Residency Insight -- A PRESENT Podiatry eZine

Ryan Fitzgerald, DPM
PRESENT RI Associate Editor
Hess Orthopedics &
Sports Medicine
Harrisonburg, Virginia

The Orthopedist and Me

In tonight’s Residency Insight, I want to continue our discussion of post-residency job opportunities. We have previously heard from Dr. Nichol Salvo regarding her life working as a Veterans Administration physician and from Dr. Jay Sung regarding his choice to pursue fellowship training. Tonight, I would like to share my own experiences working in an orthopedic practice.

Tonight, I would like to share my own experiences working in an orthopedic practice.

Let me start off by saying that I did not start out seeking out an opportunity in an orthopedic group. Indeed, I had other post-graduate aspirations that I was pursuing, however—as is often the case—life events intervened and I found myself looking into a variety of employment opportunities geographically closer to home.

Initially I heard of an opportunity in an orthopedic group by a word-of-mouth referral from my residency director. I thought: “Hey, I can do that stuff” and so I sent in my CV. After several initial interviews with the partners in my group (and then several more follow-up interviews with the senior partners (i.e. the decision makers), I was offered a position. It was an interesting process, because my group was not looking to hire a podiatric surgeon, at least not initially. They had been looking for a foot and ankle orthopedist and had had a previous negative experience and were trying again. They, apparently, were surprised when I applied and the senior partners were intrigued and chose to pursue it.

They had been looking for a foot and ankle orthopedist and had had a previous negative experience and were trying again. They, apparently, were surprised when I applied and the senior partners were intrigued and chose to pursue it.

Nearly two and a half years later, we have developed our grand experiment into a well-oiled, multidisciplinary team. Despite our successes, we have had to work through numerous challenges (including orthopedists within the group who felt podiatrists should only cut toenails) However, working together, we have prevailed, and flourished. I am now a partner, and in that capacity, I am involved in numerous administrative functions of the practice.

I am now a partner, and in that capacity, I am involved in numerous administrative functions of the practice.

Having never worked in a podiatry practice, I cannot offer any specific comparing and contrasting elements as to my work in the orthopedic group; I can only speak to my own experiences. My days are split between clinic and OR –I generally operate one to two days a week (depending on the week), and the rest of the time I am in the clinic. In my clinical practice, I do receive a significant number of consults from within my group, although I have also cultivated relationships with local primary care providers and the hospitalists group that covers our local hospital to develop a referral pathway.

I would like to think of myself as a “renaissance” podiatric surgeon; I do a little bit of everything—from reconstructive ankle surgery to cutting toenails! Never underestimate the value of the non-operative care that you can provide. It is an excellent way to develop relationships with your patients, and their families. It all matters.

I enjoy the freedom that private practice provides, as a partner, I can help shape how my practice will grow and develop. I never really considered myself a businessman, however, getting to participate in various facets of running our practice has provided a tremendously eye-opening experience and I’ve found that I enjoy some of the business behind the scenes.

Working in an orthopedic group has been excellent choice for me. While it is often high-intensity, which may or may not appeal to you, there are significant benefits for working within an orthopedic group. My group has the ability to refer within the group, which can help to get a young practitioner started with a modest patient base (you can’t get lazy though!). This established base can have financial implications as you’re starting out. Additionally, being a part of a larger, established group within a community can bring you some automatic ‘street credit’, both with patients and referring primary care providers. Of course, in the end you make your own opportunities, and it is vital to never forget that.

If this sounds like you, I would encourage you to pursue a job within an orthopedic practice. I believe that time will demonstrate this will become a growing trend as podiatric physicians become increasingly integrated into the allopathic community. Please feel free to contact me with any specific questions you may have regarding working within an orthopedic practice. You can also post your questions or comments regarding your own experiences on the eTalk thread on this topic on PRESENT Podiatry.