Can Emergency Docs work in private practice?

[ASDIC]

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Can EPs work in say a private clinic just like FPs, IM docs and Peds docs? or is it mandatory for them to work in an emergency setting (in the ER of a hospital)?

 

[deleted6669]

YUP- any doc who has completed an internship and usmle step 1-3 can call themselves a general practitioner and open an office. whether or not they can get insurance reimbursement or hospital privileges without being board certified is another story...but a cash only practice, sure.

 

[deleted109597]

It's pretty easy to do urgent care doc-in-a-box stuff with as an EP. So I've heard.

 

[ForbiddenComma]

What about in a standard type of clinic environment, with regular patients?

 

[J.J.]

What about in a standard type of clinic environment, with regular patients?

Again,Yes, anyone who had completed their intern year is able to open a general clinic if they so choose. You do not have to complete a residency in order to open a general practice clnic, however reimbursment and hospital privilages are qustionable.

 

[BadVB750]

The real question is why would you want too? Most of us go into EM cause we hate the thought of clinic or rounding. Actually, I am starting to feel ill just thinking about it. But, to answer your question; you would be better off doing EM/IM if you have hopes of working in a clinic one day.

 

[Aloha Kid]

The fact of the matter is that we will always continue to have EM trained physicians who choose not to practice in the ED. The ED, is definately not somplace you can relax and let your guard down. You have to get yourself pumped every time before a shift. Factor in all the other ED stressors, and it can be tough to be doing what you're doing at age 50.

There are many opportunities in the specialty of EM to focus on other areas. Administration is a big one. Most of the EM trained physicians at my hospital who are older have some sort of administrative position enabling them to cut down on the amount of shifts. Many of the higher ups don't even do shifts anymore.

We all have this "forever young", "One path only", mentality as young physicians, residents, and students. Although many of us will be practicing EM like we do now at age 50, I also believe many of us will be doing something else. I think it is a perfectly valid thought that some of us will also have our own general practice offices M,W,F 6 hours a day or something crazy like that. The filed of EM is very open like many other specialties. It is also evolving to include and define many of its own subspecialties. I personally don't know where I'll be at age 50. Hopefully retired, maybe in an office, maybe in the ED. Who knows?

 

[docB]

Another important question, actually the most important question is should they. EPs are not trained in primary care. We're not trained to manage diabetes, hypertension, COPD and so on long term. If we are going to make the argument that only BC EPs whould staff EDs than we need to recognize that EPs should not be doing primary care.

 

[EctopicFetus]

Another important question, actually the most important question is should they. EPs are not trained in primary care. We're not trained to manage diabetes, hypertension, COPD and so on long term. If we are going to make the argument that only BC EPs whould staff EDs than we need to recognize that EPs should not be doing primary care.

👍

 

[Miami_med]

Another important question, actually the most important question is should they. EPs are not trained in primary care. We're not trained to manage diabetes, hypertension, COPD and so on long term. If we are going to make the argument that only BC EPs whould staff EDs than we need to recognize that EPs should not be doing primary care.

I don't know, there are a number of NPs basically practicing primary care. I would think it would depend on the scope of practice, as the EP isn't as adept as the FP with the broad scope of outpatient or inpatient practice. I wouldn't really want an EP following my electrolyte trends in the ICU (without extra training), but I think that basic outpatient care could be done relatively efficiently with some brushing up. If anything, the EP may be better at recognizing warning signs for exacerbation of many of these chronic ailments.

What really ought to be available is some sort of fellowship in outpatient medicine for those that are interested. Of course, that will inevitable start a turf war.

 

[Faebinder]

I don't know, there are a number of NPs basically practicing primary care. I would think it would depend on the scope of practice, as the EP isn't as adept as the FP with the broad scope of outpatient or inpatient practice. I wouldn't really want an EP following my electrolyte trends in the ICU (without extra training), but I think that basic outpatient care could be done relatively efficiently with some brushing up. If anything, the EP may be better at recognizing warning signs for exacerbation of many of these chronic ailments.

What really ought to be available is some sort of fellowship in outpatient medicine for those that are interested. Of course, that will inevitable start a turf war.

Really? You want a one or 2 year fellowship that makes you set to do outpatient long term management.... Some people like to call that a PGY 2 spot in Internal Medicine or Family Practice... shouldn't be hard for someone who got into EM to get into.

 

[EctopicFetus]

I don't know, there are a number of NPs basically practicing primary care. I would think it would depend on the scope of practice, as the EP isn't as adept as the FP with the broad scope of outpatient or inpatient practice. I wouldn't really want an EP following my electrolyte trends in the ICU (without extra training), but I think that basic outpatient care could be done relatively efficiently with some brushing up. If anything, the EP may be better at recognizing warning signs for exacerbation of many of these chronic ailments.

What really ought to be available is some sort of fellowship in outpatient medicine for those that are interested. Of course, that will inevitable start a turf war.

FWIW EM docs do more ICU time than Fp.. not to belabor this topic but if you want outpatient clinics and continuity of care do primary care. I dont think it is that difficult to figure out.

 

[deleted6669]

"I don't know, there are a number of NPs basically practicing primary care."

sorry to state the obvious but their training is in primary care, thus the title family nurse practitioner......they do min training in er/icu/surg but spend most of their time in fp, im, peds, gyn, psych,etc......

 

[deleted87716]

"I don't know, there are a number of NPs basically practicing primary care."

There are midlevels in the ED, too. They're not any more equivalent to physicians there than they are in primary care.

 

[deleted6669]

kent- that is miami meds quote. I was just responding to it.
but since you brought it up....an experienced em pa knows more emergency medicine than an fp doc who only does fp clinic work. that is why they pay me significantly more/hr than the fp docs who moonlight in my dept.....
the only doc who knows more em than an em pa is an em physician( and yes, an fp doc who works full time in em meets my definition of an em doc for purposes of this discussion).

 

[Miami_med]

There are midlevels in the ED, too. They're not any more equivalent to physicians there than they are in primary care.

You misunderstood me. I wasn't saying NP=FP. That is why I said that it depended on scope of practice. There is plenty of outpatient work that an EP could do. I am not downing what you do in any way Kent. I have always said that I respect PCPs.

 

[Y2KPSD]

YUP- any doc who has completed an internship and usmle step 1-3 can call themselves a general practitioner and open an office. whether or not they can get insurance reimbursement or hospital privileges without being board certified is another story...but a cash only practice, sure.

What kind of medical license can you get after USMLE 1-3 & 1 yr internship?
Unrestriced? or some other limited license?

I understand getting insurance yourself & getting on provider's plans is probably the issue.

 

[deleted87716]

an experienced em pa knows more emergency medicine than an fp doc who only does fp clinic work.

But of course. And an FM doc knows more FM than an EM doc, an EM PA, or an FM PA. 😉

There's a general tendency amongst many specialists to presume than any idiot can do primary care. Those of us who actually do primary care know that it's not at all easy to do it well. Witness the occasional specialist who goes into semi-retirement as a primary care or urgent care doc. God help them, and their patients. Primary care requires specialized knowledge, no differently than any other field. The fact that this knowledge is of a general nature in no way diminishes the challenge. In fact, I think it's the opposite.

You misunderstood me. I wasn't saying NP=FP. That is why I said that it depended on scope of practice. There is plenty of outpatient work that an EP could do. I am not downing what you do in any way Kent. I have always said that I respect PCPs.

I know, and I appreciate that. I'm not trying to sound defensive here, as I'm personally not the least bit threatened by people who think they can do my job with less training and ability. Let 'em try. 😉

 

[deleted6669]

"But of course. And an FM doc knows more FM than an EM doc, an EM PA, or an FM PA.


no arguement there.

 

[bartleby]

Urgent care is one thing, but primary care medicine is quite different that we learn as EP's.

...but I think that basic outpatient care could be done relatively efficiently with some brushing up.

I am a while from having to consider this personally, but I would find it more palatable and lucrative to cut my hours way back and keep working as an EP than it would be to work in a clinic, and likely more lucrative, at that.

 

[BeardieDoc]

I was trained in Emergency Medicine. I see tons of cases in the ED that could have been handled in an office setting, thats all the primary care exposure I need.