The future of FM?

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Philotic

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Hi everyone, third year DO student hoping to go into FM after graduating.

I'm currently rotating with specialists in a mid sized hospital and an attending asked me what I wanted to do. I replied "family medicine" and the attending immediately stated that the field is being saturated with mid-levels (not untrue I know) and that to make any kind of money I would have to be willing to go rural (again, I guess not untrue, but not ideal for me).

I'm passionate about FM but I do have some worries. It will be another 4 years before I will be looking for a job, at that time will the prospect/outlook for FM docs in big cities/suburbs be poor because NPs/CNRPs/PAs have replaced the doctors in primary care? Will it be difficult to find a job after all that training?

Looking for insight from those already in the field or have been practicing for awhile and have seen the field change in recent years with the rise of NPs and CNRPs and PAs who in many states already have independent practicing rights.

Not looking to make tons of money but with large student loans I have to be realistic between FM and IM. Also not looking to debate the whole mid-level provider vs doctor thing. Just trying to go into the field with eyes wide open. Thanks everyone!

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You’ll be fine doing FM if that’s what you have interest in. Midlevels are becoming prevalent but patients always flock to the MD when the supply presents itself.
Though I recommend you consider IM if you have no interest in peds. If you change your mind and want to pursue subspecialty, you can.
 
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Most patients know there is a difference in level of care
 
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You’ll be fine doing FM if that’s what you have interest in. Midlevels are becoming prevalent but patients always flock to the MD when the supply presents itself.
Though I recommend you consider IM if you have no interest in peds. If you change your mind and want to pursue subspecialty, you can.

I don't have a particular interest in peds but don't mind it either. I actually felt the patient population was very monotonous on IM and would have liked to see more patients of varying ages haha. I used to want to go into Geriatrics but IM dissuaded me from that.

Thanks for your input!
 
Most patients know there is a difference in level of care

That may be true for mid-level and MD but I don't know if patients are as familiar with DOs. I'm not worried about the "recognition" more so just job availability and security for the remainder of my career. Definitely would not be great to go into a field of medicine where I will be struggling to find jobs that are not only rural :'). Thanks for your thoughts!
 
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That may be true for mid-level and MD but I don't know if patients are as familiar with DOs. I'm not worried about the "recognition" more so just job availability and security for the remainder of my career. Definitely would not be great to go into a field of medicine where I will be struggling to find jobs that are not only rural :'). Thanks for your thoughts!
Physicians don't go around introducing themselves as MD or DO. We all introduce ourselves as Dr. so and so. I have an MD degree and a few of my co-residents are DO, and I have not seen anyone make a distinction between myself and them, or confuse them as midlevel...
 
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Physicians don't go around introducing themselves as MD or DO. We all introduce ourselves as Dr. so and so. I have an MD degree and a few of my co-residents are DO, and I have not seen anyone make a distinction between myself and them, or confuse them as midlevel...

Certainly good to know! I obviously have zero experience in the real work world of medicine as I'm just a student currently. Haha. But as I said, I'm less worried about the distinction and more just about job security and demand. Thanks!
 
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Certainly good to know! I obviously have zero experience in the real work world of medicine as I'm just a student currently. Haha. But as I said, I'm less worried about the distinction and more just about job security and demand. Thanks!
I can't speak about FM since I am an IM resident. The few PGY3 that I talked to at my place who are not going into fellowship already got jobs.
 
In some places we start getting recruited at the end of PGY-1. I wouldn't worry about job prospects. If you want to work as FM you'll work as FM somewhere.
 
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I know a pgy2 that already got a 6 figure signing bonus, hasn't even taken step 3 yet
 
Hi everyone, third year DO student hoping to go into FM after graduating.

I'm currently rotating with specialists in a mid sized hospital and an attending asked me what I wanted to do. I replied "family medicine" and the attending immediately stated that the field is being saturated with mid-levels (not untrue I know) and that to make any kind of money I would have to be willing to go rural (again, I guess not untrue, but not ideal for me).

I'm passionate about FM but I do have some worries. It will be another 4 years before I will be looking for a job, at that time will the prospect/outlook for FM docs in big cities/suburbs be poor because NPs/CNRPs/PAs have replaced the doctors in primary care? Will it be difficult to find a job after all that training?

Looking for insight from those already in the field or have been practicing for awhile and have seen the field change in recent years with the rise of NPs and CNRPs and PAs who in many states already have independent practicing rights.

Not looking to make tons of money but with large student loans I have to be realistic between FM and IM. Also not looking to debate the whole mid-level provider vs doctor thing. Just trying to go into the field with eyes wide open. Thanks everyone!

I walked into an ophthalmologist the other day and the moment I mentioned FM he immediately talked about the midlevels. That's because he "is his own man" and is the only eye-dentist in the tri-county area and can't imagine a world where his practice is anything other than he wants it to be.

That said, I have talked to alumni from my school. One was 3yrs out from residency, moving to the twin cities for $250,000 a year as an FM. The hospitals where I am rotating have been hemorrhaging FM physicians for the last year (admin totally crapped the bed and now they're paying for it). As a result they have been signing on residents in YEAR ONE of residency.

Year ONE.

FM is in demand.
 
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I walked into an ophthalmologist the other day and the moment I mentioned FM he immediately talked about the midlevels. That's because he "is his own man" and is the only eye-dentist in the tri-county area and can't imagine a world where his practice is anything other than he wants it to be.

I guess he's never heard of optometrists.
 
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All specialties have midlevel invasion. 80% of medicine is a pattern and some doctors love to give up that 80% of easy workload to midlevels and hence offload the easy money.

Check out the other specialty forums on here, there's like midlevel threads in all of them lol. Any field can turn the specialist into a medical manager and use a 1:4 midlevel ratio to do most of the day to day work. At least in FM you have the primary physician relationship with the patient that's quite difficult to displace even as a new doctor taking over let alone an NP PA.

As for income - making 250k in a good region with very normal hours is very realistic. Work a bit more and make high 200s. Work a good amount and make low 300s. It would honestly be the same in a rural area and maybe even harder because the patient population is lower. Also the term "rural" is blown out of proportion. Some live in the suburbs of a big city and commute 15 mins to a "rural" community for work.
 
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I walked into an ophthalmologist the other day and the moment I mentioned FM he immediately talked about the midlevels. That's because he "is his own man" and is the only eye-dentist in the tri-county area and can't imagine a world where his practice is anything other than he wants it to be.

That said, I have talked to alumni from my school. One was 3yrs out from residency, moving to the twin cities for $250,000 a year as an FM. The hospitals where I am rotating have been hemorrhaging FM physicians for the last year (admin totally crapped the bed and now they're paying for it). As a result they have been signing on residents in YEAR ONE of residency.

Year ONE.

FM is in demand.
There are 15 hospitals in my state currently hiring FPs. Plus half the FQHCs. And I know of 3 PP groups hiring as well.

South Carolina isn't that big of a state...
 
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Come work in an underserved community. We have plenty of job openings and great job security. We have highly underserved areas in almost all regions of the United States, including most major cities! Many health shortage areas also have a suburb nearby!
You will likely have greater opportunity to use a larger array of your clinical skills.
The salary is sometimes on the lower end of the FM spectrum but the karma $ differential is pretty sweet. I already get to skip 10 levels towards enlightenment after my next reincarnation with only 7 years in practice.
 
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I guess he's never heard of optometrists.

Our optometrist group in town is every bit as much of an encroachment on Optho as the PA’s are to us. They’re cowboys and have been the only folks within a 70mile radius for a while now. They take call for eye emergencies in our area. Not that I agree with that. But any optho that wanted to work in our area would have competition for sure.
 
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In some places we start getting recruited at the end of PGY-1. I wouldn't worry about job prospects. If you want to work as FM you'll work as FM somewhere.


As a PGY 1 who already has a contract, the market is hot for FM. I get job offers weekly through Linkedin. Try it. Call a random hospital, ask to talk to the CEO, tell them your not close to signing but are interested and want to know if they are hiring FMs. The answer will be yes and they will prob fly you out, feed you, tour you, gift basket you, thank you card you, and then "check back" with you every 3-4 months from then on. Then come tell us how crazy hot the market is.
 
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Thanks for everyone's replies thus far. It's certainly reassuring to see that FM docs are still in demand in many different locations!

Keeping my fingers crossed haha :)
 
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