Impact of moving several times during FM career

[ShenandoahDoc]

Hi all, I just finished M1 and am very interested in FM. I grew up in a very rural area and if I choose FM I eventually would like to move back to a similar rural area and open a private practice. I am married and I anticipate that my spouse will have to move a few times, maybe 2 or 3 times every 5 years or so, for the first 15 years after I start practicing. After which we would likely be in one place for the rest of my career.

What impact would several moves have on an FM practice? I'm sure I wouldn't just start from scratch each new place and wait the time to build a new panel, and so that would make an employed position seem more realistic if I don't plan on staying somewhere long term. Likewise a partner track sort of job wouldn't be attractive at least early on when I knew I would be moving again. At the same time I know people are desperate for a PCP and the wait time is getting longer and longer to see one; so maybe building a new panel either as a private doc or employed wouldn't be as hard as the past?

What impact have you all seen on panel size, on practice scope, on income, etc. And what advice do you have? I'm sure I could just practice in urgent cares, but if that is by far the best option I also love EM and I would likely go for EM instead of planning ahead of time to do urgent cares.

What do y'all think? Thanks!

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[deleted87716]

Work part time, or do urgent care.

That is all.

 

[ShenandoahDoc]

Work part time, or do urgent care.

That is all.

Why working part time vs just full time at a large group/hospital owned practice as an employee? I would be there for 4-5 years, so not long enough to do much in terms of my own practice but still I would think enough for full time? And yep urgent care would be perfectly flexible.

 

[deleted87716]

It takes at least a couple of years to build a practice. Nobody in their right mind would hire anyone for primary care unless they expected them to stick around for a while.

 

[ShenandoahDoc]

Makes sense. Thanks for the input.

 

[cabinbuilder]

Why working part time vs just full time at a large group/hospital owned practice as an employee? I would be there for 4-5 years, so not long enough to do much in terms of my own practice but still I would think enough for full time? And yep urgent care would be perfectly flexible.

Usually I agree with Blue Dog but I would not advise to do urgent care just because you have the risk of moving in 5 years. You will lose your management skills in urgent care. Rural medicine will take you for whatever you can give as far as time. Just know that moving that much you won't ever see bonus checks, etc due to the short term you will be there. You may want to do locums and go do FP at a rural site for 3-6 months and then take time off and go to the next site.

However, as an M1 you are very far (6 years) until you even think about getting a permanent job and life definitely changes in that time. I suspect you are over thinking when you aren't even close to looking at jobs. Baby steps. Get through before you worry about career paths.

 

[smq123]

It takes at least a couple of years to build a practice. Nobody in their right mind would hire anyone for primary care unless they expected them to stick around for a while.

To be completely accurate, this isn’t quite true. Many community health centers, Native American reservations, and local health departments have high turnover and will happily hire someone for the short term. For someone who expects to be in a location for just a few years, those are decent options to look into (especially as they offer good loan repayment options and the malpractice insurance is fantastic.)

 

[deleted87716]

To be completely accurate, this isn’t quite true.

Of course. One might argue, however, that those aren’t necessarily the most desirable positions.

 

[smq123]

Of course. One might argue, however, that those aren’t necessarily the most desirable positions.

No, they’re generally not. But you can usually stick it out for 4-5 years. Again, the loan forgiveness opportunities do help.

 

[VA Hopeful Dr]

No, they’re generally not. But you can usually stick it out for 4-5 years. Again, the loan forgiveness opportunities do help.

I'm not sure I could last four to five days at your job much less years...

 

[smq123]

I'm not sure I could last four to five days at your job much less years...

Well, fair enough.