would be working or traveling when your families were home, poor, or if you were one in a million who would become famous. There are avocations such as music and art where most people do not become famous or financially secure. And there are vocations where most people do become financially secure. Thus, I made the choice to pursue a career in healthcare. That is the key word, I made a choice.
Dr. Rosenblatt is also absolutely correct, no institution can guarantee you anything in life and...
Editor's note: Dr. Kesselman's extended-length letter can be read here.
08/24/2022
PODIATRISTS AND STUDENT DEBT
From: Michael M. Rosenblatt, DPM
While I agree with Dr. Chaskin that colleges should be disclosing the possibility that podiatry may not be "a perfect substrate" in which to guarantee the ability to repay college loans and become successful, I wonder if this same risk is disclosed to talented musicians who pass the entrance exam to Juilliard? The very recent experience of healthcare workers facing Covid, and even the HIV epidemic suggests that it is impossible to guarantee anything of permanent value.
I was qualified to enter Juilliard by virtue of the fact that I could play all 4 Chopin Ballades, including the 4th, the Grieg Piano Concerto and could reasonably play all 5 Beethoven concertos. But my performances were imperfect. I was "sloppy" in the left hand and used too much pedal to "cover" my technical defects. I suppose I could have worked through those problems at Juilliard. But well enough to become a successful concert artist? No, I don't think so. Juilliard tuition and expenses are...
Editor's note: Dr. Rosenblatt's extended-length letter can be read here.
08/19/2022
RESPONSES/COMMENTS (PODIATRISTS AND STUDENT DEBT)
From: Shashank Srivastava, DPM
I think the answer to Dr. Rosenblatt's question is actually very simple... compounding interest and fees over 30 plus years. Compounding interest can be very dangerous with loans repayment (likewise very beneficial with investments). If loans are unpaid and payments are missed, the debt adds up and interest drives it up quick. It continues to add even more when there are fees added to the original principal for missed payments, etc.
It is heart wrenching to read this but should also be a wake-up call for all those who are borrowing money to get an education that could ultimately lead to an insurmountable repayment amount.
Shashank Srivastava, DPM, Rockville, MD
08/18/2022
RESPONSES/COMMENTS (PODIATRISTS AND STUDENT DEBT)
From: Michael M. Rosenblatt, DPM
Regarding the podiatrist who has an almost $900,000 college loan burden: This shocking article requires more data. I am certain that I am not the only podiatrist who wonders how this could occur. We need a detailed financial analysis of this debt. I realize there may be personal issues involved. But if it is true that she had a form of loan forgiveness which has not been actuated, we need to find out why not. Perhaps one has to inquire and follow it up. Maybe you just can't leave it alone and expect someone else to do it for you.
Otherwise, it is just incendiary publicity that the enemies of more people entering podiatry will certainly capitalize upon. She started out with a $227,000 debt. This "morphed" into a situation where it appears that only part of the interest, if any, was paid. Yet, she insists she was and is not in arrears. This makes no economic sense.
One cannot retire a debt like this without paying the interest completely on a regular basis, which would maintain the base loan amount. Reducing the original loan balance requires payment against the principal as well. It is possible to do calculations on the amount of time and accumulating interest required to balloon $227,000 into 895,512.97 over a 31-year period. Borrowing money requires financial expertise. One cannot simply divorce yourself from the mechanics of any loan. There is an object lesson here. I am certain that I am not the only DPM who wants more data.
Michael M. Rosenblatt, DPM, Henderson, NV
08/17/2022
PODIATRISTS AND STUDENT DEBT
NC Podiatrist Owes $895K in Student Debt
Kathleen LaRose, DPM, a podiatrist in North Carolina, graduated from the California College of Podiatric Medicine in 1991, having borrowed $277,000 in federal loans. Thirty one years later, she owes $895,512.97 in student debt, which Insider verified — all while on an income-based repayment plan that should have granted her loan forgiveness three years ago.
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Dr. Kathleen LaRose |
While she was in her doctoral and residency program, Dr. LaRose’s loans were placed on in-school deferment, which lets borrowers postpone loan payments until after graduation. But since her student loans were unsubsidized, interest continued to accrue during that period, adding to her principal balance and causing the debt to surge. “I thought, ‘I’m going to be working with a doctorate in this country, so I’ll make a lot of money and be able to pay this,'” Dr. LaRose, now 55, told Insider. “But I never ended up making a ton of money, and I’ve maintained the monthly income-contingent payments, and they’ve never been in arrears. But they’re just wildly out of control now.
Source: Atlanta Business Journal via Insider [8/14/22]
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