Any internal medicine docs in primary care?

[lost777]

Just want to here stories of IM docs who went into primary care.

Are you happy in outpatient primary care? Did you always want to do it, or did you kind of end up there?

If you had to do it all over again, would you do IM again to get to primary care or FM?

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[medbeewedme]

Bump.

 

[PlutoBoy]

Just want to here stories of IM docs who went into primary care.

Are you happy in outpatient primary care? Did you always want to do it, or did you kind of end up there?

If you had to do it all over again, would you do IM again to get to primary care or FM?

I'm very happy in outpatient primary care. This was the best decision I ever made for my career.

I ended up in primary care after realizing how much hospital medicine sucked for me.

I make about $20,000 less as a primary care doc than I did as a hospitalist. The trade off is worth it, IMO.

I wouldn't necessarily do FM. I would spend more time in sports medicine as opposed to the ICU/CCU. Maybe throw a little more derm into the mix.

 

[GastriqueGraffin]

Many IM residents in community programs become PCPs. Many that I know are really happy with it and wanted to do it from the beginning.

 

[Lccjblu]

To answer your question, plenty of IM residents go into primary care. Versus someone that trained FM, you would not be able to care for pediatric patients and would not get exposure to much if any OB during training. This may be an issue if you want to do rural primary care where you are the only provider for miles.

The benefits of going through IM residency for a PCP career is that you will have many more career options should you decide that PCP is not for you.

 

[DoubleBogey]

I’m one of the uncommon IM trained PCPs. I didn’t do FM as I have no interest in peds/obgyn, and wanted the options to specialize if my mind changed down the rd. I do outpt throughout the wk, inpt every other weekend for coverage, starting nursing homes next month.

I’m familiar with outpatient medicine when growing up and so it was comfortable/familiar. I like inpt as well with fast results and working up conditions (pays better as well).

I like the general flow of outpatient and check-up with management of chronic conditions and preventative medicine. However, outpt can be a grind, some pts are time burglars and some will just drain you every time (20-30yo who always have a complaint gets old fast). The stressful part of outpatient is some ppl can downplay stuff, not look “sick” when you see them, the other day I see someone for an acute visit for sinus congestion, then after further questioning they give a h/o progressive SOB , do an EKG and their in complete heart block that’s new. **** like that could easily have been missed.

So navigating through the bull**** is a challenge, and I certainly feel my IM training has given me a strong foundation in evaluating and working up ppl.

It’s a treadmill though - unless you have decent volumes which takes time as outpt (or supplement w/inpt) your compensation, on avg, will not touch a procedural based speciality. I’m not saying you can’t make money in primary care, it’s out there, just not as easy as other specialities.

Good luck!

 

[medbeewedme]

I’m one of the uncommon IM trained PCPs. I didn’t do FM as I have no interest in peds/obgyn, and wanted the options to specialize if my mind changed down the rd. I do outpt throughout the wk, inpt every other weekend for coverage, starting nursing homes next month.

Is it common to have so much variety anywhere or do you have to be in a particular part of the country to be able to do outpt, inpt coverage, and nursing homes? Sounds like a great deal!

I've noticed more IM primary care tracks cropping up (and movement toward the X+Y system).

Does anyone have any personal perspective on whether some/most/all of these PC tracks are really preparing you for some of the "bread and butter" of outpatient med that inpatient IM does not? (i.e. outpatient procedures, well-women/annuals, basic psych care, preventative medicine)

I feel an even split btw FM and IM right now after reading through every single thread about it on this forum. Fairly confident that primary care is calling me, but I want to be thoroughly prepared to deal with adult patients with or without multiple co-morbidities AND I feel neutral toward OB or peds (probably would not seek out these patients in practice). How can I get awesome adult-only (including lady bits) outpatient training?

Any experiences from primary care physicians appreciated!

 

[the argus]

There's a bunch of stand alone Primary Care IM programs, here's just a few in the NE alone,
NYU Primary Care Residency Program | Department of Medicine
Home > Residency Training Program: Primary Care | Internal Medicine | Residency Training Programs | Yale School of Medicine
Primary Care Residency Program - Overview
Our Program | Internal Medicine Residency

and nowadays most traditional IM programs have primary care tracks where you are set-up for specific electives, etc.

And even if you go to an IM program that doesn't have a specific track, you can always choose electives to get the training you want (gyn or psych elective).

You'll learn plenty of bread and butter outpt medicine during your clinic in residency (if you want to). Most programs provide sufficient outpt training, it's just that many IM residents have no interest and view clinic as a nuisance.

 

[CatFactorial]

Is it common to have so much variety anywhere or do you have to be in a particular part of the country to be able to do outpt, inpt coverage, and nursing homes? Sounds like a great deal!

I've noticed more IM primary care tracks cropping up (and movement toward the X+Y system).

Does anyone have any personal perspective on whether some/most/all of these PC tracks are really preparing you for some of the "bread and butter" of outpatient med that inpatient IM does not? (i.e. outpatient procedures, well-women/annuals, basic psych care, preventative medicine)

I feel an even split btw FM and IM right now after reading through every single thread about it on this forum. Fairly confident that primary care is calling me, but I want to be thoroughly prepared to deal with adult patients with or without multiple co-morbidities AND I feel neutral toward OB or peds (probably would not seek out these patients in practice). How can I get awesome adult-only (including lady bits) outpatient training?

Any experiences from primary care physicians appreciated!

Einstein supposedly has a good primary care track. Your use of bold makes me think you’re more of a bagel and cream cheese medicine person, savvy?