So I never respond to these posts, but I thought for once I would. I have been reading all about the "midlevel TAKEOVER" posts in various areas of medicine over the years. As a med student it made me nervous, and I spent a lot of wasted time worrying about the future and wondering if I was wrong to go into medicine given the huge debt load and time committment.
I am second year resident in family medicine and I am very happy. As imagine most jobs are, some days I love what i do, some days i despise it, most of the time my feelings are somewhat in between the two. Being on this forum does instill a sense of urgency and concern for the future of family medicine, but I have to say that since I have been out in the real world I haven't noticed this concern in daily practice. As a matter of fact, I have already had recruiters just about knocking down my door to recruit me. All of my fellow graduating residents have had generous sign on bonuses of some sort no matter where they have practiced. Some of them have had very generous loan repayment packages and incomes mostly depending on the area and type of practice.
Being a primary care doc is HARD work, but also very rewarding and fun. I have the opportunity, in my area atleast, to decide for the most part what practice I want. Do I want rural vs. urban/ suburban? Do I want mostly outpatient, mostly inpatient or both. Do I want to do obstetrics? Do I want to have areas of focus within primary care such as derm, geriatrics, etc. What kind of call schedule do I want (some of the bigger clinics have call 1 in 40 for example)? I could chose to be part time. The sky is the limit! I have yet to encounter the NP/ PA thing interfering with my options.
Primary care in HUGE demand right now whether you're a doc or a midlevel or even ancillary staff.
WHO KNOWS what will happen with the future of medicine. Whether we start finding our radiology or surgical jobs go overseas because it's cheaper? Whether Anesthesiologists become a thing of the past as Nurse anesthesiologist take over? So far I don't know if
any of these "fears" have
any evidence in reality. Maybe, but it sure doesn't seem like any of our incomes have taken hit....
Again, Primary care is HARD work and we get paid the least compared to our specialist colleagues. We do have a lots of paperwork and hoops, etc. We deal with chronic disease management in challenging patients, and coordinate care in a difficult healthcare system. There are indeed changes to the way we practice primary care as the patient centered medical home becomes a popular concept and we begin to approach team based care. All of this has its upsides and downsides and challenges and changes with implementation. Despite all of the challenges, I do enjoy what I do
because I enjoy practicing family medicine. I enjoy using my brain!! Anyone who think's it's cook book medicine, and/or inferior to other specialties is completely ignorant. I think it's among the most difficult of the medical specialties, and I have heard many specialist say the same thing....
Although there's plenty of change proposed, I'm
not worried about the future of family medicine in the forseeable future. But, I'm sure some of you have horror stories to contradict me.... I really don't care, actually...
Nothing in life is guarenteed, but I believe if you work
hard you'll generally come out just fine.
Do in your heart what you want to do.
but to think nurses can become threat to PCPs will be an over extension. Nurses can address some medical question which could have been better handled by a doctor but anyway it will increase accessibility to basic health services and should be welcomed by the medical community with proper guidelines and procedure.
