DO grad, 1 year of internship, then private practice?

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TheSeanieB

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I realize that very few grad become GPs these days. However, I was wondering what the downside would be if a DO grad wanted to focus their practice on osteopathic medicine to only do an internship to get their medical license?

Would they have restricted hospital rights, ability to refer, etc?
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Do a residency as GP is a hard road ahead.
 
TheSeanieB said:
I realize that very few grad become GPs these days. However, I was wondering what the downside would be if a DO grad wanted to focus their practice on osteopathic medicine to only do an internship to get their medical license?

Would they have restricted hospital rights, ability to refer, etc?
Click to expand...

The downside is you will always have to have your own practice.
No company or hospital will hire you.
You will never be re-imbursed by insurance companies.
You will have difficulty getting licensed in almost all states.
You will have difficulty paying your student loans.
No locum company will ever touch you.
May be able to work in the prison system? Don't count on it.
You would never get hospital privileges.
No one will take you seriously.

Don't be silly, finish residency, secure your future. Then do OMM only if you want.
 
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cabinbuilder said:
The downside is you will always have to have your own practice.
No company or hospital will hire you.
You will never be re-imbursed by insurance companies.
You will have difficulty getting licensed in almost all states.
You will have difficulty paying your student loans.
No locum company will ever touch you.
May be able to work in the prison system? Don't count on it.
You would never get hospital privileges.
No one will take you seriously.

Don't be silly, finish residency, secure your future. Then do OMM only if you want.
Click to expand...

Or just become OMM faculty at a DO school, rake in about as much as a GP only do and teach omm.
 
RUcereus said:
Or just become OMM faculty at a DO school, rake in about as much as a GP only do and teach omm.
Click to expand...

You think a DO school would hire someone with only one year of residency? I know LECOM would not as all their faculty are required to maintain and office and see patients. Never gonna happen.
 
cabinbuilder said:
You think a DO school would hire someone with only one year of residency? I know LECOM would not as all their faculty are required to maintain and office and see patients. Never gonna happen.
Click to expand...


Uh...yeah, you just need an internship to be licensed and see patients (and you don't even need that for OMM). Anywho, since you threw out LECOM I thought I would check and show you that even the most prestigious places allow this (said with sarcasm).

Dr. Eng Huu D.O. Asst. Prof. of OMM <- Education
Medical School: Kirksville College of Osteopathic Medicine

Internship: Delaware Valley Medical Center, Langhorn, PA

And thats it....not even a NMM residency! CRAY!

-OP the wise thing to do is to do a residency even the NMM one.
 
There are certainly a number of DO's out there that have OMM practices that are cash only. It can work and you can do fairly well but there's not a lot to fall back on if it doesn't work out...

Survivor DO
 
...Dude, his education says KCOM.

Either way we agree on the OP's original questions, the best course of action is residency.
 
There are very few (if any) states that will license you unless you complete a full residency any more. Kansas used to, but this may not be the case any more?
 
CDI said:
Any idea which states or where I could find this info?
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http://bit.ly/12ClLJN

tumblr_mk078gnqoa1r0ftodo1_500.gif
 
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sluggs said:
There are very few (if any) states that will license you unless you complete a full residency any more. Kansas used to, but this may not be the case any more?
Click to expand...

Looking at the link that Gutonc sent I would say you misfired on this attempt of BS... seems the MAJORITY of states will license you after completing an internship especially if you consider the OP is a DO.' Not saying you shouldn't complete a residency... but you CAN get a license if you don't.

Survivor DO
 
survivordo said:
Looking at the link that Gutonc sent I would say you misfired on this attempt of BS... seems the MAJORITY of states will license you after completing an internship especially if you consider the OP is a DO.' Not saying you shouldn't complete a residency... but you CAN get a license if you don't.

Survivor DO
Click to expand...

Had no idea it was like this. Why did someone say insurances would not reimburse you though?

Would be awesome to join a private practice after just a year and learn the ropes while making $150-200k/yr instead of $50k as an overworked resident.
 
cabinbuilder said:
The downside is you will always have to have your own practice.
No company or hospital will hire you.
You will never be re-imbursed by insurance companies.
You will have difficulty getting licensed in almost all states.
You will have difficulty paying your student loans.
No locum company will ever touch you.
May be able to work in the prison system? Don't count on it.
You would never get hospital privileges.
No one will take you seriously.

Don't be silly, finish residency, secure your future. Then do OMM only if you want.
Click to expand...

Damn. Everything you've mentioned is making me look into this more seriously.

Family owns a standing practice. No student loans. Will never do locum for someone I don't know. Will never work in a prison setting. Not worried about hospital privileges (maybe I should be?). Also, considering a shift to a concierge model anyways, so insurance reimbursement is even less of a concern if that occurs. Something to think about...
 
CDI said:
Had no idea it was like this. Why did someone say insurances would not reimburse you though?

Would be awesome to join a private practice after just a year and learn the ropes while making $150-200k/yr instead of $50k as an overworked resident.
Click to expand...

Trust me when I say that practices who are hiring have the stipulation of being BE/BC. Your resume will not even get looked at with one year of training (unless it's before 1976?), generall those folks are grandfathered in. I've been on the job search/locum track for the last 4 years.

Insurances are very strict about what they will pay for. Most major insurances do not recognize a doctor who had only one year of training and will not pay for those services (unless you are licensed while still in residency) and are working under a fully licensed doc with the knowledge that you are completing residency.
 
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cabinbuilder said:
Trust me when I say that practices who are hiring have the stipulation of being BE/BC. Your resume will not even get looked at with one year of training (unless it's before 1976?), generall those folds are grandfathered in. I've been on the job search/locum track for the last 4 years.
Click to expand...

Right, I guess my situation is just specific. I can see the benefits otherwise. In my case, I may instead lose $200-300k on the front end just by completing the full residency. Just a distant thought. Ideally I'll finish the full 3 years. Its more of a back up in case I have difficulty landing a categorical position and I can find an out of match 1 year position (absolute worst case scenario).
 
CDI said:
Damn. Everything you've mentioned is making me look into this more seriously.

Family owns a standing practice. No student loans. Will never do locum for someone I don't know. Will never work in a prison setting. Not worried about hospital privileges (maybe I should be?). Also, considering a shift to a concierge model anyways, so insurance reimbursement is even less of a concern if that occurs. Something to think about...
Click to expand...

So you are saying that you plan to work at your family's clinic for the rest of your life? May backfire, never know what lies ahead in life. Seems silly not to secure your future earnings by finishing residency so you have options countrywide.

http://www.medicallicensedirect.com/staterequirements.html. Here is the link for requirements by state to be licensed. As I have said above, just because a state will license you doesn't mean a company will hire you.
 
CDI said:
Right, I guess my situation is just specific. I can see the benefits otherwise. In my case, I may instead lose $200-300k on the front end just by completing the full residency. Just a distant thought. Ideally I'll finish the full 3 years. Its more of a back up in case I have difficulty landing a categorical position and I can find an out of match 1 year position (absolute worst case scenario).
Click to expand...

Yes your case is very specific. Almost no one in the US graduates medical school debt free. My concern is other students slitting their throats on their future by only doing one year when they have 200-300K in loans to pay. Jobs will not come to them easily (if at all) with only one year of training.
 
cabinbuilder said:
Yes your case is very specific. Almost no one in the US graduates medical school debt free. My concern is other students slitting their throats on their future by only doing one year when they have 200-300K in loans to pay. Jobs will not come to them easily (if at all) with only one year of training.
Click to expand...

Well, knowing my family, they'll probably make me slug it out in residency and get BC regardless. :laugh:

It really is a last resort type scenario for me. Mostly just nervous about not getting a categorical IM spot and being stuck with nothing as 50% of IMGs are these days.
 
survivordo said:
Looking at the link that Gutonc sent I would say you misfired on this attempt of BS... seems the MAJORITY of states will license you after completing an internship especially if you consider the OP is a DO.' Not saying you shouldn't complete a residency... but you CAN get a license if you don't.

Survivor DO
Click to expand...

These are "minimum requirements". Good luck actually getting a license after internship, without at least a contingency rider saying you will finish a residency. This is a whole different game! By the way, no need for pissy little personal attacks-- I am sure your mommy and daddy raised you better!
 
sluggs said:
These are "minimum requirements". Good luck actually getting a license after internship, without at least a contingency rider saying you will finish a residency. This is a whole different game! By the way, no need for pissy little personal attacks-- I am sure your mommy and daddy raised you better!
Click to expand...

As long as you fulfill the state requirements, you can get a license. There's no "contingency" saying you have to finish a residency. Doesn't mean you'll be able to get a job of course, but you'll have a license.
 
sluggs said:
These are "minimum requirements". Good luck actually getting a license after internship, without at least a contingency rider saying you will finish a residency. This is a whole different game! By the way, no need for pissy little personal attacks-- I am sure your mommy and daddy raised you better!
Click to expand...

Minimum requirements...is that like residency where you have minimum cutoffs, and minimum pass scores? In those instances you have to get more to be competitive. Is there "competition" for licensure?
 
CDI said:
Minimum requirements...is that like residency where you have minimum cutoffs, and minimum pass scores? In those instances you have to get more to be competitive. Is there "competition" for licensure?
Click to expand...

As stated above, just because a state will license you doesn't mean an establishment will hire you. That's a whole different entity.
 
gutonc said:
As long as you fulfill the state requirements, you can get a license. There's no "contingency" saying you have to finish a residency. Doesn't mean you'll be able to get a job of course, but you'll have a license.
Click to expand...

True these folks are working the narcotic pill mill pain clinics and marijuana clinics.
 
cabinbuilder said:
As stated above, just because a state will license you doesn't mean an establishment will hire you. That's a whole different entity.
Click to expand...

I understand that, I was just asking about licensure. I wasn't sure how that worked. I'll definitely look into it on my own time.
 
How well does an intern year really train someone to be a PCP?
 
OP here. Thanks for all the response. Can you clarify some of the following.

So I am going to graduate with a DO. If I just did the internship, could I bill insurance for osteopathic treatments? My understanding was that we are certified in that upon graduation. Also, with Obamacare, will GPs get insurance reimbursement from the government? FWIW, I have no interest in anything other than private practice and concierge oriented. Also, what are the requirements for hospital right? Does it vary by hospital, by state, or is it a federal thing?
 
TheSeanieB said:
OP here. Thanks for all the response. Can you clarify some of the following.

So I am going to graduate with a DO. If I just did the internship, could I bill insurance for osteopathic treatments? My understanding was that we are certified in that upon graduation. Also, with Obamacare, will GPs get insurance reimbursement from the government? FWIW, I have no interest in anything other than private practice and concierge oriented. Also, what are the requirements for hospital right? Does it vary by hospital, by state, or is it a federal thing?
Click to expand...

Do not expect to be able to bill insurance with only one year of residency. Doesn't matter if you are "certified", it comes down to what the insurances will pay for. You most likely would have to be cash only. You have to understand that you have to "apply" to be accepted as a payee for every insurance company you plan to bill, this is different from medicaid and medicare which are federal. Just because you apply doesn't mean they will accept you as a payee as they do look at your education. Hospital privileges vary by hospital and state, who owns them, and how large an entity they are. You will be hard pressed to get any of them to grant you admitting status.

My question to you is how do you plan to come up with the funding for your own privated practice? Seems very short sighted to purposely not do a full residency.
 
cabinbuilder said:
Do not expect to be able to bill insurance with only one year of residency. Doesn't matter if you are "certified", it comes down to what the insurances will pay for. You most likely would have to be cash only. You have to understand that you have to "apply" to be accepted as a payee for every insurance company you plan to bill, this is different from medicaid and medicare which are federal. Just because you apply doesn't mean they will accept you as a payee as they do look at your education. Hospital privileges vary by hospital and state, who owns them, and how large an entity they are. You will be hard pressed to get any of them to grant you admitting status.

My question to you is how do you plan to come up with the funding for your own privated practice? Seems very short sighted to purposely not do a full residency.
Click to expand...

It's just a curiousity at this point. I am an M3. From my experiences so far, it seems that our system is owned by insurance and influenced by pharmaceutical companies. Primary care doctors have no time to find underlying disease and can only treat symtoms. I would rather make 80K a year doing what I want than load patients up with medications each time they have a new symptom. I'm not sure what the benefit of an additional two years of residency would be working for a hospital that is run by management pushing revenue maximization dictated by metrics derrived from our insurance system. Would I learn the pathogenesis of autoimmunity or would I just be further educated on which pill goes with which complaint by a pharmaceutical rep that says, "Patients have not problem getting off our PPI according to our rock solid research."
 
TheSeanieB said:
It's just a curiousity at this point. I am an M3. From my experiences so far, it seems that our system is owned by insurance and influenced by pharmaceutical companies. Primary care doctors have no time to find underlying disease and can only treat symtoms. I would rather make 80K a year doing what I want than load patients up with medications each time they have a new symptom. I'm not sure what the benefit of an additional two years of residency would be working for a hospital that is run by management pushing revenue maximization dictated by metrics derrived from our insurance system. Would I learn the pathogenesis of autoimmunity or would I just be further educated on which pill goes with which complaint by a pharmaceutical rep that says, "Patients have not problem getting off our PPI according to our rock solid research."
Click to expand...

The point would be...so you can be cheap labor for a hospital for 2 years. :naughty:
 
I have numerous opportunities available and wanted to check in to see if you might be looking for something new for the summer. We are looking for the following to work with us in Government facilities across the country to help assist our Veteran's and our enlisted men and women in both Hospital and Clinic settings:



Our current openings are in Montana, Washington, Oregon, Wisconsin and Missouri.



Board Certified or Eligible Family Practice or Internal Medicine
Must be available for a minimum of 90 days, preferably longer

Must be able to use Computerized Record Keeping Systems

Any state license

BLS Certification

Working in an outpatient clinic Monday- Friday 8-4:30. No call or OT required.

See an average of 12-15 patients per day.
 
Out of curiosity, what would something like that pay?
 
cabinbuilder said:
I have numerous opportunities available and wanted to check in to see if you might be looking for something new for the summer. We are looking for the following to work with us in Government facilities across the country to help assist our Veteran's and our enlisted men and women in both Hospital and Clinic settings:



Our current openings are in Montana, Washington, Oregon, Wisconsin and Missouri.



Board Certified or Eligible Family Practice or Internal Medicine
Must be available for a minimum of 90 days, preferably longer

Must be able to use Computerized Record Keeping Systems

Any state license

BLS Certification

Working in an outpatient clinic Monday- Friday 8-4:30. No call or OT required.

See an average of 12-15 patients per day.
Click to expand...

Yes, what would something like this pay?
 
kdur said:
Yes, what would something like this pay?
Click to expand...

The VA pays PCPs and hospitalists in the $100-200K range depending on location. Expect other "gummint" jobs to be similar.

A real world example is a friend of mine taking a VA Hem/Onc job straight out of fellowship for $160K. So, assuming insufficient training and no board certification...probably in the neighborhood of $100K...about what they pay NPs and PAs.
 
I got my Illinois full license after internship.

My locums EM and UC had no issues with billing.

I did weight loss stuff too. Easy money, not fun.

It was HARD to find these gigs. Required an inside connection for the ER and had to go to BFE for urgent care.

If you are highly motivated and start your own gig then perhaps its doable but if you go to court and you arent BE or BC then best of luck.
 
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