California FM Outpatient Clinics

[dabears405]

Hi everyone,

As a 3rd year medical student, Ive been deciding if I should pursue FM. I like outpatient FM clinic, but was curious as how the lifestyle of outpatient clinics specifically in California? I prioritize lifestyle over anything, but of course have always been a hard worker. Is it possible to have a good lifestyle (i.e. take vacations every year etc) as an outpatient FM doc at the cost of salary? I'm not that knowledgeable about attending life so perhaps someone can fill me in if they've been happy with their life as an outpatient FM doc.

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[QueenJames]

Hi everyone,

As a 3rd year medical student, Ive been deciding if I should pursue FM. I like outpatient FM clinic, but was curious as how the lifestyle of outpatient clinics specifically in California? I prioritize lifestyle over anything, but of course have always been a hard worker. Is it possible to have a good lifestyle (i.e. take vacations every year etc) as an outpatient FM doc at the cost of salary? I'm not that knowledgeable about attending life so perhaps someone can fill me in if they've been happy with their life as an outpatient FM doc.

M-F, 16-20 patients a day for 220K+ salary with no call or weekends all over the state.

It's ridiculous.

 

[dabears405]

M-F, 16-20 patients a day for 220K+ salary with no call or weekends all over the state.

It's ridiculous.

I heard a lot of the time, you bring home work, worrying about patients/orders/labs etc. Can you really have a life outside medicine with outpatient FM?

 

[deleted87716]

I heard a lot of the time, you bring home work, worrying about patients/orders/labs etc. Can you really have a life outside medicine with outpatient FM?

Family Medicine is the ultimate lifestyle specialty.

That being said, you couldn’t pay me enough to live in CA.

 

[IntheClouds4ever]

I heard a lot of the time, you bring home work, worrying about patients/orders/labs etc. Can you really have a life outside medicine with outpatient FM?

16-20 patients is a relatively light load and you should be able to have charting done by end of day (this being said after being in clinic with attending seeing 15-19 patients/day.)

Why worry about any labs or orders? There’s nothing you can do once you press “send” and if anything is critical, the lab will call you (if they don’t, then set it up that way if you desire). Imo, that’s an acquired emotional aspect of any sector of medicine that you have to learn with experience. Outpatient FM has about the best lifestyle you could get in medicine with the exception of Derm..

 

[KeikoTanaka]

General question, not necessarily in regards to California, but lets say you were to go interview at a place that was like "M-F" 8-5... But you wanna do only M-Th 9-4... (hypothetical) how much say would you have in being able to make this definitive? Obviously it depends on the location I'm sure, but with FM being in such a hot commodity right now, will employers do their best to try and appease you?

 

[QueenJames]

General question, not necessarily in regards to California, but lets say you were to go interview at a place that was like "M-F" 8-5... But you wanna do only M-Th 9-4... (hypothetical) how much say would you have in being able to make this definitive? Obviously it depends on the location I'm sure, but with FM being in such a hot commodity right now, will employers do their best to try and appease you?

To be "full-time" that is usually 40 hours a week.

Your hypothetical situation is only 7 hours a day X 4 days ---> 28 hours a week.

Employers will probably not give you benefits.

You can do locums instead and make ur own schedule.

Plenty of work to go around in primary care.

 

[mabinante]

Opened a DPC in So cal out of residency. Average 6 patients per day. $200k+. 5 days a week. 1 month off a year. Life is amazing.

 

[VA Hopeful Dr]

To be "full-time" that is usually 40 hours a week.

Your hypothetical situation is only 7 hours a day X 4 days ---> 28 hours a week.

Employers will probably not give you benefits.

You can do locums instead and make ur own schedule.

Plenty of work to go around in primary care.

Yep. Most places will let you do one half day off per week (36 hours) and still be full time. If you get busy enough and are bringing in enough money, you can sometimes get to 4 days/week 8-5.

 

[FrustratedFamDoc]

If you only want to worry about your patients during office hours, primary care is probably not for you.

With that said, I may get called after hours 4-5 times a month during the week and share call with 5 other family docs in the area. Phone call only. Most calls I've ever taken over a weekend is maybe 8. I'm in the Southeast but am pretty sure California isn't much different.

Unless you're seeing all private insurance, I don't see how you can see <20/day 4.5 days/week (in a traditional OP practice) and and make over $200k without subsidization coming from somewhere.

 

[VA Hopeful Dr]

If you only want to worry about your patients during office hours, primary care is probably not for you.

With that said, I may get called after hours 4-5 times a month during the week and share call with 5 other family docs in the area. Phone call only. Most calls I've ever taken over a weekend is maybe 8. I'm in the Southeast but am pretty sure California isn't much different.

Unless you're seeing all private insurance, I don't see how you can see <20/day 4.5 days/week (in a traditional OP practice) and and make over $200k without subsidization coming from somewhere.

Easy.

19 patients/day is 85.5 patients per week if working 4.5 days. We'll round down to 85.

1.4 wRVU per patient is what I'm running these days. So 119 wRVU/month.

Let's assume 48 weeks per year. That's 3 weeks off and holidays. 5721 wRVUs.

I get paid $40/wRVU so 228.5k/year.

 

[deleted87716]

Unless you're seeing all private insurance, I don't see how you can see <20/day 4.5 days/week (in a traditional OP practice) and and make over $200k without subsidization coming from somewhere.

Depends what you mean by "subsidization." If you're part of a private multispecialty group, you have access to income streams from ancillaries, payer bonuses, profit sharing, etc. That's money the group has earned collectively, however, so it's not exactly "subsidization." In a health system with salaried docs, administration will be scooping most of that up. Practically all of the primary care docs in our group make >$200K, and more than a few make >$300K. I average 20-25 patients/day, and work four days/week (and I'm Medicare-heavy).

 

[KeikoTanaka]

Easy.

19 patients/day is 85.5 patients per week if working 4.5 days. We'll round down to 85.

1.4 wRVU per patient is what I'm running these days. So 119 wRVU/month.

Let's assume 48 weeks per year. That's 3 weeks off and holidays. 5721 wRVUs.

I get paid $40/wRVU so 228.5k/year.

How do you increase your wRVU per patient? Just by working for more years, having more experience? Or does it all come down to the contracts you work out

 

[VA Hopeful Dr]

How do you increase your wRVU per patient? Just by working for more years, having more experience? Or does it all come down to the contracts you work out

RVUs are entirely dependent on coding: Understanding Medical Bills: What Relative Value Units (RVUs) Mean

 

[Shufflin]

16-20 patients is a relatively light load and you should be able to have charting done by end of day (this being said after being in clinic with attending seeing 15-19 patients/day.)

Why worry about any labs or orders? There’s nothing you can do once you press “send” and if anything is critical, the lab will call you (if they don’t, then set it up that way if you desire). Imo, that’s an acquired emotional aspect of any sector of medicine that you have to learn with experience. Outpatient FM has about the best lifestyle you could get in medicine with the exception of Derm..

This comment is outdated by about 5 to 8 years.

 

[VA Hopeful Dr]

This comment is outdated by about 5 to 8 years.

How so

 

[IntheClouds4ever]

This comment is outdated by about 5 to 8 years.

If you’re in FM and complaining about lifestyle, you aren’t doing something right. Due to the excessive need of PCPs (especially rural) most employers are going to bend over backwards to accommodate your required strings for employment. This is true to most of the area of my state (excluding major metropolis areas).

 

[deleted87716]

This comment is outdated by about 5 to 8 years.

Um...no.

 

[Shufflin]

Um...no.

Tell me how FM is a lifestyle specialty especially in a congested region as California?

Due to reimbursement cuts, Derm has had to ramp up the number of patients seen in a day to keep up. They're some of the busiest doctors I know.

 

[deleted87716]

Tell me how FM is a lifestyle specialty especially in a congested region as California?

Due to reimbursement cuts, Derm has had to ramp up the number of patients seen in a day to keep up. They're some of the busiest doctors I know.

Can't speak to CA. You couldn't pay me enough to live there. Elsewhere? We're good, bro. Unless, of course, you work for The Man or don't know WTF you're doing. In which case, your specialty doesn't really matter.

 

[Shufflin]

Can't speak to CA. You couldn't pay me enough to live there. Elsewhere? We're good, bro. Unless, of course, you work for The Man or don't know WTF you're doing.

I agree that FM in a rural setting does enjoy much more leverage with employers.

 

[deleted87716]

I agree that FM in a rural setting does enjoy much more leverage with employers.

Multispecialty groups will do the same in more populous areas.

 

[Shufflin]

By the way, other specialties have emerged over the past 5 years that are much more lifestyle friendly.

The old ROAD to happiness no longer applies as it did 10 years ago.

 

[KeikoTanaka]

By the way, other specialties have emerged over the past 5 years that are much more lifestyle friendly.

The old ROAD to happiness no longer applies as it did 10 years ago.

like what