Cranjis McBasketball

2+ Year Member
Jul 20, 2015
1,478
1,864
Status
Medical Student
Is this similar to everyones experience? As a second year hoping to go into FM, that was a scary article to read..
 
Jul 15, 2018
51
70
Is this similar to everyones experience? As a second year hoping to go into FM, that was a scary article to read..
I think FM as a whole is no where near as hard hit as many other specialities from what I've heard and read but things aren't exactly rosy either from what others who currently working told me. Just an upcoming intern but I'd still do FM again if this happen in my third year. However, the future of medicine as a whole seem so uncertain at this time
 
About the Ads

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,704
5,668
Status
Attending Physician
Experiences vary. My group went through some of that, but we were able to secure emergency funding through various sources (including the PPP), quickly implement telemedicine, keep patient volumes up (my office is seeing something like 68% of our pre-COVID volume), and are currently re-hiring previously furloughed and laid off employees. Physicians in my group expected to go without a paycheck for a month or two, but that didn't transpire.
 

Cranjis McBasketball

2+ Year Member
Jul 20, 2015
1,478
1,864
Status
Medical Student
Experiences vary. My group went through some of that, but we were able to secure emergency funding through various sources (including the PPP), quickly implement telemedicine, keep patient volumes up (my office is seeing something like 68% of our pre-COVID volume), and are currently re-hiring previously furloughed and laid off employees. Physicians in my group expected to go without a paycheck for a month or two, but that didn't transpire.
Thats great to hear. So no long lasting/permanent negative effects for you guys?
 

Sardonix

7+ Year Member
Sep 6, 2010
633
1,579
Status
Resident [Any Field]
Wasn't ever planning to go into private practice, so never even really occurred to me.

Also as an incoming FM intern, unless residency programs suddenly started suffering (which given the versatility of FM training and the basically cheap labor that residents are, I doubt) the only major way that I see myself being affected 3yrs from now is if they somehow have not developed a vaccine. I suppose in the mean time there is a chance that my new program's controlling hospital system freezes my pay (which would be insulting and obviously would suck) but I'd still be okay.

Beyond my own selfish outlook, US healthcare and the economy at large won't be the same once we leave the pandemic behind. That said, with todays data for physicians... the day that an FM doc can't find work in the US is the day Skynet takes over aka never.
 

AMEHigh

10+ Year Member
Jul 25, 2008
1,548
1,465
Status
Attending Physician
Wasn't ever planning to go into private practice, so never even really occurred to me.

Also as an incoming FM intern, unless residency programs suddenly started suffering (which given the versatility of FM training and the basically cheap labor that residents are, I doubt) the only major way that I see myself being affected 3yrs from now is if they somehow have not developed a vaccine. I suppose in the mean time there is a chance that my new program's controlling hospital system freezes my pay (which would be insulting and obviously would suck) but I'd still be okay.

Beyond my own selfish outlook, US healthcare and the economy at large won't be the same once we leave the pandemic behind. That said, with todays data for physicians... the day that an FM doc can't find work in the US is the day Skynet takes over aka never.
Yeah from an individual perspective getting an FM job is likely going to not be a problem for the foreseeable future.

I’m actually applying for jobs right now and there’s tons out there (Full time, part time, per-diem, in all areas) and I’m looking for something pretty specific, yet haven’t had problems applying and interviewing. However, 3 jobs that I was interested in are currently on a hiring freeze.

Community health centers and private practices have definitely taken a large hit over the past few months. It’s definitely unfortunate for patients and people working there. I think there will definitely be long term affects for certain places especially in areas hardest hit.
 
  • Like
Reactions: Sardonix
Dec 27, 2019
4
7
Status
Resident [Any Field]
Bleak for whom?

I'm a second year and signed a HTFM (hospitalist trained in FM) gig last week. I'm a second year. Yes, I know I signed early. Yes, I had my contract reviewed by a faculty member at our affiliated university as well as a lawyer. But I'm a dirty ass foreigner (Canadian eh) and wanted a job where I wanted to be, with a good salary, and would cover my visa stuff.
 

Fatalis

7+ Year Member
Jan 14, 2012
556
315
Status
Attending Physician
Bleak for whom?

I'm a second year and signed a HTFM (hospitalist trained in FM) gig last week. I'm a second year. Yes, I know I signed early. Yes, I had my contract reviewed by a faculty member at our affiliated university as well as a lawyer. But I'm a dirty ass foreigner (Canadian eh) and wanted a job where I wanted to be, with a good salary, and would cover my visa stuff.
Good to see another fellow Canadian here!
 
  • Like
Reactions: EMTAB

Fatalis

7+ Year Member
Jan 14, 2012
556
315
Status
Attending Physician
Of course man! FM was 100% the way growing up in Canada. I still don't understand the hate the LARGEST speciality in the US receives.
exactly, it is a canadian thing for sure!
 

Sardonix

7+ Year Member
Sep 6, 2010
633
1,579
Status
Resident [Any Field]
Of course man! FM was 100% the way growing up in Canada. I still don't understand the hate the LARGEST speciality in the US receives.
How dare you question things? Back to Canada with you. Haha, take that!
 
About the Ads

AMEHigh

10+ Year Member
Jul 25, 2008
1,548
1,465
Status
Attending Physician
Bleak for whom?

I'm a second year and signed a HTFM (hospitalist trained in FM) gig last week. I'm a second year. Yes, I know I signed early. Yes, I had my contract reviewed by a faculty member at our affiliated university as well as a lawyer. But I'm a dirty ass foreigner (Canadian eh) and wanted a job where I wanted to be, with a good salary, and would cover my visa stuff.
Did you read the article?
Right now it's bleak for small private practices and also community health centers.
Most places have greatly reduced volumes right now especially in the hardest hit areas, so if you're not associated with a large health system months of reduced revenue makes the future look bleak.
 
  • Like
Reactions: studentxx8800

VA Hopeful Dr

Senior Member
15+ Year Member
Jul 28, 2004
22,210
32,072
Status
Attending Physician
Of course man! FM was 100% the way growing up in Canada. I still don't understand the hate the LARGEST speciality in the US receives.
FM isn't the largest specialty in the US
 
  • Wow
Reactions: Goro

VA Hopeful Dr

Senior Member
15+ Year Member
Jul 28, 2004
22,210
32,072
Status
Attending Physician
It actually is. You can’t count internal medicine, which only has a few more physicians then FM, since the vast majority of them subspecialize.
Incorrect: 2018 Physician Specialty Data Report Executive Summary

Key Findings — Active Physicians • In 2017, the specialties with the largest numbers of active physicians were the primary care specialties of internal medicine (115,557), family medicine/general practice (113,514), and pediatrics (58,435). (See Table 1.1.)

 

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,704
5,668
Status
Attending Physician
Incorrect: 2018 Physician Specialty Data Report Executive Summary

Key Findings — Active Physicians • In 2017, the specialties with the largest numbers of active physicians were the primary care specialties of internal medicine (115,557), family medicine/general practice (113,514), and pediatrics (58,435). (See Table 1.1.)

Much more recent data from the Bureau of Labor and Statistics:

GIM: 44,610

FM: 126,440
 

VA Hopeful Dr

Senior Member
15+ Year Member
Jul 28, 2004
22,210
32,072
Status
Attending Physician
Much more recent data from the Bureau of Labor and Statistics:

GIM: 44,610

FM: 126,440
Some marked discrepancy between my 2018 numbers and your 2019 numbers. Wonder why that is? I saw the BLS doesn't have a separate category for hospitalists but it doesn't say what category they are put in.

Looking at ABMS data, from 2005-2015, there were 74k IM certifications granted and 62k subspecialty certificates granted. You'll get some difference from folks who get more than 1 specialty: hematology (4k) and medical oncology (5.5k) are technically separate but the vast majority get both, similar with pulm (5.4k) and CC (5.9k). I also think every interventional cardiologist (3k)/EP (1.2k) is also boarded in regular CV disease. So I'd wager when all is said and done, it's closer to 45-50k who specialize out of that 74k.

Compare that to 34k FPs and the 4k who specialize past that and the numbers are very close.
 

FamilymedMD

10+ Year Member
Nov 25, 2009
92
75
Rockport, ME
www.megunticookfamilymedicine.com
Status
Attending Physician
Is this similar to everyones experience?
Far from it. Almost all the Direct Primary Care (DPC) practices are doing fine. We have two more Maine docs opening new ones later this year.

We had one employer lay off some sponsored patients and we're carrying a few patients that are having trouble financially now but our revenue is stable and our wait list is growing. That employer has already rehired some of those folks too.

I used all the extra time during the slowdown to improve my point of care ultrasound skills.

We might have some more patients having trouble paying out of pocket later this year since most of them are working class, not wealthy, but so far, so good.

The acute on chronic problems in primary care are due to a terrible 50 year old payment model. Prepaying care as fee for service via a third party was a goldmine for the previous generation of docs but is a horribly expensive, inefficient payment model for routine services. The pandemic slowdown is just further weakening an already sick patient.
 
Last edited:

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,704
5,668
Status
Attending Physician
Some marked discrepancy between my 2018 numbers and your 2019 numbers. Wonder why that is?
Maybe because it's in the AAMC's interest to overestimate the number of residents going into primary care?

And, it's not just about the number of doctors. It's also about who's providing the most patient care.

From the AAFP: "The AAFP represents 136,700 physicians and student members nationwide. It is the only medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits – that's 192 million visits annually – 48 percent more than to the next most visited specialty."

 

VA Hopeful Dr

Senior Member
15+ Year Member
Jul 28, 2004
22,210
32,072
Status
Attending Physician
Maybe because it's in the AAMC's interest to overestimate the number of residents going into primary care?

And, it's not just about the number of doctors. It's also about who's providing the most patient care.

From the AAFP: "The AAFP represents 136,700 physicians and student members nationwide. It is the only medical society devoted solely to primary care. Family physicians conduct approximately one in five office visits – that's 192 million visits annually – 48 percent more than to the next most visited specialty."

Well of course we have way more office visits than anyone else, we have way more even just as a percent of total within the same specialty who practice 100% outpatient medicine.

Looking at ABMS numbers, I'd bet it's because the BLS doesn't count hospitalists.
 

EMTAB

2+ Year Member
Oct 21, 2015
23
22
Status
Medical Student
exactly, it is a canadian thing for sure!
Totally!! A lot of my friends who got into Canadian schools (jealous of their tuition) picked FM. That R3 year in Anesthesia, Sports Med, ESS, OSS, EM is so cool! I wish those opportunities existed in USA!
 
About the Ads
Jul 15, 2018
51
70
Totally!! A lot of my friends who got into Canadian schools (jealous of their tuition) picked FM. That R3 year in Anesthesia, Sports Med, ESS, OSS, EM is so cool! I wish those opportunities existed in USA!
I have always wondered...what make Canadian want to come practice in the US? It seems like you guys have such sweet set up for FM up there and from the rumor mill you guys can also make a killing up there compared to here
 
  • Like
Reactions: EMTAB

EmergDO

2+ Year Member
Sep 7, 2016
340
547
Status
Medical Student
I have always wondered...what make Canadian want to come practice in the US? It seems like you guys have such sweet set up for FM up there and from the rumor mill you guys can also make a killing up there compared to here
Lots of Canadians come to school here because US schools are less competitive than Canadian ones. Then it ends up easy to stay in the states for residency. Some will eventually move back though.
 
  • Like
Reactions: EMTAB
Nov 16, 2018
15
16
Totally!! A lot of my friends who got into Canadian schools (jealous of their tuition) picked FM. That R3 year in Anesthesia, Sports Med, ESS, OSS, EM is so cool! I wish those opportunities existed in USA!
FM is a nice gig for sure, but not as easy as you make it sound if you want to expand your scope. The anesthesia and surgical training can only practice rurally. FM+1 in emerg is more competitive numbers wise than actually matching emergency medicine meaning <50% matching so not good odds at all. The 5 year emerg programs are also preferentially hired so its getting harder to get a job in cities with the 3 year program as well. Sports med, obstetrics and surgical assist are still good options though

From the financial perspective, I think the US wins out because they cover more in pension/CME while most canadian FM are FFS. Seems way worse on the insurance/litigation/documentation troubles though.
 
  • Like
Reactions: EMTAB

EMTAB

2+ Year Member
Oct 21, 2015
23
22
Status
Medical Student
Lots of Canadians come to school here because US schools are less competitive than Canadian ones. Then it ends up easy to stay in the states for residency. Some will eventually move back though.
This exactly. In my province the averages were a 3.90 GPA for in-province and 3.96 GPA for out of province applicants with a 512 average mcat and 10 APGAR. I had 3.75 and 506 MCAT and probably a 7 APGAR haha so it was never going to happen. Going FM here in the US and may go back to Canada after loans are paid off and if I can convince my American wife to come to the great white north. The practice environment (at least where I shadowed in Canada) was pretty nice. One clinic I was in had each doctor billing over 700K each year with 30% overhead.
 

EMTAB

2+ Year Member
Oct 21, 2015
23
22
Status
Medical Student
FM is a nice gig for sure, but not as easy as you make it sound if you want to expand your scope. The anesthesia and surgical training can only practice rurally. FM+1 in emerg is more competitive numbers wise than actually matching emergency medicine meaning <50% matching so not good odds at all. The 5 year emerg programs are also preferentially hired so its getting harder to get a job in cities with the 3 year program as well. Sports med, obstetrics and surgical assist are still good options though

From the financial perspective, I think the US wins out because they cover more in pension/CME while most canadian FM are FFS. Seems way worse on the insurance/litigation/documentation troubles though.
Yeah that's what I hear. I'm not looking for a big city, just around 100K. I know of a few places that have the ESS surgeons about 45 minutes away from 100K cities so not too too bad. I'm still trying to find out more about it, or if I could even apply for it after doing residency down here, assuming I even have the stamina at that point for it.
 

Sardonix

7+ Year Member
Sep 6, 2010
633
1,579
Status
Resident [Any Field]
This exactly. In my province the averages were a 3.90 GPA for in-province and 3.96 GPA for out of province applicants with a 512 average mcat and 10 APGAR. I had 3.75 and 506 MCAT and probably a 7 APGAR haha so it was never going to happen. Going FM here in the US and may go back to Canada after loans are paid off and if I can convince my American wife to come to the great white north. The practice environment (at least where I shadowed in Canada) was pretty nice. One clinic I was in had each doctor billing over 700K each year with 30% overhead.
Why not go back to pay your loans off then?

Also do you guys seriously have a med school exam called APGAR or are they recording your vitals as a neonate too?
 
  • Haha
Reactions: Blue Dog

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,704
5,668
Status
Attending Physician
Why not go back to pay your loans off then?

Also do you guys seriously have a med school exam called APGAR or are they recording your vitals as a neonate too?
Well, they said Canadian med schools are competitive. I guess the folks who have to come to the U.S. to train had a nuchal cord or something.

topk2lutpkn31.jpg
 
  • Like
Reactions: EMTAB and Sardonix
Jan 22, 2019
1,924
1,864
Status
Resident [Any Field]
Bleak for whom?

I'm a second year and signed a HTFM (hospitalist trained in FM) gig last week. I'm a second year. Yes, I know I signed early. Yes, I had my contract reviewed by a faculty member at our affiliated university as well as a lawyer. But I'm a dirty ass foreigner (Canadian eh) and wanted a job where I wanted to be, with a good salary, and would cover my visa stuff.
Nice... I got a couple of emails from recruiters about hiring for the class of 2021. I think it's a little too early to start looking for job. I plan to do that by October/November. Maybe I should jump into the market if I can secure something that fits my 'wants'...
 

SXMMD

5+ Year Member
Jul 19, 2013
161
206
Status
Resident [Any Field]
Nice... I got a couple of emails from recruiters about hiring for the class of 2021. I think it's a little too early to start looking for job. I plan to do that by October/November. Maybe I should jump into the market if I can secure something that fits my 'wants'...
Never too early to look. Treat it as your introduction to the market/businness of medicine- learn early so when you get super serious in your search you're well prepared. Just cuz you talk to someone on the phone doesn't mean you have to sign on the dotted line
 
  • Like
Reactions: Splenda88

EMTAB

2+ Year Member
Oct 21, 2015
23
22
Status
Medical Student
Why not go back to pay your loans off then?

Also do you guys seriously have a med school exam called APGAR or are they recording your vitals as a neonate too?
The daily patient volume was pretty high in order to make that. My wife also has a well paying job here that she wouldn't be able to do in Canada.
 
About the Ads