I'm finding a primary care physician to shadow at a local hospital. So far I've been looking at the Internal Medicine and the Pediatric Departments. Are there any other ones? If the doctor is a Pediatric Cardiologist is that still primary care or is it too specialized?
Stupid question...What exactly counts as primary care?
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This article would include the following in primary care: general internal medicine, general pediatrics, internal medicine subspecialties, pediatrics subspecialties, family medicine, and obstetrics–gynecology.
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Primary care basically entails any doctor that a patient goes to initially with a complaint. So this would be a family practitioner, a general internist, a pediatrician. ED physicians also fall under primary care, though in a different setting. If you're having, say, heart palpitations, you'll see your FP/internist/whatever first. Then, if they can't diagnose you, they'll refer you to a cardiologist (a specialist).
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It's usually just internal med, pediatrics and family med. Gynecology is starting to be considered primary care, though some insurance companies it doesn't.
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Interesting Maubs. I guess the answer depends on what you're doing with the information. For the purposes of shadowing a primary-care practitioner, then a pediatric specialist like pediatric cardiologist would not count since the point of shadowing a PCP is so that you see a wide variety of complaints. It's a good broad-based clinical exposure.
If you are designing a research study, then the answer could include pediatric cardiology, it seems.
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I asked my dad about this (he's an OB/GYN). He said that it is considered primary care for most insurers because women don't like to be told that they need a referral to go see their gynecologist. Since you usually don't need a referral, it's seen as primary care.
In his hospital, they just call it "women's health" now
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Makes complete sense and I agree with it. A GP or internist isn't as well equipped to deal with "women's health" issues as is the OB/GYN.
No offense to women. But you're complicated.
A few extra years of residency and learning more, will benefit the level of/quality of care you receive. Residency might suck the big one from I've been told. But you learn, more than you ever thought you could.
Internal and family may provide you some of the problems that are common. But not the rare stuff that would go misdiagnosed, if you didn't know about it firsthand.
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Yeah, I only tossed the reference in there because you beat me to the post.
For the OP's purposes, I'd look at general IM, FM, peds (not peds subspecialties), and gyn.Oh interesting, I didn't know OB/GYN counted. thanks
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I've been wondering why EM isn't really primary care, when it's essentially a faster paced, intense version of general practice minus the continuity of care. Must be the last thing...
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I'd guess it's because of the lack of continuity of care. EM docs should never be your "primary" source of medical care (although much of the public does not see it this way). To call EM "primary care" undermines its purpose, which is to be an alternative source of care for when a primary care provider is not immediately available. Notice that the other primary care specialties are all generally entry-level for the pt -- they are long-term/consistent providers a pt would schedule an apt w/ who have a very broad range of expertise and can appropriately refer out as needed. An EM doc can fulfill those needs but fails on the criteria of appointments/scheduling and consistency.
I think one could say that in an ideal world, EM is NOT primary care. In our current healthcare climate, however, it probably is very much primary care (functionally, anyway).
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Yeah, I know I'd argue that EM is primary care...though it's not always classified as such. The ED deals with the initial complaint and then sends the patient off to someone else if it isn't something they can treat or manage. Seems like primary care to me. Plus, any ED physician would tell you that they see plenty of people over and over again.
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Yeah I agree with both of the above. Totally true about the repeats Smiter, I've gotten that from EM docs myself.Yeah, I know I'd argue that EM is primary care...though it's not always classified as such. The ED deals with the initial complaint and then sends the patient off to someone else if it isn't something they can treat or manage. Seems like primary care to me. Plus, any ED physician would tell you that they see plenty of people over and over again.
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Yeah I agree with both of the above. Totally true about the repeats Smiter, I've gotten that from EM docs myself.
Yeah... I give my repeat pts so much grief about that! (In a joking manner, of course.) Some pts just don't seem to get it. I bet 50-70% of my pts on any given day in the ED don't have a PCP.
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Makes complete sense and I agree with it. A GP or internist isn't as well equipped to deal with "women's health" issues as is the OB/GYN.
No offense to women. But you're complicated.
A few extra years of residency and learning more, will benefit the level of/quality of care you receive. Residency might suck the big one from I've been told. But you learn, more than you ever thought you could.
Internal and family may provide you some of the problems that are common. But not the rare stuff that would go misdiagnosed, if you didn't know about it firsthand.
A FM resident said that originally she wanted to go ob/gyn and focus on "women's health," but that whole operating part just didn't sit well with her and hence family medicine.
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Here's my advice.
1) Private offices are easier than a hospital setting, and usually easier than clinics
2) Offices/clinics farther away from a big university are easier
3) Be willing to accept rejection and move on. Cold calling is rough, don't be surprised if it takes 10+ offices in order to find someone
4) Ask around. If you've already shadowed a doctor in a speciality, then ask if he or she knows a PCP you can shadow. Also, the normal advice of asking family and close friends about their own doctors
5) Be persistent. I ended up calling one place about 6 or 7 times. I finally got to do it, a month and a half later. It took a while to talk to the right person (usually the office manager), and she told me that the doctor already had a shadow for the next month. So I called a month later, I told her that I had talked to her a month earlier about it, and I was able to start shadowing soon thereafter. I'm convinced that my persistence convinced her that I was serious.
6) Always be courteous and polite, even when you're rejected
7) Be very flexible if your schedule allows it. If they ask you "How much were you looking to shadow?" I would recommend saying "I'm looking to get a good exposure to the field. What do you recommend?" or "How long do you normally have students shadow?" etc.
Other people have recommended dressing up in business casual, and visiting offices and clinics to show them you're a normal person and that you're dedicated. I never had to do this and I ended up getting 33 hours of PCP shadowing (family med and peds)
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Quick question:
From a cost/benefit point of view, what's the "benefit" that the private clinic physician gets from letting you shadow him? I mean some costs to him are: he has to ask patients if they are willing to let someone else in the room (confidentiality issues), patients are there to see the MD not some volunteer, etc.
What I'm really asking, is how can I approach a physician in a way that can maybe be a little more beneficial to him rather than just someone who's gonna be observing and maybe get in the way? Plus, as you shadowed, this is just clinical exposure right? No patient interaction that you got here?
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It's an ego stroke for some to have someone shadow them. Others like to teach. Others find scut you can help them with. Others feel they need to pay it forward because they were in your position once.
As far as your last question, I'm not sure what you are saying. Clinical exposure without patient interaction is pretty meaningless. To get any sort of value for med school you had better be getting patient interaction, or at least observing the doctor patient interactions.
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Reason I asked that is this: My parents asked me, if they were a doctor, why should they LET me shadow them. Or in other words, how could I make their day-to-day or 1 hour of letting me shadow them "better" than if they didn't let me shadow them.
And I asked for doctor shadowing, how can you get much patient interaction if you are just observing doctor-patient interactions?
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Primary physicians are the first person you see when you get sick, unless it was something that required immediate hospitalization (ex. myocardial infarction). A specialty is just that - a special focus on one organ system or a couple of closely-related systems. A pulmonary pediatrician focuses on the lungs of children and they usually deal with genetic lung diseases such as cystic fibrosis.
