Twenty plus years ago when I began working in the field of Podiatry (yikes that makes me feel old), the climate of private practice and healthcare in general was very different than today. It was not uncommon for podiatrists to treat patients in multiple locations (whether they were solo or had multi-physician practices) and their bank accounts justified doing so.

Over the next decade this would begin to change as overhead costs rose and insurance reimbursements plummeted. For those in practice “a while”, think about bunionectomy reimbursement in the 80s and early 90s compared to the past ten years. And how much were you paying staff members in the early 2000s versus now? Fun fact, the average medical assistant starting wage is about $19/hour. I won’t ruin your day by giving a comparison of allowed amounts for bunionectomies today versus the 80s.

Over the past decade we’ve seen a dramatic shift in private practice. Podiatrists and other specialists alike have accepted employment from hospital systems, private equity and venture capital groups that have purchased large numbers of practices throughout the country. In some areas solo practitioners and small practices are finding it hard to stay afloat with their “corporate” competitors’ dramatically higher fee schedules and staff members leaving to seek employment opportunities with more benefits than they could ever afford.