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Life Skills Life Skills

Career Development for Podiatric Residents

Marie Williams, DPM

**** This lecture is not available for CME ****

  • Author
  • Marie Williams, DPM

    Director, Podiatric Medical Education
    Aventura Hospital and Medical Center
    Aventura, FL

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    ---

    Marie Williams has nothing to disclose

  • Lecture Transcript
  • Dr. Williams: So now, what we're going to do is we're going to do something fun. Career development for the podiatric resident. Do we have a lot of residents in the room? Please state. I can't tell. Okay. Good. Good, good, good. So any of your friends that -- Suhad [phonetic] and I are going to actually go over this, we're going to keep it very informal. We want to do this informal because -- and I think we should step down and maybe--

    Dr Hadi: Maybe come forward.

    Dr. Williams: Or why don't you guys all come forward and we can keep it very informal.

    Dr Hadi: People in the back come on forward and we'll actually go over this. This can be very interactive, okay?

    Dr Hadi: So our goal with this life skills talk is to kind of give you guys a big picture about different types of practices out there. Between Marie and I, I think we've covered quite a few of them. And my husband who's also a podiatrist. So we're going to talk a little bit about employment opportunities and private practice, multi-specialty, academic, government, the super groups that you hear about now joining a group, and kind of some pros and cons and some questions you can ask. If you have any questions, don't wait until we're done. So we just kind of -- and there's microphones up there that you can walk up to. Or raise your hand and we'll call on you. Just a little background about me. You guys have heard about Dr. Williams and so I trained at UT and Health Science Center in San Antonio. From there, I stayed on as faculty attending at the university for three years and then went on to private practice in a multi-specialty group out in Sacramento, California for seven years. And then after that, since then, I've been in the VA system serving in the government system. So hopefully, between she and I, we can answer a lot of questions that you might have. Especially, how many of you now are second years going into third year? Okay. So now, is a good time to start looking. And are the rest first years or third years? First? Okay. It's never too early. So we'll get started and have Dr. Williams get started and then we'll both kind of feed off each other.

    Dr. Williams: Yeah. I mean would it be easier -- it's easier to use the mic like that?

    Male Voice: Yup.

    Dr. Williams: Okay. Good. I think what we'll do, I was going to try to send -- okay. We'll start here. It's a lot harder to see you guys up here that's all and then a small group here. Yeah. We'll just do it that way. We'll see if it's a little bit easier. Excellent. Okay. So the types of practices, there's many of them really, many kinds. And actually, when we look at this, you have to look at all the types, all the options. We messed them up. Sorry, guys. Okay. Good. So there's many types of practices. There's the self-employed solo practitioner, professional corporations that are made sometimes solo, and there's different types of those professional corporations. Then you're either employed by another DPM which is very common, partnerships, group practices, and other -- with other group specialties. And there's the super groups and then there's the teaching professions being a full-time professor. And also with the government system. So we'll try to get in a little bit of everything. And if you have a question, don't be shy. Just talk. So here's all the types of practices. Now, the reason why this was taken -- all these slides that are graph-like were taken from the practice management in 2013. It just came out in March of 2014. So it's pretty accurate data that shows that solo practitioners in podiatry is still 31 percent. But what is interesting is that, earlier -- maybe five years earlier, it was much higher. So actually the solo practitioner is starting to decrease while all other types of practices are starting to increase. And maybe when we do this lecture five years from now, the solo practitioner might be on the bottom. Who knows? But things are changing rapidly. The solo practitioner, you know, you look at that and you go, Oh my God, you know, you're responsible for everything as a solo practitioner. There's advantages, you're your own boss. You don't have to share your income with anyone unless you have a husband. Then -- sorry, but you got to share. And then you make your own schedule. But the disadvantage to that is that you don't have any real paid vacations. So when you take a vacation, you have to think, "Okay. Well, these are the two weeks that nobody gets paid."

    [0:05:02]

    Dr. Williams: "I have to work really hard before I go. And I have to work really hard when I get back." Because you still have a staff to pay and you still have to keep the lights on. And you still have to be responsible for all the expenses in the business and also have to be responsible for your contractual agreements like lights, rent, you know, everything that goes. So there's an advantage to being a solo practitioner and you're your own boss. But you definitely have many responsibilities. I was a solo practitioner for 15 years. I could tell you that when I took a vacation, I never really was on vacation because I was always worried about my patients or my office or what was happening. And I would bring somebody in to watch my office. And I was worried about the person watching my office. So it was uncomfortable. But the advantage to that was nobody told me when to work, when not to work. If I wanted to work or didn't want to work, that was my choice. So you know, you have some autonomy there. Then you have this thing called the professional corporation or the professional limited liability corporation. And it's a formation, you look and you ask your accountant or your lawyer, "What should I be? Should I be a solo practitioner or should myself into a professional corporation or a professional limited liability corporation?" And basically, there's lots of different laws that go with that. My business is a professional limited liability corporation. What it does is it actually protects you a little bit overall, then your business pays you as opposed to you just being you on your business. And there's other things that are protected. Your staff is being paid by your corporation. And you can have other tax benefits. And definitely need to talk to an accountant. I never really talked about that too much to people because everybody's accountants think differently and their lawyers think differently. And I think if you got everybody together and everybody said, "Well, how are you doing it?" There really isn't one right answer on that. So that's something that you have to put in your notebook and say, "When I have a solo practice or if I have a solo practice, am I going to be a professional corporation? A limited liability corporation? Nothing? Or how do I protect myself?" Because you always have to protect yourself in your profession. In the professional corporations, there's a state licensing board that approves articles of the organization. It's a licensed profession. And then there's documents that have to be signed and followed. And there's board approval with these articles by state. And it depends on state regulations. And then you have restriction of who owns stocks. So it's different in that respect. You definitely have to pay a separate licensing fee to the state for your corporation as opposed to a solo practitioner. So there may be some increase cost. The actual way to -- you know, you may have to have the bank help you get personal loans to back up your professional limited liability. Also, these agreements that you signed are not only for you but for the corporation itself so you become very responsible. Here, in this professional limited liability corporation, it protects you from your employees which sounds kind of funny. But here's something that I wanted to tell people. That you think your employees are your best buddies because they're working for you and everything is going great. And so one day, something doesn't go so great. And then they make up -- they leave or they go away. And all of a sudden you find yourself in a situation where they're saying things about you or your other staff. And you're like, "Well, when did that happen?" So I have learned from this that, not only are you protected by your professional limited liability corporation but you also have to realize that you also have the Equal Opportunity Employment Agency that you need to protect yourself and your employees from. So there's a whole issue as a solo practitioner that you have to worry about in that regard. But that's something that when you become a solo practitioner, every state is different. You need to look into that. There's definitely different laws with different states. And a disadvantage is that you must have malpractice for yourself and your corporation, by the way. You definitely can't just have malpractice for yourself but you have to have it for both. Now, do you want me to take that one? Okay.
    And then there's the -- you're employed by another DPM. So here's where you get a salary and you request benefits and you're not the decision-maker of the business. And that, for some people, is good. You want to just do your job and go home. But the patients are not really yours even if you develop a really incredible doctor-patient relation. The patients are the practice's patients. And the income potential is based on the package you get.

    [0:10:00]

    Dr. Williams: So I always tell my residents to go get the most they can get. When I hire somebody, I say, "I'm going to try to give the least I can give them." No. I'm just joking. But it's a fine line because when you -- it's funny, right? When you hire somebody, you want them to work really hard and definitely don't want -- you see a lot of guys out there trying not to give them what they deserve. I was making a joke about that. I have a very different philosophy because, you know, I believe that the people that work with you, if they're happy, you grow. And you grow big. So if you're in competition with the people that you hire then you're going to have a problem. So you definitely want to avoid that. The employee package, what you get as a package definitely should be discussed with the person that's hiring you and make sure that both have an equitable stake in doing well. And the way I mean by that is if you're getting a salary and then let's say, you're bringing the practice -- I use a straight easy figures because I can only think in straight numbers. But let's say, you're getting a salary of $100,000. And then you bring in $200,000. How much percentage of that extra $200,000 are you responsible for? Or how much are you going to get bonus back? Now, that's something that I think you should negotiate and you should negotiate well. Because it's your work, it's your production, it's what you're bringing to the practice. The person that's hiring you might say, "Well, that extra money goes to your car or your expenses or this or that." But that's something that you negotiate with your salary plus your bonus. So you should be bonus though. Everybody should get a bonus. I'm going to get a bonus. And your income potential should be as much as you work. That's my personal feeling. A partnership, now, that's like a marriage. You know, you're basically becoming -- there's no competition in a partnership. You're working together. You have a mutual trust. You have the same ethical qualities. When you join, you're asking for a buying option. Everyone has a different way of buying into a practice. Definitely, in a partnership, you need to be equal in all respects. I think in the end of a partnership, equals everything. And no one is more value than the other person. Well, that's just my opinion. But the key on that, I think, in a good partnership is there's no competition. Everything is shared and there's mutual trust. It's just like a marriage.

    Dr Hadi: And working with someone can lead to a partnership. These things are all negotiable. So just remember, you can always start with somebody but maybe within the package -- the employee package, you negotiate that in a certain number of years or a certain level of production or certain criteria, getting boarded, whatever they require of you to bring to the practice can lead to partnership and what that line would be for you.

    Dr. Williams: And I think the partnership goes both ways. You have to actually feel comfortable with the person you're being hired by before partnership. And they have to be comfortable with you. It has to be mutual. And it has to be a mutual respect and trust. Group practice.

    Dr Hadi: So group practices, I think, vary. You can either join, like today, what they say are the super groups. The super groups or you can join group practices in the sense of multispecialty groups or even systems like the veteran system which is technically like a multispecialty group. And be within the group. And so what are the arrangements with this groups and the benefits. One, you want to find out if you're just an employee or is there a potential to become a shareholder partner in any way. So for example with the multispecialty group, you can be within that group for a year or two. And then there's the potential for them as shareholder. So I use an example, when I was with Mercy Medical in Sacramento, I was there when I started. They required that I had to be there at least two years before I could become a shareholder. But in order to become a shareholder, I also had to be board certified. So they gave me a two year window to get certified and boarded. So these are things that you negotiate into the contract. And I think that was feasible at the time, yes, because I knew where my numbers were from leaving practice three years prior and that she was going to sit for my board. So for me, that was a good negotiation. And in two years, actually, they put me on a fast track because I was the only podiatrist. And in one year, they actually offered me shareholdership. And from that, you become production based and then you negotiate your salary, production, and percentage, and all of that and what you're going to get back. So there is definitely just a group practice. Group practice, you may also negotiate things like your overhead. So you may have to bring in certain income that covers the cost of having a nurse who works with you. And you may also negotiate that your malpractice insurance gets covered so that's another expense for you and your medical insurance. Okay. Let's go kind of specifically into the super groups.

    [0:15:03]

    Dr Hadi: So super groups are, essentially, groups that start as a podiatry group and they acquire different podiatry groups within the area or region. Sorry. And they become these large super groups. So there is a nice level of autonomy. They kind of function as a single entity as one large group and everyone has their almost kind of like an individual practice but you still are responsible to the group and you are bringing in to the group. Within this super groups, there is the potential to become a partner or to become a shareholder within the group. And it really comes down to you. I've seen a couple of super groups. My husband is going to be joining one of these super groups. And there are members in the group who are not partners because they're very comfortable with where they are and what they're doing and what they're making and don't want that extra workload that would push them to becoming a shareholder or the cost of the buy-in to become a member. So you have a lot of opportunity with super groups. To almost function like a solo practitioner and yet have somebody who is kind of managing a lot of the business side for you, and yet, you are still reporting to that entity or you buy in and you are also responsible for all the other factors in the hiring and firing and all that. So you kind of get a feel of both having a solo practice as well as working within a group. Some other advantages, a lot of these super groups actually have a lot of specialty services within them. So a lot of these specialty groups have their own MRI machines and own radiology person that they send their patients to all within their group. And all these physical therapists, all this generates income for your group. Yet, you have to refer to them only. So you are kind of limited in that sense. But the hope is that the group has people who are more than willing and able to perform every task that you need for them and yet keep everything within the group. So it's almost having the benefits of a multispecialty group but all run by podiatry. So look at it that way. And with these super groups also you'll get a base and, like Dr. Williams mentioned, you will negotiate a percentage of bonus as what you generate in revenue above and beyond your base. So a lot of things are negotiable in the super groups. So joining a multispecialty group, again, I really like them too much, the specialty group especially right out of residency. Mainly, because, one, you find yourself. You kind of learn what you know and what you don't know and where you need to grow. And the other thing is, it's a constant referral base for you. You're not trying to get out there like you would in solo practice and sell yourself not only to the patients in the community but also to members of the medical community and the hospitals as well. You're kind of automatically in. And the nice thing is, everyone in that multispecialty group is on your side because, of course, you want to keep everything within your network. So it's a nice referral system. You establish a lot of interdisciplinary communication and relationships. People that you can lean on in terms of other specialties who can help maximize your patient's care, not just the podiatric side of it. And there is lots of opportunities for growth not just professionally in terms of podiatry but again, for example, I got to be clinical director and chief of podiatry at the hospital site. So I got to manage my own clinic -- one of their satellite clinics. And I got to also be the chief of podiatry at the hospital that we all worked at. So there is a lot of opportunity where you don't have to just have a practice within the group. You can actually grow professionally within the group from the business side as well. Okay. Did I just get through all these lines real quick? Sorry. So the VA, I kind of wanted the VA. I did part of my training at UT, was at the VA as well. And the government systems vary. The government system is like a big multispecialty group. There are so many benefits in the sense that your insurance is covered. You have matched to your retirement program. So you always want to maximize because they're going to maximize the certain percent, too. There's also -- you can be invested. So after a certain number of years with the VA, it's in five years, you become invested within the group. So a lot of your insurance and everything lives on even if you had to depart from the group. So there is a lot of advantages to being with the system. Plus, you can't beat the pathology. There really is a lot more pathology with us -- with the state that we're in as a nation and the ward. You're actually seeing a larger and younger population, more females. So there's actually a lot more variety within the system as opposed to when I trained 15 years ago and you saw a lot more of the elderly. There actually is a larger younger population and more pathology coming through now. So it's been really interesting to see the change system in years from when I left the VA and came back into it. So the VA is also step in grade system pay.

    [0:20:00]

    Dr Hadi: So you're going to start at a base. There is for podiatry right now no bonus incentive like with the primary care and MDs. But you're started a certain step and grade and you are up for promotion every two years. So if you're doing well in the group and you're generating what you should and you're keeping your clinics running at a certain production then you can pretty much feel comfortable that you're going to get that raise. There is cost of living allowance expenses. So even if you're started a certain step and grade, if you go on site and live in San Francisco compared to where I'm at in Youngstown, Ohio, your cost of living allowance helps kind of offset what it costs to live there with the base salary that you have. So that's kind of nice. The other thing too within the VA system, you do actually have professional growth. You can start taking on leadership roles with different committees, like OR committees, wound committees, administrative type roles with different committees that you can be part of that planning committees. And so you don't have to really feel tunneled just into your practice if you have other interests to grow within such a system which is really nice. And you don't worry about your malpractice insurance. Everything is covered for you. You're essentially going in and growing with the system as much as you want to grow within it. So a lot of opportunity.

    The university system kind of offers you the same thing as the VA systems. The nice thing is that there is opportunity for professional growth in the sense of you have access to a lot of the classes that they offer. So when I was at UT, I was fortunate that I got to take a clinical instructor's course for one year. When I was put into the position, I thought, who am I to teach anybody? I just got out of residency. So I took a clinical instructors course for one year and it was eye-opening. I felt like my teacher skills improved. I could understand personality types a little bit better, learning types, teaching types. So there is a lot of opportunity in the academic settings. You are free to take any of their classes that they offer you. And also, within the academic setting, you not only get to teach but you get to learn also and establish those relationships that you can in a lot of multispecialty settings where you get to interact with a lot of different specialties and have colleagues beyond just your podiatry colleagues who are there for you and kind of have your back and you get really comfortable talking patient scenarios with them as well. So also with the government, you also have the advantage of the retirement which they'll also match. I mean, the universities and some of the government that they'll also match your retirement. So it's kind of nice to see that grow that way. You're also not responsible for your overhead. So your malpractice and your insurance, that's all covered for you if you join an academic institution. That's always nice as well. So the big thing is you don't really have much autonomy in these things. Like, these patients are not yours. They're the university's or the VA's or the government's. But you do have autonomy to run a practice in those settings to the way you want to run it. And the resources in both are pretty much unlimited. Research opportunities are unlimited. Not that you don't have research opportunities in the private sector. You definitely do but they are definitely more abundant and more accessible within the -- I find -- within the government and within the academic settings. And then if you like to teach or you think that you have the knack for that, places that tend to have residency programs are definitely a nice place to go.

    Dr. Williams: I want to tell you that I've been in practice for 30 years. It seems like it was yesterday when I started my practice. I love what I do. I think that we're one of the most special professions that there are in medicine. I can tell you that when you sit down at a table with orthopedic surgeons, plastic surgeons, vascular surgeons, medicine, internal medicine, the hospice, probably the happiest people that you see are the podiatrists. It sounds weird but true. You know, we have options. We have so many options. We can work in or out of an office. We can be surgeons or not. We can actually make people feel better on the same day they walk in, we know that. We can save limbs. We can save lives. We can change families. We can help. We're the primary care physician, believe it or not, for many of these people because we can listen. We have the time to sit there while we're working. And they feel really comfortable with us. So for me, every day I get up, I'm really happy that I'm going to work and working as a podiatrist. You know, when I first get into podiatry school, I remember my first two years thinking, "What the heck am I doing? What am I doing in this school? And why am I doing this foot doctor stuff when I'm just learning all this medicine?" And you know, it wasn't until I was a third year podiatry student that I realized that I like what I was doing. And then when I got through my residency, I realized our value. So -- and it's going to get more valuable because you're at a point where when coming out of residency, the diabetic population has increased. The age population has increased.

    [0:25:04]

    Dr. Williams: The awareness of podiatry is ten, 15, 20, 30-fold when we first got out -- when I got out in practice. When I first got out of practice, I was told, "Oh, you're a woman. You're not going to be able to see any patients. Nobody will go to a girl." "You know, like, what?" No one goes to female doctors. And see, that was sort of like what I started with. I was like, "That's not really real is it?" But men don't go to women. I go, okay. My first patient was a male patient. But anyway, the funny thing was is that all that stereotype stuff is gone. And you know, we are really respected in our areas. Yes, we do have our competition with orthopedic still. And you know what? But once you get to work, you forget they're even around because you're so busy doing what you're doing and you're so happy. So I just want to tell you whatever -- which way you go, the profession that you've picked is a profession in my opinion. If you really have a passion for it, you're going to love it. And you're going to love it when you get out. And you're going to love it every day. Some of the things that I think are important for you as an individual because everybody wants something different, whether you sit down and decide, do I want my own practice? Do I want a group practice? Do I want to be with other specialties? Do I want to be in a VA system? Do I want to be in a teaching system? Because now is the time to start thinking about that. You know, I had a really, really incredibly good resident. I mean, I'm telling you, he was hands down, one of the best skilled residents I had. So in his third year, I said, "Okay. You're not going to do surgery anymore. You're going to teach." Now, if you would have seen anyone go into like fits of fear, it was him. Because he wasn't really quite a teacher and I knew that. I was trying to teach him, to teach how to teach. I was trying to teach him to be a teacher because he could do it. That wasn't the problem. But could he tell someone else how to do it? And it was really funny because, you know, he would never have been a university physician because that wasn't his role. Yes, he was residency director, believe it or not. And yes, he's a great teacher now. But you had to see that in him and he had potential to teach but that wasn't his goal, right? He works in an orthopedic practice with a bunch of orthopedics but he's very good at what he does. So you look at your own personal skills is my point. If it's teaching it is, then get involved in teaching. If it's a solo practitioner, then it's a solo practitioner. I can tell you -- and not to be sexist or anything -- it doesn't matter. Family is family. So whether you're male or female, you have family obligations. You can have a practice and have your family obligations. You don't have to miss the soccer games and the dance recitals and everything you have and ability to do all that as well in our profession. Even if there is an emergency, they can wait while the kids are playing soccer, if you know what I mean. So that's the other plus point. I don't know if we've addressed that.

    Dr Hadi: But I think you also have to know kind of what you really realistically want to practice. A lot of people want to join these big orthopedic groups or these big groups and do this surgery and be on call. But you really have to realize, is that kind of where your five-year plan is. So you know, if you do have family, you have to take that in account. Do I want to be on call every day? Do I want, you know, to be called at 3:00 in the morning. So you have to really look into what the practice option you choose really gives you and know how you want to handle that. When I first start out in practice, I mean, I've just got married seven years ago. I have three kids now. But when I first started out in practice, yeah, it was all about my practice. They called me whenever I went in. They called me, I went in and I went to the ER, I went to the clinics, I walked over across the street. I mean, whenever I was called, work was really kind of what I had. But then, you know, as I got married and had kids, I started tailoring my practice to allow me to have more of a balance on the other side. So you have to realize kind of where you're at, where you're at in life, you know, your first five years. How are you going to balance it with what you want on the personal side as well. So your practice option has to be realistic to allow you to have that balance. I don't know, like you said, how many people are married out there and have kids or families. But it's a factor. It wasn't a factor for me because my first, you know, ten years of practice were single and no kids so it was all about work.

    Dr. Williams: I left this slide up mainly because of the board certification point. Because some people think that maybe that's not as important or maybe it's the only thing that's important. But from an actual financial standpoint, board certification is important. So I've been asked that question, is it really important that we get board certified? Nobody even knows. Well, it doesn't state board certified in ABPS. It doesn't say board certified in wound care. It doesn't say that. It just says board certification. Most hospitals, as long as you're board certified, you're board certified. But people who are board certified tend to have a higher income than the people that aren't.

    [0:30:00]

    Dr. Williams: That's like a simple statement. And it doesn't reflect on which board so I just want to make that a point because I'm not pushing one board or another. Just board certification, higher education, more education, you make a little more money. Now, the female ratio that wasn't intended to stay up there because of male or female, I don't know if that really is -- that says accurately from the recent survey. And I don't think that's discriminatory. And I don't exactly know what was behind that whole survey. It could be that women choose to work less because they have a family to take care of. I don't know whatever those issues are. But I can tell you that, you know, the other point of view that I have is you make as much as you need. You know, you always have enough to make it and probably some extra -- mostly not. If you have kids, you sure don't have extra because you're using it for them. But anyway, that's my personal philosophy because I have also three kids who are always out there. And they'll always get supported by me no matter what. And do not let them know that I just said that, okay?

    Dr Hadi: I can tell you, of the female podiatrists I know that are my friends, I can probably tell you probably a third of them work only part-time. So that might be some of the reasons that -- salary discrepancy. I don't think going out there that -- because my husband is a podiatrist. I don't think going out there that I've ever been offered a lower salary than he would be offered. But I can tell you that probably a third of my female podiatry friends that I know probably all work part-time. So they cut their hours somehow to accommodate on the family side. So that, I think, might be reflective of it.

    Dr. Williams: Yeah. So do you have any questions? I mean, we hit a lot of information. There's probably a whole lot more we can go over. But I think that feedback is good and questions are good. And something that you've been sitting on or thinking about for the past couple years or while you've been in school. And you know, we can help you or answer any questions we feel--

    Dr Hadi: Yeah. It's a lot to throw at you in a session, but we want to leave time for questions.

    Dr. Williams: Yes?

    Dr Hadi: What kind of [indecipherable] [0:32:10]?

    Dr. Williams: That's a good question.

    Dr Hadi: I think the first step is to be realistic with yourself with what you want. Do you want a multispecialty? Do you want to start a solo practice? Do you want to join a university or basis? And that's, I think, the first step. So I'll give you an example. When I was at UT in San Antonio, we had a graduating resident who wanted to join a multispecialty group but wanted to stay in San Antonio. So what she did was research which multispecialty groups were in the area and made a list of them and saw which ones didn't have podiatrists in them. And so what she did was write a letter and pretty much sold herself to the groups that didn't have a podiatrist. And so that's one way to do it, kind of sell yourself to -- if you already know an area you want and what you want to join, you kind of just write a letter about yourself and what you feel you have to offer. And you know, send it out to them and see if there are any job opportunities. And sure enough, she got recruited and they asked her to put a presentation together about what she felt podiatry could offer to their group that they couldn't get by sending people out. She got a really nice package deal and joined a multispecialty group [indecipherable] [0:33:35] she wanted. So sometimes, it's a matter of just sending that letter to a group. I know someone in Austin, Texas wanted to work also in a group and sent them a letter and said, "I think you should have a podiatrist." So there is a couple ways that way that's really taking initiative. The other way is just kind of a lot of word by mouth. If you wanted to join a group and just kind of looking around. And the government system, there's USAjobs.gov and you can go in there and see what areas have positions for podiatrists and see if you're a candidate and apply for those positions.

    Dr. Williams: The other resource you have is your residency director. As a residency director, I get at least five to ten letters especially around April, May asking for anyone who is interested in joining their practice from our residency program. So your residency director is getting letters. I can tell you it's going out massively not just to me but to all directors. "Dear Residency Director. I have an opening in Virginia. We need a well-trained podiatric surgeon. Please have them contact this number with their resume."

    Dr Hadi: And a lot of conferences, too, have boards where they have people posting positions and, you know, it's not wrong to look into the back of one of the journals and see where positions are being offered and openings and kind of just see if you can at least get into an area that you want to be in if it's something that offers you the opportunity. It's hard.

    [0:35:00]

    Dr Hadi: You have to, I think, first narrow it as to what you want out of a practice and how you want to practice and if you an idea and then you can really focus or search that way.

    Dr. Williams: But it's a good idea. Actually, it's something that I just thought of just in one split second that maybe we can get something together for residents where you put out something in the podiatry community or medical communities if they need to list, they might go to this website. Maybe we can do something. There is? Okay. Good. Okay. Good. There you go. [Indecipherable] [0:35:38] that would be great.

    Dr Hadi: I know people who have used, like, recruiters and headhunters. So that's not a bad option. When I went to Sacramento, I had no intention to go to Sacramento. Actually, a recruiter called me and said, "I heard you're looking to leave San Antonio. They had been looking around." And so that's how I got that job I have never -- really was not even looking for it. So there's recruiters out there who look for podiatric positions for you especially if you're interested in a particular area. I hope that helps.

    Dr. Williams: Okay. Any other questions? Well, we're available anytime. You can call us. Or I mean, I know --

    Dr Hadi: Yeah. For me, too.

    Dr Hadi: You can call me.

    Dr Hadi: You can call us.

    Dr Hadi: We're here all weekend and you'll see our e-mails pop up, too. I’ll be speaking tomorrow and my e-mails will pop up. And if you guys want to just chat one-on-one, I'm here all weekend.

    Dr. Williams: We're always available on the phone or by e-mail. Well, thank you very much. I hope it was helpful. And have a good dinner.