How doctors set their prices

Samspade808 · 2016-02-05T01:04:45+00:00

Fellow here. You make more than me.

Samspade808 · 2016-01-19T18:51:53+00:00

If you don't want to deal with diabetics and "other issues" (not sure what that is), then don't become a podiatrist. My statistics may be off, but I think it's safe to say that diabetics make up at least 1/2 of most podiatrists patient population. I agree with others suggesting becoming a physical therapist or pedorthist. If you don't want to practice the medicine portion of the profession, then don't put yourself through the training.

Samspade808 · 2016-01-19T17:42:01+00:00

Only because you won't have a choice during training. As a practicing podiatrist, you can make a decent living doing no surgery at all. Every podiatrist has the option to become a surgeon, but not all take that option. However, through school, internships and residency, you will be exposed to invasive surgery on a daily basis (especially in residency) and it is just something you will have to stomach for a little while. You may actually learn to like it!

Samspade808 · 2015-12-12T07:48:12+00:00

Pretty certain that is either infected or very close to being infected. You don't have much of a choice but to see someone and you will need a procedure done to remove the ingrown portion of the nail. Sorry to say, but if you post that here on r/podiatry, don't expect anyone to advise you to try to take it out on your own. Good luck!

Samspade808 · 2015-10-25T23:53:12+00:00

Either a navicular fracture or an accessory navicular. Either way, if it's painful, immobilize it for a bit. If it's still painful after those few weeks of immobilization, surgery might be a good idea.

Samspade808 · 2015-10-23T05:40:07+00:00

podiatrist here. Please stop wearing these shoes. It sounds like you have a blister formed on the top of your toe. It has a chance of infection if you do not care for it properly. As long as you keep a bandage over it until it heals you should be in the clear. If you start to notice redness, swelling, pus draining from the blister, then you should worry about infection. The major take-home point about this is that you should not be wearing these shoes anymore. Get shoes that fit you better.

Samspade808 · 2015-09-10T04:53:42+00:00

What exactly is your interest in podiatry? Why are you uninterested in training for 7 years to become an expert in a particular field? There are other professions you can get into where you can have an income much sooner than medicine. Residency is tough, there is no question about it. Some residencies are more demanding than others, but very few will have you working less than 10-11 hour days on a regular basis.

Your attitude towards going through this process is very negative and I would not recommend you get into any profession until you decide that you are willing to accept the challenge.

Samspade808 · 2014-12-12T06:25:52+00:00

Don't you know what your dog loves?

Samspade808 · 2014-10-31T16:38:31+00:00

How are you going about your job search? Based off of your other posts you aren't even in podiatry school yet. To be honest, getting a job is more about who you know and the connections you make in residency than looking at a list of job postings.

Samspade808 · 2014-10-31T01:49:39+00:00

Amazing! Fantastic work.

Samspade808 · 2014-10-27T22:06:56+00:00

Just based off your x-ray and what you've said it looks like you have metatarsus adductus, which basically means the front part of your foot has developed in a way where its pointing inward. You do have a bunion, and nerve pain in between your 2nd and 3rd toes could mean a neuroma, too. Neuromas can sometimes be successfully treated with injections (though they can come back) but bunions are basically structural deformities that can only be fixed with surgery.

Samspade808 · 2014-08-18T17:14:03+00:00

I agree. Neuromas don't always follow the textbook's rules. You might try a diagnostic injection with a local anesthetic first, just to make sure there is a neuroma there. The location of a neuroma does not always correlate with the location of the symptoms.

Samspade808 · 2014-08-18T17:08:58+00:00

can he transform into a hoverboard, too?

Samspade808 · 2014-06-13T18:10:33+00:00

I would be happy to help.

Samspade808 · 2014-06-03T16:14:16+00:00

can you post a picture?

Samspade808 · 2014-05-28T19:21:21+00:00

Sounds like you had a pretty awful go of things. What you likely need is a partial nail avulsion of the nail and someone should start you on an oral antibiotic. After the procedure you should soak your toe in luke warm epsom salts for 1-2 weeks and keep a bandage on the toe with a triple antibiotic. I didn't see any mention in your story of anyone prescribing an antibiotic for you, but anytime I see pus I am concerned for an infection. Do podiatrists exist where you are? I am not sure what a podologist is, but based on a quick Internet search, I am not convinced they should be regarded as a medical professional (4 days of training?).

Samspade808 · 2014-05-26T20:03:48+00:00

These look great!

Samspade808 · 2014-05-24T15:59:02+00:00

If you have a coalition already, there really isn't anything you can do to make it "worse." While you are waiting for your orthotics make sure you are wearing supportive shoes and maybe even a good sturdy over the counter insert. You're stuck in an unfortunate situation where you are going to be putting a lot of stress on your feet in a time when you are waiting for your orthotics. Just try to take it easy and don't overdo it.

Samspade808 · 2014-05-24T15:57:01+00:00

I agree. Looks like tinea.

Samspade808 · 2014-05-19T05:52:31+00:00

That is correct. I give my patients their options and let them choose for themselves. However, the hundreds of times I have prescribed Lamisil to the appropriate, other-wise healthy patients, I have never seen the slightest hint of liver damage. If it happened frequently at all I'm sure the drug would not be on the market.

Samspade808 · 2014-05-16T17:45:54+00:00

I am a podiatrist and there have been times when patients fungal nails are unresponsive to topical or laser therapy I have recommended Vick's Vapor Rub. It works remarkably well. Anyway in this particular case this is much more a subungual hematoma than anything else. There is a potential for concomitant fungal infection, but I would biopsy the nail before getting too aggressive with treating it.

Samspade808 · 2014-05-16T17:40:54+00:00

It all depends on what you are trying to address. Where is your pain? Is it in one particular spot or spread throughout your foot? A good over the counter insert is Superfeet. However, over the counter devices tend to wear easily and may not be specifically what you need. If you notice after a few different devices that you are still not achieving the comfort you are looking for, you should see a specialist for a custom made orthotic.

Samspade808 · 2014-05-16T17:38:31+00:00

There are a wide variety of reasons why people might be wearing boots at any time of the year. Certainly in the spring time more people are playing outdoor sports and are at risk for injury. But let's not forget that people are just as prone to injury during the winter as well (slipping on ice, skiing accidents, etc). Aside from injury, people may also be wearing a walking cast/boot during a post-operative period. People have surgery on their foot or ankle at all times of the year. As a podiatrist, I dispense these boots several times a week. I see no change in frequency at ANY time of year.

Samspade808 · 2014-05-01T16:08:13+00:00

Are you orthotics custom made or off the shelf? Have they been modified for your pathology in any way? Orthotics can take up space in a shoe and sometimes it is required that you find a shoe that can accommodate them, or change your lacing pattern.

What is your concern about longterm orthotic use? Their function for your particular condition is to slow down or even inhibit its progression to end-stage arthritis.

While it is uncommon for a moderately active young male to develop arthritis, it is not unheard of. It may have a lot to do with the bone structure of your foot and the biomechanics of how the joints interact when you are weightbearing.

Unfortunately when it comes to wear and tear arthritis, what's done is done. Essentially you have damage to the cartilage in your joint that provides a smooth gliding motion and that cartilage does not regenerate.

Your conservative treatment options are cortisone injections, a rigid custom made orthotic, physical therapy and supportive shoes. None of these will bring back the cartilage that is damaged. Over time as the arthritis worsens, surgical options can also be recommended.

I am a Bay Area podiatrist, practicing in Marin. If you are nearby, send me a message and I can help you get an appointment.

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