Chemistry Cat 3.0

Cylon Model 21
7+ Year Member
Mar 3, 2011
269
20
Status
Pre-Medical
What's the difference between FM residency from ACGME and AOA? It seems like they're pretty much the same. If I want to do FM should I just apply to DO schools instead of MD schools?
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
What's the difference between FM residency from ACGME and AOA? It seems like they're pretty much the same. If I want to do FM should I just apply to DO schools instead of MD schools?
They're basically the same. AOA residencies have training in OMM whereas Acgme residencies do not. It's not hard to match an Acgme family medicine as a DO.

However, you will likely change your mind about family medicine, so you're better off going to the best school you can get into. I thought I wanted to do primary care before I started school. After being thoroughly exposed to it, there is no amount of money you could pay me to do it.
 
OP
Chemistry Cat 3.0

Chemistry Cat 3.0

Cylon Model 21
7+ Year Member
Mar 3, 2011
269
20
Status
Pre-Medical
They're basically the same. AOA residencies have training in OMM whereas Acgme residencies do not. It's not hard to match an Acgme family medicine as a DO.

However, you will likely change your mind about family medicine, so you're better off going to the best school you can get into. I thought I wanted to do primary care before I started school. After being thoroughly exposed to it, there is no amount of money you could pay me to do it.
What made you change your mind specifically? The environment or the amount of paper work (w/ insurance)?
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
What made you change your mind specifically? The environment or the amount of paper work (w/ insurance)?
Yeah, i disliked the paper work and the social work aspect of family medicine. Most of all, however, I thought it was dreadfully boring. It's the same stuff over and over (hypertension, diabetes, etc). All of medicine is repetitive, but family medicine, at least to me, is the worse. I feel like most 4th year medical students could run a family med clinic adequately. I cannot think of any other speciality like that.

I'm over simplifying family medicine; I know. It's harder than I described, but in comparison to other medical fields, I think it's pretty straightforward.

Everyone is different, though. You may really enjoy developing relationships with your patients. I never really enjoyed that aspect of medicine.
 
Last edited:

Lost Vagus

5+ Year Member
May 10, 2013
353
332
Status
Medical Student
They're basically the same. AOA residencies have training in OMM whereas Acgme residencies do not. It's not hard to match an Acgme family medicine as a DO.

However, you will likely change your mind about family medicine, so you're better off going to the best school you can get into. I thought I wanted to do primary care before I started school. After being thoroughly exposed to it, there is no amount of money you could pay me to do it.
Good thing you won't be a primary care provider then. Loads of physicians love primary care. Just because it isn't your cup of tea doesn't mean other people wont like it.

As far as the original questions goes, I'm not sure how far in to medical school you are but you have plenty of time to think about your specialty. I am interested in primary care as well but I do not want to do an AOA primary care residency at all. I don't want to spend any more time learning OMM and I want to be affiliated with a large hospital/ university. This can be done with AOA as well but is much easier with ACGME. Good luck
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
Good thing you won't be a primary care provider then. Loads of physicians love primary care. Just because it isn't your cup of tea doesn't mean other people wont like it.

As far as the original questions goes, I'm not sure how far in to medical school you are but you have plenty of time to think about your specialty. I am interested in primary care as well but I do not want to do an AOA primary care residency at all. I don't want to spend any more time learning OMM and I want to be affiliated with a large hospital/ university. This can be done with AOA as well but is much easier with ACGME. Good luck
I completely agree.

I was, like you, 100% gung ho for family medicine before I started, but I quickly changed my mine as a 3 rd year. The point of my post was that your goals may change once you're in medicial school and, therefore, it's in your best interest to keep as many opportunities open as possible.
 

csx

May 8, 2013
1,075
211
Status
Pre-Health (Field Undecided)
So basically, if you have no interest in practicing OMM and you want to avoid it at all costs, go ACGME rather than AOA? That is, if I am understanding you correctly. I think OMM is cool and has some value to it but I was just curious.
 

NontradCA

American Hero
5+ Year Member
Sep 19, 2012
4,992
4,143
Trump Tower
Status
Medical Student
Yeah, i disliked the paper work and the social work aspect of family medicine. Most of all, however, I thought it was dreadfully boring. It's the same stuff over and over (hypertension, diabetes, etc). All of medicine is repetitive, but family medicine, at least to me, is the worse. I feel like most 4th year medical students could run a family med clinic adequately. I cannot think of any other speciality like that.

I'm over simplifying family medicine; I know. It's harder than I described, but in comparison to other medical fields, I think it's pretty straightforward.

Everyone is different, though. You may really enjoy developing relationships with your patients. I never really enjoyed that aspect of medicine.
Really? It can't be that easy? You feel the same way about IM and Peds?
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
Really? It can't be that easy? You feel the same way about IM and Peds?
Yea, I do not think I'm exaggerating too much. I should say, however, that my family medicine experience took place in an urban environment with an ample amount of specialist available, so basically any moderately difficult case got punted to a specialist. Family medicine in a rural environment may be a more interesting and challenging experience. Also, I'm referring to out patient family medicine. Inpatient family is just like IM, which can be tough.

Outpatient IM is basically family medicine, and outpatient peds is mostly well-child checks, which are straightforward as well. Inpatient peds and IM is challenging, however, and I do not think many 4th years med students, or even interns, could run a floor independently.
 

Bacchus

Staff member
Administrator
10+ Year Member
Apr 28, 2007
20,979
2,283
Status
Attending Physician
Yeah, i disliked the paper work and the social work aspect of family medicine. Most of all, however, I thought it was dreadfully boring. It's the same stuff over and over (hypertension, diabetes, etc). All of medicine is repetitive, but family medicine, at least to me, is the worse. I feel like most 4th year medical students could run a family med clinic adequately. I cannot think of any other speciality like that.

I'm over simplifying family medicine; I know. It's harder than I described, but in comparison to other medical fields, I think it's pretty straightforward.

Everyone is different, though. You may really enjoy developing relationships with your patients. I never really enjoyed that aspect of medicine.
Sorry, to keep picking, but this is offensive. We rarely punt things unless absolutely necessary. Established docs may punt, but its a disservice to one's education to punt as soon as the 1st visit. Its a reputation you don't want to be known for.
 
  • Like
Reactions: MerickManual

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
Sorry, to keep picking, but this is offensive. We rarely punt things unless absolutely necessary. Established docs may punt, but its a disservice to one's education to punt as soon as the 1st visit. Its a reputation you don't want to be known for.
I wasn't trying to be. Sorry.
 
Nov 30, 2013
323
206
Status
Medical Student
What's the difference between FM residency from ACGME and AOA? It seems like they're pretty much the same. If I want to do FM should I just apply to DO schools instead of MD schools?
That's a fair question from a pre-med... however some of the answers on the topic are just :barf:

First of all, some basics: if you go to an osteopathic school you can apply to both AOA and ACGME residents. If you go to an allopathic school you can only apply to ACGME residencies. Some programs are dually accredited, meaning either DO/MDs may apply.

Now that we got that out of the way, the main differences: ACGME family medicine has a slight different set of requirements. In general they have more OBGYN and delivery requirements for each resident, whether you want to do obstetrics or not. Also, they have more strict work-duty hours (or, should I say they are enforced and regulated more than the AOA residencies). They also require one-two months of inpatient peds alongside the oupatient ped rotations.

As for AOA, they are slightly more loosely regulated. There are no set # of deliveries, and work hours aren't really a priority so more likely you'll work longer hours (or at least don't have to lie about your hours as much ;) ) As for OMM, each residency has different requirements, some do more than others, etc. OMM does not take up much of your time as others make it sound like.

I think those are the main differences. Explore each residency on an individual basis. Use either Freida (MD) or AOAopportunities(DO) to get an idea. Family medicine is awesome and NOT as easy as others make it sound like. Easier than surgery? Sure. Easier than IM? Don't really see how, when we're both dealing with the same population and same diseases. Biggest differences are that FM is more outpatient (typically, although I know FM hospitalists) and less specialization opportunities after residency. It is a common fallacy to think that since someone knows how to manage complex disease (like ICU/CC) that they can turn around manage chronic diseases or "outpatient medicine."
 
Nov 30, 2013
323
206
Status
Medical Student
Yea, I do not think I'm exaggerating too much. I should say, however, that my family medicine experience took place in an urban environment with an ample amount of specialist available, so basically any moderately difficult case got punted to a specialist. Family medicine in a rural environment may be a more interesting and challenging experience. Also, I'm referring to out patient family medicine. Inpatient family is just like IM, which can be tough.

Outpatient IM is basically family medicine, and outpatient peds is mostly well-child checks, which are straightforward as well. Inpatient peds and IM is challenging, however, and I do not think many 4th years med students, or even interns, could run a floor independently.
So you're saying a 4th year medical student can run an office while seeing 30 patients a day? Kudos to you if you were able to manage that. Each setting, whether it be inpatient or outpatient has its challenges and cannot be run by any MSIV. I worked with a pediatrician outpatient who, yes, did do well child checks- but he also saw chronic debilitating pediatric diseases and helped families tremendously.
 

Mad Jack

Critically Caring
5+ Year Member
Jul 27, 2013
35,437
64,823
4th Dimension
Yeah, i disliked the paper work and the social work aspect of family medicine. Most of all, however, I thought it was dreadfully boring. It's the same stuff over and over (hypertension, diabetes, etc). All of medicine is repetitive, but family medicine, at least to me, is the worse. I feel like most 4th year medical students could run a family med clinic adequately. I cannot think of any other speciality like that.

I'm over simplifying family medicine; I know. It's harder than I described, but in comparison to other medical fields, I think it's pretty straightforward.

Everyone is different, though. You may really enjoy developing relationships with your patients. I never really enjoyed that aspect of medicine.
Quite frankly I wouldn't trust most 4th years to read an abnormal EKG successfully let alone run a primary care office by themselves. Primary care residency is very much about learning rapid diagnostic skills and time management, two things most interns I have worked with have struggled to handle. And this neglects the most difficult part of primary care, which is separating the small number of patients with early signs of illness from the hundreds of healthy patients that come your way, all while treating a patient every 10 minutes. Their job may not be your cup of tea, but it is not easy by any stretch.
 
  • Like
Reactions: MerickManual

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
So you're saying a 4th year medical student can run an office while seeing 30 patients a day? Kudos to you if you were able to manage that. Each setting, whether it be inpatient or outpatient has its challenges and cannot be run by any MSIV. I worked with a pediatrician outpatient who, yes, did do well child checks- but he also saw chronic debilitating pediatric diseases and helped families tremendously.
Maybe not run an office, but, yes, I think a 4th year medical student could easily see 30 patients a day if they had to. Im sure somewhere they do. They will undoubtedly miss some stuff, but I think the overall care would be adequate. You'll be surprised how quickly you become efficient when you have to. We, the interns, have to cover the surgical icu alone on the weekends. My first weekend alone I had 15 patients. Prior to that weekend, I never covered more than 3 icu patients. That first weekend sucked, but each following weekend has become easier and easier, and now it's actually fun instead of being terrifying. And similiarly, in pain clinic, I have to see 40-60 patients a day. The visits are way shorter and more focused than a primary care visit, but I still have to take a history, do a physical exam and dictate a note. The first week I was terrible and I had to stay up all night dictating, but I quickly got the hang of it. I'm sure the same thing would happen in the scenario we're discussing. Sure, the med student would be terrible at first, but after a few days they'd probably be fine.

I'm not saying anything negative about family doctors.
 
Nov 30, 2013
323
206
Status
Medical Student
Maybe not run an office, but, yes, I think a 4th year medical student could easily see 30 patients a day if they had to. Im sure somewhere they do. They will undoubtedly miss some stuff, but I think the overall care would be adequate. You'll be surprised how quickly you become efficient when you have to. We, the interns, have to cover the surgical icu alone on the weekends. My first weekend alone I had 15 patients. Prior to that weekend, I never covered more than 3 icu patients. That first weekend sucked, but each following weekend has become easier and easier, and now it's actually fun instead of being terrifying. And similiarly, in pain clinic, I have to see 40-60 patients a day. The visits are way shorter and more focused than a primary care visit, but I still have to take a history, do a physical exam and dictate a note. The first week I was terrible and I had to stay up all night dictating, but I quickly got the hang of it. I'm sure the same thing would happen in the scenario we're discussing. Sure, the med student would be terrible at first, but after a few days they'd probably be fine.

I'm not saying anything negative about family doctors.
...sorry, still not possible. I know you're not trying to offend FM docs here (but you kinda are by insisting "it's so easy, a MSIV can do it"), but no. You're telling me a 4th year would know how to see 30+ patients, write/dictate, know how to bill appropriately, be able to hire/staff the office managers/secretaries and still be able to get the ddx/tx right over 50% of the time...? They would take about 5 minutes with each patient looking up on epocates the right dosage of Tylenol. :laugh: Have you seen the posts about students freaking out about the PE, a fake standardized exam with actors? Sure I'm sure anyone after medical school can "do it if they had to" (hell, that's where the old general practitioners came from) but they wouldn't be doing it right or doing anyone a favor.

Yes, as residents you get to do more, see more, and have responsibilities. But you're not running to ICU yourself. You're still getting your dictations cosigned. Someone is watching over you at all times.
 
Nov 30, 2013
323
206
Status
Medical Student
...sorry, still not possible. I know you're not trying to offend FM docs here (but you kinda are by insisting "it's so easy, a MSIV can do it"), but no. You're telling me a 4th year would know how to see 30+ patients, write/dictate, know how to bill appropriately, be able to hire/staff the office managers/secretaries and still be able to get the ddx/tx right over 50% of the time...? They would take about 5 minutes with each patient looking up on epocates the right dosage of Tylenol. :laugh: Have you seen the posts about students freaking out about the PE, a fake standardized exam with actors? Sure I'm sure anyone after medical school can "do it if they had to" (hell, that's where the old general practitioners came from) but they wouldn't be doing it right or doing anyone a favor.

Yes, as residents you get to do more, see more, and have responsibilities. But you're not running to ICU yourself. You're still getting your dictations cosigned. Someone is watching over you at all times.
Sorry, I just had to:
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
No, I don't think a 4th year med student could do the billing, hire staff members, or handle other business related aspects of running a practice. I do, however, think a decent 4th year student could make the correct assessment and plan way more often than 50% of time. You obviously disagree, and maybe I am wrong. I basing my assessment on 4 months of outpatient family medicine in a punt friendly environment.
 

Bacchus

Staff member
Administrator
10+ Year Member
Apr 28, 2007
20,979
2,283
Status
Attending Physician
Send a rash to a derm. Send a new onset diabetes to endocrine. Send an abnormal TSH to endocrine. Send a mole removal to derm/plastics/general surgery. Send a kid to pediatrics. Send a stress incontinent patient to urology.
 

Lost Vagus

5+ Year Member
May 10, 2013
353
332
Status
Medical Student
No, I don't think a 4th year med student could do the billing, hire staff members, or handle other business related aspects of running a practice. I do, however, think a decent 4th year student could make the correct assessment and plan way more often than 50% of time. You obviously disagree, and maybe I am wrong. I basing my assessment on 4 months of outpatient family medicine in a punt friendly environment.
.
 
Last edited:

smq123

John William Waterhouse
Staff member
Administrator
10+ Year Member
Jan 9, 2006
13,945
3,580
Status
Attending Physician
No, I don't think a 4th year med student could do the billing, hire staff members, or handle other business related aspects of running a practice. I do, however, think a decent 4th year student could make the correct assessment and plan way more often than 50% of time. You obviously disagree, and maybe I am wrong. I basing my assessment on 4 months of outpatient family medicine in a punt friendly environment.
Just so you know, being a physician is more than just making the "correct assessment and plan" the majority of the time. You make being a doctor sound more like being a game show contestant.
 

JGimpel

Say what?
5+ Year Member
Oct 11, 2012
698
115
Rahhther Far Away
FM/IM are more straightforward than some other specialties a large percentage of the time due to following pre-established algorithyms that are beaten into your head from Day 1 but in no way is it easy, especially if you have to see 40+ patients a day to make a realistic income for the amount of time you put in getting there. A 4th year with an iPhone and The Washington/Mass Gen. IM manuals could get by seeing a few patients a day, but couldn't RUN an outpatient clinic, much less an inpatient service. The variety of patient interactions may make up for the monotony of types of pathology treated, though. It's not my choice in specialties, but I have a lot of respect for the people for whom it is.
 
  • Like
Reactions: NurWollen
Nov 30, 2013
323
206
Status
Medical Student
FM/IM are more straightforward than some other specialties a large percentage of the time due to following pre-established algorithyms that are beaten into your head from Day 1 but in no way is it easy, especially if you have to see 40+ patients a day to make a realistic income for the amount of time you put in getting there. A 4th year with an iPhone and The Washington/Mass Gen. IM manuals could get by seeing a few patients a day, but couldn't RUN an outpatient clinic, much less an inpatient service. The variety of patient interactions may make up for the monotony of types of pathology treated, though. It's not my choice in specialties, but I have a lot of respect for the people for whom it is.
Hmmm, but isn't most medicine "algorithmic"? I mean, every specialty I have rotated with has some sort of algorithms they use for certain conditions they treat as well.
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
Just so you know, being a physician is more than just making the "correct assessment and plan" the majority of the time. You make being a doctor sound more like being a game show contestant.
I was directly responding to a previous post.
 

Mad Jack

Critically Caring
5+ Year Member
Jul 27, 2013
35,437
64,823
4th Dimension
No, I don't think a 4th year med student could do the billing, hire staff members, or handle other business related aspects of running a practice. I do, however, think a decent 4th year student could make the correct assessment and plan way more often than 50% of time. You obviously disagree, and maybe I am wrong. I basing my assessment on 4 months of outpatient family medicine in a punt friendly environment.
Greater than 50% of the time? I'd love to see their malpractice premiums in a year for the things they messed up the other 50% of the time. Hell, I would venture to say someone with good Googling skills could get things right around 50% of the time. Running a clinic is a combination of getting things right >95% of the time on a very tight schedule, seeing enough patients to make things profitable, and managing a business all at once. It's insulting to believe a 4th year could handle the role of a FP.

FM/IM are more straightforward than some other specialties a large percentage of the time due to following pre-established algorithyms that are beaten into your head from Day 1 but in no way is it easy, especially if you have to see 40+ patients a day to make a realistic income for the amount of time you put in getting there. A 4th year with an iPhone and The Washington/Mass Gen. IM manuals could get by seeing a few patients a day, but couldn't RUN an outpatient clinic, much less an inpatient service. The variety of patient interactions may make up for the monotony of types of pathology treated, though. It's not my choice in specialties, but I have a lot of respect for the people for whom it is.
Two major skills that make a good primary care physician (or a good physician in general) are their ability to recognize and handle situations that fall outside of the algorithms, and to make the initial observations that allow a patient to be put on an algorithm in the first place. A good PCP pays close attention to the little things during an exam- new discoloration in a patient's nails, shakiness in the hands, digital clubbing, or other small signs can be early indicators of serious health problems. By noting them on physical exam, a PCP can make a big difference in the future health and well being of their patients by treating disease processes before they become serious or irreversible medical conditions. This already difficult task is made even more so by the sentinel nature of primary care. You're always staring at so many routine things, that it is easy to become complacent and miss a major finding. A good PCP must be ever vigilant, and not give in to the desire to cut corners and brush over things. That is -hard- to do.

A bad PCP's job is easy. Look at the vitals and major complaints, and follow whatever algorithm exists for management of anything abnormal. High blood pressure? Algorithm! Cough and fever? Algorithm! PCPs that practice cookbook medicine with poor physical exam skills (or those that simply rush their exam on account of low reimbursements) are the reason primary care is quickly becoming the domain of midlevels. Without proper phsycian-level assessment skills, there is no justification for a physician to be present in primary care at all. Anyone can follow an algorithm. It's the art of assessment and diagnosis that makes a good PCP valuable.

And as was said by MerickManual, most medicine is algorithmic now. Trauma management, cardiac arrests, intensive care, surgery- algorithms are everywhere. The job of a good physician is to know when to step out of the algorithm based on his knowledge and assessment of the current situation, a skill that is just as critical to a surgeon as it is to a primary care physician.
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
Greater than 50% of the time? I'd love to see their malpractice premiums in a year for the things they messed up the other 50% of the time. Hell, I would venture to say someone with good Googling skills could get things right around 50% of the time. Running a clinic is a combination of getting things right >95% of the time on a very tight schedule, seeing enough patients to make things profitable, and managing a business all at once. It's insulting to believe a 4th year could handle the role of a FP.
Once again, my 50% statement, was in direct response to a previous post. Additionally, I think your google statement provides more support for my argument. Also, just to explain myself further, as a med student, I did 4 months of family medicine. I usually saw 8 to 14 patients a day. I did everything for these patients (write the notes, prescribe meds, called the pharmacy, did the billing, etc). Rarely did the attending disagree with my plan and, if they did disagree, it was something minor. Based on this experience, I believe I, as a 4th year med student, would have been capable of providing adequate care to 30 or so patients a day, which is all I meant with my original statement. There were plenty of things I did not know how to manage independtly, but, as I was trying to make clear before, I was in a very referral heavy practice.

I know a board certified family doc knows significantly more than a 4th year med student.
 
Last edited:

drcrispmd

Gold Donor
5+ Year Member
Sep 5, 2013
373
219
Springfield, MO
Status
Attending Physician
Not all patients fall into the algorithm. And you never know what is going to walk in your clinic. Plus medical students typically don't know which complaints are important. You cannot address everything in one visit. We don't use specialist unless we have someone with significant disease where I am at. FM also has social issues with patients to deal with. As a student you just see a portion of the work residents do. I have not seen a single student who could handle 20 patients a day (or even an intern). Remember you have messages to take care of, reports on your patients coming in that have to reviewed and signed off, home health orders to review and sign off, prior authorizations to take of, etc. we do this in between seeing patients. If you are seeing 40 patients a day you either have long hours or not really seeing your patients and they are not getting good care (and definitely not getting any noted done) Also with the meaningful use regulations we have to document a lot more in the EHR. I am glad you are not doing family medicine I would hate to have to work with an intern with that attitude.
 

Mad Jack

Critically Caring
5+ Year Member
Jul 27, 2013
35,437
64,823
4th Dimension
Once again, my 50% statement, was in direct response to a previous post. Additionally, I think your google statement provides more support for my argument. Also, just to explain myself further, as a med student, I did 4 months of family medicine. I usually saw 8 to 14 patients a day. I did everything for these patients (write the notes, prescribe meds, called the pharmacy, did the billing, etc). Rarely did the attending disagree with my plan and, if they did disagree, it was something minor. Based on this experience, I believe I, as a 4th year med student, would have been capable of providing adequate care to 30 or so patients a day, which is all I meant with my original statement. There were plenty of things I did not know how to manage independtly, but, as I was trying to make clear before, I was in a very referral heavy practice.

I know a board certified family doc knows significantly more than a 4th year med student.
So you're saying 4th year med students would make great physician assistants, basically. I buy that. They do have twice as much training, after all.
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
So you're saying 4th year med students would make great physician assistants, basically. I buy that. They do have twice as much training, after all.
Yea, pretty much, and I think a PA can handle most family med clinic patients.

And what you said about a "bad pcp" basically sums up my experience with family medicine. I do not know how other pcps operate.
 
Last edited:

BestDoctorEver

Membership Revoked
Removed
Account on Hold
5+ Year Member
Sep 26, 2009
2,883
810
Status
Medical Student
Yea, pretty much, and I think a PA can handle most family med clinic patients.

And what you said about a "bad pcp" basically sums up my experience with family medicine. I do not know how other pcps operate.
If PAs are basically doing what FM doc do with no major issue... Why can't a 4th year med student do it then? I know a PA that operate a clinic on his own every day and the MD just comes one day every week or two weeks to sign off on his notes... I am not a med student, but based on what I have seen working in healthcare for a few years, I kind of agree with your assessment.
 
Last edited:

BestDoctorEver

Membership Revoked
Removed
Account on Hold
5+ Year Member
Sep 26, 2009
2,883
810
Status
Medical Student
That's how my school's clinics worked. There were no PAs. We, the 4th years, would do everything and the attending would pop his/her head in for a few minutes and sign off on our electronic notes.
Why are you getting blasted by others in this thread then?A PCP physician (family med) I heard suggested that they should separate and shorten PCP education from the whole medical school stuff. He suggested that after the first two year of med school that people who know they want to become PCP ( FM, PEDs, Psych) should do a 1 year rotation+ 2 years residency. I am not a med student; therefore, I have no idea how would that work and how these students would do on the board. He excluded IM from that, which was interesting to me since I have seen IM physicians function just like family medicine where I work. But again I am not in medical school, so I don't if there is any plausibility in what he said.
 
Last edited:

smq123

John William Waterhouse
Staff member
Administrator
10+ Year Member
Jan 9, 2006
13,945
3,580
Status
Attending Physician
Yea, pretty much, and I think a PA can handle most family med clinic patients.

And what you said about a "bad pcp" basically sums up my experience with family medicine. I do not know how other pcps operate.
I wish that a PA could handle most family med clinic patients. That would make my job a lot easier.

I'm an FM attending who is a year and a half out of residency. I am supervising NPs and PAs, some of whom have been midlevels longer than I have been able to vote. They still ask me what to do with complicated patients, and seem genuinely lost without guidance.

I wish you could have spent some time in our clinic. We cannot refer patients out because many of our patients don't have insurance or have crappy Medicaid.
 

csx

May 8, 2013
1,075
211
Status
Pre-Health (Field Undecided)
To divert you all away from arguing over something that really doesn't matter (it's just opinion), Sorry to be a noob, but why is it that pcp don't make as much money? Search function didn't work/google came up with nothing for me..:/

Also, if you think they made as much money as other specialties, do you think more people would 'suddenly be interested' in going into pcp and the pcp shortage would be gone?
 

NontradCA

American Hero
5+ Year Member
Sep 19, 2012
4,992
4,143
Trump Tower
Status
Medical Student
Also, if you think they made as much money as other specialties, do you think more people would 'suddenly be interested' in going into pcp and the pcp shortage would be gone?
Duh. But supply and demand my friend. Supply and demand.
 

BestDoctorEver

Membership Revoked
Removed
Account on Hold
5+ Year Member
Sep 26, 2009
2,883
810
Status
Medical Student
To divert you all away from arguing over something that really doesn't matter (it's just opinion), Sorry to be a noob, but why is it that pcp don't make as much money? Search function didn't work/google came up with nothing for me..:/

Also, if you think they made as much money as other specialties, do you think more people would 'suddenly be interested' in going into pcp and the pcp shortage would be gone?
Reimbursement rate, and people usually go where the money is after accumulating 250k in debt. If PCP start making 300k /year, a lot of US med students will be interested...not mostly IMG.
 
Nov 30, 2013
323
206
Status
Medical Student
Because procedures are more reimbursed then actually spending time with the patient with how RVUs are set up.... and since PCPs take care of more medicare/medicaid population, they have less cushiony private insurance reimbursements. And when you specialize, you can focus one patient visit in 10-15 minutes and not have to take care or readdress the other 10+comorbid conditions the patient may have and get to charge 2X-3X an office visit since you are a specialist.
 

NontradCA

American Hero
5+ Year Member
Sep 19, 2012
4,992
4,143
Trump Tower
Status
Medical Student
If that's true, then PCP should be among the highest earners and radiologists and cardiologists among the lowest.
It's simple economics. A cardiologist and radiologist spend 6 years being trained, and is more competitive causing a much smaller % of them in the physician population. That's why specialists such as neurosurgeons will not see their income slashed that much. All the reimbursement bull**** aside, you can't back these specialists into corners without them jumping ship and having a real problem at hand.
 
  • Like
Reactions: MerickManual
Nov 30, 2013
323
206
Status
Medical Student
Why are you getting blasted by others in this thread then?A PCP physician (family med) I heard suggested that they should separate and shorten PCP education from the whole medical school stuff. He suggested that after the first two year of med school that people who know they want to become PCP ( FM, PEDs, Psych) should do a 1 year rotation+ 2 years residency. I am not a med student; therefore, I have no idea how would that work and how these students would do on the board. He excluded IM from that, which was interesting to me since I have seen IM physicians function just like family medicine where I work. But again I am not in medical school, so I don't if there is any plausibility in what he said.
One doctor's opinion doesn't mean he's right.... There was one school who is/was(?) shortening the curriculum one year if you decide to do primary care, but I have reservations how that will pan out.
 

cliquesh

10+ Year Member
Nov 2, 2007
3,090
1,089
Status
Resident [Any Field]
Why are you getting blasted by others in this thread then?A PCP physician (family med) I heard suggested that they should separate and shorten PCP education from the whole medical school stuff. He suggested that after the first two year of med school that people who know they want to become PCP ( FM, PEDs, Psych) should do a 1 year rotation+ 2 years residency. I am not a med student; therefore, I have no idea how would that work and how these students would do on the board. He excluded IM from that, which was interesting to me since I have seen IM physicians function just like family medicine where I work. But again I am not in medical school, so I don't if there is any plausibility in what he said.
Ill let them speak for themselves. I can see how my original statement was offensive, however.

In regards to IM, I think outpatient IM is pretty similar, as you mentioned, to outpatient family medicine. Inpatient IM/FM, however, in my opinion, can be challenging and requires more education. I had a patient the other day status post a multiple organ abdominal transplant (pancreas, liver, a portion of small bowel) with an acute rejection, a possible CMV infection, and some other stuff. I didn't really know where to begin expect to keep him breathing. I've never been completely dumbfounded like that in an outpatient setting.
 
OP
Chemistry Cat 3.0

Chemistry Cat 3.0

Cylon Model 21
7+ Year Member
Mar 3, 2011
269
20
Status
Pre-Medical
Why are you getting blasted by others in this thread then?A PCP physician (family med) I heard suggested that they should separate and shorten PCP education from the whole medical school stuff. He suggested that after the first two year of med school that people who know they want to become PCP ( FM, PEDs, Psych) should do a 1 year rotation+ 2 years residency. I am not a med student; therefore, I have no idea how would that work and how these students would do on the board. He excluded IM from that, which was interesting to me since I have seen IM physicians function just like family medicine where I work. But again I am not in medical school, so I don't if there is any plausibility in what he said.
There are medical schools that offer fast track 3 yrs program for family medicine.