Family medicine Lifestyle

[dabears405]

Can someone PLEASE let me know how the lifestyle for family medicine is? Let's say Inpatient Hospital setting and Outpatient private practice setting? Of course hours may vary for private practice but in general, how would a typical day/week be for a family physician? I.e. wake up at 7 am get home by 6 pm M-F and are there any work involved when you get home?

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[smq123]

Can someone PLEASE let me know how the lifestyle for family medicine is? Let's say Inpatient Hospital setting and Outpatient private practice setting? Of course hours may vary for private practice but in general, how would a typical day/week be for a family physician? I.e. wake up at 7 am get home by 6 pm M-F and are there any work involved when you get home?

Unfortunately, there is no good answer. It depends on how much you want to make, how much you want to work, where you want to live, etc.

 

[smq123]

Can someone PLEASE let me know how the lifestyle for family medicine is? Let's say Inpatient Hospital setting and Outpatient private practice setting? Of course hours may vary for private practice but in general, how would a typical day/week be for a family physician? I.e. wake up at 7 am get home by 6 pm M-F and are there any work involved when you get home?

If you're asking if there are good jobs where you can make a decent living and not have to work that hard, then yes. There are.

 

[cabinbuilder]

Can someone PLEASE let me know how the lifestyle for family medicine is? Let's say Inpatient Hospital setting and Outpatient private practice setting? Of course hours may vary for private practice but in general, how would a typical day/week be for a family physician? I.e. wake up at 7 am get home by 6 pm M-F and are there any work involved when you get home?

Most FM don't admit their own patients anymore. Most are overwhelmed because there is a shortage of FM. Not enough time to see all the patient's who need to be seen. After hours there is always dictation, charting, labs to review, xray reports to review, path reports to review. Depends on if you take call for just you or more than one doc on any given day, etc. Too many variables. I think most anymore work 9-5 4.5 days a week if you just do clinic.

 

[JustPlainBill]

Can someone PLEASE let me know how the lifestyle for family medicine is? Let's say Inpatient Hospital setting and Outpatient private practice setting? Of course hours may vary for private practice but in general, how would a typical day/week be for a family physician? I.e. wake up at 7 am get home by 6 pm M-F and are there any work involved when you get home?

Sure --

Outpatient private practice : For me -- 12 to 7pm straight through, 4 patients per hour, 8-1 on Saturdays straight through 4 patients per hour, 50 weeks a year; That translates into leaving the house at 11am to get to work at noon, grab a plate of whatever the drug rep brought in before seeing my first patient (good thing -- means I don't have to talk to the drug rep and pretend I'm interested) -- start seeing patients -- try to complete charts when I can, usually means 1 hour per night charting before I go home; lab results, patient messages, review studies during that time also -- I generally catch up on my slow days (Wed/Thurs); Home by 9PM, late dinner chatting with the wife and remaining child at home; asleep by 2300 and up at 9AM; Wash, rinse, repeat; Saturdays are blown so we usually go out to eat dinner and take in a movie, Sundays are for church, laundry, grocery shopping and preparing for the next week. Call Q8weekends and Q8days. At home, no need to come in anywhere since we're a clinic.

Now, for the partners? -- M-F, 4.5 days a week -- typical is 8-5 M-Th, 8 to 3 F, with a half day off during the week somewhere; 25 to 40 patients per day, stacks of labs, reports, charts to finish -- plus they run the business side of things;

I know of a guy in a major suburb locally that runs Q10 minutes from 7am to 2pm M-Th, and 7-noon Friday -- he doesn't like to be in clinic, he'd rather be at his farm that's about 45 minutes from clinic so when he works, he WORKS -- has a front office receptionist, 3 exam rooms and a good, long time MA -- banking close to $500K.

Work at home? Depends on whether or not I feel like finishing my charts in the office or not, or finishing them that day or not -- I've got a 2 day lag that's acceptable.

 

[SansaStarkMD]

Is it realistic for a resident graduating today to join a private group?

 

[cabinbuilder]

Is it realistic for a resident graduating today to join a private group?

Not really. In 7 years of doing this I have only ever come across one private practice who was hiring (where I was looking).

 

[smq123]

Is it realistic for a resident graduating today to join a private group?

It depends on which part of the country. But yes....It does happen.

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[deleted87716]

Is it realistic for a resident graduating today to join a private group?

We have to hire somebody, don't we?

 

[simpler2]

I would say the least you can do is work for a health department STD screening and treatment program (8-5pm, no take home work, mind numbingly simple work, get government holidays, government benefits). The most would be working in a semi rural location with provider shortage, taking inpatient/OB/ER call q week, training residents unpaid, in a system with one of the worst EHRs (80+ hours weekly average with irregular hours, no real holidays, need to get your own malpractice insurance, and 2 hours+ EHR charting at the end of most days). The nice part of being a family physician is the plethora of employment opportunities and ability to pick your poison.

 

[YoungDoc25]

Sure --

Outpatient private practice : For me -- 12 to 7pm straight through, 4 patients per hour, 8-1 on Saturdays straight through 4 patients per hour, 50 weeks a year; That translates into leaving the house at 11am to get to work at noon, grab a plate of whatever the drug rep brought in before seeing my first patient (good thing -- means I don't have to talk to the drug rep and pretend I'm interested) -- start seeing patients -- try to complete charts when I can, usually means 1 hour per night charting before I go home; lab results, patient messages, review studies during that time also -- I generally catch up on my slow days (Wed/Thurs); Home by 9PM, late dinner chatting with the wife and remaining child at home; asleep by 2300 and up at 9AM; Wash, rinse, repeat; Saturdays are blown so we usually go out to eat dinner and take in a movie, Sundays are for church, laundry, grocery shopping and preparing for the next week. Call Q8weekends and Q8days. At home, no need to come in anywhere since we're a clinic.

Now, for the partners? -- M-F, 4.5 days a week -- typical is 8-5 M-Th, 8 to 3 F, with a half day off during the week somewhere; 25 to 40 patients per day, stacks of labs, reports, charts to finish -- plus they run the business side of things;

I know of a guy in a major suburb locally that runs Q10 minutes from 7am to 2pm M-Th, and 7-noon Friday -- he doesn't like to be in clinic, he'd rather be at his farm that's about 45 minutes from clinic so when he works, he WORKS -- has a front office receptionist, 3 exam rooms and a good, long time MA -- banking close to $500K.

Work at home? Depends on whether or not I feel like finishing my charts in the office or not, or finishing them that day or not -- I've got a 2 day lag that's acceptable.

Your setup sounds awesome. Do you enjoy those hours and feel you're compensated well?

Sidenote, how many FM attendings have time for money making opportunities outside of their practice/medicine while working full time? Possibly managing real estate property?

 

[FrustratedFamDoc]

Your setup sounds awesome. Do you enjoy those hours and feel you're compensated well?

Sidenote, how many FM attendings have time for money making opportunities outside of their practice/medicine while working full time? Possibly managing real estate property?

It really just depends. What sort of debt are you graduating with, do you personally live below your means, how hard are you willing to bust your butt, what sort of work/family balance are you looking for, etc. for me, the biggest factor affecting my finances has been loan debt.

 

[YoungDoc25]

It really just depends. What sort of debt are you graduating with, do you personally live below your means, how hard are you willing to bust your butt, what sort of work/family balance are you looking for, etc. for me, the biggest factor affecting my finances has been loan debt.

Ah, that's a good point. I'm fortunate to probably only have a max of ~115k in loans including undergrad. I'm definitely not looking at FM as a way to work less. I know that's a great plus about the specialty, but I'd definitely be looking to work hard so I can play harder. I just never see much about that on SDN. Is working 50-60 hours/week in FM really rare? Or is it just financially (tax wise) not worth it?

 

[hsmooth]

I remember the cartoon Duck Tales as a child when they talked about working 'smarter, not harder'

This year I took the time to learn how to bill my visits appropriately and not miss on billable services and I added around $20k to my salary while seeing a similar amount of patients as last year.

Ah, that's a good point. I'm fortunate to probably only have a max of ~115k in loans including undergrad. I'm definitely not looking at FM as a way to work less. I know that's a great plus about the specialty, but I'd definitely be looking to work hard so I can play harder. I just never see much about that on SDN. Is working 50-60 hours/week in FM really rare? Or is it just financially (tax wise) not worth it?

 

[YoungDoc25]

I remember the cartoon Duck Tales as a child when they talked about working 'smarter, not harder'

This year I took the time to learn how to bill my visits appropriately and not miss on billable services and I added around $20k to my salary while seeing a similar amount of patients as last year.

I heard that recently from a family friend in FM but didn't get the chance to ask much about it. What are some good resources to learn about coding? Is it just being in the business or is it something you can read up on?

 

[hsmooth]

I heard that recently from a family friend in FM but didn't get the chance to ask much about it. What are some good resources to learn about coding? Is it just being in the business or is it something you can read up on?

I learned basics in residency, then reinforced in practice with billers and coders. Also this journal often has some good tips and things:

http://www.aafp.org/journals/fpm.html

 

[YoungDoc25]

I learned basics in residency, then reinforced in practice with billers and coders. Also this journal often has some good tips and things:

http://www.aafp.org/journals/fpm.html

Bookmarked that for future reference. I appreciate it!

 

[zyxab]

I would say the least you can do is work for a health department STD screening and treatment program (8-5pm, no take home work, mind numbingly simple work, get government holidays, government benefits). The most would be working in a semi rural location with provider shortage, taking inpatient/OB/ER call q week, training residents unpaid, in a system with one of the worst EHRs (80+ hours weekly average with irregular hours, no real holidays, need to get your own malpractice insurance, and 2 hours+ EHR charting at the end of most days). The nice part of being a family physician is the plethora of employment opportunities and ability to pick your poison.

What is the pay like for the health department job you described? Also, is that a relatively easy job to get?

 

[Bacchus]

I work 36 patient hours. Tues/Weds (0800-1900) and Thurs/Fri (0800-1700). My charts are usually done within a half hour of seeing my last patient. We get 4 weeks off and 5 days of CME.

Salary is close to 200,000 starting.

 

[Mjolner]

I work 36 patient hours. Tues/Weds (0800-1900) and Thurs/Fri (0800-1700). My charts are usually done within a half hour of seeing my last patient. We get 4 weeks off and 5 days of CME.

Salary is close to 200,000 starting.

Is that a teaser salary which will switch to productivity next year or whatever?


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[Bacchus]

Is that a teaser salary which will switch to productivity next year or whatever?


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Of course I'd never get a straight answer if I ask but we are slowly but surely switching to value based care. That said, between our end of the year bonus and my retention bonus for the next 5 years, it should hover and 180-200.

 

[simpler2]

What is the pay like for the health department job you described? Also, is that a relatively easy job to get?

The pay would be on low end of FM spectrum for the community you are in. However, these are generally government jobs with good benefits and retirement options that would be better than most private practice opportunities. Availability is more difficult to comment on as this varies greatly and is not predictable. In general, I would say they are not the most highly coveted or sought after positions. If you were motivated and flexible, I can't imaging it being difficult to obtain a health department practitioner position.

In general, it is good to remember that easy jobs (certainly those funded by public funding) are often more liable to change/elimination.

 

[MJB]

I work rural primary care in an outpatient only setting as part of a mid-range sized health system. I'm in a very underserved area, and am about to be the sole provider so only getting busier. That said, I work 4 days a week in that clinic 8-5 and one day a week in our wound healing center (8-5). I see my first pt. at 815 most days and usually finish seeing patients by about 430. Walk out every night with all notes done, labs and docs reviewed, etc (I do NOT take work home with me) and get home almost never later than 6 (live 30 min from clinic). Started at 200, and now on production have increased my pay about 20-25% 2.5 years in. That goes up every quarter as I have gone from averaging about 15-17/day when I exceeded guarantee/went to production and will continue to go up as I'm routinely seeing 20+. Average RVU/patient hovers around 1.3-1.4

 

[letsdoit]

Sure. I work 5 days a week. I do family medicine clinic 2.5 days a week, Palliative medicine clinic 0.5 days per week and Inpatient Palliative consultation 2 days a week. Clinic days are typically 8 to 5 though I stay till 6 to finish my charts and chart checks. Consult days depend on how many new consults I get, usually 3 or 4 new consults and also a few follow ups. I also have to attend weekly Palliative Care IDT rounds for or 1 hour and monthly family medicine department meeting for 4 hours.