£12 DOM fee

Thanks for the kind words Claire.

Unless you're ancient, your dad....... Not literally of course!

I can only go by my own experience of podiatry. I've come away from podiatry twice briefly. Both times I couldn't resist meddling a bit, and both times I came back. I love the work. I'm in a different type of podiatry work now, but its still podiatry, and I still love it.

In your circumstances (female and young or youngish - please correct me if I'm wrong) I advise you to look at all your options, and do a five and ten-year plan. Set aside a full day for doing this, not an hour at night when you're tired. Do it and do it until you find what you really want to do and where you want to be. Until it feels right to you.

With a 1st or 2.1 you have to consider training for a higher-paid profession like Law or Medicine. Those degrees will allow you entry onto most UK Law and Medicine courses. You also have to consider Drug-rep (not bad pay and a nice car), and other grad-only entry jobs.
And then there is podiatry.
Teaching, research, clinic, dom, surgical practice, forensic. medico legal - it's all there if you look.

PM me if you get stuck.


David

ps I really hate that there doesn't seem to be any good employment advice given on entry to Pod School in the UK.

 

David, I am ancient (Claire72 being a clue, rather dob, not yrs!)

But I did get a solid 2:1 (and had I worked that out in my second year I would have studied a little harder!)

I will spend some time on it. Forensic podiatry was the reason behind my career change into Podiatry, I must have forgotten about that.

Thanks for your advice and any more stalking shall be done privately.:drinks

Thanks again and kind regards

Claire

 

Hi Claire,

With a 2.1 you have some good options open to you, and believe me, you're NOT ancient!

Ian Linane has quite a bit of hands-on experience in forensics. I've dabbled on the outskirts but not actually worked on a case - civil law is my thing (personal injury and clinical negligence).

Do well, and don't forget to be available to advise others when you've made it.
Give me a shout if I can be of further help.

Best wishes,

David

(being watched by a VERY pregnant mare - she's lovely. but a bit disconcerting - not my horse).

 

Hi David,

Don't get me wrong, I too see the drawbacks of Doms, and I would love to have my own clinic, but it isn't possible right now and hasn't been. In my mind, the most important thing when graduating was to keep my skill up however that was possible. I love what I do and that's what counts, treating patients. To be honest, and certainly not to go on, with hindsight I just think maybe 'lazy' could have been supplemented with a different word, I don't think you intended it literally.
I guess you don't stomp the hills much due to working from home but you see the challenges of rural life, to be fair I'm nearer civilisation now.

In regards to my other options with a first, I probably could have been given more advice on what was open to me.... I was only really advised about research (having gained an outstanding first for my dissertation - not showing off at all, honestly, just stating a relevant fact), which wasn't for me, I wanted to treat patients, my degree grade was beside the point. So, I took the only route available that facilitated this. I'm no spring chicken but not a fossil either, ha! so who knows what the future will bring.

 

It would probably help newly qualified pods to be given more information on the options open to them, this is something which has obviously slipped through the net, so if anyone out there can make this happen, then it won't be a bad thing

 

Thanks for coming back Fliss,

I really think the careers advice for UK Pod students could be better:deadhorse: It won't happen though.
If the employment prospects were honestly laid out before students signed up I feel there would be a lot of empty seats.......

Cheers,

David

 

Hi Claire,
For what my opinion may be worth (I graduated in 2010 and am not too far off your age) ...... don't give up on podiatry. Most importantly, if you love it, then it's worth getting back into it. So, as far as I see you have 3 primary options:
1. Take the bits of associate work and start doing doms (research competition first) to get those skills resurrected and get some money at the same time, whilst considering other more long term options.
2. Relocate.... (IF this is possible for you) this will open up NHS jobs/associate/locum work etc. the world is your oyster!
3. Get seriously researching the other options with the grade you have gained, as advised by David. If teaching interests you look into a PGCE etc, get advice from your uni lecturers, if forensic podiatry is your thing then go for it (maybe look over some previous dissertations for info).
You have options and it would be a shame to waste your degree and love of podiatry.... but failing that, maybe a change would do you good.
Either way, sorry for poking my nose in, have the best of intentions, hope your decisions work out well for you

 

It's crazy really, considering it is something so simple... a powerpoint, hey, here's what you can do with the degree you have slaved over! If only things could change.... (forever the optimist!)

 

Hi all
Can I just ask if anyone trains none BSc pods?
The reason I ask is that looking at some of the "None BSc" (like the SMAE) they seem to have BSc pods as clinical teachers!

Do you think this is fair?

 

I wouldn't risk RSI for £12 in the surgery least of all as a Dom. When you take into account all of the overheads of being in business (if you have premises) it's just not worth closing the door and getting in the car.

There is no harm in being reassuringly expensive, I charge an extra £10 on top of my normal surgery fee to make sure those who can get in by taxi do so and not to make it too onerous for the genuinely housebound. I don't do the discount for 'simple nails' which I do in the surgery and I don't make it any cheaper for a second person at the same address, they can make it into the surgery if they want to save money and I can get home to my family earlier.
I will however cut the fingernail of blind people if they ask and nails that are obviously impossible for carers to manage.

Yes you have to take into account what everyone else is charging in your area, but someone has to be the most expensive, I believe in being that person.

Nina

 

imagine that the nhs stopped doing podiatry

except for the "Specialist" grades who cover rheumatology,diabetes, minor and podiatric surgery.
Podopediatrics, wound care all manner of MSK stuff and high risk patients.

what's left?
do you need a high level of clinical skill to do doms?
Can you justify charging high fees for this?

I wonder were we would be if the profession had been closed to only BSc pods and patients could only access care like dentists or Dr's?

just some food for thought!

 

I can justify my fees, it's the amount of money I want to earn after all my overheads are paid divided by the number of hours which I can work, bearing in mind that I my hands have to keep going for 7 years longer than previously envisaged.

It's simple ecconomics, supply and demand, people will pay extraordianry amounts of money for the right care and service, obviously the higher your prices the fewer people will buy.

I can only work 4 days per week if I do 5 my hands hurt. I have to earn enough to pay the mortgage the rates water rates wages for receptionists avdertising costs etc etc etc before I can pay myself.
My patients have to pay more to see me than my associates, my view is that if they were going to go somewhere else due to an increase in fees they can do so without having to go somewhere else. Most patients understand the concept of paying more to see the senior member of staff, apart from being the proprietor of my business I also have been qualified the longest have more wide ranging experience and do more CPD than my associates. That's not to deride them they're all very good at what they do. I know my strengths and I also know my weaknesses, I have a good network of colleagues who I will refer patients to if I think they need their expertise, patients appreciate that.

A friends Dad once said 'don't work for nothing you can sit on the beach for that'

Nina

 

I don't have a clue what the acronym DOM means. Maybe some of you British podiatrists can educate your cousins across the Atlantic as to what DOM is.

I did a little research on DOM and I think it must mean one of the following:

It has got to be one of these.

Just remember, that just because you and your immediate podiatry friends knows what an acronym means, this does not also mean that everyone else following along here on Podiatry Arena also knows what that acronym means!

 

Kevin,

Dom is short for domiciliary.
A Dom is a domiciliary or home visit.
If you say Domiciliary ten times you will see why we shorten it to Dom.

But point taken.

 

Although, of course, David has given an adequate definition of Dom. I think Kevin's list offers the opportunity to personalise the definition, giving increased sensitiy to reflect your mood of the moment.

I can think of days when the accuracy of the definition of dom. would be enhaced by incorporating elements of:

Director of Missions;
description of managed;
Digestible Organic Matter;
Dispersed Organic Matter;
dissolved humic organic matter;
Department of Mining;
Director of Operations and Merchandising;
Department of Misinformation;
Death of One Man
Duke of Marlborough

Bill

 

Bill,
Whilst I rather like Duke of Marborough, I think that Department of Mining has distinct possibilities....

"Who's at the door?" "It's only the Duke of Malborough darling - he's here to do your feet".

I've worked for a few Depts of Mining in my time......... .

 

I don't believe in re-inventing the wheel, so here is a useful article covering all the factors to be taking into consideration, when setting a price for goods or services.

As you can see there are quite a few variable, which making any pricing structure a individual decision by the trader.


http://bizfinance.about.com/od/pricingyourproduct/a/Pricing-Your-Product-Using-Markup.htm

 

I have read post 39 and an appalled at your attitude. When I qualified, I had no money. I managed not to have any student debt, but I had just enough money to buy my instruments, an autoclave and a cheap car, I was renting a room in my ex-boyfriends house. I had no capitol and no security. There is not a bank in the land that would have lent me the money to rent a premises. That is why I became a dom, not out of laziness, but out of need.

I now have my own flat, a surgery and a nice car. It was VERY hard work, no laziness was involved. Yes there are a lot of very low priced doms out there, but, as someone said earlier, they often turn out to be people working more as a hobby than having to earn a living wage.

Please do not tar everyone with the same brush and please remember that some people have to start their business with very little.

 

Why not just call it a "home" visit....same number of syllables, one extra vowel, and a whole lot more meaningful to 99% of the rest of the population!

 

Exactly Suzanne! my point entirely.

Just curious (having been in the similar situation as you, see my previous thread 49), how long did it take you to achieve what you have?

 

Hi Fliss,

It took me 11 years to get my surgery, I could have done it earlier if I had stayed in rented accommodation, but I wanted a home of my own. I still do the home visits from before, but do not take on new ones, so hope to be mostly surgery based within the next couple of years.
How about you?

 

I believe a price guide would be seen as a cartel, and therefore illegal, but if different practices were more open about when they charge in their advertising material, new practitioners would have more idea what to charge.

 

after all you can buy corn treatments but I don't think you can buy root canal kits!



You can buy home filling kits though!

 

That's a good question. Who first used the word 'domiciliary' instead of 'home'? Why did he/she use it? When did he/she use it?

I think it's a word that podiatry borrowed from some other area probably medicine.

Apparently it's a word that entered the English language in the late 19C and came from the French domiciliaire

I wonder if the word found its way into the English language as a result of the Eight Nation Alliance during the Boxer Rebellion only because it occurred at about the time that the word appeared in the English language and it is one of the few times up to that point that England and France were on the same side. That's really a stab in the dark but I wouldn- be suprised if it was something like that. If it was it raises the question, why didn't it enter the American language at the same time?

Maybe it's a little like trying to find the name of the person who invented the wheel.

Bill

 

You have been working long and hard and achieved what you wanted, I'm pleased for you, it's always good to hear of a success story, good for you

I'm still doing doms but I'm currently working on getting them in a much closer area, to reduce travelling time etc (also have family commitments), which is helping a lot as they were very spaced out before. So, I'm slowly getting there, would still like to be part of a practice one day. Luckily I have patience

 

what is the score on doing "home/dom visits in the usa or aus?

what type of patients do you guys see?

I was in an old guys home yesterday after the community nurse asked me to debride the necrotic tissue of the end of his left 1st toe ulcer.

after removing a large amount of crap and some loose bone i started to think of this thread.

It took me 20 min to debride stem bleeding bottle the bone for culture ? osteomyelitis.
10 min to clear up and write notes.
just wondered what it would have been worth in the private sector?

One of the posts points out the crux of home visits which is route and been effective then lower prices will pay enough.

ta tony

 

Hi Tony,
My fee for a visit and treatment as you have described, at a care home would be £45.00.

In my experience, care homes only ring me when they have a serious problem and their usual footcare provider isn't available/can't deal with it.

I was "sucked in " once by a care home who said they needed an urgent nail cut for a resident. I quoted my usual fee of £30.00 which the manger said was a "bit steep" as their usual chiropodist only charged £12.00. ( ! )

On examining the patient, I found that they needed a significant amount of nail work (o/g's BF 1st with ulceration of both nail beds) and extensive scalpel-work and padding for the PMA.

I supplied dressings and gave written intructions for re-dressings. I spent an hour at the home including writing extensive notes. This did not include travelling time.

I decided after this that I wasn't going to be duped like that again and put my prices for one-off home visits at a level that would reflect the true cost to my business.

I have only visited one care home since then as an "emergency" - the others wouldn't pay my new fee - and that suits me fine.

I have found that most care homes want the cheapest footcare service they can get. ( This topic has been discussed before on this forum - I believe)

 

Please see the title of this thread - it sums up all that is wrong with building a practice based on doms.
I believe that most of us don't sit down to plan out or professional career properly.
This vital step may be discussed a bit after work, or worried about, or mulled over without doing the research, and that in my book is lazy.
Your chosen career will probably be where you work for the rest of your life after all.

I believe the problem faced by UK pod students and graduates is simply lack of careers advice. Good advice prior to being accepted for the course would be a start.
Then there is somehow an assumption that getting onto the course automatically guarantees the new graduate work at the end of the course. It doesn't, unless you go down the dom route.
You can see the pattern I'm sure.

 

I understand your point bill

But Doms/home visits can be just as good for development as a private clinic.
but yer point the pods in a better realistic direction.
doing fca clinic this morning "nail cutting as a band 7" lots of tea!!!

 

Podess,

I was once asked to do someone in a care home (a new admission)who had a corn at breakdown stage.

It was classed as an emergency. I had to go there, treat it, dress it, write extensive notes, and go back home, all for £7.

Nowadays, having heard an expert barrister talk, I would have said, "£45 or not all all. Well find another monkey to do it for you for peanuts"

 

yep;loads around by the sound of the stuff I have seen on podiatry arena

 

"sound of stuff" ! you know what I ment!!

 

DavidH

It seems to me that you are suggesting that if you cannot afford to set up a clinic as soon as you are qualified, then you should not train in the first place.

So, that means that no-one without independent means, or bank of mum and dad should not even consider a career in podiatry.
What do you suggest that those of us from poor backgrounds stick to? Being a cleaner? Chambermaid? Waitress?

I thought the days of class division were behind us, it seems I was wrong!

 

Why do you think that the only two routes to work after completing your podiatry degree are doms or opening a clinic?

Why do you think you are the only one who has had to struggle through debt?

Every single person I know who has built up a private practice has had a period of months or years (three years in my case) when they put everything into the practice and were skint.

Check out the debt that medics build up over their training, or lawyers, or Pods in the USA.
It will make your eyes water!

 

I put everything I had into it too, as I said, I bought my instruments, an autoclave etc. and a cheap car, that was all I had, and I worked part time in a sandwich bar while I started my business.
I do not think that I am the only one who has to struggle with debt. I chose not to struggle with debt, with no fallback to pay it off if things didn't work out.

I was skint for four years, but I didn't get into debt, not until I opened my surgery and had to borrow £8,000 to set it up. I chose to work for myself, that was my choice, I thought long and hard and decided that was the route for me, I PLANNED my career very carefully, and decided that starting out as a dom, whilst not ideal, was the best way for me.

NO LAZINESS INVOLVED!!!

If you said that the dom route was the easiest route, I would have no objection, but lazy is not an acceptable description. It is VERY insulting.

 

Hi Suzanne

I have to say it is terribly sad that you have encountered such difficulties establishing practice after graduating - and you are far from being an exception. Many graduates in recent years have met similar problems - I think one of the greatest failings in our profession is the dependency on the NHS for training and employment of podiatry students and graduates. When government policy or NHS priorities change, we, as a profession, are at their mercy. Much of this has to do with deficiencies in regulation - but the profession also has to shoulder much responsibility in its short-sightedness in developing an adequate practice platform for graduates. Hopefully that will change in the not too distant future. You are to be commended in your perseverance and dedication - it is extremely difficult to secure adequate practice finance these days, but the fact you have kept your borrowing costs down should work to your advantage in the future - good luck. House calls are never easy and are certainly not for the idle minded. I see only three long terms patients as house calls - one with Parkinson's and one with vascular dementia. I don't charge them any more than I did when they attended surgery. Any new enquiries for home visits usually baulk at my fee when pressed - which is £150 - but I try whenever possible to suggest one of the many other colleagues who undertake house calls as their main practice in my area as I really do not enjoy the experience!

Best wishes

 

why dont we have a box by the door with a note on it

"pay what you think it was worth"

i wonder what would be the outcome!!

 

On the strength of your previous posts, Tony, you'd be busy applying for tax credits.

 

better tax credits then fantasyland were you get £150 a dom!

are you for real?

 

hay mark
were did you train?