Unique career paths in FM

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abl223

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I'm currently an intern in family medicine. I'm still figuring out what exactly I want to do, and I'm constantly impressed by all the possibilities in terms of career paths in FM. So I thought it might be interesting to reach out to the FM docs on here and see where your interests/subspecialties led you and the careers you've led - love to hear from you!
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So I don’t want to give too much away as I try to stay anonymous but I don’t think I really have a "traditional" career. Like I don’t just work regular outpatient or inpatient. I do a lot of reproductive health care and some international health care work. I also do a lot of advocacy work. If you have any interest in any of those then you can message me and I can provide a few more details.

Edited to add: I love my jobs :)
 
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I love my setup. I'm 60% clinical and 40% education. Practice family, sports med, and inpatient with the resident team. The rest of the time I'm a faculty advisor for med students and on faculty that teaches the physical exams for MS1's. I've always wanted to do education but I thought it would be with residents and fellows. Where I'm at there's no FM sports fellowship, and the residents at are another teaching clinic site, so most of my education endeavors are in the med school realm.
 
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galactus said:
I love my setup. I'm 60% clinical and 40% education. Practice family, sports med, and inpatient with the resident team. The rest of the time I'm a faculty advisor for med students and on faculty that teaches the physical exams for MS1's. I've always wanted to do education but I thought it would be with residents and fellows. Where I'm at there's no FM sports fellowship, and the residents at are another teaching clinic site, so most of my education endeavors are in the med school realm.
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Did you do a sports med fellowship by chance?
 
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I’m rural, in a college town. I have chosen this location for the full-spectrum nature of being rural, and the young adult aspect of being in a college town.

I do a lot of minor injuries (sutures, fractures, etc), and TON of family planning (IUD’s nexplanon etc.). I have quite a few young families in my panel so I do a fair bit of peds as well.

The local religion has a fairly strict health code, so most of my older patients are in pretty good shape. I have very few people with smoking or alcohol histories, little drug use. I end up doing a lot of procedures with my older patients (skin excisions, joint injections, etc). Then I keep track of garden variety health concerns like HTN, DM2, etc. not too many people with long med-lists.

all in all, I love this place and this job. I genuinely look for the weekends to end so I can get back to work rather than the other way around.
 
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Anyone ever go on into a non-clinical position?
Curious what non clinical options there are out there
 
TheOther said:
Did you do a sports med fellowship by chance?
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Sure did. I am also the faculty advisor for the sports medicine interest group for the med school as well, so I provide workshops and stuff to the students. I also have students come with me to games I cover, but due to this COVID world that really has been limited to just HS sports. For the college/pro teams I take care of I can't have a "guest" like a med student or resident come with me because everyone has to be COVID tested before games, so this year unfortunately is attendings and ortho sports med fellows only.

Someone also mentioned non-clinical positions. Teaching at a med school is a great alternative, however the vast majority of us (even the deans) still do some clinical work.
 
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I have a few friends who went into cosmetic stuff: varicose veins therapy, laser hair removal, liposuction, botox, collagen fills.
 
goldsummer said:
Anyone ever go on into a non-clinical position?
Curious what non clinical options there are out there
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I'm currently a sub-investigator for a clinical research company. It's a lot of signatures, lab/ekg reviews, and rating scales. It's about 50% of the work-load compared to my urgent care job and I get paid the same. I got burned out seeing 30-50 pts per day. This new job allows me to focus on my real estate investments.
 
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hieusays said:
I'm currently a sub-investigator for a clinical research company. It's a lot of signatures, lab/ekg reviews, and rating scales. It's about 50% of the work-load compared to my urgent care job and I get paid the same. I got burned out seeing 30-50 pts per day. This new job allows me to focus on my real estate investments.
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I see wide ranging incomes for FM doing Urgent Care. All the way up to 500k/year. Can you provide more specific numbers? Are you making like 500k/year working 20-30 hours/week? Thanks!
 
SLC said:
I’m rural, in a college town. I have chosen this location for the full-spectrum nature of being rural, and the young adult aspect of being in a college town.

I do a lot of minor injuries (sutures, fractures, etc), and TON of family planning (IUD’s nexplanon etc.). I have quite a few young families in my panel so I do a fair bit of peds as well.

The local religion has a fairly strict health code, so most of my older patients are in pretty good shape. I have very few people with smoking or alcohol histories, little drug use. I end up doing a lot of procedures with my older patients (skin excisions, joint injections, etc). Then I keep track of garden variety health concerns like HTN, DM2, etc. not too many people with long med-lists.

all in all, I love this place and this job. I genuinely look for the weekends to end so I can get back to work rather than the other way around.
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*checks username

Must be nice in Utah right now :)
 
sloh said:
I see wide ranging incomes for FM doing Urgent Care. All the way up to 500k/year. Can you provide more specific numbers? Are you making like 500k/year working 20-30 hours/week? Thanks!
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I make close to 500K/yr doing urgent care. My regular shifts are 10/month. I generally pick up 4 extra. Except the final quarter when I generally pick up 10-15 extra for the holidays.
 
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cabinbuilder said:
I make close to 500K/yr doing urgent care. My regular shifts are 10/month. I generally pick up 4 extra. Except the final quarter when I generally pick up 10-15 extra for the holidays.
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Compared to outpatient clinic, do you feel that the workload is higher/lower and more/less stressful? Thank you!
 
cabinbuilder said:
12 hour shifts. avg 33 per shift. But my contract is base salary + hourly wage for extra shifts + RVU's + benefits go into the final number
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SLC said:
I’m rural, in a college town. I have chosen this location for the full-spectrum nature of being rural, and the young adult aspect of being in a college town.

I do a lot of minor injuries (sutures, fractures, etc), and TON of family planning (IUD’s nexplanon etc.). I have quite a few young families in my panel so I do a fair bit of peds as well.

The local religion has a fairly strict health code, so most of my older patients are in pretty good shape. I have very few people with smoking or alcohol histories, little drug use. I end up doing a lot of procedures with my older patients (skin excisions, joint injections, etc). Then I keep track of garden variety health concerns like HTN, DM2, etc. not too many people with long med-lists.

all in all, I love this place and this job. I genuinely look for the weekends to end so I can get back to work rather than the other way around.
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Amazing you love your work so much!

what are your hours/day/week like?

also how many patients you see in a typical day/time per patient?

just wondering if satisfaction is correlated with time spent per patient
 
himomitsme said:
Amazing you love your work so much!

what are your hours/day/week like?

also how many patients you see in a typical day/time per patient?

just wondering if satisfaction is correlated with time spent per patient
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My hours are usually 8:30-4, I take a 2hr break for lunch. I live in town so I go home for it. Right now I work M-F, but I’m only required to do 4days/week, I chose to work Friday because I was getting bored having it off, and I missed work too much.

daytime patient load depends on the day. Usually it’s 18-20/day. 15-30 mins per visit. I don’t get that much actual time though because my MA’s need to room the patient. With that schedule, I’m averaging a hair under 600wRVU’s/month right now, I’m 2.5yrs in as attending.

I move fast, but I’m personable and can get along with almost anyone. I’ll also take extra time when needed. My patients know that I’ll take that time with them when and if they need it, even if it gets me running behind. I’ll then apologize to the next few as I catch up, and at this point the response is usually along the lines of “I know you were just doing what needed to be done, and would do the same for me if I needed it”.

My main issue that has been less fun at times is that I don’t suffer fools well. Mainly that manifests as me chasing off drug seekers and people violating pin contracts. I don’t start narcotics for chronic pain, or Benzos for anxiety, but I’ve inherited people already on them and have decided to continue rather than taper for the ones who seem to be thriving on them. But I’m strict, so I’ll terminate a contract without giving more than a small second chance. I’m going to do that today to a patient on Ativan who’s shown me she overuses (scrip not lasting as long as agreed) and who has taken up drinking while on the drug. I’m not looking forward to it, I’m sure it will get heated. But when you’re new to an area the druggies will try to get to you, and see if you’re weak or a push over, so in the first couple of years here, I’ve had to deal with a handful of people and dismiss them from my practice.

But a big advantage is that this being a small town, word travels and I don’t get many fools anymore.

I’d say that for me, more than time with patients, satisfaction comes from doing good work that people need, and recognizing the privilege I have to be filling such a vital need for an entire community.
 
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I did residency at Odessa/Midland. It isn’t bad. . . You are just 5 hours from El Paso, 5 hours from Dallas, 5 hours from San Antonio. My wife and I had a running joke that resturants were limited to 1/5, while we generally rank things 1-10. There isn’t much green. I saw a bunch of tumbleweeds. When it rained, it flooded. I-20 is one of the more dangerous stretches of highway in Texas (Lots of big trucks, lots of amphetamine use).

Big dependence on boom/bust from oil can markedly effect the regional economy. My rent at the 2 bedroom 1980’s apartment went from $1000 to $1400/month while a was a resident (Boom years as you can tell).

I have really fond memories from my time there. . . I just really don’t want to go back.
 
goldsummer said:
Anyone ever go on into a non-clinical position?
Curious what non clinical options there are out there
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Yes:
-Did a Public Health and Preventive Medicine fellowship (2 years). Now working as a public health physician medical director at a department of health (DOH). It is semi-clinical because it involves developing clinical guidelines for health policies, and resolving clinical issues that come to DOH. I enjoy being a public health physician, and I believe my fellowship prepared me very well for this job.
-I also have been working part-time as an urgent care physician in a practice made up of emergency medicine physicians. I like urgent care because I like helping people with their immediate health issues, and also like the quick procedures involved.
 
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