FM options in larger cities?

[Jdobe]

Hi...haven't posted in a while, but I'm a long-time lurker

I am in the process of applying to FM residencies, and one of the things that I love about the specialty is the sheer variety of practice options. As many on this forum have pointed out, a family medicine doc can do outpatient, hospitalist work, ER, academics, and I'm sure a plethora of other things. However, for someone such as myself who plans to practice in medium to large cities, what are the realities of having these options when there are other specialists around? Do any of you find that family medicine is more pigeon-holed in larger cities? For reference, I'm talking about cities about the size of Portland or Seattle.

Thank you for your help. These answers won't change my mind, obviously, since I'm about to start interviewing in two weeks, but I like to have opinions from realists out there in the world.

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[6ft3dr2b]

I live in the nyc metro area. My colleagues keep telling me that FM is terrible except for if u live in Wyoming or some small town (in the middle of no where FM drs do well because there are no other options). This is my main concern with FM. I love NYC because its home for me. I keep hearing to go with "your heart". I just hope FM is a logical decision to make even though Id be in a big city (where there r a zillion other specialists & competition).

 

[deleted87716]

70% of family physicians practice in areas with a population of 250,000 or more (source: http://www.aafp.org/online/en/home/aboutus/specialty/facts/13.html ).

Most of America isn't rural; neither are most of America's family physicians.

 

[Old_Mil]

For all the promise of FM, in cities of any size where specialties have any representation, the career options of the FM trained physician are very limited. In one town where I rotated - population of roughly 60,000 - the hospital system had refused to grant FM trained docs privileges to do scopes. The draw for the subspecialists being - "look, you'll get all the procedures and we'll restrict our PCPs so you'll be unopposed."

To really find full scope family med, you have to get out into the boonies. Towns of less than 20,000 people, preferrably less than 10,000 and an hour or more drive from specialty groups. West is better, east is bad.

 

[deleted87716]

In one town where I rotated - population of roughly 60,000 - the hospital system had refused to grant FM trained docs privileges to do scopes.

Yeah, but that's a "local politics" thing. The AAFP has people who can assist with credentialing issues, if needed. It's not always a no-win situation.

http://www.aafp.org/fpm/20040300/69figh.html