i'm finishing up my first year of IM and realizing i don't want to practice it. i'm thinking of taking my step 3, applying for my general practitioner license, and doing only cosmesis procedures--botox,sclerotherapy, laser...is this possible? people around me are saying that it's not. anyone know of anyone who has gotten a gp license after their first year of residency? anyone know of anyone doing cosmesis?

i'm finishing up my first year of IM and realizing i don't want to practice it. i'm thinking of taking my step 3, applying for my general practitioner license, and doing only cosmesis procedures--botox,sclerotherapy, laser...is this possible? people around me are saying that it's not. anyone know of anyone who has gotten a gp license after their first year of residency? anyone know of anyone doing cosmesis?

There's no such thing as a GP license. There are training licenses, unrestricted licenses and board certifications. Most states permit domestic medical grads with one year of US post-graduate medical education and steps 1-3 to get such an unrestricted license. Some states require more training. Theoretically, an unrestricted license permits you to do everything from neurosurgery to psychiatry. In reality, what you can do is restricted by insurance reimbursement, malpractice coverage and credentialing. If you intend to open up your own cash shop, you can pretty much do what you want. There may be some other restrictions you will want to clear up (business regulation and whatnot). Finally, many areas are over-saturated with similar practices. You will also need a big upfront capital outlay to set up your practice.

Ed

thanks! that was helpful...
is there any benefit of finishing IM residency (besides practicing medicine if you change your mind) if you know this is what you're wanting to do?

thanks! that was helpful...
is there any benefit of finishing IM residency (besides practicing medicine if you change your mind) if you know this is what you're wanting to do?

Yes. You may change your mind down the road and if you do, it will be much harder to get a residency. If you finish residency and get board certified, you'll be able to take insurance and you will seem far less sketchy. Finally, if the Botox biz doesn't work out, you'll have a backup career.

Finish.

Subspecialties.

The IM escape hatch.

Yes. You may change your mind down the road and if you do, it will be much harder to get a residency. If you finish residency and get board certified, you'll be able to take insurance and you will seem far less sketchy. Finally, if the Botox biz doesn't work out, you'll have a backup career.
thanks...i'll try to finish up. i'm sure it's partially the program that's making me lose interest in medicine..

Finish.

Subspecialties.

The IM escape hatch.

i'll try to tough it out and finish. i applied to IM b/c i wanted to do heme-onc, but i've given up on that idea...i'm getting too old...

The days of a GP are over. Each state has evolving requirements for licensure and you won't receive coverage from any health plans. Many states no longer offer a license after a single year of post-graduate training.

It's also not very realistic to set up a cash-only practice out of scratch when you're surrounded by board-certified physicians. The best advice is to finish residency.

Many states no longer offer a license after a single year of post-graduate training.

Actually 37 states allow unrestricted licensure after completing one postgraduate year.

http://www.fsmb.org/usmle_eliinitial.html

The days of a GP are over. Each state has evolving requirements for licensure and you won't receive coverage from any health plans. Many states no longer offer a license after a single year of post-graduate training.

It's also not very realistic to set up a cash-only practice out of scratch when you're surrounded by board-certified physicians. The best advice is to finish residency.
I beg to differ. I believe the days of the GP may see a resurgence. More than half the states have autonomous NPs. Partialists are using PAs more than ever. Insurance due to government meddling and lawyer tinkering has escalated in costs beyond reach.

So in the future when we have no insurance, and you have some change in your pocket and are sick. Who do you want to see?

The NP/DNP?
The PA?
The GP?

I'll take the GP every time. American medicine has regressed in quality and the GP is far from being the least experienced and trained. All this person would have to do is advertise this. "Dr. GP, a real physician when you need it." Open up an urgent care style practice. http://www.patmosemergiclinic.com/ similar to this one. Look at who and how he catered his practice. You have a game plan.


Plan B, if you are artistic is to team up with some tattoo artists (better yet if you could do them too!) We perfrom conscious sedation for colonoscopies, which we know is not necessary for 98% of people. So go forth and offer the pain free tattoo parlor. "Our needles don't hurt" So you can then capture the market of all the people too afraid of the pain to get tattoos, or those who simply don't want to deal with it. Plus, you will be able to present the imagine of a surgicaly sterile, and professional facility in contrast to the typical shady grimy parlors. You can also get referrals from surgeons for post mastectomy women who may want the cosmetic nipple tattoo. You would also be able to offer lidocaine injections for piercings. Botox. And, for those who do get infections afterwards, they can come back to you and you'll be able to write the script for it and even I&D if necessary. Now that is service. Of course you would still have to go through the pain of an H&P since you will be using your license. And don't forget, these are all cash paying procedures. Art meets medicine, enjoy, and good luck.

If you're not going to rely on 3rd party payers like managed care, Medicare, etc. then you can practice as a GP. However, if you're a recent grad and you're not board certified or eligible, then you'll have a very difficult time getting hospital priv or getting listed on these payers.

Cash only?
Concierge?

Those may be options.

Actually 37 states allow unrestricted licensure after completing one postgraduate year.

http://www.fsmb.org/usmle_eliinitial.html

These requirements evolve each year. Currently, there may be 37 states. In a few years, that could be down to 35 or 33. Then, in another few years, 28, 25. Etc.

There's a movement to go towards maintenance of certification (MOC) as the "gold standard" to measure physician competency and performance. If you're not certified, then you'll have nothing to maintain. Therefore, we have to look ahead to the future and consider the evolving world of healthcare (and the evolving requirements that we will all face).