do you find family medicine boring?

[png-girl]

hi, i am just about to start med school and so i always get the question, what kind of doc do you want to be, and i think i want to do family medicine. i am really interested in disease prevention, health promotion and i wouldn't mind working in a rural area, for example, the catskills in upstate ny. i was just wondering if those of you who are family docs, if you get bored, or sick of seeing people with colds and things.

what do you like about being a family doc, and what do you dislike? thanks for the info.

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[DrMom]

I'm going to respond generally.

Every specialty has things that the docs see over and over again. Don't let that deter you from a particular specialty. Spend time with rural family practice docs and see if you like it.

 

[Mad Scientist]

I'll second DrMom's comments...with the increased specialization of medicine, many doctors see only a small number of related conditions. In my experience, for example, most surgeons (even general surgeons) have 5-6 "bread and butter" surgeries that they spend 80-90% of their time on, and maybe a dozen more less common surgeries make up the remainder. Same thing for medical specialties; usually 80-90% of their patients have one of a very small number of conditions.

(Of course, consider what this means...if the average doc sees 30 patients on a clinic day, still 3-4 will probably have something outside of the "bread and butter" diagnoses for that specialty.)

I used to think FP would be boring, seeing nothing but runny noses all day...probably because that's the only thing I ever went to our family doc for while growing up. But as it turns out, a good primary care physician who spends time listening to his patients will end up with more variety than any of the specialties. He will even have to know a fair amount about the diagnoses outside of the range of treatment for a family practitioner, since a crucial part of primary care is the ability to make a good referral or consult. I believe I read somewhere that the top 40 diagnoses in primary care make up only about 80% of the patient visits...far more variety than in a more highly specialized field.

 

[png-girl]

that's a good point, i never thought about it that way. i really want to get to know my patients and their families and things like that, so i that is why i think family medicine is suitable to my desires. although, being that i haven't even started school i have a long time to decide any of that, and will probably change my mind.

it's just kind of scary embarking on this path. hopefully it will be well worth it and i will end up where i am supposed to be.

 

[jekel]

Originally posted by png-girl
that's a good point, i never thought about it that way. i really want to get to know my patients and their families and things like that, so i that is why i think family medicine is suitable to my desires. although, being that i haven't even started school i have a long time to decide any of that, and will probably change my mind.

it's just kind of scary embarking on this path. hopefully it will be well worth it and i will end up where i am supposed to be.

I feel the same way.

 

[secretwave101]

Relax for now, and have fun learning about the differences between all the specialties. Until 3rd year, everything is mostly speculation anyway. No matter how much you THINK you'll like one thing, you won't really know until you do it.

I have 3rd year friends who completely changed their minds after working in the specialty they thought they'd love. Others never changed. You won't know until you get the chance to try it.

 

[png-girl]

don't worry, i'm relaxed, not at all stressing over this and am just psyched that i can go to school. i was just looking for some opinions of how people like thier job, i just want to see what people who have been doing it for years like or dislike about thier work. some stories, you know? i'm not the supercompetetive person who looks at match lists when they haven't begun school. that's not me. i'm not the tenth grader who posts on the pre allo forum, looking to see how hard it is to get into med school.

ok, so if there is anyone out there who is a real family doc and has some anecdotal stories, i'd love to hear them. thanks

 

[gungho]

Have been in practice in FP for 17+yr, so I'm approaching dinosaur status but have enough functional gray matter to remember school/residency days. From my perspective, FP is one of the most challenging specialties due to its breadth. There is so much to keep up with. The flip side of that is that because of its breadth, you can pick certain area you like and focus more on that area, plus there are many other vocational permutations you can get into-administration, etc.

 

[SDN]

I've been practicing for just 3 years since my residency. I really love it. FP is one of those specialties where you to see such a variety of cases and patients that you could never get bored. Sure, I see my fair share of patients with routine sinus infections and bronchitis, but each day I also diagnose and treat patients with fascinating pathology and disease processes.

I also like being a family doc because I can do just about anything. The flexibility is unbelievable. I can be a hospitalist, an office-based physician, or do a combination of both. I focus on geriatrics and adult medicine, and don't do OB (hate the hours) or kids under age 5 (hate the screaming).

However, I know other local FPs that only do OB and women's health. I know others that only do preventive medicine, another that does just sports medicine, and a number of FPs that do academic research and teaching. You can do what you enjoy.

If you'd like to do additional sub-specialty training, FPs can do additional fellowships in geriatrics, sports med, or obstetrics.

So what don?t I like about FP? There are 2 things I don?t like:

1. The massive amount of paperwork required for insurance companies (for prior auths, referrals, billing, etc.). It's truly ridiculous. In the past, all a doc needed was a receptionist/biller and a nurse. Thanks to HMOs, now my 4 physician office has an average of 5 staff members for each physician (this includes: front office staff, nurses, a referrals coordinator, medical records staff, and billing and management staff).

2. The pay is lower than most procedure-oriented specialties (surgery, interventional radiology, etc). However, I know many local FPs that easily make in the 250,000-350,000/year range.

 

[png-girl]

i think i want to work in a small town, but i also want to be involved in the community with preventative medicine. do any of you aout there do that? i like the fact that you can do what you want in family medicine.

 

[Jim Henderson]

Every rotation during medical school eventually bored me, but I liked all of them.

That's what's great about FP.

However, with variety also comes risk.

Part of being a family doc is knowing some of everything, lots about basic, common ailments, and where to get information about less common entities and when to refer.

It's less boring than most fields I think.

There are patients that are frustrating because:
1. many have chronic conditions that I can't cure but they think I can.
2. many patients need a psychiatrist more than me but won't see one because of the stigma
3. Most patients who over-use the system are uneducated and or seeking disability and or drugs.

I'm very good at what I do, and that's not immodesty but confidence. I'm not sure I would do medicine again. However I am sure I would not do any other field.

 

[HappyFP]

Boring??? I haven't had a boring day of being a family physician during my entire career since 1991 ! The problem with Family practice is exactly the opposite--too many opportunities to grow into things I never thought I'd be doing. I work and teach 50% in an inpatient medicine / ICU in a very busy hospital in California, 20% time in my own Family Pracitce Clinic (the most challenging site of my work by far), and 20-30% teaching in Family practice clinic and doing hospital administration / leadership stuff.
FP's can be useful in so many different settings. I have FP friends who work full-time in emergency rooms, on labor and delivery, in itegrative health clinics, in migrant farm clinics, in ICU's, assisting in the OR, running complex organizations....the sky is truly the limit. DON'T EVER BELIEVE A WORD YOUR MEDICAL SCHOOL SUBSPECIALTY FACULTY TRY TO BRAINWASH YOU WITH---they tried to brainwash me too "you'll only be wiping people's noses, you'll be a glorified nurse, you'll be bored and burned out in 2 years, you have too much talent to waste your time doing FP garbage, be a real doc be a surgeon, go into medicine at least they're smart, you can only work out in the boonies in family practice...and on and on). Part of me believed them for a while until I learned what so many FP's are doing--particularly those who dedicated themselves to the underserved.
The underserved are underserved throughout the healthcare system...not just in clinics...but ICU's emergency rooms, OR's, inpatient wards, etc. The underserved provide ample human experience as well as complex healthcare challenges that many of our brightest subspecialty faculty wouldn't know what to do with without 10 consultants.
Our country needs generalists in a huge way--despite what our medical school graduating classes seem to be choosing at the moment.
I can't blame students exposed to tertiary and quarternary centers as their only experience of healthcare during their education...losing faith in the capacity for any of us to provide broad, effective, evidence-based, sound and high quality care.
My decision to go into Family Practice was the best one I've made in my life.
I am proud of our specialty and greatly admire the heros who made it happen in the 1970's.

HappyFP !!