Family Medicine - only kids?

[Pediatrician87]

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Hi, I matched into fam med. I was wondering how feasible it is to do fam med residency and the open a private practice where I would see women and children patients? Or even just see children? Is it possible to tailor one's practice towards a specific focus/interest?

Thanks so much!

 

[VA Hopeful Dr]

Hi, I matched into fam med. I was wondering how feasible it is to do fam med residency and the open a private practice where I would see only young women (prenatal care, for example) and children patients? Or even just see children? Is it possible to tailor one's practice towards a specific focus/interest?

Thanks so much,

Technically, such a thing would be possible. Practically, there are a few issues with the specific focuses you have.

First, with prenatal care - are you going to be doing deliveries? If yes, that will restrict where you can practice as most decent sized cities have plenty of OB/GYNs. If no, you then have to find someone who will deliver the babies you've been following and that won't be easy.

As for kids, yeah you could do just that but I'm not sure why you would do family med if that's your goal.

 

[MedicineMan99]

Hi, I matched into fam med. I was wondering how feasible it is to do fam med residency and the open a private practice where I would see only young women (prenatal care, for example) and children patients? Or even just see children? Is it possible to tailor one's practice towards a specific focus/interest?

Thanks so much

You can do anything you want in Family Medicine. If you want a practice that only does OB, sure. If you want a practice that only does cosmetic Botox and hair transplants, you can do that too.

But if you do OB, that's a lot of malpractice coverage and you'll need OB backup if you plan to deliver babies. Also, you have to get patients to go to your practice somehow and do a good job advertising exactly what you offer.

And, you have to get through Family Medicine residency first. So, you'll be taking care of a lot of old guys with chest pain. If you really only want OB and/or Peds, I'd seriously consider doing one of those residencies instead.

 

[cabinbuilder]

I agree, it would be pretty hard to have that narrow of a practice focus. Plus, if you are an employed physician, not sure how you would sell that spin when there is such a hug shortage of FP for the aging population. I would do Peds or OB residency instead. May want to get through your intern year and then try to switch into a different residency.

 

[Pediatrician87]

Thank you all for the advice. Anyone with any other thoughts? Maybe obgyn is a bit complex to do as a fam med doc, but surely one can open an office and be somewhat focused on a certain patient population or type of disease? I shadowed someone this year whose focus was geriatrics, and he had no special training in that field per say . . .

 

[MedicineMan99]

Thank you all for the advice. Anyone with any other thoughts? Maybe obgyn is a bit complex to do as a fam med doc, but surely one can open an office and be somewhat focused on a certain patient population or type of disease? I shadowed someone this year whose focus was geriatrics, and he had no special training in that field per say . . .

Sure. For instance, I know a few Family Drs who are more focused on sports medicine, or more focused on adolescent health or womens' health. Yes, Family Doctors can do fellowships but you do not have to. If a Family Dr wants to focus on geriatrics or sports medicine, that's fine. They do not NEED to do a fellowship (although it is required in certain situations). Family Drs get training in all those fields during their residency. It's not like you are a pediatrician trying to practice geriatrics (as pediatricians get no training in geriatrics, amongst other things).

In terms of OB, the only reason you would need to do a fellowship in OB as a FP is if you wanted C-section privileges or if the hospital you are trying to get privileges at requires it.

 

[VA Hopeful Dr]

Thank you all for the advice. Anyone with any other thoughts? Maybe obgyn is a bit complex to do as a fam med doc, but surely one can open an office and be somewhat focused on a certain patient population or type of disease? I shadowed someone this year whose focus was geriatrics, and he had no special training in that field per say . . .

That's fairly common. Its also not unusual for a family doctor to have a certain area of interest (as MedicineMan points out), but it isn't usual for that to be their entire practice.

In addition, there aren't enough geriatricians to go around. By contrast, except in rural areas, there are plenty of pediatricians and OB/GYNs.

 

[styphon]

That's fairly common. Its also not unusual for a family doctor to have a certain area of interest (as MedicineMan points out), but it isn't usual for that to be their entire practice.

In addition, there aren't enough geriatricians to go around. By contrast, except in rural areas, there are plenty of pediatricians and OB/GYNs.

The exception being academic centers. Where I did my Family med residency we had "specialist" family med who only did specific areas. We have sports medicine, OB (vaginal delivery only, no fellowship), derm, and addiction management Attendings who pretty much only did those fields.

In the rural areas you will have a mixture of everything, and I suppose you could exclude a particular part of practice (geriatrics), but if you are "the only game" in town it would be tough to do.

 

[primadonna22274]

I'm hoping to build a heavily geriatric practice. I like that mix of chronic care, complicated medicine and generally pleasant self-actualized people (I said GENERALLY lol). I hate OB and will never do it after residency. I don't mind kids and adolescents but the 25-60 age range doesn't do much for me.
I do love rural practice though so will do what's needed...except for OB.

 

[DIce3]

There will be zero problem building a mostly geriatric practice. Or rather, internal medicine is by definition already mostly geriatric simply because the well people just don't come to the office as often. That said, a twenty year old with a two minute visit is a welcome break in the schedule.

 

[Pediatrician87]

Do you think it's possible to build a practice for children and young adults? Say . . adults under 45?

 

[DIce3]

Do you think it's possible to build a practice for children and young adults? Say . . adults under 45?

Not sure why you would want that exact demographic. Opening an office near a military base would get you close.

 

[galactus]

Do you think it's possible to build a practice for children and young adults? Say . . adults under 45?

Working at Student Health!

 

[styphon]

-As the above poster says - Student health
-I also looked at a job near a large military base (the job was civilian, there was no military hospital, but the majority of the population lived on the base) - they told me average age in the 20s, lots of OB, injuries, and STDs.
-Partner with another pediatrician/group and you can see the kids as they graduate from the pediatrics into you.
-Find a partner who does OB but hates seeing non-pregnant adults
-Work at a Occupational health clinic - mostly 20-50 y/o who are pretty healthy.

 

[primadonna22274]

I have never been so bored as I was doing student health. Monday morning STD checks, minor ailments, occasional orthopedic injuries and the ubiquitous teen angst/depression/anxiety. Once in a while for excitement a chronic RA/DM/some other interesting disease and the rare new onset psychosis.