Any FP's who don't practice GYN?

[novacek88]

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The only aspect of family medicine that does not appeal to me is the GYN aspect. We all know of FP's who don't do obstetrics but do you know of any FP docs who don't do any gyn procedures like pap smears, breast exams etc? I have no desire to do any GYN but the peds and adult medicine aspect intrigue me. At the same time, I don't want to do a med/peds residency because of the duration and insensity of that residency.

What is your take?

 

[iatrosB]

I would love to know this as well.

 

[raptor5]

The last few family docs I had did not do any GYN. Mostly b/c there is a OB/GYN practice across the hall in the same building. My FP said that the offices share referrals back and forth and it works out well.

 

[thanks]

I was told by a physician that to break even with OB you'd have to deliver 60 babies per year - not profit, but just to break even due to malpractice. That's in AZ. May be different in other states.

 

[dr.smurf]

you dont have to do or practice anything you dont want to. thats the beauty of fp. several of our private fp attendings we admit for do not do any ob or gyn anymore. there are some that dont even do peds anymore. they just do adult medicine. many start out seeing and doing it all to build up the population base then tailor down to what they want to practice. the reasons are many....age, semi-retirement, litigation, etc. my personal fp doc back home sees women and does physicals on them but not the gyn portion. he advises them to get that done with their ob/gyn doc.

to give you guys examples of what you can do with fp let me share with you some of my senior residents (3rd years) career goals when they are done this summer.

hospice-1
hospitalist-1
urgent care-1
occupational med-1
traditional with hospital-2
outpatient fp only-1
sports medicine fellowship-1

 

[novacek88]

you dont have to do or practice anything you dont want to. thats the beauty of fp. several of our private fp attendings we admit for do not do any ob or gyn anymore. there are some that dont even do peds anymore. they just do adult medicine. many start out seeing and doing it all to build up the population base then tailor down to what they want to practice. the reasons are many....age, semi-retirement, litigation, etc. my personal fp doc back home sees women and does physicals on them but not the gyn portion. he advises them to get that done with their ob/gyn doc.

to give you guys examples of what you can do with fp let me share with you some of my senior residents (3rd years) career goals when they are done this summer.

hospice-1
hospitalist-1
urgent care-1
occupational med-1
traditional with hospital-2
outpatient fp only-1
sports medicine fellowship-1

Thanks for the thorough response. Yeah, obstetrics was out of the question but even GYN does not appeal to me. Gyn' has lawsuit written all over it. If you fail to diagnose cervical cancer or a lump in the breast, you are totally liable. And even skilled physicians can easily miss a small lump or misdiagnose cervical cancer. Then there is the sexual harrasment issue too. It just leaves too much of an opportunity for an unethical patient to exploit you. Maybe I'm paranoid but I would just rather avoid gyn altogether.

 

[banannie]

i'm just a med student, so correct me if i'm wrong, but i don't understand how you could practice primary care but not provide your patients with routine screening exams like pap smears and breast exams? those things seems like bread and butter for a FP. i would guess if you want to do FP, you'd have to suck it up and just do those exams (or hire a PA to do them all for you)

 

[novacek88]

i'm just a med student, so correct me if i'm wrong, but i don't understand how you could practice primary care but not provide your patients with routine screening exams like pap smears and breast exams? those things seems like bread and butter for a FP. i would guess if you want to do FP, you'd have to suck it up and just do those exams (or hire a PA to do them all for you)

Primary care involves a lot more than just two screening exams. Besides, if you are like me and you plan on practicing in a large city, most women prefer to seen an OB/GYN for their routine screening exams anyway. So in a large city, pap smears and breast exams are hardly bread and butter procedures for an FP.

 

[NuMD97]

Interesting thread. When I was on the interview trail, looking at all aspects of family medicine, criss-crossing the country as many of you are doing now, I found it a fascinating experience meeting with so many FP doctors. One program director in PA left me with an interesting impression: She frankly told me that the patients drive the practice. Whatever the needs of the community are, that seek your attention as a family physician, this is ultimately what you become expert in. In her case she ended up doing Women's Health. Apparently Peds just didn't come through the door.

Just some food for thought. To all of you currently applying in this year's Match, all the best,

Nu

 

[azcomdiddy]

Interesting thread. When I was on the interview trail, looking at all aspects of family medicine, criss-crossing the country as many of you are doing now, I found it a fascinating experience meeting with so many FP doctors. One program director in PA left me with an interesting impression: She frankly told me that the patients drive the practice. Whatever the needs of the community are, that seek your attention as a family physician, this is ultimately what you become expert in. In her case she ended up doing Women's Health. Apparently Peds just didn't come through the door.

Just some food for thought. To all of you currently applying in this year's Match, all the best,

Nu

Was this in a rural setting? I agree with the OP, I didn't see a lot of women's health issues in family practice due to the high numbers of OB/GYN physicians in the area? You are much more likely to see peds than gynecology in a family practice setting.

 

[novacek88]

Interesting thread. When I was on the interview trail, looking at all aspects of family medicine, criss-crossing the country as many of you are doing now, I found it a fascinating experience meeting with so many FP doctors. One program director in PA left me with an interesting impression: She frankly told me that the patients drive the practice. Whatever the needs of the community are, that seek your attention as a family physician, this is ultimately what you become expert in. In her case she ended up doing Women's Health. Apparently Peds just didn't come through the door.

Just some food for thought. To all of you currently applying in this year's Match, all the best,

Nu

Are there any OB/GYN in her town or city?

 

[spartanburg]

Personally, I wouldn't reccomend doing FP if you absolutely do not want to do GYN and breast exams.

Gyn' has lawsuit written all over it. If you fail to diagnose cervical cancer or a lump in the breast, you are totally liable. And even skilled physicians can easily miss a small lump or misdiagnose cervical cancer. Then there is the sexual harrasment issue too. It just leaves too much of an opportunity for an unethical patient to exploit you.

A valid concern, however, I would extend that concern to all organs not just breast and cervix. "Missing something" is a risk we all take as physcians, no matter what field we're in. The typical advice for avoiding law suits includes:
1. Always use a chaperone when doing GU and breast exams.
2. Always document thoroughly.
3. Most important of all, always be nice to your patients.

PGY-I 👍 👍 👍

 

[novacek88]

Personally, I wouldn't reccomend doing FP if you absolutely do not want to do GYN and breast exams.



A valid concern, however, I would extend that concern to all organs not just breast and cervix. "Missing something" is a risk we all take as physcians, no matter what field we're in. The typical advice for avoiding law suits includes:
1. Always use a chaperone when doing GU and breast exams.
2. Always document thoroughly.
3. Most important of all, always be nice to your patients.

PGY-I 👍 👍 👍

If it was not for the Peds aspect of family medicine, I would do internal medicine in a heartbeat. I appreciate the feedback but I still fail to see why one couldn't practice family medicine and simply refer all the GYN out.

 

[spartanburg]

If it was not for the Peds aspect of family medicine, I would do internal medicine in a heartbeat. I appreciate the feedback but I still fail to see why one couldn't practice family medicine and simply refer all the GYN out.

You can, but it would be very difficult to do. You're going to have to do GYN in a FP residency regardless.

I'm not sure if insurance companies will pay you for preventative visits for your female patients if you don't do breast and pelvic exams. Does someone know how that would work?

PGY-I 👍 👍 👍

 

[iatrosB]

I know you said you didn't want to go into it because of the residency, but maybe med/peds is the way to go for you. It seems to be exactly what you are looking for.

 

[NuMD97]

Was this in a rural setting?

No, it was outside Philadelphia.