Procedures?

[6ft3dr2b]

Just wondering about the possibilities of FM Drs performing procedures such as: joint injections, Flexible sigmoidoscopy, colonoscopy, biopsies, and Pulmonary function testing. The way I see it, if I can learn some of these skills then I wouldn't have to refer out as much.

I know that many of the subspecialties in IM give you extensive training. However, I was wondering if FM docs could be trained in these (in a good residency program)

Thanks

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[sophiejane]

Just wondering about the possibilities of FM Drs performing procedures such as: joint injections, Flexible sigmoidoscopy, colonoscopy, biopsies, and Pulmonary function testing. The way I see it, if I can learn some of these skills then I wouldn't have to refer out as much.

I know that many of the subspecialties in IM give you extensive training. However, I was wondering if FM docs could be trained in these (in a good residency program)

Thanks

There are many threads on the topic, a search will yield more discussions than you probably care to read on procedures in FM.

The short answer is yes. Community-based, unopposed and some university -based opposed programs offer training in endoscopy (mouth to anus, basically), joint injection, treadmill, basic ultrasound technique, and all hospital procedures (central lines, intubation, thoracentesis, chest tube placement, paracentesis) as well as circumcision, colposcopy, c-sections, endometrial biopsies, IUD placement, mole removal by punch biopsy or excision, toenails, etc. I'm sure I'm missing a few.

Nearly all programs will give you adequate training in office-based procedures.

 

[deleted87716]

Just wondering about the possibilities of FM Drs performing procedures such as:

OK...

joint injections

Yep...almost daily.

Flexible sigmoidoscopy

Used to, no longer in demand now that insurance pays for colonoscopy. Low volume = not worth maintaining the equipment and paying the malpractice. I don't miss it...it didn't really pay that well anyway, and was kinda gross...

colonoscopy

Nah. Yuck.

biopsies

All the time.

Pulmonary function testing

We can do spirometry in the office, but the reimbursement is pretty minimal. I usually refer out for complete PFTs...better data, less time in the office.

The way I see it, if I can learn some of these skills then I wouldn't have to refer out as much.

Sometimes, it's better to refer out. Better for you, and better for the patient.

I know that many of the subspecialties in IM give you extensive training.

Only limited to their specialty. Most general internists don't do any in-office procedures. If you like procedures, you're much better off doing FM than you are IM, unless you're into self-study.

 

[Joe Richards]

OK...



Yep...almost daily.



Used to, no longer in demand now that insurance pays for colonoscopy. Low volume = not worth maintaining the equipment and paying the malpractice. I don't miss it...it didn't really pay that well anyway, and was kinda gross...



Nah. Yuck.



All the time.



We can do spirometry in the office, but the reimbursement is pretty minimal. I usually refer out for complete PFTs...better data, less time in the office.



Sometimes, it's better to refer out. Better for you, and better for the patient.



Only limited to their specialty. Most general internists don't do any in-office procedures. If you like procedures, you're much better off doing FM than you are IM, unless you're into self-study.

I once went to a procedural training course for a refresher and most of the docs has never done the procedure before. They were mostly internist.

Internal medicine is very hospital based and procedures in the hospital are more emphasized than office procedures.