PA's and NP's will continue to increase their ranks. (More power to them).
Primary Care docs won't go away. The problem is us pre-docs wanna all live in population centers <75000.
Here's my story. I'm a surg tech. I make 3x as much for a two-day gig at a rural hospital than in the big city. I'm paid by the hospital and receive a check from the surgeon, but the hospital check alone is larger than my big city checks.
The ortho surgeon I scrub for leaves his big city practice, comes on down to a rural hospital with 2 ORs and operates (Knee-hip resurfacing, etc) He told me he make more in the small hospital than he makes fighting for market share in the big city. He made more than he ever has last year. The guys is an EXCELLENT surgeon and a fairly well-known name.
That rural hospital's general surgeon only works in that community and has a similar sweet set up. So does the hospital's 3 internists.
I often get these type of rural gigs and make a killing.
If Primary care docs want to make it, they will have to be flexible. The pool of sick people hasn't dried up. There's good money out in the boonies. It's flowing milk & honey out there!
I wish I had a crystal ball. I really do, because then I would know whether it's worth the blood, sweat and tears to give up a regular and comfortable paycheck for another 7+ years to become a physician, or if I should just stay the course as a PA and wait for the winds to change.
There's always some speculation about a bridge program for experienced PAs/NPs to become physicians. Will it ever happen? I doubt it. I'm certainly not waiting around for it.
Or will primary care really become the domain of the midlevel? (I STILL hate that term...midlevel...ugh.) Hard to know. I've worked in family practice the past six years. Moved to EM to try something new. I miss primary care. I did an awful lot as an FP PA, had good autonomy, was trusted by my physician colleagues and my practice resembled theirs in a lot of ways. Differences? I didn't round in the hospital; my patients were, in general, younger and healthier (although plenty of DM/HTN/hyperlipidemia to go around and rx-juggling); and I had the luxury of time to do more preventive care (translation: all the boring well woman exams and well baby exams you could ask for, but the docs I worked with did their share too). But I never felt like I could just take over primary care--I was always very grateful for another doc down the hall when a patient looked crappy or something didn't make sense.
Most of primary care is routine. What we do most often is where we develop expertise. We all find our niche, something we do exceptionally well and enjoy doing, and we may develop a patient following based on that. But there is a big enough chunk of primary care that requires physician knowledge (you know, the deeper pathophys, basic sciences, the esoteric problems that show up with relative infrequency but nonetheless do occur) that I don't believe midlevels (that ugly term again!) should ever supplant the primary physician completely. A collaborative practice makes far more sense: the primary care physician as team captain, say, and the PA and/or NP as integral members of the team, all working together to provide quality health care (NOT the minions some of you think we are.)
For me, there's a need to know what I don't yet know. Not because my practice as a PA requires it--to do what I do, I've been very well trained--and experience is a good teacher. But it's about personal satisfaction and filling a void, completing the process so to speak. BUT it's becoming more and more expensive to be trained as a physician and the opportunity costs are tremendous. THEN consider will my role as a physician be obviated in primary care, the only place I really want to work? If so, I should have stayed a PA and just made the best of it.
So, anyone have that crystal ball?
PA's and NP's will continue to increase their ranks. (More power to them).
Primary Care docs won't go away. The problem is us pre-docs wanna all live in population centers <75000.
Here's my story. I'm a surg tech. I make 3x as much for a two-day gig at a rural hospital than in the big city. I'm paid by the hospital and receive a check from the surgeon, but the hospital check alone is larger than my big city checks.
The ortho surgeon I scrub for leaves his big city practice, comes on down to a rural hospital with 2 ORs and operates (Knee-hip resurfacing, etc) He told me he make more in the small hospital than he makes fighting for market share in the big city. He made more than he ever has last year. The guys is an EXCELLENT surgeon and a fairly well-known name.
That rural hospital's general surgeon only works in that community and has a similar sweet set up. So does the hospital's 3 internists.
I often get these type of rural gigs and make a killing.
If Primary care docs want to make it, they will have to be flexible. The pool of sick people hasn't dried up. There's good money out in the boonies. It's flowing milk & honey out there!
Another thing to consider-
What kind of 'quality of life" or "lifestyle" will you have when you have $300k in debt, kids 17 years away from college and the mortgage for a decent home in your metropolis cost $300K?
Yep,I'll leave others to duke it off for turf among the 40 gazillion medical practioners in Gotham. I'll set up shop in some nice little community, where I'm the cat's meow. I'll be grinning the whole time I mow my 2 acre front lawn and catch a mess o' fish in the stream running through the back woods of my 100 acre spread I paid less than 2 million for.
Even the swanky stores have an internet presence. UPS, USPS and FEDEX do deliver to small town America. As long as I can get to Tar-jay twice a year and the ballet/opera once a year on my vacation, I'm happy!
Modern day Doc Baker's don't get paid in chickens people. They get take in cold, hard green.
*cleans Remington 700* Just call me Whitefeather.
(*waits patiently for someone to figure out this analogy*)
White Feather is the only authorized biography of Gunnery Sergeant Carlos Hathcock II, who was recognized as the most successful sniper in the Vietnam War with more than 93 confirmed kills. The book White Feather is written by brothers Roy and Norm Chandler, who publish military shooting publications through Iron Brigade Publishing, a Jacksonville, North Carolina based corporation. As Marine Sniper, a best seller for nine years relayed his heroism in Vietnam, White Feather covers Carlos' entire career and the other details not found in any other title. Written in true "Chandler" format, this volume covers, from beginning to end, the story and tales of a true Marine Corps legend and last American Hero. As far as biographies go, this book will forever immortalize Hathcock, who passed away Feb. 1999.*cleans Remington 700* Just call me Whitefeather.
Since we all have the same amount of time, I guess that means either you don't have a brain, or you couldn't find the right book. I'll assume the latter.
emedpa said:
