Questions about FM physicians who work in EM, do special procedures,etc?

[qqw]

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Can you work in any emergency room with a board certification in FM? Only 75% of them? 30%?

I know some FM docs do some procedures that dermatologists also do, Do they get the same compensation a derm would get for the same procedure? And is it hard to find workshops, fellowships, to learn to do these procedures?

Thanks!

 

[VA Hopeful Dr]

Yes, but its getting harder and harder to do. In my area, you're stuck at either the VA or a rural place.

Generally speaking, we get paid the same. That's not always true, but it is more often than it isn't.

Lots of places to learn to do more things. The annual AAFP meeting has some good workshops this year - http://www.aafp.org/events/fmx/cme/opportunities/workshops.html

There is also the National Procedure Institute - http://www.npinstitute.com/cme-courses-s/1477.htm that does a single conference on a topic. I've never done it but have heard good things.

 

[cabinbuilder]

Yes, but its getting harder and harder to do. In my area, you're stuck at either the VA or a rural place.

Generally speaking, we get paid the same. That's not always true, but it is more often than it isn't.

Lots of places to learn to do more things. The annual AAFP meeting has some good workshops this year - http://www.aafp.org/events/fmx/cme/opportunities/workshops.html

There is also the National Procedure Institute - http://www.npinstitute.com/cme-courses-s/1477.htm that does a single conference on a topic. I've never done it but have heard good things.

I did national procedure institute for a cardiac stress testing class my job made me do. It was top notch and very thorough.

 

[VA Hopeful Dr]

I did national procedure institute for a cardiac stress testing class my job made me do. It was top notch and very thorough.

I've thought about doing that exact course in a few years, so thanks for the insider info

 

[mabinante]

I work in Los Angeles. . My guess is 99.99% of all ED docs here are boarded. I have met some FM docs working here in ERs but they were grandfathered into the EM board.

In my residency we work out on Catalina Island in their clinic and cover the ER at night for our rural med month. They do have family docs working the ER there. So, my point is, if you go rural, you can work ER as FM. The other thing to look into would be dual FM/EM programs.

 

[styphon]

Can you work in any emergency room with a board certification in FM? Only 75% of them? 30%?

I know some FM docs do some procedures that dermatologists also do, Do they get the same compensation a derm would get for the same procedure? And is it hard to find workshops, fellowships, to learn to do these procedures?

Thanks!

I work outside of Buffalo (NY's 2nd largest city). Inside the city you need to be EM boarded to work in the ER. Most of the hospitals outside of the city take both EM/FM, including suburban and rural hospitals.

We should get paid the same as derm for the same procedures by the same insurance company. Difference being lots of Derm will not take (or will cap) the amount of medicaid and medicare patients they see, which helps increase the amount of money you average per procedure. Derm will also have a greater count of procedures per year then the average family medicine doctor.

 

[JustPlainBill]

Remember also that you will be held to the standard of the specialty who's procedures you are doing -- if you're doing colonoscopies for example and perf a bowel, they won't judge you based on ,"Well, golly gee, he's an FM doc who picked up this procedure at post residency training and has only done one or 2, cut him some slack" -- no, it's going to be," Would a board certified, residency trained gastroenterologist or surgeon have botched this in this manner or would they have known better?". Just a thought ---

 

[deleted87716]

We should get paid the same as derm for the same procedures by the same insurance company. Difference being lots of Derm will not take (or will cap) the amount of medicaid and medicare patients they see, which helps increase the amount of money you average per procedure. Derm will also have a greater count of procedures per year then the average family medicine doctor.

Reimbursement for procedures is the same under Medicare regardless of specialty. Commercial insurers, however, can negotiate fees - so, anything's possible.

 

[Wahoowa23]

I've thought about doing that exact course in a few years, so thanks for the insider info

Although the NPI is an excellent resource to get initial training, I would strongly encourage you to get the procedural training you need while a resident or fellow on actual patients.
Have you considered following a cardiologist? They do these routinely and are likely to be better than a workshop. Another alternative is following a FP that does these. Although not a cardiologist, those that do them, might do them well. There are some physicians, even from our own specialty, who don't believe family medicine should do any procedure that a specialist does. So if you are going to do it, do it to the same standard as cardiologists! There is an FP fellowship in Colorado that trains in Cscopes and Stress tests, among other things, if you are really interested.

 

[VA Hopeful Dr]

Although the NPI is an excellent resource to get initial training, I would strongly encourage you to get the procedural training you need while a resident or fellow on actual patients.
Have you considered following a cardiologist? They do these routinely and are likely to be better than a workshop. Another alternative is following a FP that does these. Although not a cardiologist, those that do them, might do them well. There are some physicians, even from our own specialty, who don't believe family medicine should do any procedure that a specialist does. So if you are going to do it, do it to the same standard as cardiologists! There is an FP fellowship in Colorado that trains in Cscopes and Stress tests, among other things, if you are really interested.

OK, so a few thoughts on this.

First, I'm an attending. I'm not going back to residency (nor would they allow me to) just to brush up on stress testing.

Second, have you actually thought most of your post through? What cardiologist/competing family doctor in their right mind will say "Sure, let me teach you how to do the same thing I do. I'm sure this won't result in me losing any lucrative procedure referrals or new patients"?

Third, if one is competent with reading ECGs (which I am), a weekend stress testing course is more than sufficient. None of us need to go back to residency to learn stress testing protocols.

Fourth, I'm well aware of what standard we are held to.