Family medicine practice question

[tigers333]

Hi, sorry if this is in the wrong place. First time poster here.

I am currently in medical school, and ever since I was young, I completely wanted to do family medicine. Still do, for sure. But, I just had some questions about practicing, that I had trouble finding looking around the internet and forums. Sorry if these are pretty basic.

How easy is it to avoid the "business side" of family medicine? All family docs I shadowed were in their own practice. I hate the idea of running a business and taking on "risk," also I hate the idea of trying to pay off even more loans/overhead to start a practice, when I am going to be over $250,000 in debt. I don't mind not entering into a highly paid specialty and living extremely modestly... I grew up with mostly nothing except for an old nintendo 64, so I am not really worried about making tons of money, I just don't want the pains of a business tanking or making the primary goal to be have a successful business model. And, I want to be a primary care doctor way more than I want more money. So basically:

Is it easy to be "hired" as a family physician by a practice but not be take on any business risk?
How about by a hospital? How different would lifestyle be?
Is opening your own practice a huge pay advantage, or is there one at all?
Are family practitioner hospitalists still even done?
How easy is it to "moonlight" as a family doctor, do most hospitals have positions for that?
I see the average of family physician income is between 130k-190k, how often are these doctors working? For instance, could I just work everyday and easily make over 220k if I were feeling inclined and didn't mind having an intense schedule?

Basically, my ideal situation is showing up to a practice 8-5 (or whatever) and not worrying about how the business as a whole is doing, where I could work shifts on a weekend to help pay off my student debt. Sorry if these have mostly been answered before, but after looking for half an hour, I thought I'd just ask and risk getting yelled at.
Any and all information is helpful. Thanks everyone.

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[deleted480308]

read @cabinbuilder's thread about doing locum family practice.....you're just a contract employee so no dealing with the business end and the money has been great for her

 

[cabinbuilder]

Hi, sorry if this is in the wrong place. First time poster here.

I am currently in medical school, and ever since I was young, I completely wanted to do family medicine. Still do, for sure. But, I just had some questions about practicing, that I had trouble finding looking around the internet and forums. Sorry if these are pretty basic.

How easy is it to avoid the "business side" of family medicine? All family docs I shadowed were in their own practice. I hate the idea of running a business and taking on "risk," also I hate the idea of trying to pay off even more loans/overhead to start a practice, when I am going to be over $250,000 in debt. I don't mind not entering into a highly paid specialty and living extremely modestly... I grew up with mostly nothing except for an old nintendo 64, so I am not really worried about making tons of money, I just don't want the pains of a business tanking or making the primary goal to be have a successful business model. And, I want to be a primary care doctor way more than I want more money. So basically:

Is it easy to be "hired" as a family physician by a practice but not be take on any business risk?
How about by a hospital? How different would lifestyle be?
Is opening your own practice a huge pay advantage, or is there one at all?
Are family practitioner hospitalists still even done?
How easy is it to "moonlight" as a family doctor, do most hospitals have positions for that?
I see the average of family physician income is between 130k-190k, how often are these doctors working? For instance, could I just work everyday and easily make over 220k if I were feeling inclined and didn't mind having an intense schedule?

Basically, my ideal situation is showing up to a practice 8-5 (or whatever) and not worrying about how the business as a whole is doing, where I could work shifts on a weekend to help pay off my student debt. Sorry if these have mostly been answered before, but after looking for half an hour, I thought I'd just ask and risk getting yelled at.
Any and all information is helpful. Thanks everyone.

Yep, it's called locums. There is more locums work out there than can every be filled. I work 12 hour shifts 6 days a week and will break 220K this year easily.

 

[brats800]

Are family practitioner hospitalists still even done?
How easy is it to "moonlight" as a family doctor, do most hospitals have positions for that?
I see the average of family physician income is between 130k-190k, how often are these doctors working? For instance, could I just work everyday and easily make over 220k if I were feeling inclined and didn't mind having an intense schedule?

Basically, my ideal situation is showing up to a practice 8-5 (or whatever) and not worrying about how the business as a whole is doing, where I could work shifts on a weekend to help pay off my student debt. Sorry if these have mostly been answered before, but after looking for half an hour, I thought I'd just ask and risk getting yelled at.
Any and all information is helpful. Thanks everyone.

Locums is a good option (for some) but you don't need to do that to meet your goals. Read some threads about salary vs location. If you don't need to be in a huge city (think Chicago, LA, NYC, etc), you could find high paying jobs. I am in the midwest, primarily doing outpatient work but still doing some hospital work, and make >$200k working 8a-5p 4 days most weeks. I have the option to work overnight hospital shifts and urgent care shifts for additional income. Our hospitalists (family medicine docs) also make >$200k yearly.

 

[tigers333]

I read a little bit up being a locum type doctor, from your posts and stuff, and it sounds pretty awesome. Do you mean that you work 6 days a week, and then you have a week off while you're going to be breaking 200k? Or every week you work 6 days a week? The reason I ask is a vaguely recall reading a thread someone who worked a week on/week off and earned about 220k, but I may just be confused. Also, that is way more than the doctors I shadowed that worked in a week (8-5 Monday-Friday) who i expect were making about the family practitioner average at about 180k. Do you find it hard to be away from your family that much when you are away for long periods of time? I think my significant other would hate the idea, but it sounds like a pretty interesting gig, going to a new place every now and then while still making money with a wide range of expereinces.


Also, another general question, say I did not like the idea of being away from family very often, is it also feasible/easy to just join a smaller practice as a normal "employee" and just do physician stuff, or are all physicians usually responsible for dealing with running the practice/business? Sorry if this is too weird of a question or if no one has experiences with it.

Thanks for the awesome insight Cabinbuilder and sb247!

------ I just got your reply as I was writing all of this, brats 800
Thanks for the insight. I am actually in the midwest area and hope to practice here. Smaller area, maybe close to one of the cities around here, but probably not, so that works out well for me. I was reading somewhere, probably not from a reputable source, that family doctors as hospitalist is kind of "dying out." Is it extremely difficult (or getting more difficult) to get a job as a hospitals family physician around the midwest if you're willing to look around?

 

[tigers333]

And thanks a bunch brats800, that was really good to know!

 

[tigers333]

And thanks a bunch brats800, that was really good to know!

 

[cabinbuilder]

I read a little bit up being a locum type doctor, from your posts and stuff, and it sounds pretty awesome. Do you mean that you work 6 days a week, and then you have a week off while you're going to be breaking 200k? My current assignment I work six days a week, 12 hours shifts because I am trying to pad my bank account this summer now that my taxes are paid so I have a cushion. That is my choice. I could work as little as 2 days a week if I wanted by then that really defeats my personal goals of paying off my debt.

Or every week you work 6 days a week? Currently, yes.

The reason I ask is a vaguely recall reading a thread someone who worked a week on/week off and earned about 220k, but I may just be confused. Yes, this is also possible, usually for ER or hospitalist type jobs. Those guys working hospitalists it can be feast or famine as you are responsible for all admissions. I have seen where it's 12 hour shifts either day/night that is 7 on 7 off as well. Just depends on the need of the facility and the contract terms you agree to for that assignment.

Do you find it hard to be away from your family that much when you are away for long periods of time? Not really. my kids are older and have their lives, are very busy with high school and aren't really home either. My husband stays home with them but he does do trips to come meet me when I have a break to go do something.

I think my significant other would hate the idea, but it sounds like a pretty interesting gig, going to a new place every now and then while still making money with a wide range of expereinces. I guess it comes down to the flexibility you want. You said you didn't want to be owned by admin or tied down to a private practice, etc. Think of it this way: You can be away and work solid for 2-3 months and take a month off, go on a cruise, go tour Europe for a month, stay home, etc. When you get back from vacation go work another 2-3 months and do another short vacation, etc. That's what I did last year with my kids. However, it doesn't work if your partner works and only has 2 weeks off a year. Mine doesn't work so they go when I'm ready to go. Last year I did 2-3 weeks in Vegas, 2 weeks Orlando, 2 weeks in St. Maarten, did a week Bahamas cruise, did a week in Virginia( Williamsburg, Monticello, Mount Vernon, Norfolk, etc), one week in D.C. and dragged the kids through every museum possible, and 2 weeks in Hawaii (Maui and Kauai). Can't do that with a "real" job. Just sayin'.

 

[Postictal Raiden]

I read a little bit up being a locum type doctor, from your posts and stuff, and it sounds pretty awesome. Do you mean that you work 6 days a week, and then you have a week off while you're going to be breaking 200k? My current assignment I work six days a week, 12 hours shifts because I am trying to pad my bank account this summer now that my taxes are paid so I have a cushion. That is my choice. I could work as little as 2 days a week if I wanted by then that really defeats my personal goals of paying off my debt.

Or every week you work 6 days a week? Currently, yes.

The reason I ask is a vaguely recall reading a thread someone who worked a week on/week off and earned about 220k, but I may just be confused. Yes, this is also possible, usually for ER or hospitalist type jobs. Those guys working hospitalists it can be feast or famine as you are responsible for all admissions. I have seen where it's 12 hour shifts either day/night that is 7 on 7 off as well. Just depends on the need of the facility and the contract terms you agree to for that assignment.

Do you find it hard to be away from your family that much when you are away for long periods of time? Not really. my kids are older and have their lives, are very busy with high school and aren't really home either. My husband stays home with them but he does do trips to come meet me when I have a break to go do something.

I think my significant other would hate the idea, but it sounds like a pretty interesting gig, going to a new place every now and then while still making money with a wide range of expereinces. I guess it comes down to the flexibility you want. You said you didn't want to be owned by admin or tied down to a private practice, etc. Think of it this way: You can be away and work solid for 2-3 months and take a month off, go on a cruise, go tour Europe for a month, stay home, etc. When you get back from vacation go work another 2-3 months and do another short vacation, etc. That's what I did last year with my kids. However, it doesn't work if your partner works and only has 2 weeks off a year. Mine doesn't work so they go when I'm ready to go. Last year I did 2-3 weeks in Vegas, 2 weeks Orlando, 2 weeks in St. Maarten, did a week Bahamas cruise, did a week in Virginia( Williamsburg, Monticello, Mount Vernon, Norfolk, etc), one week in D.C. and dragged the kids through every museum possible, and 2 weeks in Hawaii (Maui and Kauai). Can't do that with a "real" job. Just sayin'.

Living the dream

 

[styphon]

Is it easy to be "hired" as a family physician by a practice but not be take on any business risk?
How about by a hospital? How different would lifestyle be?
Is opening your own practice a huge pay advantage, or is there one at all?
Are family practitioner hospitalists still even done?
How easy is it to "moonlight" as a family doctor, do most hospitals have positions for that?
I see the average of family physician income is between 130k-190k, how often are these doctors working? For instance, could I just work everyday and easily make over 220k if I were feeling inclined and didn't mind having an intense schedule?

You can easily be "hired" as a family physician and take no business risk.
-Work for a government clinic, lower pay but you will be eligible for loan repayment programs
-Work for hospitals as a hospitalist (not likely to have 8-5 shifts)
-Work for hospitals in a hospital owned clinic - these fade and increase due to trends. Currently hospitals are investing in PCP clinics.
-Work for a clinic owned by a large group, where you can be an employee. Being a "partner" in one of these clinics include business aspects - but is not required (but usually brings in more money)
-Work for an Urgent Care. May have 12 hour shifts.
-Work for a rural/semi-rural ER. May also have 12 hour shifts

A hospitalist more than likely works 12 hour shifts as the hospital is open 24 hours a day, every day - as opposed to a clinic which has limited hours. Because of this, it needs to be staffed. The hospital group I interviewed with wanted 7 days of 12 hour shifts, then 7 days off. Another local hospital was advertising 4 days x 12 hour shifts on, 4 off.

When first opening your practical - a traditional practice - you will be at a loss of income at first before estabilishing a patient base. People enjoy owning their practices because you have total freedom - what insurances to take, if any, what to charge, who to give free services, what services you offer, what incentives you go for (Medical home? EHR? etc), who you hire - who you fire, etc. You very rarely have these choices when you are an employee of a group or hospital.

There are many FM hospitalists in my area - you have to show that you had an "inpatient heavy" residency and that you have done multiple ICU rotations.

FM can moonlight at ERs, Urgent cares, clinics that offer afterhours/weekend care, even some hospitalist shifts... These are easy to find - I am a year out of residency and work urgent care. I have been offered ER shifts, hospitalist shifts...

I have been an attending for one year and I make the upper range of the numbers you give - and that is without my urgent care pay... My regular job is 40 hours a week, M-F, 8-4:30