How do IM trained make way to urgent care job

[cutefamilydog]

Thinking about working in urgent care settings. However, I am IM trained therefore I am not familiar with some procedures such as I&D, putting on cast for fractures, not good at suturing ..etc. Also, I am not allowed to see ped and ob/gyn. Is there CME class to help with gaining these experiences or should i stay away from getting onto urgent care work?

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[collegestud2013]

CME may be a start but will probably need on the job experience once you start. Definitely possible for IM-trained to do urgent care if you can find a good position. Problem is that there's a increased use of midlevels to staff urgent care facilities so pay MDs/DOs there tends to be on the lower side at most places and will require supervising midlevels.

 

[Make Or Break]

Easiest way to get your feet in the door is to find a friend already doing urgent care and ask to tag along with them or see if you can do double coverage for half pay with them watching you if that’s a possibility. Would probably work at a privately owned urgent care not so much a corporate run.

There are urgent care “boot camps” and procedure workshops which will teach you the procedures. You can also buy a suture kit from Amazon and watch some good YouTube videos on technique and just practice.

It’s going to be the peds you will struggle with. All you can do there is read and see if you have a peds friend who can help guide you. Lots of peds urgent care books out there. I’ve even seen younger IM docs working the emergency room in more rural settings so it is possible.

 

[chessknt]

Why do you want to work in a setting you weren't trained for? Did you suddenly discover this burning urge to see OB and peds and are willing to risk the enormous liability and pay trade off for the 'opportunity' to see mostly well people with the sniffles?

 

[rokshana]

Why do you want to work in a setting you weren't trained for? Did you suddenly discover this burning urge to see OB and peds and are willing to risk the enormous liability and pay trade off for the 'opportunity' to see mostly well people with the sniffles?

Prolly because they can do shift work, and deal with mostly well people…and get paid well.

 

[chessknt]

Prolly because they can do shift work, and deal with mostly well people…and get paid well.

Urgent care isn't going to pay well and hospitalist medicine is 100% shift work. You also don't have to try to practice outside of your training and assume liability for things you don't understand. Makes no sense for a relatively fresh IM graduate with no peds or EM procedure exposure to want to work in an UC at all unless they are not BE or have other red flags that will make them unable to credential in a hospital.

The closest OP could do is try to find a VA emergency room (no peds and almost never any ob) which has most urgent care level stuff. It also probably pays better and has government level benefits.

 

[VA Hopeful Dr]

Prolly because they can do shift work, and deal with mostly well people…and get paid well.

Unless you own the urgent care, you'll likely make more as a hospitalist or PCP.

 

[InternistDO]

There are systems that have IM in urgent cares in the Northeast, usually big enough to have double coverage with an EM/FM doctor or a midlevel who will see OB and peds. I&D and suturing are pretty easy, and there are courses every year at ACP if you want a bit of a foundation.

Fracture care I personally have less experience with but assuming you aren't doing actual casting you may be able to get on teaching on the job.

There are also PCP positions where the attendings also staff an "urgent care" for the practice's patients, which limits the pool a little bit.

As others have said though, urgent care is not always the most lucrative field. You'd probably make more doing general primary care in the long run, at least with the offers I've seen.

 

[Make Or Break]

I will say a lot, if not most, urgent cares will not touch an obgyn problem and just tell them to go to the ER. But yes don’t expect to make a lot more doing urgent care. Some shops will make you work hard for your money too seeing 50-70+ patients a shift that are mostly sniffles.

 

[rokshana]

I will say a lot, if not most, urgent cares will not touch an obgyn problem and just tell them to go to the ER. But yes don’t expect to make a lot more doing urgent care. Some shops will make you work hard for your money too seeing 50-70+ patients a shift that are mostly sniffles.

Well… that could be better that 25 pts all with copd, gyn, dm, anemia, coming in for problems with everything…if you are looking to do the least amount of working/thinking…

 

[cutefamilydog]

Why do you want to work in a setting you weren't trained for? Did you suddenly discover this burning urge to see OB and peds and are willing to risk the enormous liability and pay trade off for the 'opportunity' to see mostly well people with the sniffles?

Yes mainly because of the ability to do shift work....

 

[AlbinoHawk DO]

I'd say you'd better off if you just did regular clinic with walk-ins

 

[scoopdaboop]

Well… that could be better that 25 pts all with copd, gyn, dm, anemia, coming in for problems with everything…if you are looking to do the least amount of working/thinking…

how? seeing 40 patients with URIs and UTIs etc. is an overwhelming amount of charting. the charting itself seems awful.

 

[rokshana]

how? seeing 40 patients with URIs and UTIs etc. is an overwhelming amount of charting. the charting itself seems awful.

i don't disagree...but once your shift is done..you are done...unlike seeing the same type of pts as a pop, still having to do the charting, and having an inbox and having to do prior auths...neither are appealing to me...its why I'm a sub specialist...

 

[VA Hopeful Dr]

i don't disagree...but once your shift is done..you are done...unlike seeing the same type of its as a pop, still having to do the charting, and having an inbox and having to do prior auths...neither are appealing to me...its why I'm a sub specialist...

If you're doing that much of those things you're doing primary care wrong.

 

[IM2GI]

If you're doing that much of those things you're doing primary care wrong.

How does your care team model work? Do you have nurses and MAs that work your inbox for you and do all your results, letters, etc?

 

[VA Hopeful Dr]

How does your care team model work? Do you have nurses and MAs that work your inbox for you and do all your results, letters, etc?

They do all my prior auths. At most I sign them and that's getting increasingly rare. They pre-screen all refill requests to make sure they patient doesn't have refills at the pharmacy that they don't know about (irritatingly common). They get first pass at all calls/patient messages and they handle what they can. For simple requests - refills, HH orders, referrals, I have a single button I press that tells them to handle it.

The results I type out (using smart phrases most of the time) my plan and they contact the patient. For example, if all the labs are normal I have a single button I press which types out my "labs are normal" spiel and sends it to them. Takes less than 20 seconds including reviewing the labs themselves.

Most phone calls I can answer with a single sentence. If its much more than that, I have a button that tells them to schedule an appointment for the patient. Refills that do make it through I either hit the button to refill or I have a button that sends it to my MAs that says "patient needs appt, OK for small refill if needed to make it to appointment".

 

[HemeOncHopeful19]

They pre-screen all refill requests to make sure they patient doesn't have refills at the pharmacy that they don't know about (irritatingly common).

A-freaking-men to that one. It is bizarre the number of requests - like dude it says on the bottle you have refills