Surgical procedures in FM?

[Makati2008]

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I am wondering what surgical procedures can a Family Physician perform with his or her training? Is it program dependent(like going ot an unopposed program like JPS) or all programs pretty similar? Also how much could this boost your income?

Sorry if this is asked a lot but googled this and searched sdn and could only find some vague things.

thanks

 

[ghost dog]

I am wondering what surgical procedures can a Family Physician perform with his or her training? Is it program dependent(like going ot an unopposed program like JPS) or all programs pretty similar? Also how much could this boost your income?

Sorry if this is asked a lot but googled this and searched sdn and could only find some vague things.

thanks

Yes.

There is a high demand for the surgical procedure of fecal disimpaction.

Corkscrew that sucker outta there! 😀

 

[Makati2008]

Yes.

There is a high demand for the surgical procedure of fecal disimpaction.

Corkscrew that sucker outta there! 😀

Lol yuckkkk. I was asking this in seriousness due to remembering my doctor's back home could do appendectomies, hysterectomies, scopes, etc... and I am wondering has the tide changed where the FP can no longer can do this? I want to do combined residency in EM/IM or EM/FM but if I don't get into that then FM is my back up plan and trying to get a feel for the state of things.

 

[cabinbuilder]

Depends on location and proficiency really. The more rural you live, the more FP gets to do.
When I was in North Montana there were FP's doing full OB, C-sections, vasectomies, appys, colonoscopy and EGD.

However, you have to show that you are proficient and usually get proctors for so many procedures and show your logs from residency as well.

 

[Makati2008]

Depends on location and proficiency really. The more rural you live, the more FP gets to do.
When I was in North Montana there were FP's doing full OB, C-sections, vasectomies, appys, colonoscopy and EGD.

However, you have to show that you are proficient and usually get proctors for so many procedures and show your logs from residency as well.

thank you for those answers. It is very very rural lol. My poor wife won't know what to do. I want to do that for about 10-20years and teach when I get older hopefully it all works out.

Thank you so much.

 

[Onscene]

I was wondering the same thing and came upon this.

http://fmignet.aafp.org/online/etc/...001.File.dat/FMAdvancedProceduralTraining.pdf

 

[Ultralisk415]

How about for urban areas? I read that many hospital privileges are limited to FP's. Just curious what kind of procedures FPs do in suburban/urban areas.

 

[Hamhock]

How about for urban areas? I read that many hospital privileges are limited to FP's. Just curious what kind of procedures FPs do in suburban/urban areas.

Do you really think that an FP should be doing an appy in urban areas?

Who cares what FPs CAN do in some urban areas? What you should be concerned about: Is there ever an indication for an FP to operate in an urban area?

No...unless all of the surgeons are dead or completely unavailable.

HH (not a surgeon)

 

[Ultralisk415]

Do you really think that an FP should be doing an appy in urban areas?

Who cares what FPs CAN do in some urban areas? What you should be concerned about: Is there ever an indication for an FP to operate in an urban area?

No...unless all of the surgeons are dead or completely unavailable.

HH (not a surgeon)

I should have clarified. Actually I meant more along the lines of in office procedure in an urban setting.

 

[Hamhock]

I should have clarified. Actually I meant more along the lines of in office procedure in an urban setting.

Like what in-office procedures (vague line between procedures and operations)?

If they are within the scope of FM, it should not matter if the office is in an urban or rural location (unless the procedure/operation is emergent)?

[Yes, I realize there are many deeply rural parts of the US that contain folks who can't afford to travel far for non-EBM-based-procedures like colonoscopy or endoscopy (when not emergent)]

HH

 

[EdibleEgg]

non-EBM-based-procedures??? What do you mean?

 

[SnakeOil]

Do you really think that an FP should be doing an appy in urban areas?

Who cares what FPs CAN do in some urban areas? What you should be concerned about: Is there ever an indication for an FP to operate in an urban area?

No...unless all of the surgeons are dead or completely unavailable.

HH (not a surgeon)

The Shouldice center in Toronto has a FM trained doc doing hernia repairs. It's a pretty urban area and probably one of the best places in the world to have a hernia repair.

 

[absolutproof]

Alot of it I would imagine comes down to your case log. I plan on doing some surgical procedures but only if I can get enough numbers in the next three years. Having done a prelim year in surgery this year helped me to get a good number of basic cases and a head start for building numbers but ultimately it comes down to how aggressive you are to scrub in cases when you're on your surgery month rotations or how aggressive you are to do procedures- alot of this comes down to how busy or large the surgical service is and how many surgery residents on that service are available to cover cases- after all they have priority.

Secondly a lot of it will come down to being diligent in logging everything you do and learning how to use the case log system on ACGME and learning how to code your procedures (which ultimately will lead you into learning how to bill one day in the future). For example, most people would not log a central line exchange with J-wire or a diagnostic exam like a FAST exam (I think the FAST exam has two CPT codes that can be logged- limited transthoracic echo and some variation of a limited abdominal ultrasound). I would imagine that having a detailed log of your experience and procedures would be helpful in attaining privileges outside of clinic be it OR, ER, Urgent care, etc..