Possible forewarning...?

[235788]

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[Poliscidoc]

I hope this thread doesn't blow into rants. The internal medicine MD that i've been seeing over the past 4 years is giving up internal medicine to do an emergency medicine residency at the age of 37. Is internal medicine/family practice being left behind for urgent care centers? I volunteer in the second largest ER in my state and between personally experiencing and talking to the ER staff; there is a noticable surge in ER visits that are more appropriate for a family doctor (Preg. Check, casual STD check, Acne 😕, sure you can imagine). I understand that high percentage of these patients are medicaid and medicare; however a lot of them are insured by respected insurers. Any thoughts?

Um, he wants to do EM and he has probabaly little to no debt and thinks 3 years is worth it. Don't really see how this means internal medicine is declining while EM is thriving. I just think it points to the lack of people with primary care doctors or the lack of coverage.

 

[morning]

Just because a lot of ER visits are from impatient and ignorant people does not mean most people are impatient and ignorant and will use the ER over their PCP.

 

[Rickybobby]

Point 1: N=1 and who cares.

Point 2: Poverty is increasing therefore ER visits are increasing. I agree this statement is fallacious...

Random point not mentioned in original post: Emergency rooms are family practice clinics - face it for christ's sake.

 

[shiftingmirage]

I think it's more that a significant amount of the population has no PCP. Therefore, when something minor happens, they say,, let's go to the ED. Also, I don't know what time you volunteer at the ED, but most docs offices are open 9-5. If you're paid by the hour, you wont want to take the time of work, so that leaves you with even hours, and the ED is open during those times. And those tend to be the busier times. So I don't think FM/IM are going to disappear.

Like Rickybobby stated, something like 50% of ED visits are for things that one should really go to a PCP for. That's not a new thing.

 

[Bernoull]

I hope this thread doesn't blow into rants. The internal medicine MD that i've been seeing over the past 4 years is giving up internal medicine to do an emergency medicine residency at the age of 37. Is internal medicine/family practice being left behind for urgent care centers? I volunteer in the second largest ER in my state and between personally experiencing and talking to the ER staff; there is a noticable surge in ER visits that are more appropriate for a family doctor (Preg. Check, casual STD check, Acne 😕, sure you can imagine). I understand that high percentage of these patients are medicaid and medicare; however a lot of them are insured by respected insurers. Any thoughts?

As for the ridiculous things people go to the ED for, I recommend "Things I learn from my Patients" in case u haven't seen it, effing golden (as Blagojevich would say..)

 

[LizzyM]

Look at it from the doc's perspective. EM has defined hours. Sure you are going to work some nights, weekends, holidays but when you are off you are OFF and you are not going to be called at home at 5 am on a Sunday morning for a birth control pill refill or any number of other ridiculous things that primary care internists are subjected to.

 

[caseofthemndays]

Even those insured by "respected insurers" might have crappy HMO's and can't get in to see a PCP for 3 months if they aren't returning patients.