mountains of info?

[marcus_aurelius]

Hey guys,

i am interested in family practice as a career. the thing that seems like it might frustrate me is how do you deal with knowing everything about everything. i think i might be a little nervous if i missed something in a patient....how do u get over this....is there a lot of litigation against f.p's these days?

what board scores do you need to get into a top notch family practice residency?

thanks a lot. any help would be appreciated.

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[deleted87716]

how do you deal with knowing everything about everything. i think i might be a little nervous if i missed something in a patient....how do u get over this....is there a lot of litigation against f.p's these days?

First of all, give up the notion that you have to know everything about everything. You have to know something about a lot of things, and you have to know what's important and what's not. Unlike a specialist, you don't have the luxury of saying, "Sorry, that's not my area." It's potentially all your area, up to a point. But then...that's what makes it so much fun!

As for litigation, FPs generally are sued far less than a lot of other fields. If we get sued for anything, it's usually for a missed/delayed diagnosis. So don't do that. Seriously, you just need to rule out the really bad stuff first, and know your limitations. Don't be afraid to say "I don't know", and don't be an island. If you have a complicated case, talk to your colleagues, including specialists. Refer when necessary. If you're worried, make sure the patient knows you're worried. Communication is key. Don't drop the ball. Follow up on the important stuff. And document, document, document.

what board scores do you need to get into a top notch family practice residency?

I don't really know, as I've been out of residency for a few years. However, given the relative lack of interest among med school grads in primary care in recent years, you'll probably find it easier to get into a good program now compared to when I was a resident.

 

[8744]

Hey guys,

i am interested in family practice as a career. the thing that seems like it might frustrate me is how do you deal with knowing everything about everything. i think i might be a little nervous if i missed something in a patient....how do u get over this....is there a lot of litigation against f.p's these days?

what board scores do you need to get into a top notch family practice residency?

thanks a lot. any help would be appreciated.

You won't know everything and you won't have to as one of the jobs of every primary care physician (including EM) is to know when to consult a specialist.

All you need to match in FP is a pulse and the desire. Don't sweat it.

 

[deleted87716]

All you need to match in FP is a pulse and the desire. Don't sweat it.

And if you're a U.S. medical grad, the pulse is optional.

KIDDING!

 

[Mike59]

As someone who will start my FP residency in July, I have to say that I've been forced to defend the field on numerous occasions. Everyone from specialists to other med students argue "no one can know all that about that much"...

Regarding "top notch" residencies, FP is different because the best programs tend to be community based. Even then, a reputation means nothing because in the job market there's so little competition and you may be opening your own practice so it doesn't matter where you went. It's more about choosing a place that you'll enjoy 3 years at and acquire the skills you want to acquire for what you hope to do...Be warned, the "top notch" programs like Ventura, JohnPeterSmith will clobber you over the head for 3 years and run you like a pseudo-surgical resident. The skillset acquired is unparalleled but do you honestly see yourself cutting open abdomens to remove gallbladders just outside of small-town-USA 10 years from now when in practice!?

Regarding the monstrous breadth you are concerend about- in FP, 90% of your day focuses on about 30 bread and butter conditions (low back pain, DM, htn, asthma etc, dizziness.) If you know these well, the other 10% is a matter of realizing what needs to be referred and who needs to go to ER. If you keep a "generalist" perspective through med school and learn of these 30 or so conditions, you will be very well rounded and well prepared for the uncertainties of FP. Don't be scared of "missing anything" because you will develop a clinical sense of what's emergent and what isn't- many times it's a lab result (WBC of 30+, maybe they should see heme-onc) or the patient has an acute abdomen (they need to be operated on TONIGHT, I'll call the ambulance).

Litigation has been shown to be LOWEST in primary care because if you do a decent job, your patients will like you, trust you and keep coming back to see you. Who sues someone they get along with!? Good FP is all about rapport, prevention, counselling and trust. When patients encounter an a$$hole specialist who whips in and out in 3 minutes, charges them hundreds of dollars out of pocket and then botches the diagnosis, you can imagine how this is different and more prone to a lawsuit.

FP is one of medicine's best kept secrets IMHO, there are lots of new innovative reforms happening (Veterans system, Canada, Oceania) and I think salaries/reputation will improve greatly in the next few years when the powers that be realize that prevention and good primary care is the only way the health care system can sustain itself .

Good choice of field!