Urgent Care an option for a very lazy FM resident?

[FMRESIDENT135]

I'm a soon to be graduating PGY-3 FM. I truly despise clinic as I have no interest in long-term bonds / relationships and continuity of care with patients. The endless amount of disability paperwork, insurance forms, labs/results, follow-up, 20-min appointments that turn into 45-min long life stories, etc etc has made me realize that I have no interest in this type of practice at all. Like most FM residencies, however, our program is geared towards outpatient practice.

We do some hospitalist and EM work, but not enough that I'd feel comfortable with really sick and crashing/critically ill patients. Stable bread and butter stuff yeah, but ventilator management, ICU stuff, coding patients, etc - don't have the experience yet. I also hate 12+ hour shifts and would rather work like 2-3 days/week max. Don't care if I only make 100-120K/year.

Then I come across urgent care and I've never done it before. From the threads I've read online, it sounds like a lot of it is bad medicine, overprescribing antibiotics, low level of critical thinking, 1-problem visits and dumping follow-ups onto PCPs / outpatient. Sounds like you can also just send people to the ER if you're worried they might be unstable soon.

Anybody here done urgent care or have thoughts on it? Sounds like something I could tolerate.

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[FMRESIDENT135]

Also, for those who have done urgent care, what's the typical hourly rate for $$?

I've read online as low as $75-80 and as high as $110-120, but I imagine this depends on location, big city, desperate rural location, etc.

Our residency currently allows us to moonlight at an urgent care for $135/hour but I imagine this is likely not the case once you start practicing, right? It seems like most urgent cares are mostly run by midlevels/APPs.

 

[VA Hopeful Dr]

UC is variable. During slow periods, you might not work that hard. Back when I was doing that full time, I'd have days where I saw 20 people across a 12 hour shift. During cold/flu season, I might see 60+ in a 12 hour day.

 

[FMRESIDENT135]

UC is variable. During slow periods, you might not work that hard. Back when I was doing that full time, I'd have days where I saw 20 people across a 12 hour shift. During cold/flu season, I might see 60+ in a 12 hour day.

What was your hourly rate at this gig? Do you think swinging 2 days/week via a locums tenens or other agency is an existing option?

Also as far as procedural competence, anything in particular? During my ER / clinic rotations I mostly have done superficial laceration repairs, orthopedic casting/splinting, joint injections, skin excisions/biopsies, toenail removals, abscess / infected cyst I&D's and a few Nexplanons here and there.

Not much beyond that, just curious if I need to have procedural competency at other things for UC.

 

[FrustratedFamDoc]

Do you have any student loans?

 

[UODOCPDX]

I agree with VA Hopeful Dr, urgent care can vary a lot and it depends on the resources you have. At my urgent care we have access to ultrasound and CT scan along with ability to check cardiac labs like stat Trops, D-dimer, and BNP and even ability to check stat lactic acids and get results back within the hour. We are located right next the ED so we operate like a mini ED with higher acuity. On other hand while we do superficial laceration repairs we don't do orthopedic casting or splinting as we have access to the cast techs from the ED and most of us don't do joint injections or skin excisions or biopsies or toe nail removals as most of the time we can refer back to primary for this. At our clinic we work 10 hour shifts and the expectation is 2.0 - 2.5 patients per hour or about 20-22 patients per 10 hour shift. At this time our clinic is mainly staffed by MD/DOs some supporting PA/NPs but that changed in the past based on provider turn over.

Contrast this to the urgent care just a mile down the street from a different health network which does not have access to in house CT and ultrasound or even access to cardiac labs and so they have to send any patient that needs advanced imaging or cardiac labs to the ED for rule out. On other hand it seems like they do their own orthopedic casting/splinting, joint injection, derm procedures, and toe nail removals. At that clinic the shifts are 12 hour shifts and given lower acuity they expect you to see more patients and do more procedures.

At the end of the day while both clinics operate differently they are both good clinics and what I am getting at is that each urgent care can differ a lot and what you will do will depend on the resources of that clinic. So if you want to avoid really sick or crashing/critically ill patient and focus more on stable bread and butter stuff then focus on a clinic that isn't right next door ED and doesn't have CT or ultrasound or cardiac labs.

An advantage of urgent care is that it is shift work so it's completely possible to work full time doing 3 x 12 hour shifts a week. You could even do less if you are ok making less.

An disadvantage of urgent care is of course the shift work and not having control of what is going to come through the door. When COVID was bad and lot of primary care clinic were closed or limited in person visits we became everyone's primary care and complexity want through the roof as patient had been managed by phone and online to the max so visits took much longer.

In terms of procedures, the more you know, the more options you have in terms of jobs and what you can offer the patient. I think you are in good shape as a majority of the procedures in urgent care are laceration repair, orthopedic casting and splinting, joint injections such as the shoulder and knee, toe nail removal, and abscess I+D. If you have not had a chance to do a lot of urgent care shifts then I might recommend the HIPPO education Urgent Care Boot Camp. HIPPO education also does an Urgent Pod cast that I like called Urgent Care RAP.

I not comfortable talking about pay on a public thread, but if you want to DM me directly, I can talk to you about that.

On a more personal level, I was totally you 5 years ago. I did not enjoy continuity clinic and hated managing chronic conditions and I hated the stress of the hospital. I didn't have a lot experience in residency with urgent care but incidentally enough my family medicine rotation in medical school was actually at an urgent care which give me enough experience to feel comfortable to jump into urgent care after residency and so I ended up work in urgent care for the past 5 years.

Sometimes in medicine and in life it is not so much about what you like as much as it is about what you can tolerate.

I would recommend moonlighting and if your residency doesn't let you consider doing locum tenens at different urgent cares to get a feel for what you like and don't like before settling on a permeant job. I actually did not do locums due to family reasons and because I really wanted to pay off me student loans, but if those were not factors I would have totally done some locums or per Diems to get feel for the different clinics.

Hopefully, this answers some of your questions!

Feel free DM if you have further questions.

 

[FMRESIDENT135]

Do you have any student loans?

No thankfully not, hence why I'm ok with settling for less than the typical FM salary if it comes with the benefit of more free time / days off.

 

[FMRESIDENT135]

I agree with VA Hopeful Dr, urgent care can vary a lot and it depends on the resources you have. At my urgent care we have access to ultrasound and CT scan along with ability to check cardiac labs like stat Trops, D-dimer, and BNP and even ability to check stat lactic acids and get results back within the hour. We are located right next the ED so we operate like a mini ED with higher acuity. On other hand while we do superficial laceration repairs we don't do orthopedic casting or splinting as we have access to the cast techs from the ED and most of us don't do joint injections or skin excisions or biopsies or toe nail removals as most of the time we can refer back to primary for this. At our clinic we work 10 hour shifts and the expectation is 2.0 - 2.5 patients per hour or about 20-22 patients per 10 hour shift. At this time our clinic is mainly staffed by MD/DOs some supporting PA/NPs but that changed in the past based on provider turn over.

Contrast this to the urgent care just a mile down the street from a different health network which does not have access to in house CT and ultrasound or even access to cardiac labs and so they have to send any patient that needs advanced imaging or cardiac labs to the ED for rule out. On other hand it seems like they do their own orthopedic casting/splinting, joint injection, derm procedures, and toe nail removals. At that clinic the shifts are 12 hour shifts and given lower acuity they expect you to see more patients and do more procedures.

At the end of the day while both clinics operate differently they are both good clinics and what I am getting at is that each urgent care can differ a lot and what you will do will depend on the resources of that clinic. So if you want to avoid really sick or crashing/critically ill patient and focus more on stable bread and butter stuff then focus on a clinic that isn't right next door ED and doesn't have CT or ultrasound or cardiac labs.

An advantage of urgent care is that it is shift work so it's completely possible to work full time doing 3 x 12 hour shifts a week. You could even do less if you are ok making less.

An disadvantage of urgent care is of course the shift work and not having control of what is going to come through the door. When COVID was bad and lot of primary care clinic were closed or limited in person visits we became everyone's primary care and complexity want through the roof as patient had been managed by phone and online to the max so visits took much longer.

In terms of procedures, the more you know, the more options you have in terms of jobs and what you can offer the patient. I think you are in good shape as a majority of the procedures in urgent care are laceration repair, orthopedic casting and splinting, joint injections such as the shoulder and knee, toe nail removal, and abscess I+D. If you have not had a chance to do a lot of urgent care shifts then I might recommend the HIPPO education Urgent Care Boot Camp. HIPPO education also does an Urgent Pod cast that I like called Urgent Care RAP.

I not comfortable talking about pay on a public thread, but if you want to DM me directly, I can talk to you about that.

On a more personal level, I was totally you 5 years ago. I did not enjoy continuity clinic and hated managing chronic conditions and I hated the stress of the hospital. I didn't have a lot experience in residency with urgent care but incidentally enough my family medicine rotation in medical school was actually at an urgent care which give me enough experience to feel comfortable to jump into urgent care after residency and so I ended up work in urgent care for the past 5 years.

Sometimes in medicine and in life it is not so much about what you like as much as it is about what you can tolerate.

I would recommend moonlighting and if your residency doesn't let you consider doing locum tenens at different urgent cares to get a feel for what you like and don't like before settling on a permeant job. I actually did not do locums due to family reasons and because I really wanted to pay off me student loans, but if those were not factors I would have totally done some locums or per Diems to get feel for the different clinics.

Hopefully, this answers some of your questions!

Feel free DM if you have further questions.

Awesome thanks for the great post, I'll DM you with further Q's.

 

[MedicineZ0Z]

What was your hourly rate at this gig? Do you think swinging 2 days/week via a locums tenens or other agency is an existing option?

Also as far as procedural competence, anything in particular? During my ER / clinic rotations I mostly have done superficial laceration repairs, orthopedic casting/splinting, joint injections, skin excisions/biopsies, toenail removals, abscess / infected cyst I&D's and a few Nexplanons here and there.

Not much beyond that, just curious if I need to have procedural competency at other things for UC.

I've done complex repairs joint taps and reductions as well. Depends on your comfort level and type of urgent care.

 

[EccentricPharmD]

I'm a soon to be graduating PGY-3 FM. I truly despise clinic as I have no interest in long-term bonds / relationships and continuity of care with patients. The endless amount of disability paperwork, insurance forms, labs/results, follow-up, 20-min appointments that turn into 45-min long life stories, etc etc has made me realize that I have no interest in this type of practice at all. Like most FM residencies, however, our program is geared towards outpatient practice.

We do some hospitalist and EM work, but not enough that I'd feel comfortable with really sick and crashing/critically ill patients. Stable bread and butter stuff yeah, but ventilator management, ICU stuff, coding patients, etc - don't have the experience yet. I also hate 12+ hour shifts and would rather work like 2-3 days/week max. Don't care if I only make 100-120K/year.

Then I come across urgent care and I've never done it before. From the threads I've read online, it sounds like a lot of it is bad medicine, overprescribing antibiotics, low level of critical thinking, 1-problem visits and dumping follow-ups onto PCPs / outpatient. Sounds like you can also just send people to the ER if you're worried they might be unstable soon.

Anybody here done urgent care or have thoughts on it? Sounds like something I could tolerate.

I am also in the same boat. FM PGY2 and almost certain I can't do continuity of care. Also don't feel confident enough in inpatient setting.

 

[MateoGM416]

Following this thread because I am also extremely lazy and I have almost the same exact desires, lol

 

[MedicineZ0Z]

I am also in the same boat. FM PGY2 and almost certain I can't do continuity of care. Also don't feel confident enough in inpatient setting.

If you're PGY2, you still have time. It's ideal when programs prepare you properly, but in your case you can always do a bunch of ICU electives + take some extra courses/doing extra reading. There's no way you won't be prepared after spending all your elective time in the ICU and really working hard.

 

[Make Or Break]

I don’t know why but doctors admitting they are lazy rubs me the wrong way. Do urgent care telemed if you don’t want to work. $26/patient and do 6-8 an hour or at your leisure. Keep in mind some urgent cares want you to also function as a primary doctor so all that paperwork is still there, just not as much.

If you want to completely sell out then just do weight loss or suboxone and only take cash.

 

[UODOCPDX]

I don’t know why but doctors admitting they are lazy rubs me the wrong way. Do urgent care telemed if you don’t want to work. $26/patient and do 6-8 an hour or at your leisure. Keep in mind some urgent cares want you to also function as a primary doctor so all that paperwork is still there, just not as much.

If you want to completely sell out then just do weight loss or suboxone and only take cash.

You know what? It's ok to be burnout, to be exhausted, and of course it's ok to be lazy.

Most of us have spent more than a decade of our lives working our butts off from undergrad to medical school to residency and then jumped right into a once in a century global pandemic.

If we want to take it easy at this point that's our choice.

Do what makes you happy or what you can tolerate and allows you to pay the bills.

It's great if medicine is your calling but it's just as ok if medicine is just a job. Your job does not have to define your life or be only thing that defines you.

For anyone reading this thread you don't own anyone anything especially a group of strangers on the internet. At the end of the day your responsibility is to yourself and your patients.

You are not any less of a physician/doctor or a "sell out" just because you choose not to follow the standard route.

 

[VA Hopeful Dr]

You know what? It's ok to be burnout, to be exhausted, and of course it's ok to be lazy.

Most of us have spent more than a decade of our lives working our butts off from undergrad to medical school to residency and then jumped right into a once in a century global pandemic.

If we want to take it easy at this point that's our choice.

Do what makes you happy or what you can tolerate and allows you to pay the bills.

It's great if medicine is your calling but it's just as ok if medicine is just a job. Your job does not have to define your life or be only thing that defines you.

For anyone reading this thread you don't own anyone anything especially a group of strangers on the internet. At the end of the day your responsibility is to yourself and your patients.

You are not any less of a physician/doctor or a "sell out" just because you choose not to follow the standard route.

Lazy isn't really a word you want to use when talking about being a physician. What you seem to mean is that you don't want to work the full 40 hour work week. That is completely fine, not everyone does. But that's not the same as lazy, generally speaking.

 

[HemeOncHopeful19]

Well I was about to suggest a VA job based on the thread title but I don’t think that is the land of 1 complaint visits and certainly not light on the paperwork.

 

[MateoGM416]

Lazy isn't really a word you want to use when talking about being a physician. What you seem to mean is that you don't want to work the full 40 hour work week. That is completely fine, not everyone does. But that's not the same as lazy, generally speaking.

Semantics IMO. I think majority of humans are lazy. A lot of those humans become doctors and give up their 20's and early 30's in spite of said laziness. Does not mean they are no longer lazy and especially not burnt-out.

 

[VA Hopeful Dr]

Semantics IMO. I think majority of humans are lazy. A lot of those humans become doctors and give up their 20's and early 30's in spite of said laziness. Does not mean they are no longer lazy and especially not burnt-out.

Lazy is not the same as burned out.

Lazy to me means being lazy when you are at work. Not wanting to work 40 hours a week isn't laziness.

 

[MateoGM416]

Lazy is not the same as burned out.

Lazy to me means being lazy when you are at work. Not wanting to work 40 hours a week isn't laziness.

Again, respectfully, that's semantical, and there's no need for judgement

 

[VA Hopeful Dr]

Again, respectfully, that's semantical, and there's no need for judgement

I disagree.

 

[Brigade4Radiant]

Lazy isn't really a word you want to use when talking about being a physician. What you seem to mean is that you don't want to work the full 40 hour work week. That is completely fine, not everyone does. But that's not the same as lazy, generally speaking.

Lol no one who completes residency can be considered lazy it’s just relative we work far harder than the rest of the population

 

[Make Or Break]

Semantics? You’re not going to tell me lazy=burnt out. They mean two different things.

 

[Make Or Break]

Lol no one who completes residency can be considered lazy it’s just relative we work far harder than the rest of the population

No one is arguing that. But to say “I’m a lazy doctor” vs “I’m a burnt out doctor” mean two completely different things.

 

[VA Hopeful Dr]

Lol no one who completes residency can be considered lazy it’s just relative we work far harder than the rest of the population

That doesn't make any sense. So just because I completed residency means nothing I ever do again in my life can be called lazy?

 

[docdaddie]

Typical Millennial thread.

 

[FMRESIDENT135]

FWIW i am definitely a millennial, but I don't enjoy 80+ hour work weeks and getting up at 4-4:30 am for long 12+ hour shifts. If push came to shove I could definitely do it, and that's what had to be done on our more intensive rotations like OB and inpatient, etc, but I personally prefer to have lots of free time. Even M-F clinic sounds terribly unappealing. There's no way all the paperwork and notes could get done by 5 pm every weekday. Inevitably I assume I would take work home with me on the weekends.

Hence the idea of things like part-time clinic, possibly part time urgent care, etc.

It's lifestyle over money for me... at least currently. I've heard you can always scale up hours if you want, but it's harder to cut back hours after you've already committed.

 

[FMRESIDENT135]

Suboxone or weight loss only is interesting. Haven't explored that before but I wonder what kind of options are available there. Are you basically prescribing GLP-1's all day in a weight loss clinic?

 

[VA Hopeful Dr]

FWIW i am definitely a millennial, but I don't enjoy 80+ hour work weeks and getting up at 4-4:30 am for long 12+ hour shifts. If push came to shove I could definitely do it, and that's what had to be done on our more intensive rotations like OB and inpatient, etc, but I personally prefer to have lots of free time. Even M-F clinic sounds terribly unappealing. There's no way all the paperwork and notes could get done by 5 pm every weekday. Inevitably I assume I would take work home with me on the weekends.

Hence the idea of things like part-time clinic, possibly part time urgent care, etc.

It's lifestyle over money for me... at least currently. I've heard you can always scale up hours if you want, but it's harder to cut back hours after you've already committed.

Sure they could. Plenty of us here have described exactly how we do it.

Suboxone or weight loss only is interesting. Haven't explored that before but I wonder what kind of options are available there. Are you basically prescribing GLP-1's all day in a weight loss clinic?

Not generally. Most weight loss clinics are phentermine/HCG heavy.

 

[FrustratedFamDoc]

Suboxone or weight loss only is interesting. Haven't explored that before but I wonder what kind of options are available there. Are you basically prescribing GLP-1's all day in a weight loss clinic?

Echo what VA Hopeful said. Adipex/HCG/B12. Wash, rinse, repeat. Adipex is a sched 4 and structurally similar to Ritalin, a sched 2. You don't have to use your imagination to figure out some of the alternative uses and potential for abuse.

GLP-1s almost never go through insurance, certainly not w/o a prior auth.

 

[camng11]

I was going to make a post about the same thing. I'm in a similar position and the paperwork that is required outpatient is a real turn off. In residency, we do not have that many patients but as an attending I would imagine a panel of 20+ patients a day. Imagine how much paperwork, disability, prior auths, phone calls you have to do throughout the work week. Your job is an admin job/documentation specialist and 20% patient interaction

Inpatient can be stressful and I dont know if our program prepares us well enough compared to IM programs. I was thinking either part time outpatient vs urgent care or doing a fellowship in sports. Certainly, medicine is not a passion of mine, really just a job at this point. Looking at other investments in the meantime but need a source of income for that.

 

[ObsequiousAplomb]

Echo what VA Hopeful said. Adipex/HCG/B12. Wash, rinse, repeat. Adipex is a sched 4 and structurally similar to Ritalin, a sched 2. You don't have to use your imagination to figure out some of the alternative uses and potential for abuse.

GLP-1s almost never go through insurance, certainly not w/o a prior auth.

Adipex is much, much more closely related to Adderall than Ritalin. While people certainly abuse Adipex, it's nowhere near as fun for them. As long as you're prescribing reasonable doses of any of them, the abuse potential is very low.

 

[FrustratedFamDoc]

Adipex is much, much more closely related to Adderall than Ritalin. While people certainly abuse Adipex, it's nowhere near as fun for them. As long as you're prescribing reasonable doses of any of them, the abuse potential is very low.

Agreed... unless they're taking 4 at a time

 

[hallowmann]

Why are you doing all this stuff? In our residency clinic we have a staff member that does all PAs, she rarely might shoot us a message with a question or two but otherwise we just get involved if a peer to peer is needed. Probably 90% of my phone calls and paperwork can be done by the nurse/MA. Disability/FMLA stuff I have the patient schedule an appointment for so we can fill it out together.

This is not how it works at our resident clinic. All that was described is mostly expected at our clinic, and staff even have to deal with this stuff half the time. Literally dozens of things in the inbox daily need to be dealt with and we are expected to check it daily and address things within days.

 

[PTPuser]

I am not MD/DO nor PCP but I dated an FM guy a while back and he only did telemedicine cause he hated all those things you listed above and he absolutely loved his job. Of course there were problems and it wasn't perfect but he literally was able to carve out a nice niche and made decent money about 180K (this was 10 years ago) working 32 hrs a week at home or where ever he wanted.

 

[Prehealth1011]

I am not MD/DO nor PCP but I dated an FM guy a while back and he only did telemedicine cause he hated all those things you listed above and he absolutely loved his job. Of course there were problems and it wasn't perfect but he literally was able to carve out a nice niche and made decent money about 180K (this was 10 years ago) working 32 hrs a week at home or where ever he wanted.

Poster in this thread 2020 FM Physicians - what do you earn? made ~500k doing telemed. Seems like a grind though, apparently it's 6-8 patients an hour on the phone and you're doing a lot of triaging. An option nonetheless

 

[hallowmann]

I mean we check and respond to messages throughout the day but certainly not doing a ton of paperwork. My responses to messages are almost always just having the triage nurse call them back to give advice/make an appt/answer the question, or else just clicking approve for the refill. It's really rare that I actually have to call the patient myself. My understanding is that this setup is pretty typical in private practice as well but I'll let the attendings speak to that.

I understand that some places are short staffed and have less understanding PDs/admin, but maybe y'all should talk to your PDs about shifting some of the non physician responsibilities to non physicians? Not trying to be catty or anything, just can see how annoying and time consuming that all can be.

Its just all heavily dependent on the clinic culture honestly. The expectation is that you get the things done and you ultimately are responsible for communicating with patients. The triage RNs more or less forward every.single.thing to you. Reply to them to tell patient, X, they forward back, patient asked Y. It doesn't end and is ultimately why its so important to have good staff that you train how you like to work. Unfortunately, as residents we don't have "our" MAs that take care of everything for us and we don't have RNs specific to us or that figure out how we like things. As a result efficiency suffers. My point is that not every resident clinic runs the way you described.

This isn't also unique to just resident clinics, I've heard similar things with attendings in different academic or big box system. All the non-physician work is one of the biggest reasons why so many people hate being employed and instead join practices or go DPC. The difference is that as an attending you can vote with your feet and walk if you planned accordingly.

 

[AMEHigh]

Urgent care seems like the exact opposite place for someone who is lazy omg. No thank you. Most places want you to see a ton of patients and you literally never know what is going to walk in the door. I guess if you only work 1-2 shifts a week it would be ok, but to me urgent care does not seem easy.

Family medicine is so broad that you can definitely find a lot of different options. I feel like our speciality gets such a disservice for people not getting to know different options. Working outpatient private practice isn’t the only option.

 

[cabinbuilder]

Hardly, a "slow day" is 40 patients. You don't know what is coming through the door, you may be hit with procedures all day. What if you miss an acute abdomen and that person dies because you think UC is easy? Suggest you do pain management or botox where you don't have to think too hard.

 

[FMRESIDENT135]

Hardly, a "slow day" is 40 patients. You don't know what is coming through the door, you may be hit with procedures all day. What if you miss an acute abdomen and that person dies because you think UC is easy? Suggest you do pain management or botox where you don't have to think too hard.

No doubt the shifts are likely incredibly busy. But there seems to be options for 2-3 day work weeks (2 for part time and 3 for full time). In addition, the lack of chronic care management, continuity of care, disability/insurance paperwork and the surplus of 1-problem only visits is the appeal. Never said it was easy, just preferable to working 6-7 days/week with critically ill / coding patients (inpatient), 5 days/week with endless paperwork, inbasket, talkative patients making you fall behind (clinic), etc.

 

[VA Hopeful Dr]

No doubt the shifts are likely incredibly busy. But there seems to be options for 2-3 day work weeks (2 for part time and 3 for full time). In addition, the lack of chronic care management, continuity of care, disability/insurance paperwork and the surplus of 1-problem only visits is the appeal. Never said it was easy, just preferable to working 6-7 days/week with critically ill / coding patients (inpatient), 5 days/week with endless paperwork, inbasket, talkative patients making you fall behind (clinic), etc.

You're generalizing residency clinic with attending non-academic clinic which is unwise. I experience literally none of the things you describe in my clinic.

 

[MedicineZ0Z]

You're generalizing residency clinic with attending non-academic clinic which is unwise. I experience literally none of the things you describe in my clinic.

This probably depends where you work though and how well trained your staff are. In basket stuff is a real issue in most places. And talkative patients without any real pathology are also a big outpatient problem.

 

[VA Hopeful Dr]

This probably depends where you work though and how well trained your staff are. In basket stuff is a real issue in most places. And talkative patients without any real pathology are also a big outpatient problem.

Admittedly it does take time to train your staff, but its very doable.

You also learn with time and experience to redirect the chatty patients. Or they get mad and find a new doctor. Either way is fine.

 

[Keona]

Work in an urgent care for a bit after you graduate. Family medicine mds are always high in demand. My office actually has added a walk in clinic to our office. I worked in walk in clinic during residency and honestly didn’t enjoy it. I felt less in control of what I was seeing. In my clinic I control my schedule in walk in clinic I had to see everyone who was there until the door closed. Working in urgent care helped me realize that I was much happier with seeing my own patients. You could work part time also as outpatient family med without doing urgent care but patients find it frustrating if you’re working part time.

 

[emergentmd]

I would do telemedicine if you just want to work as much as you like, when you like, and pay the bills. You could easily make 100k/yr.

I did a month stint doing telemed during high flu season and could see/chart 7pph x $30pp (bonus) = $210/hr sitting in my media room.

A more realistic and relaxing shift could be 4pph x $20 = $80/hr. This would look like talking to a pt/chartx 10 min, get up grab a cup of coffee. See 2nd pt. go grab a snack. see 3rd pt, go read the news, then see 4th pt. Repeat this x 3 more hours and you are done by noon if you want. Maybe start at 10am after a workout and finish at 2p. "lazy" and sleep in late, then start at 4p and finish at 8p.,

The schedule world is you oyster. Do this for 5 dys a week.

$80x4x5x52=$83K. Work some of those bonus shifts during the winter and you will be right at $100k/yr.

Realize that you will completely lose your clinical skills. You essentially will be prescribing antibiotics, med refills for 80% of your patients.

 

[FMRESIDENT135]

I would do telemedicine if you just want to work as much as you like, when you like, and pay the bills. You could easily make 100k/yr.

I did a month stint doing telemed during high flu season and could see/chart 7pph x $30pp (bonus) = $210/hr sitting in my media room.

A more realistic and relaxing shift could be 4pph x $20 = $80/hr. This would look like talking to a pt/chartx 10 min, get up grab a cup of coffee. See 2nd pt. go grab a snack. see 3rd pt, go read the news, then see 4th pt. Repeat this x 3 more hours and you are done by noon if you want. Maybe start at 10am after a workout and finish at 2p. "lazy" and sleep in late, then start at 4p and finish at 8p.,

The schedule world is you oyster. Do this for 5 dys a week.

$80x4x5x52=$83K. Work some of those bonus shifts during the winter and you will be right at $100k/yr.

Realize that you will completely lose your clinical skills. You essentially will be prescribing antibiotics, med refills for 80% of your patients.

How did you do telemedicine during high influenza season without physically seeing patient?

 

[VA Hopeful Dr]

How did you do telemedicine during high influenza season without physically seeing patient?

The same way all of telemedicine is done

 

[FMRESIDENT135]

The same way all of telemedicine is done

During the early days and peak waves of the COVID pandemic, we were introduced to the concept of telemedicine / televisits for outpatient clinic visits as a way of minimizing exposure. This was pretty limited to things like chronic care management of HTN, DM2, HLD, anything psychiatry, etc as it didn't really require a physical exam and was a lot of medication management and stuff.

I still don't understand how you can see respiratory patients in a peak respiratory season via telemedicine. But if so, that's awesome.

 

[VA Hopeful Dr]

During the early days and peak waves of the COVID pandemic, we were introduced to the concept of telemedicine / televisits for outpatient clinic visits as a way of minimizing exposure. This was pretty limited to things like chronic care management of HTN, DM2, HLD, anything psychiatry, etc as it didn't really require a physical exam and was a lot of medication management and stuff.

I still don't understand how you can see respiratory patients in a peak respiratory season via telemedicine. But if so, that's awesome.

For the majority of primary care, I think telemedicine is interior care no matter chronic disease versus acute care.

 

[hallowmann]

For the majority of primary care, I think telemedicine is interior care no matter chronic disease versus acute care.

Agree, I think at best it's "good enough". The main advantage is that you can potentially see people more easily/more often.

 

[Proudfather94]

Agree, I think at best it's "good enough". The main advantage is that you can potentially see people more easily/more often.

I think it has a place in helping people who don't have transportation or may be severely immunocompromised and don't want to risk catching something at the office for something minor.