The Denigration of Family Medicine

[JustPlainBill]

I've recently experienced something that is starting to get irritating ---

In various conversations that come up with either non-medical personnel or people in support staff roles (RNs, EMTs, etc.), the question of "what do you do?" will often come up. I relate that I'm a physician and the next question is usually, "What's your speciality?".

Usually, when I respond, "I'm a Family Medicine doc.", I'll get one of the following responses --

1)"Oh".
2)"Oh" with a look that says,"You poor thing, you're not a specialist".
3) Ignored

and now recently at a parent-teacher meeting for an EMT course for one of my children in high-school, the EMT instructor intimated that with an EMT-P/Firefighter designation and after completing a 4 month online bridge to RN offered at the local community college, a person could wind up making close to $160K with little more than 2.5 years of training ----

That's about what an average FM doc in DFW makes ---

And I've also had people ask if I'm worried about being replaced by a PA or NP ----

Anyway -- can I get a little help here -- how does everyone else deal with this --- I chose FM because I got bored on rotations after doing something for a month or 2 -- I would go nuts if I had to do nothing but hospitalist work, or surgery, or OB/Gyn, or peds for the rest of my life --- plus I have a family and really enjoy being with them more than I enjoy being at a hospital at O-Dark-30 dealing with the next surgery case or ER shift -- all the people I care about are usually at home sleeping at that time and I prefer the M-F schedule so I can be with my family on the weekends ---

I busted my ass and fought through my medical school/residency time to be where I am today and I tend to get a case of the *(& when people start talking trash about what we do ----

Can some of the more senior physicians here put some perspective on this ---

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[NurWollen]

I've recently experienced something that is starting to get irritating ---

In various conversations that come up with either non-medical personnel or people in support staff roles (RNs, EMTs, etc.), the question of "what do you do?" will often come up. I relate that I'm a physician and the next question is usually, "What's your speciality?".

Usually, when I respond, "I'm a Family Medicine doc.", I'll get one of the following responses --

1)"Oh".
2)"Oh" with a look that says,"You poor thing, you're not a specialist".
3) Ignored

and now recently at a parent-teacher meeting for an EMT course for one of my children in high-school, the EMT instructor intimated that with an EMT-P/Firefighter designation and after completing a 4 month online bridge to RN offered at the local community college, a person could wind up making close to $160K with little more than 2.5 years of training ----

That's about what an average FM doc in DFW makes ---

And I've also had people ask if I'm worried about being replaced by a PA or NP ----

Anyway -- can I get a little help here -- how does everyone else deal with this --- I chose FM because I got bored on rotations after doing something for a month or 2 -- I would go nuts if I had to do nothing but hospitalist work, or surgery, or OB/Gyn, or peds for the rest of my life --- plus I have a family and really enjoy being with them more than I enjoy being at a hospital at O-Dark-30 dealing with the next surgery case or ER shift -- all the people I care about are usually at home sleeping at that time and I prefer the M-F schedule so I can be with my family on the weekends ---

I busted my ass and fought through my medical school/residency time to be where I am today and I tend to get a case of the *(& when people start talking trash about what we do ----

Can some of the more senior physicians here put some perspective on this ---

I'm just a med student so I'm not the answerer you're looking for, but I am married with kids, and all I can say is it sounds like you've got your priorities strait.

 

[VA Hopeful Dr]

Oh I love it when this happens. Here's my rough response...

I work banker's hours, home phone call only and not very often (1 week every 6 weeks), no holidays, plenty of vacation time, most patients LOVE their family doctors, and we rarely get sued. All of this and I still get paid 6 figures.

If you have kids you can add stuff like getting to go to all their soccer games, school plays, and plenty of time to spend with them in general.

Ask your friendly neighborhood cardiologist, ER doctor, or surgeon how many Christmases, Thanksgivings, or Birthdays they have missed by being in the hospital.

I'm pretty family oriented, so the extra 200k isn't worth all the time I would lose with my family.

 

[cabinbuilder]

Just remember that it is your life and as long as you are happy with your choice to do FM that is all that matters. I think a lot of it is that you are in a very large city where views are different. Like we discussed, I generally don't get those types of comments in more rural settings. There are always going to be those who try to make themselves feel better by putting down others. Envy can be ugly. Carry on.

 

[Mad Jack]

I've recently experienced something that is starting to get irritating ---

In various conversations that come up with either non-medical personnel or people in support staff roles (RNs, EMTs, etc.), the question of "what do you do?" will often come up. I relate that I'm a physician and the next question is usually, "What's your speciality?".

Usually, when I respond, "I'm a Family Medicine doc.", I'll get one of the following responses --

1)"Oh".
2)"Oh" with a look that says,"You poor thing, you're not a specialist".
3) Ignored

and now recently at a parent-teacher meeting for an EMT course for one of my children in high-school, the EMT instructor intimated that with an EMT-P/Firefighter designation and after completing a 4 month online bridge to RN offered at the local community college, a person could wind up making close to $160K with little more than 2.5 years of training ----

That's about what an average FM doc in DFW makes ---

And I've also had people ask if I'm worried about being replaced by a PA or NP ----

Anyway -- can I get a little help here -- how does everyone else deal with this --- I chose FM because I got bored on rotations after doing something for a month or 2 -- I would go nuts if I had to do nothing but hospitalist work, or surgery, or OB/Gyn, or peds for the rest of my life --- plus I have a family and really enjoy being with them more than I enjoy being at a hospital at O-Dark-30 dealing with the next surgery case or ER shift -- all the people I care about are usually at home sleeping at that time and I prefer the M-F schedule so I can be with my family on the weekends ---

I busted my ass and fought through my medical school/residency time to be where I am today and I tend to get a case of the *(& when people start talking trash about what we do ----

Can some of the more senior physicians here put some perspective on this ---

Just a note on the whole RN salary thing- I would be highly surprised if there were more than a handful of nurses without NP degrees making 160k. 100k is doable if you can get a ton of overtime, but with the glut of RNs, most places aren't exactly handing out OT like crazy. Starting RNs usually pull 60-70k for a 40 hour week.

 

[JustPlainBill]

Mad Jack -- the whole $160K thing came from the following calculation --- local firefighters/EMT-P's can get pain ~$60K/year essentially working 1 24 hour shift Q3days, then add the RN salary of almost $100K and that's how he arrived at that number.

 

[Mad Jack]

Mad Jack -- the whole $160K thing came from the following calculation --- local firefighters/EMT-P's can get pain ~$60K/year essentially working 1 24 hour shift Q3days, then add the RN salary of almost $100K and that's how he arrived at that number.

That would be an impossible schedule to maintain- at $30/hr (high starting pay, usually it's closer to 26-28) a nurse would have to work 56 hours a week, in addition to the 365/3*24/52=56 average hours weekly as a paramedic/firefighter, or 112 hours a week. And that's if you can even get the schedules to line up, which is basically impossible. That gives you exactly 8 hours per day to eat, sleep, commute, and take care of your ADLs- it's just not realistic for any period of time longer than a few months.

 

[SLC]

Your story sounds to me like someone trying hard to get on your level, when he's clearly not.

That salary is all but impossible for most everyone doing the EMT-P - RN route. But it's pretty standard for an FM with a great QOL and it would be relatively easy to work a little harder and make even more.

Plus as a FM, you don't have to do or put up with some of the demeaning things that nurses have in their job descriptions (sponge bathing, adult diaper changes, etc). And you don't have to deal with some of the garbage that EMS deals with on the regular (believe me, I've been there). There's little to be jealous of as an FM doc, it's a pretty sweet gig if you ask me!

So I'd just keep that in mind when dealing with those types.

 

[SLC]

Plus, I just wrapped up a Cardiology rotation. No thanks! Those guys may have some sort of "street-cred" with the layperson, but I want no part of that lifestyle. 100+ hours per week doesn't make the pay worth it in my opinion.

 

[deleted87716]

I've honestly never run into anyone who said any of those things. Usually, once somebody finds out what I do, I immediately get asked for free medical advice.

 

[sluggs]

1. On $: a very wise man told me: never count other people's money. Unless you live somewhere super pricey, you can live nicely on your salary.
2. Prestige: who gives a rat's ass?
3. Family med: you know a ton of stuff about a lot, and you help keep people healthy. You can diagnose and treat a wide variety of conditions. You provide tangible help to a lot of people every day, in ways that actually help them... not just highly advanced futile care at the end of life (read: crit care med).
My man, you are doing well!

 

[SLC]

I've honestly never run into anyone who said any of those things. Usually, once somebody finds out what I do, I immediately get asked for free medical advice.

I already do, and I'm not even a Med-school grad (technically). I just tell them "you should ask your doctor about that"

 

[Modeselektor]

Honestly people who talk smack have no idea how much an FM doc who cares about money and has the smallest amount of business sense makes. One of my attending physicians received over $800,000 in compensation this year. This figure doesn't even include payment from workman's compensation or auto insurance. This is NOT an unusual number in my area.

His awesome hours allow him to take this kind of money and use it to buy assets. His property and stocks generate a ton of money and he recently sold a plot of land for $2 million.

Read the book "Rich Dad, Poor Dad." Med students tend to fall into this stupid "become more specialized and earn more money" trap that is just about the dumbest way to make money in terms of effort/reward ratio. Truth is you should just do what you want and get satisfaction from your job. Money is best made by having your money make more money.

I have loved FM well since forever. I like being a "whole doctor" and actually being in a position to improve health in a way that doesn't merely define it as "the absence of disease." I could give a rat's ass what anyone thinks and I assure you my attendings who make a bunch of money, working normal hours, while being their own boss care even less.

 

[septoplasty]

I think the problem is people don't necessarily understand what we do. Their images of doctors is painted by tv shows which portray people coming to the hospital constantly w/ gun shot wounds.

 

[princekc]

[QUOTE ] Starting RNs usually pull 60-70k for a 40 hour week.[/QUOTE]

Not true. 30-40k range typically. Without OT.

 

[SuckySurgeon7]

[QUOTE ] Starting RNs usually pull 60-70k for a 40 hour week.

Not true. 30-40k range typically. Without OT. [/QUOTE]

I have friends in the DFW are and talked with some nurses about how much they make down there. Starting nurses at an HCA-owned hospital could make 40k starting, or just over that. Working 60 hours per week as an experienced nurse would get you a little over 80 because of overtime, and if you do night shifts, this number could potentially break 100K. The nurses who received that money were locked into a contract that the hospital was no longer offering to new employees. Seemed like a sweet deal.

But getting back to the main point of this thread- OP has stated that UTSW family medicine residency is not well respected at that university. This is exactly what I have heard about the attitude of the facility in general. It's very competitive and values its specialists, but there are better FM programs in Texas. If the OP is still in that environment, this thread is more understandable.

FM is much more highly valued outside of the academic sphere. And, yes, FM can make good money if that's one of your goals.

 

[W19]

Honestly people who talk smack have no idea how much an FM doc who cares about money and has the smallest amount of business sense makes. One of my attending physicians received over $800,000 in compensation this year. This figure doesn't even include payment from workman's compensation or auto insurance. This is NOT an unusual number in my area.

A FM doc making that much! How?

 

[Bluefiya]

how/??

Honestly people who talk smack have no idea how much an FM doc who cares about money and has the smallest amount of business sense makes. One of my attending physicians received over $800,000 in compensation this year. This figure doesn't even include payment from workman's compensation or auto insurance. This is NOT an unusual number in my area.

His awesome hours allow him to take this kind of money and use it to buy assets. His property and stocks generate a ton of money and he recently sold a plot of land for $2 million.

Read the book "Rich Dad, Poor Dad." Med students tend to fall into this stupid "become more specialized and earn more money" trap that is just about the dumbest way to make money in terms of effort/reward ratio. Truth is you should just do what you want and get satisfaction from your job. Money is best made by having your money make more money.

I have loved FM well since forever. I like being a "whole doctor" and actually being in a position to improve health in a way that doesn't merely define it as "the absence of disease." I could give a rat's ass what anyone thinks and I assure you my attendings who make a bunch of money, working normal hours, while being their own boss care even less.

 

[JustPlainBill]

No -- I escaped UTSW with my sanity intact -- interestingly enough, most of the specialists were ok and decent -- they knew the FM program sucked and tried to help us where they could -- I'm getting this in the community --

 

[jl lin]

Your story sounds to me like someone trying hard to get on your level, when he's clearly not.

That salary is all but impossible for most everyone doing the EMT-P - RN route. But it's pretty standard for an FM with a great QOL and it would be relatively easy to work a little harder and make even more.

Plus as a FM, you don't have to do or put up with some of the demeaning things that nurses have in their job descriptions (sponge bathing, adult diaper changes, etc). And you don't have to deal with some of the garbage that EMS deals with on the regular (believe me, I've been there). There's little to be jealous of as an FM doc, it's a pretty sweet gig if you ask me!

So I'd just keep that in mind when dealing with those types.

You make some excellent points; but I guess I will share a little pet peeve as a nurse gearing up to apply to MS: If you or I or our family members were in the bed needing that bath (You can assess a lot during a bath.) or a diaper change, we might initially be embarrassed to have to have someone help us in this regard, but ultimately we would be appreciative, b/c no one wants to be left like that. Shoot, when my dogs have had surgery--one had very serious surgery and couldn't move until nerve recovery--well my son, who is interested in anything but healthcare--actually software development--smart kid at young age--and I, the RN, were on top of our dog all through a number of days and nights until adequate recovery. That dog was cleaner than clean, even though he had to be on diazapam to help relieve his bladder and had not control over it at that time. (Seriously, I was very proud of my son and other kids for helping out; b/c they appreciated the core needs of humanity.) . It's a human-caring thing. It's not at all demeaning; b/c it helps people (and other beings) have comfort and for people, dignity. That's an honorable thing, not a demeaning thing. I only bring this up bc way too many (certainly not all) docs have the demeaning notion in mind. Why isn't cutting into pus-filled tissue and doing a I&D not "demeaning?" No offense b/c I'm sure you get my point when you think about it, but giving excellent care on ALL levels is never demeaning unless one chooses to make it so.

Having said all of that, doing such things has been the least of my stress while working in the field. Absolutely, hands down true. No, I don't want to do primarily that; but when people need that kind of care, it can be a privilege to make them feel and be better in that regard. I consider it a form of relieving suffering; b/c the poor person, adult, baby, or dog would be suffering to be left in such a state.

 

[styphon]

[QUOTE ] Starting RNs usually pull 60-70k for a 40 hour week.

Not true. 30-40k range typically. Without OT.[/QUOTE]

In our area the starting wage for a nurse (RN) is 22-25/hr which is 44k to 50k/yr. Lots of the jobs will prevent overtime, and would rather go short staff than pay over time.

 

[bronx43]

Honestly people who talk smack have no idea how much an FM doc who cares about money and has the smallest amount of business sense makes. One of my attending physicians received over $800,000 in compensation this year. This figure doesn't even include payment from workman's compensation or auto insurance. This is NOT an unusual number in my area.

His awesome hours allow him to take this kind of money and use it to buy assets. His property and stocks generate a ton of money and he recently sold a plot of land for $2 million.

Read the book "Rich Dad, Poor Dad." Med students tend to fall into this stupid "become more specialized and earn more money" trap that is just about the dumbest way to make money in terms of effort/reward ratio. Truth is you should just do what you want and get satisfaction from your job. Money is best made by having your money make more money.

I have loved FM well since forever. I like being a "whole doctor" and actually being in a position to improve health in a way that doesn't merely define it as "the absence of disease." I could give a rat's ass what anyone thinks and I assure you my attendings who make a bunch of money, working normal hours, while being their own boss care even less.

This is 100% true. I know a PCP in the Cleveland area pulling $1 mil. Dude's straight up a G. His clinic is run to perfection. Volume is approximately 50-70 per day. His support staff has been with him for 20 years, and has their workflow DOWN. He pays them well to keep morale and job satisfaction high. He has his own ancillary revenue generators like labs and imaging. He has his staff get labs, imaging, etc for each individual chief complaint, and he has all the data prior to seeing the patient. His volume also allows him to have an enormous supply of sample drugs since he's the largest prescriber in the area. His poor patients NEVER have to pay for meds out of pocket.

When it comes down to it, business acumen >>>>> specialty. This will only become more true as reimbursement rates equalize.

 

[jl lin]

Not true. 30-40k range typically. Without OT.

In our area the starting wage for a nurse (RN) is 22-25/hr which is 44k to 50k/yr. Lots of the jobs will prevent overtime, and would rather go short staff than pay over time.[/QUOTE]


Yes, it fairly area-dependent. Around here I think they start at or near $50,000. Of course there is also shift differential, and if you are new, heck, even when you are not, most often, off-shift is expected. It's about 20% shift diff, depending.

 

[jl lin]

This is 100% true. I know a PCP in the Cleveland area pulling $1 mil. Dude's straight up a G. His clinic is run to perfection. Volume is approximately 50-70 per day. His support staff has been with him for 20 years, and has their workflow DOWN. He pays them well to keep morale and job satisfaction high. He has his own ancillary revenue generators like labs and imaging. He has his staff get labs, imaging, etc for each individual chief complaint, and he has all the data prior to seeing the patient. His volume also allows him to have an enormous supply of sample drugs since he's the largest prescriber in the area. His poor patients NEVER have to pay for meds out of pocket.

When it comes down to it, business acumen >>>>> specialty. This will only become more true as reimbursement rates equalize.

Seriously? Wow.

 

[FiveRivers]

This is 100% true. I know a PCP in the Cleveland area pulling $1 mil. Dude's straight up a G. His clinic is run to perfection. Volume is approximately 50-70 per day. His support staff has been with him for 20 years, and has their workflow DOWN. He pays them well to keep morale and job satisfaction high. He has his own ancillary revenue generators like labs and imaging. He has his staff get labs, imaging, etc for each individual chief complaint, and he has all the data prior to seeing the patient. His volume also allows him to have an enormous supply of sample drugs since he's the largest prescriber in the area. His poor patients NEVER have to pay for meds out of pocket.

When it comes down to it, business acumen >>>>> specialty. This will only become more true as reimbursement rates equalize.

This is extremely true. I remember as a med student, the attending I worked with had a similar model. Ancillary staff knew EXACTLY what to do and were extremely efficient. On top of this, their job satisfaction must have been high, as some had been working with him for 20+ years. He too saw a large number of patients, with excellent efficiency, but still managed to answer questions and address any issues, and patients really liked him, and had been coming to him for years. (And managed to teach us at the same time.)
I'm pretty sure he was also allowed to bill a high code, due to the complexity and chronicity of cases seen in primary care, and majority of his patient's had chronic issues. And in addition, had in house labs done.
As stated with similar cases above, his nursing manager reported close to $1 million for his salary.

The theory of time spent per patient=quality of service isn't always true. Key to any private practice is efficiency.

 

[SLC]

You make some excellent points; but I guess I will share a little pet peeve as a nurse gearing up to apply to MS: If you or I or our family members were in the bed needing that bath (You can assess a lot during a bath.) or a diaper change, we might initially be embarrassed to have to have someone help us in this regard, but ultimately we would be appreciative, b/c no one wants to be left like that. Shoot, when my dogs have had surgery--one had very serious surgery and couldn't move until nerve recovery--well my son, who is interested in anything but healthcare--actually software development--smart kid at young age--and I, the RN, were on top of our dog all through a number of days and nights until adequate recovery. That dog was cleaner than clean, even though he had to be on diazapam to help relieve his bladder and had not control over it at that time. (Seriously, I was very proud of my son and other kids for helping out; b/c they appreciated the core needs of humanity.) . It's a human-caring thing. It's not at all demeaning; b/c it helps people (and other beings) have comfort and for people, dignity. That's an honorable thing, not a demeaning thing. I only bring this up bc way too many (certainly not all) docs have the demeaning notion in mind. Why isn't cutting into puss-filled tissue and doing a I&D not "demeaning?" No offense b/c I'm sure you get my point when you think about it, but giving excellent care on ALL levels is never demeaning unless one chooses to make it so.

Having said all of that, doing such things has been the least of my stress while working in the field. Absolutely, hands down true. No, I don't want to do primarily that; but when people need that kind of care, it can be a privilege to make them feel and be better in that regard. I consider it a form of relieving suffering; b/c the poor person, adult, baby, or dog would be suffering to be left in such a state.

You're right, I used some pretty offensive language there. It was not my intent and I didn't really think about how that would. Come across.

You are absolutely correct that giving good care is never "demeaning" and shouldn't be viewed as such. And nurses have a vital and irreplaceable role in patient care. Those things that I called "demeaning" are all extremely important and I guess the point I was trying to make is that while the work of a nurse is critical, I'm certainly glad that I won't be expected to do it. Mainly because it's hard work and much of it is not at all glamorous.

But let it be known that I have nothing but respect for the role of a RN.

 

[JustPlainBill]

I agree that a good RN has saved many a physician's rear end by being the trained eyes/ears on the patient all the time. The one's that tend to get me irritated are the one's that equate, in their mind, NP with Board Certified attending -- I've actually seen one ICU RN with a DNP fail to order an XRay ordered by a weak ICU attending and then fail to act on a pulse ox of 77% in a patient who had suffered a posterior wall MI that morning -- it was the RT that brought the SpO2% to the ICU attendings attention.... that sort of stuff makes me want to scream and chew the carpet.....

 

[jl lin]

You're right, I used some pretty offensive language there. It was not my intent and I didn't really think about how that would. Come across.

You are absolutely correct that giving good care is never "demeaning" and shouldn't be viewed as such. And nurses have a vital and irreplaceable role in patient care. Those things that I called "demeaning" are all extremely important and I guess the point I was trying to make is that while the work of a nurse is critical, I'm certainly glad that I won't be expected to do it. Mainly because it's hard work and much of it is not at all glamorous.

But let it be known that I have nothing but respect for the role of a RN.

Yes. I understand. It's just that as I nurse, I have heard such comments by some of the GP and have read some of them online. The people that get what I do are those in the CT surgical recovery unit, once they are a bit better, they actually see what we do, and then they have a different perspective. But those that haven't seen it, particularly in the setting to which I refer, well, they don't really understand.

They don't understand that helping a person with the basic needs is an important, yet ultimately very minuscule part of what we do in these areas. It's also a very minor issue in terms of the overall stress--which really involves making sure you know what you are doing, dotting your i's, crossing your t's, documenting things well. Making sure you don't miss very important issues in assessment or re: tx.

Surgeons can be very particular and they comb through all your hemodynamics, gtt titrations, blood gases, the meds which are ordered on the physician order sheets only if certain parameters are not met--as they should! You just have to be very careful, and you can't blame the surgeons for being particular--at all. I am part of the team that requires excellence, and if I am not careful, I could hurt a patient, be less than therapeutic with a patient and set things backward, and that also reflects upon the surgeon/s, b/c these are their patients--and the M&Ms follow on them for a certain period of time post-operatively. It's an anal-retentive area for good reasons. You can't take anything personally b/c it's really about focusing on helping to create the best outcomes for the patients.

On top of that, you have some very stressful family members and stressed out patients with whom you must deal. Then as the nurse, you have to work with so many disciplines--from ID, consulting specialists, nutrition-dietician people, RRTs, Rad Tech people, you name it. You are like this cog in a wheel dealing with all the surrounding disciplines, and yes. This can become stressful--along with the stress of being very careful about everything do--as well as being very careful with all your documentation.

Then, you have administrative types that can add to the stress at times--and some fellow nurses that have issues and cause loads of needless stress. Thank God not all nurses, but there are those that are ridiculous PITAs.

Heck. The surgeons just want things done in a particular manner, and I totally respect that. It's the other disciplines that can be odd at times and cause needless issues and conflicts.

I think every healthcare discipline should take and make A's in cooperative, teamwork behaviors and ethics. And the courses should include actual practicums.

So, some messes to clean up in order to keep the patient comfortable and healthy is like absolutely nothing compared to a lot of other stuff. It's just that that is what people, strangely, focus on when it comes to nursing. This is laughable to me. It's like which would I find more stressful, helping to clear a baby's airway and give him some albuterol and steroids and oxygen, or change a baby's diaper? Obviously, the less stressful deal is changing the baby's diaper. So, really, it's nothing compared to a kid potentially or actually coding from respiratory issues. Like I said somewhere else. I laugh at code browns.

 

[jl lin]

I agree that a good RN has saved many a physician's rear end by being the trained eyes/ears on the patient all the time. The one's that tend to get me irritated are the one's that equate, in their mind, NP with Board Certified attending -- I've actually seen one ICU RN with a DNP fail to order an XRay ordered by a weak ICU attending and then fail to act on a pulse ox of 77% in a patient who had suffered a posterior wall MI that morning -- it was the RT that brought the SpO2% to the ICU attendings attention.... that sort of stuff makes me want to scream and chew the carpet.....

Absolutely. Fortunately most of the ICU nurses I know wouldn't do that, unless it was say a kid with hypoplastic left heart, etc. In those kids, you don't want the O2 sat in the normal range.

 

[postbacpremed87]

I've recently experienced something that is starting to get irritating ---

In various conversations that come up with either non-medical personnel or people in support staff roles (RNs, EMTs, etc.), the question of "what do you do?" will often come up. I relate that I'm a physician and the next question is usually, "What's your speciality?".

Usually, when I respond, "I'm a Family Medicine doc.", I'll get one of the following responses --

1)"Oh".
2)"Oh" with a look that says,"You poor thing, you're not a specialist".
3) Ignored

and now recently at a parent-teacher meeting for an EMT course for one of my children in high-school, the EMT instructor intimated that with an EMT-P/Firefighter designation and after completing a 4 month online bridge to RN offered at the local community college, a person could wind up making close to $160K with little more than 2.5 years of training ----

That's about what an average FM doc in DFW makes ---

And I've also had people ask if I'm worried about being replaced by a PA or NP ----

Anyway -- can I get a little help here -- how does everyone else deal with this --- I chose FM because I got bored on rotations after doing something for a month or 2 -- I would go nuts if I had to do nothing but hospitalist work, or surgery, or OB/Gyn, or peds for the rest of my life --- plus I have a family and really enjoy being with them more than I enjoy being at a hospital at O-Dark-30 dealing with the next surgery case or ER shift -- all the people I care about are usually at home sleeping at that time and I prefer the M-F schedule so I can be with my family on the weekends ---

I busted my ass and fought through my medical school/residency time to be where I am today and I tend to get a case of the *(& when people start talking trash about what we do ----

Can some of the more senior physicians here put some perspective on this ---

People always say that they CAN do this but in my experience it never happens. There are not that many special snowflakes. Some of the comments made by the lay public (read everyone who isn't a physician or physician in training) really grind my gears. I was at a party recently and one of the individuals at the party has a son who is going to be a CRNA. I mentioned I was in medical school and the individual was constantly trying to compare what I was doing to what they were doing - tit for tat. I did pre-med curriculum and got a 4 year degree. He got a 4 year BSN. I am going to medical school for 4 years. Yeah his program is almost as long as your...his CRNA program is 3o months. I have to attend residency for a minimum of 3 years after medical school - probably more for the fields I am considering. His reply " yeah I don't understand residency at all - it seems pointless".

Yeah residency is the place were you truly learn to be an INDEPENDENT confident provider - one that runs the show.

People have no f-ing clue what we go through.

 

[W19]

@postbacpremed87 I am surprised that person did not count the years that his son worked as a nurse...

 

[postbacpremed87]

@postbacpremed87 I am surprised that person did not count the years that his son worked as a nurse...

1? 1 following the order of a physician - not 1 year of giving orders and learning to run a unit like a resident physician.

 

[simpler2]

His reply " yeah I don't understand residency at all - it seems pointless".

I've never met a NP/PA who doesn't fully understand the purpose of residency and wish they had it after they start their first 3-6 months of employement. That is, unless they take a fru-fru urgent care position in a privileged community. In general, I don't find much purpose or satisfaction in conversing with people who only want to bolster their self image and importance. My professional energies are dedicated to providing the absolute best medical care for those that I am serving. I would advise avoiding conversations with individuals that are not doing the same...I find a good book or podcast much more useful/satisfying than supporting a load of BS.

 

[JustPlainBill]

Agree with simpler2 -- however, sometimes you get cornered -- I really, really try to remain polite and courteous and shut it down gently -- but every once in a while I cannot --- like the time my MIL was determined that an article she had read in Reader's Digest was the be all/end all of cardiology truth -- I had just come off of call and was running on caffeine at a birthday party for one of the kiddos when she began to pontificate re: another relative's health problem and this article and what did I think of that -- I gave a polite answer as to how the article was a general comment and should not be taken as medical advice -- she proceeded to push the issue -- I had had enough BS to last me a lifetime by that point and snapped -- I was a bit excited when I responded with,"Well, I guess we'll have to take the word of someone who's done 4 years of undergrad, 4 years of medical school, 3 years of IM, 1 year of a cardiology fellowship, is board certified in IM and cardiology and has had 10 years of clinical practice in cardiology over one F*&(^ng 2 page article in Reader's Digest, won't we?!!" --

The conversation stopped very quickly and everyone got real quiet -- I went for more coffee -- Since then, at Christmas and Thanksgiving, we sit at opposite ends of the table and exchange pleasantries with no mention of medical topics whatsoever --

 

[JustPlainBill]

I always find it somewhat humorous although I keep my mouth shut when I hear people/family members gripe about lack of sleep and how they can't function on 6 hours of sleep, complain about cold food or other such stuff that we suffered through in residency. Granted, it is nothing like what the infantry goes through by any stretch of the imagination -- Ah, well, it's good to vent but doesn't necessarily help much ---

 

[ActionFigure]

....Granted, it is nothing like what the infantry goes through by any stretch of the imagination -- Ah, well, it's good to vent but doesn't necessarily help much ---

I still wish it was

 

[JustPlainBill]

Always nice to know that I spent $250K and the last 12 years of my life to work in the medical equivalent of Burger King -- Hi, can I take your order please? Oh, a Zpack, albuterol inhaler and codeine cough syrup? Would you like a steroid with that? Injectable or Dosepack? Next--- Hi, can I take your order please? Antibiotics only prescribed for 7 days? You're going out of town? a few more days might be helpful? Ok, a few more days it is ---

WTF? If you refuse, the powers that be get upset --- I'm seriously considering running a cash only practice where I answer only to me ---

 

[SuckySurgeon7]

WTF? If you refuse, the powers that be get upset --- I'm seriously considering running a cash only practice where I answer only to me ---

If you do, please, please start a thread about your experience here. I think a lot of us would love to hear about the nitty gritty details - choosing a location, cost of supplies, how you marketed yourself, how long it takes to get into the black, and what the differences are when it's all said and done compared to working for 'the man'.

 

[kratos99]

People, especially med students, are ignorant. In clinic, I make about 300K after overhead. I also hold a 0.8 position at the local medical school. About 140K in salary for that. I'm young. But your status is not defined by how much you make. The key is to spend less than you make, and know how to invest. Just in dividends, about 7 years into practice, I add on 40K a year from my stocks (excluding capital gains). My stocks raise dividends on average 4-10% a year, plus reinvesting compounding dividends, and investing monthly, will lead to ultra high net worth at the end. I can slow down in my 40s, and essentially live on my dividends and work when I want.

 

[medimedimedi]

1)"Oh".
2)"Oh" with a look that says,"You poor thing, you're not a specialist".
3) Ignored

LOL! Try telling people you're a psychiatrist. Then you get the "I didn't know psychiatrists were doctors" the "you must be really dumb" and the "that's not real medicine"

 

[JustPlainBill]

People, especially med students, are ignorant. In clinic, I make about 300K after overhead. I also hold a 0.8 position at the local medical school. About 140K in salary for that. I'm young. But your status is not defined by how much you make. The key is to spend less than you make, and know how to invest. Just in dividends, about 7 years into practice, I add on 40K a year from my stocks (excluding capital gains). My stocks raise dividends on average 4-10% a year, plus reinvesting compounding dividends, and investing monthly, will lead to ultra high net worth at the end. I can slow down in my 40s, and essentially live on my dividends and work when I want.

Almost 2 years in practice here -- closed one clinic and now working Urgent Care to fill the gap -- thinking of opening my own DPC practice but a little unsure and risk averse given student loans plus kids going into college at the same time --- but speak more to me of the rich capitalist lifestyle (TM) to which I will become accustomed -- it's good to be the king...