So what's wrong with wanting to be just an FP?

[rjhtamu]

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When I tell some of my classmates I want to be a FP or Peds in a small town they just look at me and go Why? It's as if it's something menial in the modern world of medicine or something. Not everyone wants to be an ENT, Optho, or Ortho guy...

 

[GoodMonkey]

nothing is wrong with it. we need people to do that, and i'd rather see people who are excited about those fields go into them than someone reluctantly shunted into them.

congrats on figuring out what you want to do, too, btw. i'm still working on that one. 🙂

 

[rjhtamu]

Don't worry, sometimes you figure it out when you least expect it, but good luck with everything and I'm sure it'll work out fine. 🙂

 

[doc05]

there's nothing wrong with FP, so long as it fits with your personality and future plans. just keep in mind that in big cities/suburbs, the high density of specialists/subspecialists will eat into your patient base. In rural areas, you'll be in high demand, can develop a very broad scope of practice, and make a very good living.

 

[Obedeli]

Absolutely nothing is wrong. We need you.

 

[tofurious]

In fact, if you are a US med student, you likely have your choice of residency as most FP residencies either don't fill or have to fill with FMGs. I personally think that US can use a lot more US family med docs than all the surplus anesthesiologists and radiologists.

 

[Ross434]

When I tell some of my classmates I want to be a FP or Peds in a small town they just look at me and go Why? It's as if it's something menial in the modern world of medicine or something. Not everyone wants to be an ENT, Optho, or Ortho guy...

They're jealous of high salaries and low stress of such a job. FP is $$$ in rural areas.

 

[Blake]

Nothing wrong with that. I think it happens to almost everyone. Try telling your friends you want to become a surgeon, and you'll probably get the same kind of reactions.

 

[tofurious]

Nothing wrong with that. I think it happens to almost everyone. Try telling your friends you want to become a surgeon, and you'll probably get the same kind of reactions.

In fact, you'll probably get the same reaction for anything you want to go into with the possible exception of lifestyle specialties.

 

[tigershark]

In fact, if you are a US med student, you likely have your choice of residency as most FP residencies either don't fill or have to fill with FMGs. I personally think that US can use a lot more US family med docs than all the surplus anesthesiologists and radiologists.

Surplus radiologists? Not sure what country you live in but here in the US there's a shortage of radiologists and it's only going to get worse as the boomers start hitting medicare age and imaging continues to explode.

Nothing against FPs, I think they are great, and like someone else already said you can do extremely well in rural areas.

 

[skypilot]

There's also a shortage of Anesthesiologists right now. That is what is pushing the salaries upward. I think there will be a shortage of all docs as the population continues to age.

 

[tupac_don]

When I tell some of my classmates I want to be a FP or Peds in a small town they just look at me and go Why? It's as if it's something menial in the modern world of medicine or something. Not everyone wants to be an ENT, Optho, or Ortho guy...

I think that its just if you are gonna through all those years of schooling, people want to cash in. I think that if FP's made 200,000+, it wouldn't be an attractive field. Not that anything is wrong with being an FP, just they work probably as hard as those in life style specialites if not more, but they are underpaid.

 

[kinetic]

When I tell some of my classmates I want to be a FP or Peds in a small town they just look at me and go Why? It's as if it's something menial in the modern world of medicine or something. Not everyone wants to be an ENT, Optho, or Ortho guy...

There's nothing wrong with it. The reason your classmates ask "why" is because a lot of them are making their career decisions based on lifestyle and pay and then telling everyone that they're doing it because they're so jazzed about looking at acne for the rest of their lives.

 

[Rogue_Leader]

There's nothing wrong with it. The reason your classmates ask "why" is because a lot of them are making their career decisions based on lifestyle and pay and then telling everyone that they're doing it because they're so jazzed about looking at acne for the rest of their lives.

Lifestyle is an important decision in deciding what kind of field you want to go into. Almost 60% of physicians say that they would not go into medicine if they had that choice to make again. You need to decide which field will make you happiest, since it's not that easy to swtch fields after you've done your residency.

 

[skypilot]

When I tell some of my classmates I want to be a FP or Peds in a small town they just look at me and go Why? It's as if it's something menial in the modern world of medicine or something. Not everyone wants to be an ENT, Optho, or Ortho guy...

Also don't worry, those ENT's, Optho's and Orthos will be kissing your behind to get referrals from you when you are out in practice. And with hospitalists to cover your inpatients, family practice has a pretty nice lifestyle and an excellent income. Especially in areas where a house doesn't cost $500,000. 🙂

 

[Discobolus]

I know guys from my school that were AOA that went to community based family practice program. I know this will blow the minds of a lot of city folks, but some people want to be rural doctors and really enjoy it. They can also make really good money if they are business savy and are willing to work. There are some programs that are very heavy in procedural training and out in some really rural areas it's the FPs doing colonoscopies and the like. There are other people that need the "prestige" of some specialty to get their rocks off, but others don't need that and tend to be happier.

 

[SanDiegoSOD]

When I tell some of my classmates I want to be a FP or Peds in a small town they just look at me and go Why? It's as if it's something menial in the modern world of medicine or something. Not everyone wants to be an ENT, Optho, or Ortho guy...

Don't forget that you can now open a botique practice in a small afluent town, care for 600 patients, and pull in at least twice what these specialists are making... jk 😉

 

[fun8stuff]

Lifestyle is an important decision in deciding what kind of field you want to go into. Almost 60% of physicians say that they would not go into medicine if they had that choice to make again. You need to decide which field will make you happiest, since it's not that easy to swtch fields after you've done your residency.

Oh yes, and almost 60% of statistics are bullsh*t! 🙄

 

[thackl]

Almost 60% of physicians say that they would not go into medicine if they had that choice to make again.

And the vast majority of Dr's don't know anything else. Let the 60% try something different for 5yrs then re-poll. I bet most would want to go back to medicine.

 

[Rogue_Leader]

Oh yes, and almost 60% of statistics are bullsh*t! 🙄

The statistics for physicians aren't good. Here are the numbers I have from the syllabus of a psychology course I took as an MS1.

50% of physicians would not enter the field if choosing a career again. (Ok, so I was a bit off)

87% of physicians say their morale has declined in the past 5 years.

145 physicians commit suicide every year.

75% of female physicians report getting sexually harrassed by a patient at least once in their carreer, mainly by male patients

80% of male physicians report being sexually harrassed, also primarilly by male patients.

37% of physicians are stalked at one point in their carreer.

40% of physicians are physically assulted at least once in their carreer, with higher rates of verbal assult.

70% of marrages involving at least one physician end in divorce, with medical students who get married before graduation having even higher rates of divorce.

Physicians are sued for malpractice 2-3 times in their carreer, and it takes about 7 years from when the subpeona is served to when the case is settled.

Only 10% of physicians take regular time off, and only 11% take vacations that aren't related to attending a conference or meeting.



Medicine is not all rainbows and sunshine. It's more like a VH1 Behind the Band special where there are so many dirty secrets that aren't shown to the public.

 

[Vandyfox]

87% of physicians say their morale has declined in the past 5 years.

My moral isn't nearly as high as when I was 17 years old either.


Ask anybody (well, unless they are within 5 years of residency. . .anything's gotta be better than that) and I bet they'd remember being better off 5 years ago despite profession

Oh, to be 17 again. . . . .
-Vandyfox

 

[gwyn779]

There is absolutely nothing wrong with wanting to do FP. In fact, I think it's one of the hardest specialties, because you really have to know a lot about a lot of different areas. It's very unfortunate that many people in medicine have the idea that FP's only know a little about a lot of different things, but not enough to do any of them well. The problem is that there are FP's like that and those are the ones that seem to stand out. Some of the most intelligent people I have met are the really good FP's, because they know SO MUCH.

Luckily, I haven't encounted too much of the negative attitude personally, I think mostly because the family med dept. at my school is really good and well respected.

In the end, however, we need every kind of doctor and if everyone wanted to do the same thing, the world would be very boring and nothing would work.

 

[kinetic]

I think it's one of the hardest specialties, because you really have to know a lot about a lot of different areas.

Hey, nothing wrong with being an FP, but let's not go crazy here.

 

[wolfvgang22]

The statistics for physicians aren't good. Here are the numbers I have from the syllabus of a psychology course I took as an MS1.

50% of physicians would not enter the field if choosing a career again. (Ok, so I was a bit off)

87% of physicians say their morale has declined in the past 5 years.

145 physicians commit suicide every year.

75% of female physicians report getting sexually harrassed by a patient at least once in their carreer, mainly by male patients

80% of male physicians report being sexually harrassed, also primarilly by male patients.

37% of physicians are stalked at one point in their carreer.

40% of physicians are physically assulted at least once in their carreer, with higher rates of verbal assult.

70% of marrages involving at least one physician end in divorce, with medical students who get married before graduation having even higher rates of divorce.

Physicians are sued for malpractice 2-3 times in their carreer, and it takes about 7 years from when the subpeona is served to when the case is settled.

Only 10% of physicians take regular time off, and only 11% take vacations that aren't related to attending a conference or meeting.



Medicine is not all rainbows and sunshine. It's more like a VH1 Behind the Band special where there are so many dirty secrets that aren't shown to the public.

Wow. Sounds a lot like my previous career as a teacher. Trade ya salaries.

 

[aphistis]

Wow. Sounds a lot like my previous career as a teacher. Trade ya salaries.

Zing! 😀

 

[swedcrip]

I don't mean to start a flame war and I don't full agree with the following, but ...

The job of family physician and nurse practioner/PA seems to be getting blurred to me. The health system as it cuts costs and maximizes profitability will find it much cheaper to train the latter.

As a physician, we'll have to demonstrate a justification for any higher value of our services if we expect to make more than NP/PA's.

I know that NP/PA's have to be under the supervision of MD/DOs, but if you look out there at what's going on, especially outside of academic practices, how much supervision is really happening. How much time do these doctors spend overlooking their NP/PA's?

I could foresee a time when the system moves towards less supervision and pairing up large #'s of NP/PAs under a single MD/DO's supervision. What percent of FP's can still afford to do OB?

Plus my impression is that 3 years of IM give a stronger preparation for primary care adult medicine.

I didn't consider FP for other reasons. I don't like the shift towards NP/PAs working so independently, but I think it is and will continue to happen.

So I wonder if as a FP I'd feel that needed over the next 40 years. Clearly in rural areas right now there is a definite place. But I'd be concerned that specialists & NP/PAs will start dominating the system 10-20 years from now. Maybe it won't happen, but I think that might be part of what keeps some away from the field. I think a large share of my classmates want to live within driving distance of a larger city (sports, arts, etc). So unless you want to live very rural (I grew up in a fairly rural area), I can see why the field isn't appealing to everyone.

For me, being responsible for keeping up to date on all areas of medicine is daunting. I desire no further training in OB!

If I wanted to do primary care, I'd probably choose IM/peds over FP. Just based on my personal experiences.

Other specialities are facing threats (nurse anesthetists, radiology consults over the internet/overseas, etc), but if some day NP/PAs can start consulting MD specialists and actually be officially granted the little oversight I think some get (say allow a primary care MD to run a practice of 20+), the field might face incredible competition for jobs anywhere near a large city.

 

[Vandyfox]

Doc's I've worked with here at school (and out other places) have noted the EXTREME difference in knowledge base between any M.D. (FP's) and the nurses.

Which makes sense, considering the training each receives. PA's are helpful in a time / money crunched healthcare system, but they will never be as competant / productive / important as the Family Practice peeps. Unless you want your PA's having speed-dial for their specialists, and calling them 1.3 million times a day. OR, train PA's a whole lot better. . . . . but then they'd be MD's and thus the need for Family Practice.

I will agree, that FP is more necessary in rural areas where IM / Peds are abundant in cities. The simple fact is that lots and lots of these small town cannot support IM / Peds, they need the FP because of wide age gaps with smaller clientel (clientel that cannot drive 1+ hours for a physical). I was / am considering Peds, but I want to work in my hometown, which cannot support the specialty. FP looks better and better every day for me.

just some thoughts, I don't mean to say other arguments are straight wrong. it's clearly a healthy debate and something that we all need to consider.

-Vandyfox

 

[swedcrip]

Doc's I've worked with here at school (and out other places) have noted the EXTREME difference in knowledge base between any M.D. (FP's) and the nurses.

Which makes sense, considering the training each receives. PA's are helpful in a time / money crunched healthcare system, but they will never be as competant / productive / important as the Family Practice peeps. Unless you want your PA's having speed-dial for their specialists, and calling them 1.3 million times a day. OR, train PA's a whole lot better. . . . . but then they'd be MD's and thus the need for Family Practice.

I will agree, that FP is more necessary in rural areas where IM / Peds are abundant in cities. The simple fact is that lots and lots of these small town cannot support IM / Peds, they need the FP because of wide age gaps with smaller clientel (clientel that cannot drive 1+ hours for a physical). I was / am considering Peds, but I want to work in my hometown, which cannot support the specialty. FP looks better and better every day for me.

just some thoughts, I don't mean to say other arguments are straight wrong. it's clearly a healthy debate and something that we all need to consider.

-Vandyfox

I mostly agree. If you want to live in a smaller hometown, FP may be a good way to go.

What I'm talking about is say one IM doctor running a practice of 10-20 PA/NPs. Spending all his time answering their questions. I could see the system moving that way.

I think there is a gap. I think moving towards more NP/PA care might worsen outcomes, but the cost of training is so much less. So if they're less productive per capita, the system might not care as long as the production/dollar training is better. A certain amount of worsened outcomes will be tolerated as long as most of the population remains unaffected. With technology advances, even rural America isn't that far away. A practice heavy on NP/PA's might be allowed to be very spread out with a central MD supervising. It's the sort of thing that's at least worth considering. For me, I felt that's important that I myself not feel "replaceable" for all the years of training that's put in. Just something that kind of bugs me when looking at how the system is working. Some fields like specialist surgeons, probably Path, etc are more protected as the governement/insurance companies/employers look to slow the rate of increase of health care costs (and I'm not going into one of those really anyway). One reason I stayed away from psych is the push for pscyhologists to get prescribing rights. When looking 20-30 years into the future, these are things to at least consider.

 

[TexasRose]

And the vast majority of Dr's don't know anything else. Let the 60% try something different for 5yrs then re-poll. I bet most would want to go back to medicine.

A very good point, and one that nontrads are already familiar with. 😉

To the OP. I think there are a lot of folks at your school that are planning on specializing, as much for the prestige as anything else. Also, you're probably likely to find fewer rural-minded folks in a big metro school.

 

[Fantasy Sports]

rjhtamu dont worry about it too much. FP is where everything starts. It is intellectually stimulating in the sense that your differentials start at EVERYTHING. Sure, you don't have the depth of a specialist, but a specialist sure as heck won't be able to handle a patient coming in with generalized pain in a particular region. So there are advantages to both.

And each time a gunner tries to diss your FP desires, just remember not to refer any patients to them when you're a FP (this is especially true if you go to a state school where people tend to stay in the same area). It absolutely amazes me how gunners want to diss FPs and pediatricians etc, but don't realize that that is who they are going to get their patients from!

 

[John Deere Gree]

When I tell some of my classmates I want to be a FP or Peds in a small town they just look at me and go Why? It's as if it's something menial in the modern world of medicine or something. Not everyone wants to be an ENT, Optho, or Ortho guy...

Because you go to Baylor, and they're a little stuck up on themselves.

So what, f*** 'em!

 

[snaklee]

What's wrong with wanting a FP?

Well for starters, many medical students are competitive. They see this as a paleo-relic from the age of blood letting and myasms.

They think (mds other than FP types) that they are the smartest doctors ever created and human kkind will be greatly indebt to all of their wonderful future contributions.

After they reach the age of around fifty, these aging aristocrats of medicine (ie surgery) begin to feel inferior because they did not leave any type of lasting legacy.
Because they are never satisfied with anything they have been in their former life, they take it out on those they deem inferior(ie FPs). They bad mouth other professions, as if there was a competition. Suddenly, even the Ph.D. has become their biggest threat, or maybe it is the FP down the hall. They hear the nurses and other "common" workers speak highly of thier inferior peers and get jealous.

Then they tear into foreign trained physicians and act as if their pill A is better than some other (foreign trained) md has an inferior pill A.

Really, there is nothing wrong with FP in my opinion.

I once had an md tell me that Ph.D.s were less honest than md's. He also still believed that the only real doctors held the md title! These guys are still running around. They haven't become extinct yet.

I thought to myself, "what an unhappy slug."

By the way, he was always very cordial to those he back stabbed.

AKA the doctor with MANY FA(e)CES!


Strange huh?

 

[Kimmer]

Gotta love the small town life! Soap operas are usually set in small towns because - little known fact - small towns have the greatest scandals. I love it and can't wait to get back! God only knows why!
You know, everybody says that we need more doctors in the small towns out west but no medicals school in the west will let in people who want to be rural docs! That is why I am stuck in this Eastern anthill for the next 3.5 years. It is ironic or some such ****.
BTW does anyone know what happened to my avatar? I used to have a pig and it done run off on me.

 

[Trismegistus4]

The statistics for physicians aren't good. Here are the numbers I have from the syllabus of a psychology course I took as an MS1.

50% of physicians would not enter the field if choosing a career again. (Ok, so I was a bit off)

87% of physicians say their morale has declined in the past 5 years.

145 physicians commit suicide every year.

75% of female physicians report getting sexually harrassed by a patient at least once in their carreer, mainly by male patients

80% of male physicians report being sexually harrassed, also primarilly by male patients.

37% of physicians are stalked at one point in their carreer.

40% of physicians are physically assulted at least once in their carreer, with higher rates of verbal assult.

70% of marrages involving at least one physician end in divorce, with medical students who get married before graduation having even higher rates of divorce.

Physicians are sued for malpractice 2-3 times in their carreer, and it takes about 7 years from when the subpeona is served to when the case is settled.

Only 10% of physicians take regular time off, and only 11% take vacations that aren't related to attending a conference or meeting.

I'm willing to believe almost all the items in that list, but the last one... are you kidding? 89% of physicians take no vacation except to attend conferences or meetings? 89% of physicians don't take a week off to take their family to the beach in the summer or skiing in the winter? I'd have to see another cite for that, because as it's worded, it's completely unbelievable. I know the plural of anecdote is not data, but geez, I know some doctors, and more than 11% of them take vacations.

(Not to mention how this squares, or doesn't, with the stories one sees being thrown around in the residency forums about job offers starting with 6 weeks of vacation.)

 

[rjhtamu]

You know what/ I'm drunk right now, and all I can think of to say is **** everytyhing and **** you all.

I'm willing to believe almost all the items in that list, but the last one... are you kidding? 89% of physicians take no vacation except to attend conferences or meetings? 89% of physicians don't take a week off to take their family to the beach in the summer or skiing in the winter? I'd have to see another cite for that, because as it's worded, it's completely unbelievable. I know the plural of anecdote is not data, but geez, I know some doctors, and more than 11% of them take vacations.

(Not to mention how this squares, or doesn't, with the stories one sees being thrown around in the residency forums about job offers starting with 6 weeks of vacation.)

 

[fotolilith]

When I tell some of my classmates I want to be a FP or Peds in a small town they just look at me and go Why? It's as if it's something menial in the modern world of medicine or something. Not everyone wants to be an ENT, Optho, or Ortho guy...

Have you ever read "My Own Country," by Verghese? He's an infectious diseases doc that gets judged a lot *by his own peers* for choosing a primary care specialty, instead of a lucrative specialization (where he charge $$ for a procedure).

It's not about FP, but it's a great book, and shows how he is happy with his work and the impact he makes, and he pretty much just laugh at his peers for their unsolicited advice.

I highly recommend reading MY OWN COUNTRY cuz I think you will find a kindred soul, and you will realize that your classmates' opinions don't matter.

We need more primary care specialists and if it is truly your calling you will be very fulfilled for the rest of your life.