Hey guys, does anyone have any opinion about residencies based at an FQHC (Federally qualified health center)? What are the benefits and drawbacks, if any? Thanks
Pros/Cons of residency at an FQHC?
- Thread starter ggidgetzz
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You would see lots and lots of pathology
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Pros:
-Can't be sued - to sue a doctor working at FQHC you must sue the federal government, and as I am to understand - no one has ever won a malpractice case against them.
-Very sick people with a high burden of uncontrolled disease who NEED your help and who you can make a DRASTIC change in. As opposed to adjusting someones A1c from 7.0 to 6.8
-Most likely qualify for federal NHSC loan repayment (currently 50k for 2 years of service in addition to your income, renewable each 2 years)
Cons
-Lower pay.
-Pt's not as health educated and likely to have a higher rate of noncompliance ("I don't feel sick, so why would i need meds!")
-high burden of disease (which I list as a pro, but others may see as a con)
-harder time with referrals (pt's likely to have medicaid/medicare or no insurance, makes it harder for them to see specialists such as derm, rheum)
-You do not have control over staff hiring/firing or the patient population (very important to some people)
-Can't be sued - to sue a doctor working at FQHC you must sue the federal government, and as I am to understand - no one has ever won a malpractice case against them.
-Very sick people with a high burden of uncontrolled disease who NEED your help and who you can make a DRASTIC change in. As opposed to adjusting someones A1c from 7.0 to 6.8
-Most likely qualify for federal NHSC loan repayment (currently 50k for 2 years of service in addition to your income, renewable each 2 years)
Cons
-Lower pay.
-Pt's not as health educated and likely to have a higher rate of noncompliance ("I don't feel sick, so why would i need meds!")
-high burden of disease (which I list as a pro, but others may see as a con)
-harder time with referrals (pt's likely to have medicaid/medicare or no insurance, makes it harder for them to see specialists such as derm, rheum)
-You do not have control over staff hiring/firing or the patient population (very important to some people)
Thank you!
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I currently work at a FQHC. Referrals are very difficult to impossible so you treat a wider variety of diseases because you are the only doc they can see. You learn to refer only when you really have to and you know the few who will work with the uninsured.
Pay may be lower but I walk into the clinic at 8am and leave 5-5:15 Monday -Friday. No call no weekends. All notes done before patients leave. Nurses do most of the paperwork and I just have to sign. The are also great about updating meds and histories. I am salary so I get paid the same if I see 5 patients or 25.
You definitely see sicker patients and patients who have not seen a doc in a long time. You do a lot of educating patients. Noncompliance is an issue.
You learn what tests and meds are absolutely necessary because the patient does not have insurance or money.
I am in a rural area and never know what may walk in the door.
You do may not have control over the patient population but I was able to set my clinic's controlled substance policy which was weeded some patients out.
We are working on becoming FQHC or FQHC-like.
I like working there but can't imagine doing residency at one. The access to specialists and continuing to follow patients at the hospital really adds to the learning during residency. The volume may not be high enough to meet numbers requirements. Where I am, the union rules all, and most union staff do very little actual work. So, you could be stuck doing a lot of nursing instead of doctoring. You could be stuck with the cheapest, barely functioning EHR, equipment, staff, etc.
I don't know. It depends on how organized the place is for teaching. Where I am would be just an awful place for residency.
I like working there but can't imagine doing residency at one. The access to specialists and continuing to follow patients at the hospital really adds to the learning during residency. The volume may not be high enough to meet numbers requirements. Where I am, the union rules all, and most union staff do very little actual work. So, you could be stuck doing a lot of nursing instead of doctoring. You could be stuck with the cheapest, barely functioning EHR, equipment, staff, etc.
I don't know. It depends on how organized the place is for teaching. Where I am would be just an awful place for residency.
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Are you asking about a hospital-clinic pairing where your continuity clinic is an FQHC, or are you asking about this newer model where some residencies are really based in ambulatory settings (FQHC or not), rather than at a hospital?
Sorry, I am asking about an FQHC clinic, in addition to a hospital.
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As long as the residency is set up so that you have plenty of support and teaching at clinic, I think a FQHC is a great place for a residency clinic. You will see lots of disease processes and learn how to handle a lot of patient volume. When you are used to this type of medicine- it makes other jobs in primary care seem easier.
Employers are always impressed when you have FQHC experience.
Employers are always impressed when you have FQHC experience.
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Sometimes I feel like I'm at a FQHC. Sigh. I'd imagine it'd be "worth it" if that is what you wanted in the future.
