Top 10 Reasons to Start a Podiatry House Calls Practice

There are many advantages of a house calls based Podiatry practice dependent upon your particular lifestyle.

1. Extremely Low Overhead.
In fact, when compared to a conventional podiatry practice there is almost no overhead. There is no rent to pay. There are no employees to pay.

2. Absolute Freedom and Flexibility in Scheduling.
This is perfect for people who like to spend time with their children, exercise,

I once had lunch with another Dr. who asked me, "Do you really answer your telephone when you are running?"

I explained that I do. He said, "But doesn’t it bother you the you have to answer your phone to talk to patients when you’re out for a run."

I replied I guess it depends on your perspective. If I told myself that it was annoying that I had to talk to patients when I was out running maybe it would. But instead what it used to tell myself is that if I was working at Kaiser or in some other similar conventional practice model, I wouldn’t be out for a long run at 3 o’clock in the afternoon.

3. Immediate Payment.
In a housecalls based practice you’re not required to take insurance because you’re not competing with all the other podiatrists in your area. Because you do not accept insurance you get paid immediately. Immediate payment is much better than net 30 60, or 90 days… or worse yet… never. If you’re reading this and you have been in practice you understand the pain of providing podiatry care for services provided and then never receiving payment from the insurance company. It happens to everyone. It is a reality of accepting insurance. In 3 years of providing housecalls with a cash-based practice, I have never had an episode where I didn’t get paid.

4. Lower Malpractice Insurance.
Malpractice insurance carriers offer part-time insurance rates for those who do not have full-time practices. This is not based on the number of hours that you work but it is based on face-to-face time with patients. I currently see about 1/9 of the patients that I used to see in a conventional practice. My malpractice insurance is based on one quarter time. It is also paid at about one fourth of the rate.

5. The Best Podiatry Office in the World.
I routinely post pictures that I take while I’m out on house calls. The vast majority of the podiatry offices I have ever been in are dark enclosed boxes. Many of them are in the basement. Even those that are relatively nice, can't hold a candle to the views that I see when I’m out treating patients. It is much better to take in the views all day long.

6. Variation in Routine.
I like the idea of driving around town and going to different settings all day long. It probably doesn’t hurt them in one of the most beautiful cities in the world. However if I were in any city in America, I would still prefer to do house calls to and sit in a dark claustrophobic office. I like the variation of seeing different parts of town all day long.

7. Increased Job Satisfaction
There is absolutely no question that a house calls base practice model allows me to use the full knowledge that I have acquired through years of school and clinical practice. I get to interact with patients in a meaningful way where I actually apply everything that I know.

This was simply not true of a conventional practice. I had treatment protocols that were applied to the most common conditions when I had a practice that accepted insurance in an office setting. I have a large staff that was trained to take over many of the functions that I is a physician would provide. Patient education was provided by protocol by the staff.

I now perform all physician functions myself. This ranges from taking the full history to making a diagnosis to providing patient education and explaining the treatment plans. I feel like a real doctor again. I used to feel like an assembly line worker. I’m able to actually stop and think about what is really going on with a competent patient. I don’t just offer them one treatment and then tell them to come back in a week or two. We talk about "if this, then that" possibilities. We talk about all sorts of scenarios that could unfold based upon how their treatment is evolving. We talk about different recovery options.

All of this is what I initially perceived would be my job when I decided that I wanted to be a doctor. Today my practice is exactly as I wanted to be.

8. Gratitude From Patients.
Although I only see about 1/9 of the patients I used to see, I receive about 10 times as many thank you letters. Believe it or not I actually receive tips. I have had patients that even sent more money than I asked for. I had one surgical patient that actually paid me $100 extra in cash on the day of his surgery just so I would “do an extra good job.” No insurance company ever sent me a tip. For that matter no insurance company ever sent me a thank you letter either. Although it is not my primary goal, it is nice to feel appreciated.

9. Higher Income
If you have a practice the grosses $500,000 per year it sounds like you’re making a lot of money. If your expenses happen to be $400,000 per year, you’re not making a great living at all. In fact you’re making less than the average podiatrist in the United States.

If you have a house call space practice and you earn $200,000 per year, with almost no overhead at all, you’re making significantly more money. After all, the goal of work is to earn money to facilitate the lifestyle that you choose.

10. Time with Friends, Family and for Other Interests.
When you have a house calls podiatry practice with significantly lower overhead and immediate payment for services provided you have a lot more freedom.

If you don’t want to work on the weekend you can charge more to work on the weekend. If you don’t want to see patients in the evening you can choose to either not see those patients or you can see them at a much higher rate. Earning significantly more money during these more lucrative windows of opportunity allows you the freedom to spend time with family or pursue other interests.

A side benefit that many don’t consider is that when you have a practice with multiple employees high rent and other expenses you are probably less likely to take a vacation simply because you know will cost you thousands of dollars.

When I go on vacation now I no longer worry about paying 7 employees to sit in the office on Facebook, while no income is being generated. In fact, I often schedule remote consultations while I’m on vacation so that I can continue to generate income and follow-up with patients even while I’m sitting by the pool in Hawaii. That’s not a joke. I have actually performed consultations for patients while on vacation in Hawaii while my son is playing in the swimming pool.

When I had a conventional practice, I took very few vacations and all were based around podiatry conferences. Last year, I went to Houston twice to visit my sister, I trained for and competed in an Ironman race, I went to Portugal, I went to Los Angeles, I went to Las Vegas, I went to Washington DC, and I went to Hawaii..twice.

This year I’m training for and competing in 3 Ironman races. I will also be visiting my brother in Phoenix twice. I’ll be visiting my sister in Houston twice. I’ll be spending a couple of weeks on the French Riviera. I’ll be spending a month in Hawaii. I’ll be going to Miami to visit friends. I’ll be vacationing in Mexico as well. I will go to Las Vegas. I’ll go to Los Angeles a couple of different times also to visit friends.

This amount of time away from work would have been unthinkable with the limitations of a conventional practice.

Dr. Christopher Segler is a podiatrist who previously practiced podiatry in a conventional insurance-based high-volume surgical podiatry practice, which he started from scratch straight out of residency. He became increasingly frustrated with the long wait for payments from insurance companies, insurance denials, massive overhead, and administrative hassles of running a conventional office-based podiatry practice. He then converted his practice into a low overhead, high profit house calls based podiatry practice. Today it is his mission to help other young practitioners and frustrated long-term podiatry practitioners develop the freedom of lifestyle that allows them to have significantly higher income with more fulfilling patient physician interactions in a much more profitable practice model. He has even written an entire Podiatry House Calls How-To Manual to help other podiatrists start a house calls practice on their own.