Dear Jon,
Thanks for writing. You do have dilemma. I love being a
podiatrist. I make a god living seeing wonderful patients with a variety of
problems, without too much stress and have a good relationship with my medical
community. The physical therapists I know love what they are doing, make a good
living, see wonderful and grateful patients, do not have too much stress and
have great relationships with the medical community as well. The new physical
therapy programs all seem to have doctorate level degrees and the physical
therapists get to be called "Dr. Jon". Most work for another physical therapist
or a group of therapists for a few years and the ambitious ones open up their
own practice and build their own client base - just like podiatrists. This is a
hard decision.
Usually as a physical therapist you will see patients on
referral from a physician with a specific problem: rehabilitate a shoulder,
start a back program, get a joint moving. Less common (but getting more common)
you will be the entry point for a patient into the medical system.
Theoretically, you can charge for the assessment, the ultrasound treatment, the
hot packs, the range of motion exercises, the massage, the electrical modality,
the fitting and dispensing a TENS unit and the time on the treadmill, all
generating a big bill. In reality the insurance companies will limit the number
of visits and the amount of things you can do at one visit but you still can
make a reasonable amount of money on a visit. The more mature physical
therapists I know all have fine lifestyles and all their kids can go to even the
expensive colleges. .
The new podiatrists are a little different from those that
graduated when I did. The profession is evolving rapidly into a full fledged
medical and surgical sub-specialty. After four years of podiatric medical school
you will likely do a three year surgical residency at a major teaching hospital.
Your first year will be learning medicine working with internists, the emergency
room, neurologists, vascular surgeons and infectious disease specialists. The
next two years will be spent learning surgery of the foot and ankle, including
joint replacements, tendon transfers, joint fusions, ankle fracture repair, bone
grafting techniques, external fixation techniques, reconstruction of the foot
and ankle after trauma, infection or diabetes. You will also spend time learning
how to manage huge infections of the feet that, in the hands of other
specialists, would require foot amputation but you will learn to save the foot.
You will be trained well enough to join multispecialty medical and surgical
groups as the foot and ankle surgeon. Local politics may well get in the way of
what you actually get to do, but your training can make you the best foot and
ankle surgeon around. . While there are some podiatrists who devote a majority
of their practice to sports medicine, most use their medical and surgical
training to treat the injury from the evaluation, including ordering MRIs and
neurological tests, to ordering the physical therapy or doing a surgery to
repair the damage.
Regarding salary, there are online surveys that show the
average salary of a physical therapist in one area in 1998 to be $64,000 and the
podiatrist in the same area to be $80,000. The salary today for both is probably
double with many in both specialties making much more. Keep in mind that any
salary surveys you see online are based on the average salaries which, in
podiatry, are weighted down by all of us who did not have nearly the level of
training you will receive. I know of no self-respecting graduate of a three year
program who will work for less than $100,000 and the upper limit is quite
impressive. A federal labor surgery showed that podiatrists earn about the same
as dentists, more that family practitioners and less than general surgeons.
Orthopedic surgeons are, by the way, off the charts.
But more than salary, there is tremendous job satisfaction
with a podiatrist who has excellent training and is in a position where he or
she has some autonomy. With nearly every patient you can make an improvement in
their lives with only a few visits and, often, on the first visit. These happy
patients will send their family members and friends to you and your practice
will grow quickly. The podiatrists who are not happy with their lives, and you
will see these on some podiatry blogs, are ones that, I believe, would be
unhappy with whatever they choose to do with their lives. Never listen to a
complainer.
Podiatric medicine and surgery also allows you to have a
family life. There is little night and weekend call, unless you choose to
use your training and get involved in the emergency room or have a diabetic foot
practice where infections do not always occur at a convenient time. You will be
able to put money aside for retirement and be able to retire young enough to
enjoy it.
Finally, the move in podiatry is toward combining our
training with an MD or DO degree. While a combined degree is several years off,
a couple of schools are currently associated with medical and osteopathic
schools and I might encourage you to look in that direction, There is a
new school planned not far from me in Pomona, California, associated with the
Osteopathic School of hte Pacific. The Founding Dean, Larry Harkless, DPM,
is a great teacher and will be creating a fantastic school. I have a link for
that school here. Remember, you heard about this school here first. Jon, neither
choice is wrong and both will give you a great life. As I said at the beginning,
this is a tough choice.
No, check out the Pomona school:
http://www.westernu.edu/xp/edu/podiatry/welcome.xml
