To be or not to be, help needed

[AverageNeighborhoodDoc]

Hi all. Longtime lurker here. I'm a M3 who is currently in limbo trying to decide what I want to do with my medical career and I'm hoping that you all can help. I'm really struggling with this decision and find myself laboring about it daily(even when I can't necessarily afford to be) Some background on myself and my mindset.

I'm a former collegiate athlete who is a current M3. I believe and have been told by others that I genuinely care for my patients and seem to be involved in all aspects of their care. My rotation on family, personality quizzes from the AMA and meyers brigs, research online all points me towards wanting to become a family sports medicine doctor(Psych and PM& were 2 and 3). I think family would allow me to holistically take care of patients while also practicing my favorite specialty in medicine which is MSK, sports injuries, minor procedures like injections, etc. This all seems great right? Pick a residency which has a sports medicine fellowship and I'll be able to ride my dream into the sunset!

However, I'm running into a hiccup. This might seem childish, but I have a father who is a private practice family physician. Recently, when I came home to tell him about what I thought was my newfound, at long last decision my dreams were sort of crushed. I always thought that he really enjoyed being a family doctor. His patients love him and he is truly their "doc". He makes a good living, is working into his late 60s and takes a fair amount of vacations. Seems great to me. However, what I found was that while he did like treating patients he doesn't love family medicine. In fact he explicitly implored me to heavily consider another specialty career path. He believes that for the amount of work FP docs put in they are severely under compensated vs other specialties. He also explained to me how FP docs are under increasing burden from insurance companies, patient centered medical homes ding you for work ups done outside your control(like CT or MRI done at an ER), and how you have to see such a larger volume of patients to maintain an income. This to me all sounded like someone who has worked very hard in their life, may be having some "grass is greener syndrome" and is probably starting to experience burnout. And, he's apparently not alone either. According to the latest medscape survey FP had the highes % of doctors who would choose medicine agai(in the 60s) but only about 30% would choose family again. Unfortunately FP are not top earners either, however its all relative when any doctors salary is in the top percentage of earners.When I look to online forums like this or meddit it always seems to be positive FP docs so I'm kinda wondering where all these pessimists are?

So TLDR My father, a FP doc who really inspired me to enter medicine and be an everyday persons doctor who takes care of the whole person, is really trying to push me away from primary care. I realize its my decision alone, but I clearly have less experience than him. I guess what I'm looking for is validation that FP docs really do find a lot of enjoyment from their practice and 2/3 don't wish they had done something else. Sorry that was so long but I look forward to hearing back from anyone who replies. Thanks.

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[Atlas Shrugged]

I am in the military, which has its own problems, but compensation is pretty decent relative to other specialties compared to their civilian counterparts. If I was a civilian, I don't know that I would be choosing family medicine. But if I were, I would be going straight to direct primary care once an attending. I encourage you to check it out.

 

[AverageNeighborhoodDoc]

I am in the military, which has its own problems, but compensation is pretty decent relative to other specialties compared to their civilian counterparts. If I was a civilian, I don't know that I would be choosing family medicine. But if I were, I would be going straight to direct primary care once an attending. I encourage you to check it out.

Thanks I will. I know the old adage is choose 2 location, patient population, or pay. The thing about the military is I wonder how much control I would have over where I get to live? I'd like to stay in home region if possible.

 

[Bacchus]

Don't listen to your dad.

 

[F1rstGen]

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Direct Primary Care my friend, that is the answer.

Even if the current system is our only future practice option, I would advise you to set down and have a conversation with any surgeon or sub-specialist and see what their work is like. While their compensation is more, I would not want their hours or the thought of going through their residency training/fellowship to get to their position. Yes being a PCP can be stressful but a large majority of practicing Family Med doctors work 8am-5pm M-F and still make >200K. If money is a major stumbling block, you can pick up shifts in an urgent care, direct a nursing home, cover a delivery unit while an OBGYN is on vacation, etc. If a family med doc desired to work surgeon hours, the compensation gap would be not be as significant as you might think.

The one thing I take solace in is that in our current political/economic climate, healthcare costs have a massive bulls eye on their back. It is not hard to imagine a scenario in the future where legislation is passed that would severely decrease the salary of specialist and procedure based fields. If that were to happen, would you still like the choice you made? If you like sports or family medicine, do it. The compensation really can only go up from when it hit rock bottom ~5 years ago and if that happens, you'll be in a field you enjoy and be well compensated.

 

[TableMD]

Hey

I know how disappointing it can be to have family in health care try to push you away from primary care. I had to deal with that as well. In the end I went with family med and will be doing sports med next year. The "dream job" is a mix of primary care and a sports clinic (with the toys that I want to be able to use).

Ultimately your dad wants you to be happy and compensated for your hard work. I am sure you can have that via either primary care, or a subspecialty.

In talking to grads who are working, my sense is that a good job is like a good residency and is all about fit and support, with location and other perks playing a role as well.

Good luck!

 

[AverageNeighborhoodDoc]

Hey

I know how disappointing it can be to have family in health care try to push you away from primary care. I had to deal with that as well. In the end I went with family med and will be doing sports med next year. The "dream job" is a mix of primary care and a sports clinic (with the toys that I want to be able to use).

Ultimately your dad wants you to be happy and compensated for your hard work. I am sure you can have that via either primary care, or a subspecialty.

In talking to grads who are working, my sense is that a good job is like a good residency and is all about fit and support, with location and other perks playing a role as well.

Good luck!

Thanks I really appreciate the insight from everyone, especially somebody in a field I'm heavily considering.

 

[JonMonkey]

You have to be your own "doc" and not your dad. Yes, primary care is undervalued, underpaid and not as "sexy" compared to other specialties but there are other things that offset that. 1. Freedom to live and practice where ever you want and not be required to work in or near a medical center. 2. Little to no call schedule or inpatient rounding depending on what/where you practice. 3. Fairly routine M-F 8-5 work schedule. etc, etc. You are not your dad so if primary care is what gets you going then pursue it.

On a side note sports medicine unless you choose to do it on your own without training is a specialty aside from traditional primary care. Pay is better if you have the CAQSM, day to day life is different with the addition of training rooms, sideline coverage, mass participation, etc. The procedural volume is greater. You don't have the feeling that you are talking to a wall in regards to people participating in their care because most athletes/active people want to get back to their activity.

The question I would ask myself is while on your FM or sports medicine rotations, could you see yourself waking up everyday for the next 40 years doing that?

 

[Atlas Shrugged]

Thanks I will. I know the old adage is choose 2 location, patient population, or pay. The thing about the military is I wonder how much control I would have over where I get to live? I'd like to stay in home region if possible.

Almost zero. Moving every three years is likely, but not guaranteed. Some people stay in one location all their lives, but it is unlikely.