Urgent Care anyone?

[andwhat]

anyone doing Family Medicine considering Urgent Care? Is it lucrative in big cities, smaller cities, financially as well as personally? I personally like the idea of no call, no pager and no hospital. Its alot of patients to see during a day, but it just seems perfect, a huge varienty of cases, and you can do as much as you want. Anyone have any input positive or negatively? I have found some sweet job offers out there for this.

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[iatrosB]

anyone doing Family Medicine considering Urgent Care? Is it lucrative in big cities, smaller cities, financially as well as personally? I personally like the idea of no call, no pager and no hospital. Its alot of patients to see during a day, but it just seems perfect, a huge varienty of cases, and you can do as much as you want. Anyone have any input positive or negatively? I have found some sweet job offers out there for this.

I'm considering it...but I'm fairly far away. If I choose FM, it will be with the intent of working in an urgent care center. They have their vices, but I like the idea of them. Problems include bad hours (nights, weekends, holidays at some centers), bad complaints (lot of back pain, narc seeking), and not as much continuity (which doesn't bother me, but most people enter FM with continuity as a major selling point).

 

[andwhat]

I'm considering it...but I'm fairly far away. If I choose FM, it will be with the intent of working in an urgent care center. They have their vices, but I like the idea of them. Problems include bad hours (nights, weekends, holidays at some centers), bad complaints (lot of back pain, narc seeking), and not as much continuity (which doesn't bother me, but most people enter FM with continuity as a major selling point).

dude its extremely nice, I did a month and a half of it, a month as a resident, and two weeks as a med student. Med student part of it wasnt all that glamorous or fun, it was more like preceptors giving me sh+t, when you are a student it doesnt really feel like a true rotation at times the manner in which we are treated... at times in residency also, doing FM and my Ob Gyn preceptor is not nice at all....
Urgent care rocks dude. I would prefer it seperately from a hospital. Only drawback to that, and huge one, is that what if theres a code that walks in, and cannot get that patient the available treatment on time.
Bad hours, usually not man. Depends on how well staffed your center is, and how badly they need you. Nobody is unhappy at the Urgent Care center where I worked for a month. Except for me, because they didnt seem to be hiring any new physicians. In other words they are well staffed. But getting offers from other places too. And your right somewhat, the hours are minimum ten hours per day at some places, and two weekends per month. Thats alot of hours man, then again the work is usually pretty laid back, USUALLY that is. Bad complaints? yeah man have seen that in Connecticut, scary stuff, then again it depends on where you want to be. Midwest is usually friendlier, then again drug seekers are everywhere dude. You can always just say FOLLOWUP WITH YOUR DOCTOR!!!!!! You dont have to do that if you are a Radiologist or Anesthesiologist. You have to deal with a small number of pain med seeker complaints -- like maybe one or maximum two per week, but it becomes faster and more routine. Drug seekers are not all that persistent at walk in clinics believe me. They get the hint pretty fast, and yes they go out unhappy, but hey thats life. Continuity, you wont miss your chronic drug seekers coming in once a month like clockwork -- they look like freakin zombies man they look surreal, on boatloads of Vicodin, MS Contin, Valium and Soma. Sorry to say, but thats the sad state that we live in. Not so sad though, I mean you can make a great living in Urgent Care.

 

[bricktamland]

I'd also be interested to learn more about careers in Urgent Care. The concept seems appealing--kind of like doing Emergency Medicine minus the trauma (I know, probably the total opposite of why most people choose EM). I really enjoy the diagnostic aspect of primary care, and the variety you get in FM. I'm less excited about prev med and the management of chronic disease. The idea of shift work with no call is enticing.

 

[andwhat]

I'd also be interested to learn more about careers in Urgent Care. The concept seems appealing--kind of like doing Emergency Medicine minus the trauma (I know, probably the total opposite of why most people choose EM). I really enjoy the diagnostic aspect of primary care, and the variety you get in FM. I'm less excited about prev med and the management of chronic disease. The idea of shift work with no call is enticing.

dude Urgent Care -- it is nothing short of amazing pick your spots anything that you want to do. Incision and Drainage, your choice of antibiotics, Bipolar lady with a toenail avulsion that wont even let you touch her foot with a needle and is screaming until you cannot hear anymore. -- and you are the man, you successfully performed the procedures, under those conditions at times lol. I am telling you, no better job to work in. No better field to be in. Huge variety of stuff, fast pace, its great. Just my hometown is fully staffed unfortunately. Urgent Care is great. I dont think that alot of people chose to do EM for trauma, the majority that I have talked to liked the lifestyle and pay.
Primary care Family Medicine notably, is the perfect transition into Urgent Care, all age groups, Ob Peds and even Psych -- unfortunately Psych that is at times lol.
Prev med and management of Chronic disease, lets leave that for the IM specialists. I hate call, and am not fond of a pager. Cannot fathom the idea of hospitalist work either. Monotonous, and no matter how hard you try to get to the next patient, something else always comes up. One thing or another. Exciting exciting placement issues -- the 95 year old lady lives at home alone and fell, and is now wobbly and no family around! thats guaranteed three days of hospitalization, oh wait just a second here, she is refusing a Nursing Home, and Nursing homes dont work on the weekends (the social workers who make the calls and connections to the prospective nursing homes, unless it is a patient of the particular nursing home previously, there is no way in the world that the patient will go as a new patient to a nursing home on a Saturday or Sunday, or even Friday after like 11 am), so make that 5 days of hospitalization for placement issues only, wow......
oh wait I know what certain people are thinking, I should be proud to become a physician and to have made it this far. Well yes, of course, but also have to do what you enjoy most, which DOESNT INCLUDE one hour hospital visits -- (oh man I am late to clinic again, she asked me about a thousand questions, how can I possibly be to clinic on time) , well child checks (mom asking ten thousand questions -- "is it normal for him to move his arm like that?" , unexpected "well the rest of the kids are here, I know that you have a packed schedule, but can you look at Tommies sore throat, and Mollies tummy ache, and Billies ear, and can you refill my husbands MSContin and Vytorin, even though hes not a fully established patient yet?" sorry wont miss those days.
I think that Urgent Care rocks -- granted it is a relatively new field, and I see it as the perfect ticket to adding more interest into Primary Care, notably Family Medicine.

 

[iatrosB]

dude Urgent Care -- it is nothing short of amazing pick your spots anything that you want to do. Incision and Drainage, your choice of antibiotics, Bipolar lady with a toenail avulsion that wont even let you touch her foot with a needle and is screaming until you cannot hear anymore. -- and you are the man, you successfully performed the procedures, under those conditions at times lol. I am telling you, no better job to work in. No better field to be in. Huge variety of stuff, fast pace, its great. Just my hometown is fully staffed unfortunately. Urgent Care is great. I dont think that alot of people chose to do EM for trauma, the majority that I have talked to liked the lifestyle and pay.
Primary care Family Medicine notably, is the perfect transition into Urgent Care, all age groups, Ob Peds and even Psych -- unfortunately Psych that is at times lol.

I would think EM trains you pretty well for Urgent Care. What do you think?

 

[andwhat]

I would think EM trains you pretty well for Urgent Care. What do you think?

EM definitely, plus they can go back and forth, Trauma stuff, and then Urgent Care when they want to chill a bit.... I think that EM also is a perfect fit to this subspecialty.

 

[deleted87716]

Many urgent care centers also do primary care, and EM training doesn't really prepare you very well for that. If urgent care is in your future, FM or IM/peds will prepare you better than anything else. Urgent care is basically primary care without an appointment.

The biggest turn-off for me is the schedule, which invariably includes lots of nights and weekends.

 

[iatrosB]

Many urgent care centers also do primary care, and EM training doesn't really prepare you very well for that. If urgent care is in your future, FM or IM/peds will prepare you better than anything else. Urgent care is basically primary care without an appointment.

The biggest turn-off for me is the schedule, which invariably includes lots of nights and weekends.

Is the extra peds exposure what you think makes FM a better fit for urgent care?

 

[deleted87716]

Is the extra peds exposure what you think makes FM a better fit for urgent care?

Yes. There's a fair amount of that in urgent care.

 

[bricktamland]

A couple questions:

1. What type of patient populations attend Urgent Care clinics? Are these services only available for people with insurance? Or is it like the Emergency Room, where you're obligated to treat anyone who stumbles in, whether it's drunken Joe Hobo or Paris "DUI" Hilton?

2. How flexible are the schedules? I imagine you have to work some night and weekend shifts, but it seems like with enough providers, it would be easy to work Part-time or arrange for coverage for long weekends.

3. How does compensation compare with more traditional Family Med, or IM jobs?

4. What are the most commonly performed procedures at these clinics?

I've been doing a form of urgent care for over 2 years now (Navy GMO). I see "sick call" all day, Marines just pour into the clinic at random times (though they're supposed to come in during the morning). I don't even remember what it's like to have scheduled patients. At times it can be frustrating--we have what we call our "sick-call commando's," who are like drug seekers but instead of drugs they want "light duty chits" which they get for minor injuries/illnesses and keep them from having to go on mandatory runs, hikes, working parties, etc.

Nevertheless, it's worth it not to have to carry a pager and take call. My most aggravating chore is physicals, which I absolutely loathe. I like kids, but I couldn't do Peds because of all those mind-numbing "well-child" exams. Elderly people are cool, but geriatrics seems like glorified social work most of the time. I enjoy cases like the 22 year-old Marine I saw today who came in complaining of pleurtic chest pain and SOB, and ended up having a giant pulmonary effusion on his CXR. That's pretty interesting.

I'm sure Urgent Care has it's share of the mundane and the monotonous (I'm picturing acute pharyngitis, VGE, etc), but what field of medicine doesn't have it's downside?

 

[andwhat]

Many urgent care centers also do primary care, and EM training doesn't really prepare you very well for that. If urgent care is in your future, FM or IM/peds will prepare you better than anything else. Urgent care is basically primary care without an appointment.

The biggest turn-off for me is the schedule, which invariably includes lots of nights and weekends.

depends on where you work, and its usually flexible. I will bet that in Chicago or NY or Los Angeles or other highly desirable locations its tough to get the schedule that you want without resistance. Surprisingly, never heard of this around the midwest, sure that it exists though, and have been around 4 different locations, not too many people mentioned invariability and adding nights and weekends to the schedule. Usually only have to work two weekends per month period. Yes its primary care, without the Epidemiology and chronic narcotic seekers that will follow you across the globe pretty much.
Urgent Care does have some Primary Care, can you please be more specific though, they do Gonorrhea / HIV tests, order labs, but at the end of the day, its always a smile, and "follow up with your doctor"
unless theres a sebaceous cyst drainage that I want to show off to other doctors in a few days, I mean followup and make sure its not infected ;-)
Primary Care into Urgent care, dunno..... perhaps. having a brain freeze at the moment though.
You know I suppose if you add on a center on the side of your office building for Urgent Care and you are an internist there. Our John Deere pavilion is set up like that, but usually Urgent Care is connected to ER, or isolated.

 

[awdc]

Many urgent care centers also do primary care, and EM training doesn't really prepare you very well for that. If urgent care is in your future, FM or IM/peds will prepare you better than anything else. Urgent care is basically primary care without an appointment.

The biggest turn-off for me is the schedule, which invariably includes lots of nights and weekends.

Something irked me about your statement so I read it in a different way by replacing some words...

"Many urgent care centers also do emergency care, and FM training doesn't really prepare you very well for that. If urgent care is in your future, EM or IM/peds will prepare you better than anything else. Urgent care is basically emergency care without the emergency and critical care. "

Anyways, not to get into a whole debate of EM vs FM that will never get resolved. I guess it's about perspective. If in your perspective that primary care training is more important for urgent care, then you'll gravitate toward the primary care training. And if you feel that EM training is more important for urgent care, you'll gravitate toward EM training. There's definitely a big overlap. I could argue for both ways.

And I don't think it's the "extra" peds exposure in FM because I don't think there is "extra" peds exposure in FM. It's just a different peds exposure. For example, at my program we do all of our pediatric EM shifts at the children's hospital next door (and other programs may have integrated adult and peds ED). Whereas in FM, it's more peds in a primary care setting. In EM, peds experience is more centered on the PEM and PICU aspects. In FM emphasis is on primary care and continuity of care from office to floors.

Bottom line is that I feel that there's a place for both FM and EM trained folks to do urgent care. There's advantages to both specialties but I don't think anyone going into EM thinks about doing urgent care. We see enough of it in the ED anyways.

 

[andwhat]

A couple questions:

1. What type of patient populations attend Urgent Care clinics? Are these services only available for people with insurance? Or is it like the Emergency Room, where you're obligated to treat anyone who stumbles in, whether it's drunken Joe Hobo or Paris "DUI" Hilton?

2. How flexible are the schedules? I imagine you have to work some night and weekend shifts, but it seems like with enough providers, it would be easy to work Part-time or arrange for coverage for long weekends.

3. How does compensation compare with more traditional Family Med, or IM jobs?

4. What are the most commonly performed procedures at these clinics?

I've been doing a form of urgent care for over 2 years now (Navy GMO). I see "sick call" all day, Marines just pour into the clinic at random times (though they're supposed to come in during the morning). I don't even remember what it's like to have scheduled patients. At times it can be frustrating--we have what we call our "sick-call commando's," who are like drug seekers but instead of drugs they want "light duty chits" which they get for minor injuries/illnesses and keep them from having to go on mandatory runs, hikes, working parties, etc.

Nevertheless, it's worth it not to have to carry a pager and take call. My most aggravating chore is physicals, which I absolutely loathe. I like kids, but I couldn't do Peds because of all those mind-numbing "well-child" exams. Elderly people are cool, but geriatrics seems like glorified social work most of the time. I enjoy cases like the 22 year-old Marine I saw today who came in complaining of pleurtic chest pain and SOB, and ended up having a giant pulmonary effusion on his CXR. That's pretty interesting.

I'm sure Urgent Care has it's share of the mundane and the monotonous (I'm picturing acute pharyngitis, VGE, etc), but what field of medicine doesn't have it's downside?

1) what type of population? The type that says this exact quote almost every time " I didnt want to wait forever to get in to see my doctor" or "I am from out of town, and do not want to visit the ER for this, and my doctor is out of town" Only with insurance, I believe so, could be mistaken though. Pretty much never ever seen anybody turned away though, so I am assuming that they see and treat everybody, unless they are turned away due to lame excuses "the doctor that saw me yesterday gave me ten percocet script, and just as I filled the bottle, somebody stole it from me" yeah unfortunately a few of those, but they are not very popular around our parts fortunately, because they are turned away easily and routinely cleanly and simply.

2) flexibility in the schedules, well from my perspective, not a whole lot of complaints that I have seen at all. The occasional covering shift due to medical or personal emergency I would assume. I think that everyone works at least one or two weekends minimum.

3) job offers I have seen up to $200,000 yearly, depends on how much you want to work. Max I have seen is like close to or a bit over $300,000.
Usually starting out between 120,000 and $150,000 and up from there.

4) tons and tons of cool procedures, foreign body of eye removal, with slit lamp, stitches, Incision and Drainage, Toenail avulsion injuries, either taking them out or fixing them and leaving the rest in, abscess drainage, and if you are not comfortable with it, then the General Surgeon can see them the same day if they are nice ;-) You dont want to mess with something buried underneath the skin on the face. Thats for plastics and perhaps derm, not for an Urgent Care clinic. And of course run of the mill not so fun at times Pelvics, Gonorrhea and Chlamydia screens, etc. Procedures are the funnest part.

that "sick call commando" deal sounds rough, of note coincidentally just saw the "Hills have eyes part 2" -- truly gruesome... imagine that Urgent Care clinic....
I hate doing Physicals, they slow everything down, and they shouldnt be allowed, but they are. As a matter of fact they are encouraged, to get more patient volume. I think that this is Primary Care as mentioned, doing Physicals for school and so forth. Yeah dude Geriatrics and Hospice and Nursing home stuff is alot of Social work. But it has its own rewards too. Like helping people out. I have read some truly disgusting things lately pertinent to Hospice, our local idiot newspaper published some dumbas+ calling it "physician assisted suicide"
well those idiots obviously dont know jack about the Health Care system, I once sent a guy from Hospice into the ER at about 3 am for placement of Double Nephrostomy tubes because he couldnt void, and his wife wanted him to be comfortable, even though he died a few days later. He ended up getting the procedure done the next day in the afternoon after I sent him.
Pleuritic chest pain, yeah those can be drug seekers unfortunately, were in the ER the day prior, without telling me, got worked up, but didnt get their Vicodin, so later on I found out about it, just before the thousand or so dollar workup proceeded, which was negative the previous day.
Acute pharyngitis is fine any day, as opposed to the boring unnecessary placement issues in the hospital.

 

[andwhat]

Something irked me about your statement so I read it in a different way by replacing some words...

"Many urgent care centers also do emergency care, and FM training doesn't really prepare you very well for that. If urgent care is in your future, EM or IM/peds will prepare you better than anything else. Urgent care is basically emergency care without the emergency and critical care. "

Anyways, not to get into a whole debate of EM vs FM that will never get resolved. I guess it's about perspective. If in your perspective that primary care training is more important for urgent care, then you'll gravitate toward the primary care training. And if you feel that EM training is more important for urgent care, you'll gravitate toward EM training. There's definitely a big overlap. I could argue for both ways.

And I don't think it's the "extra" peds exposure in FM because I don't think there is "extra" peds exposure in FM. It's just a different peds exposure. For example, at my program we do all of our pediatric EM shifts at the children's hospital next door (and other programs may have integrated adult and peds ED). Whereas in FM, it's more peds in a primary care setting. In EM, peds experience is more centered on the PEM and PICU aspects. In FM emphasis is on primary care and continuity of care from office to floors.

Bottom line is that I feel that there's a place for both FM and EM trained folks to do urgent care. There's advantages to both specialties but I don't think anyone going into EM thinks about doing urgent care. We see enough of it in the ED anyways.

yeah both specialties could be of benefit, but we see ALOT of ED sort of stuff in the clinic, lance boils, and neb treatments, even Rabies exposures. I think that it depends on what sort of background you have, I think that FM training or IM/Peds you get plenty of exposure to very worthwhile instances that could help out in Urgent Care tremendously, such as evolution of a rash, could be Streptococcal, and not poison Ivy. Also Mononeuritis , workup for autoimmune disorder -- ANA, CBC with Diff, Vit B12, CMP (DM) etc and Electromyography, and followup with primary care provider -- certainly Primary Care is a great argument in this setting, and several others also. EM over FM for Urgent Care -- whoa? dont think thats accurate, like you said arguments for both exist. EM is great training for Urgent care, and so is FM.

"Many urgent care centers also do emergency care, and FM training doesn't really prepare you very well for that. If urgent care is in your future, EM or IM/peds will prepare you better than anything else. Urgent care is basically emergency care without the emergency and critical care. "


I think that this is better worded like this personally --
"Many urgent care centers also do Primary care, and EM training doesn't really prepare you very well for that. If urgent care is in your future, FM or IM/peds will prepare you better than anything else. Urgent care is basically emergency care and primary care without the emergency and critical care. "

I mean with FM experience you really can understand what your intervention is going to do later on from the acute setting. EM you just treat them and let them go -- without any emphasis at all on continuity whatsoever. There really is alot of Primary care intermingled into Urgent Care, and not so much Emergency Medicine stuff.

It is also truly interesting to note how many Family Medicine physicians work in ERs. Primary Care in the ER??
OH MY GOODNESS!

""And I don't think it's the "extra" peds exposure in FM because I don't think there is "extra" peds exposure in FM. It's just a different peds exposure. For example, at my program we do all of our pediatric EM shifts at the children's hospital next door (and other programs may have integrated adult and peds ED). Whereas in FM, it's more peds in a primary care setting. In EM, peds experience is more centered on the PEM and PICU aspects. In FM emphasis is on primary care and continuity of care from office to floors.""

you tell em awdc, those FM and IM and IM/Peds docs working in the ER in some cities must be lost, how in the world can they be making as much as the ER docs -- and making the same decisions maybe even better too?? that just isnt fair is it ;-)

 

[deleted87716]

I feel that there's a place for both FM and EM trained folks to do urgent care. There's advantages to both specialties but I don't think anyone going into EM thinks about doing urgent care.

Um...thanks. For proving my point, that is.

EM training is largely a waste if all you want to do is urgent care. That's not to say that an EM-trained person couldn't do it; many do. Heck, a lot of the people working in urgent care aren't boarded in anything, and many are semi-retired specialists who have no business doing it in the first place.

 

[awdc]

It is also truly interesting to note how many Family Medicine physicians work in ERs. Primary Care in the ER??
OH MY GOODNESS!

you tell em awdc, those FM and IM and IM/Peds docs working in the ER in some cities must be lost, how in the world can they be making as much as the ER docs -- and making the same decisions maybe even better too?? that just isnt fair is it ;-)

Wow, it looks like I really struck a nerve and all I meant to say that FM and EM could work equally well in urgent care. Apparently you feel that urgent care is best provided by FM. I disagree. I think I see enough merits to both specialties to say that they could do the job equally well in most cases. And then there's a small percent of urgent care that a FP will be better suited for and a small percent of urgent care that a EP will be better suited for.

EM physicians on average make more than IM/FM physicians staffing ED's. You'll also find that it's increasingly difficult for FM/IM physicians to staff an ED in cities. And those FM or IM physicians are relegated more and more to fast-track type of ED work. So someone out there must think that EM residency training is worth something. Sure there are still plenty of FM/IM physicians working in more suburban and rural areas and I'm sure they do a good job of it, too. But I'm also pretty sure that those same facilities would love to have EM residency trained physicians if they could.

 

[awdc]

Um...thanks. For proving my point, that is.

EM training is largely a waste if all you want to do is urgent care. That's not to say that an EM-trained person couldn't do it; many do. Heck, a lot of the people working in urgent care aren't boarded in anything, and many are semi-retired specialists who have no business doing it in the first place.

You're welcome.

 

[andwhat]

Wow, it looks like I really struck a nerve and all I meant to say that FM and EM could work equally well in urgent care. Apparently you feel that urgent care is best provided by FM. I disagree. I think I see enough merits to both specialties to say that they could do the job equally well in most cases. And then there's a small percent of urgent care that a FP will be better suited for and a small percent of urgent care that a EP will be better suited for.

EM physicians on average make more than IM/FM physicians staffing ED's. You'll also find that it's increasingly difficult for FM/IM physicians to staff an ED in cities. And those FM or IM physicians are relegated more and more to fast-track type of ED work. So someone out there must think that EM residency training is worth something. Sure there are still plenty of FM/IM physicians working in more suburban and rural areas and I'm sure they do a good job of it, too. But I'm also pretty sure that those same facilities would love to have EM residency trained physicians if they could.

striking a nerve?? no way dude.... just saying that its a (Urgent Care) subspecialty that deserves respect from all considerations. its a discussion board, open for all discussions, and your point is very valid. Yes you are correct, EM trained physicians do make more than FM / IM physicans staffing an ER, albeit still those primary care docs make a nice chunk of change nonetheless. Definitely EM residency trained physicians are in high demand will agree.

 

[deleted87716]

Wow, it looks like I really struck a nerve and all I meant to say that FM and EM could work equally well in urgent care.

I don't think anyone has disagreed with you on that. There's no reason for this to become an FM vs. EM debate.

Apparently you feel that urgent care is best provided by FM.

Well, think about which forum you're in.

You'll also find that it's increasingly difficult for FM/IM physicians to staff an ED in cities. And those FM or IM physicians are relegated more and more to fast-track type of ED work.

Which further proves the point that FM/IM training is well-suited to urgent care, since that's pretty much the same stuff you see in an ED's fast-track.

 

[andwhat]

]

""EM physicians on average make more than IM/FM physicians staffing ED's. You'll also find that it's increasingly difficult for FM/IM physicians to staff an ED in cities. And those FM or IM physicians are relegated more and more to fast-track type of ED work. So someone out there must think that EM residency training is worth something. Sure there are still plenty of FM/IM physicians working in more suburban and rural areas and I'm sure they do a good job of it, too. But I'm also pretty sure that those same facilities would love to have EM residency trained physicians if they could. ""


well at least I can confirm that this is completely false. What kind of individual would compare salaries in the first place of physicians in health care. Only ones working in burn out fields that dont work longer than like 7 to 10 years and then retire -- due to utter exhaustion, cannot take it anymore, and just complete fatigue. I mean what are your options after EM? Absolutely nothing. Must not be all that luctrative if you ask me, coming out of an ER residency that is.
So I got the salaries, and FM and IM trained ER physicians, make on average in my town about $210-225 K, as compared to EM trained physicians, making $230 - 245 K -- and btw WORKING THE SAME FREAKIN HOURS. Now I think that $210,000 to $225,000 probably pays the bills doesnt it? That is completely preposterous what you have mentioned -- sad thing is, that you are trying to turn this thread into your personal circus, because maybe you are bored or something. This is obviously due to some inferiority complex. At the very least post the true facts, other than speculative at the very best biased opinions. Burn out in 7 years, no thanks thats for you dude. Go ahead and knock yourself out...... and deal with that code and trauma alert...

"But I'm also pretty sure that those same facilities would love to have EM residency trained physicians if they could. ""

I checked on that too, last I heard, hospital was more willing to pay better physicians for slightly less. Your on the wrong forum dude. Oh and my city, between 500,000 to 600,000, with virtually no EM trained physicians, almost all primary care docs. Not at all to knock the ER residency trained physicians, who are paid SLIGHLY more and happen to be excellent physicians also. Just for no reason at all and whatsoever this has become an EM vs FM and primary care argument. Its sad, how people just cannot resist the temptation, but then are jealous and conniving, learning the realization that it doesnt take an ER residency to do ER work. Sigh but this will always be the issue sadly enough as it is.

 

[deleted87716]

C'mon, guys...no name-calling.

Again, this shouldn't be about FM vs. EM. We're talking about urgent care.

As for the income question, it may very well be true that in some cases, non-EM physicians working in EDs are paid somewhat less than BC/BE EM physicians. It's probably nothing more than supply and demand: hospitals that pay less have more trouble recruiting BC/BE EM physicians, and non-EM physicians who want to work in the ED may be willing to work for less.

No matter which salary survey you look at, the average income difference between FM and EM is around $50K/year, and that's working in their specialty. That's not much of a difference, IMO, particularly when you consider the different lifestyles. As far as I'm concerned, the EM guys are earning every penny of that extra $50K.

Once you start talking about moving out of your primary field into a different field, such as urgent care, you can't compare these average incomes any longer. Urgent care is urgent care, and your income will be affected more by your practice and work hours than what you're boarded in.

 

[andwhat]

C'mon, guys...no name-calling.

Again, this shouldn't be about FM vs. EM. We're talking about urgent care.

As for the income question, it may very well be true that in some cases, non-EM physicians working in EDs are paid somewhat less than BC/BE EM physicians. It's probably nothing more than supply and demand: hospitals that pay less have more trouble recruiting BC/BE EM physicians, and non-EM physicians who want to work in the ED may be willing to work for less.

No matter which salary survey you look at, the average income difference between FM and EM is around $50K/year, and that's working in their specialty. That's not much of a difference, IMO, particularly when you consider the different lifestyles. As far as I'm concerned, the EM guys are earning every penny of that extra $50K.

""Once you start talking about moving out of your primary field into a different field, such as urgent care, you can't compare these average incomes any longer. Urgent care is urgent care, and your income will be affected more by your practice and work hours than what you're boarded in.

this is exactly why I would like to combine the traditions of family medicine, with up and coming new age Urgent Care. Still I very much enjoy the continuity of seeing my own patients prosper and do well with my interventions, plus I like the fast pace of Urgent Care. btw you cannot do that as an ER physician, last JAMA magazine that I picked up, job offers were Derm and then Family Medicine, there wasnt even a section for Emergency Medicine. You be the judge and then tell me who is in demand. Also I am getting heavily recruited to do ER work in smaller areas all over the midwest at this very moment, for close to $100 per hour. I better call them back and inform them that I am not an ER trained physician, and that they better love an EM trained physician or else!

 

[awdc]

]
well at least I can confirm that this is completely false. What kind of individual would compare salaries in the first place of physicians in health care. Only ones working in burn out fields that dont work longer than like 7 to 10 years and then retire -- due to utter exhaustion, cannot take it anymore, and just complete fatigue.

People keep quoting these burnout figures but no one takes into account that much of this came about when EM wasn't a specialty and the "culture" of an EM lifestyle had not been established. With the advent of EM residencies, EP's come out of residency probably much more comfortable in their role as an "ER doc." You won't find very many older EP's simply because the majority of EM residencies began in the 1980's and you have a lot of relatively young residency programs in EM compared to other more established specialties. I mean we're talking about senior attendings barely in their 50's.

I mean what are your options after EM? Absolutely nothing. Must not be all that luctrative if you ask me, coming out of an ER residency that is.

Options for EP's other than ED... urgent care, cruise ship medicine, ED administration, EMS direction/admin, toxicology, state dept foreign regional medical officer (pretty much a primary care role also open to FP's and internists but with some EM flavoring of operational/tactical/disaster medicine thrown in), critical care medicine, peds EM, operational/tactical medicine, international EM, etc. And with the wide variety of EDs (from inner-city level 1 trauma centers to small, easy-going community ER's) it's probably not that difficult to find a setting that one would enjoy as an EP.

So I got the salaries, and FM and IM trained ER physicians, make on average in my town about $210-225 K, as compared to EM trained physicians, making $230 - 245 K -- and btw WORKING THE SAME FREAKIN HOURS. Now I think that $210,000 to $225,000 probably pays the bills doesnt it? That is completely preposterous what you have mentioned -- sad thing is, that you are trying to turn this thread into your personal circus, because maybe you are bored or something. This is obviously due to some inferiority complex. At the very least post the true facts, other than speculative at the very best biased opinions. Burn out in 7 years, no thanks thats for you dude. Go ahead and knock yourself out...... and deal with that code and trauma alert...

Inferiority complex? Nah. Bored...? Maybe a little. I'm just decompressing on my post-call day. And I suspect our zeal is tainted by the different regions of the country that we are familiar with. Besides, I was just responding to your statement about FP's in the ED making as much as EP's... which I thought was inaccurate. Speaking of true facts, again where is the evidence that EM trained physicians burn out after 7-10 years? Do they really burn out at a higher rate than other physicians? I hear a lot of talk these days of physicians not wanting to work until the traditional retirement age and that goes for even us younger guys in EM who are bright-eyed and bushy-tailed. I don't think the desire to retire early means burn-out... people just want to do other things in life. Which kind of fits into the EM mentality of being able to take days off at a time and the flexible schedules to do other things. I know you guys probably don't agree with shift work but it does for those of us in EM. Anyways, I digress...

"But I'm also pretty sure that those same facilities would love to have EM residency trained physicians if they could. ""

I checked on that too, last I heard, hospital was more willing to pay better physicians for slightly less.

Yes, within their respective areas of expertise. And are you implying that FP's are better? Last I checked, we were all physicians... just with different areas of specialization. And I hope you feel the same way.

Your on the wrong forum dude. Oh and my city, between 500,000 to 600,000, with virtually no EM trained physicians, almost all primary care docs. Not at all to knock the ER residency trained physicians, who are paid SLIGHLY more and happen to be excellent physicians also. Just for no reason at all and whatsoever this has become an EM vs FM and primary care argument. Its sad, how people just cannot resist the temptation, but then are jealous and conniving, learning the realization that it doesnt take an ER residency to do ER work. Sigh but this will always be the issue sadly enough as it is.

And you are right, it doesn't take EM residency to do EM work... just like it doesn't take FM residency to do FM work. What residencies give to us is solid training in our respective fields and the ability to hold ourselves as specialists in whatever field it is.

By the way, JAMA isn't a great resource for EP jobs... the publication doesn't exactly target the EM readership. And most EP jobs aren't even advertised. From what I hear of former grads is that it's ridiculously easy finding a job as an BE/BC EP. I suspect it's the same thing with FM.

Sorry that I posted here again but just had to respond to what I feel are inaccuracies regarding EM.

 

[andwhat]

People keep quoting these burnout figures but no one takes into account that much of this came about when EM wasn't a specialty and the "culture" of an EM lifestyle had not been established. With the advent of EM residencies, EP's come out of residency probably much more comfortable in their role as an "ER doc." You won't find very many older EP's simply because the majority of EM residencies began in the 1980's and you have a lot of relatively young residency programs in EM compared to other more established specialties. I mean we're talking about senior attendings barely in their 50's.
Options for EP's other than ED... urgent care, cruise ship medicine, ED administration, EMS direction/admin, toxicology, state dept foreign regional medical officer (pretty much a primary care role also open to FP's and internists but with some EM flavoring of operational/tactical/disaster medicine thrown in), critical care medicine, peds EM, operational/tactical medicine, international EM, etc. And with the wide variety of EDs (from inner-city level 1 trauma centers to small, easy-going community ER's) it's probably not that difficult to find a setting that one would enjoy as an EP.

Inferiority complex? Nah. Bored...? Maybe a little. I'm just decompressing on my post-call day. And I suspect our zeal is tainted by the different regions of the country that we are familiar with. Besides, I was just responding to your statement about FP's in the ED making as much as EP's... which I thought was inaccurate. Speaking of true facts, again where is the evidence that EM trained physicians burn out after 7-10 years? Do they really burn out at a higher rate than other physicians? I hear a lot of talk these days of physicians not wanting to work until the traditional retirement age and that goes for even us younger guys in EM who are bright-eyed and bushy-tailed. I don't think the desire to retire early means burn-out... people just want to do other things in life. Which kind of fits into the EM mentality of being able to take days off at a time and the flexible schedules to do other things. I know you guys probably don't agree with shift work but it does for those of us in EM. Anyways, I digress...

Yes, within their respective areas of expertise. And are you implying that FP's are better? Last I checked, we were all physicians... just with different areas of specialization. And I hope you feel the same way.

And you are right, it doesn't take EM residency to do EM work... just like it doesn't take FM residency to do FM work. What residencies give to us is solid training in our respective fields and the ability to hold ourselves as specialists in whatever field it is.

By the way, JAMA isn't a great resource for EP jobs... the publication doesn't exactly target the EM readership. And most EP jobs aren't even advertised. From what I hear of former grads is that it's ridiculously easy finding a job as an BE/BC EP. I suspect it's the same thing with FM.

Sorry that I posted here again but just had to respond to what I feel are inaccuracies regarding EM.

ok so come to the realization that nothing will keep this thread from not becoming EM vs FM.
I think that definitely all physicians are good.
It doesnt take an FM residency to do FM you are 110% accurate.
This used to be an Urgent Care thread. Your ideas are appreciated, and yes I will agree actually JAMA is more of a primary care book, which is probably why.
I dont necessarily agree with the burnout figures either, I know of alot of people in various specialties, like Urology, ENT FM, and IM that just didnt like working the routine work, and went into academics.
I think that EM residencies have been around for a while, and you dont have to say that the ER residents and attendings look old, because man do they look aged -- and they are in their 30s. Probably like nine out of thirty in my class, said that they wanted to do ER at first, and that dropped to like five and then three over time. I think that ER received alot of publicity and increasing awareness in medical school after the big TV hit ER. This popularity has subsequently dropped. Then again maybe I am wrong again.
Yeah your right theres opportunity after EM in the EM field, and can easily blend into other fields and aspects of medicine.
No way are FM docs better than EM docs in the ER. As a matter of fact, yes there is recruitment of younger ER docs in smaller cities every day, where primary care docs are also working in the same ED.
Primary care docs are retiring relatively early also at times..... I consider early fifties young sorry...
shift work is good, that is Urgent care too, but yes you are correct cannot do that in the realms of primary care.
well, I guess forget about that thread topic, which used to be Urgent Care. It turned into EM vs FM. I am really hoping that it doesnt continue, and that it was and is over with, but somehow I doubt it.

 

[windcold]

I would think EM trains you pretty well for Urgent Care. What do you think?

fact is I am doing FM and like the way EM do

 

[desertdocaz]

I saw lots of pros and tought I'd add a few cons having worked in UC for 2 years and my solo FP for 10 years. You get to establish relationships in the office you will never gets in the UC. Money-wise I've done much better in the office. When I started it was 120k per year for office salary and about 96 in the UC. I've since done much better. The best part of UC is the flexibility. I do enjoy seeing my patients and asking how the fishing trip was last month or how the daughter's wedding went. Try UC for a while first. Then if you leave you won't be leaving anyone you've built a relationship with. Then try office work.

 

[andwhat]

I saw lots of pros and tought I'd add a few cons having worked in UC for 2 years and my solo FP for 10 years. You get to establish relationships in the office you will never gets in the UC. Money-wise I've done much better in the office. When I started it was 120k per year for office salary and about 96 in the UC. I've since done much better. The best part of UC is the flexibility. I do enjoy seeing my patients and asking how the fishing trip was last month or how the daughter's wedding went. Try UC for a while first. Then if you leave you won't be leaving anyone you've built a relationship with. Then try office work.

96K ouch... that would not be lucrative at all.. I mean compared to the mean average US salary its alot, but I have student loans to pay... I mean I am not going to be a jerk like Latrell Sprewell, and sound like I am turning down a 3 million dollar contract as opposed to what that guy (Ex NBA star) thought that he was worth, and said "I got kids to feed" but I need more than that starting out.... and no Ob hopefully.
dude I have been entertaining much higher starting salaries than that, almost double as a matter of fact... my friend two years out makes close to double that in UC also in the midwest and he loves it.... you just see many more patients... when I was doing the rotation, I was seeing between 30 and 35 per day.. wonder what is the missing loophole here... must be somewhere.. some unforseen taxes or what not? I am not sure exactly... but yeah I will agree, in office salary must be nice if you add stress tests, and vasectomies into the schedule.. thanks alot desertdocaz I will look into that... btw I have heard that Az is a sweet place to be, salary and cost of living wise.

 

[RisingSun]

96K ouch... that would not be lucrative at all..

I want to echo this with an example from Bellingham, WA. A physician I was shadowing (DO in FP) last year mentioned that the urgent care center up the road was hiring a BC/BE FP. Pay: 80K. He told me this was a full time position, and that they were trying to recruit him (he laughed at the idea of giving up his PP for 80K salary). I was actually really surprised to hear that urgent care centers paid so poorly, but at least they do up here.

He said that I should move to Alaska after graduating because the pay is much higher up there - i.e. better reimbursement from Medicare and all the other insurance companies than down in the lower 48. He suggested that after a few years up there I could move back down and set up shop, after paying off my loans and saving up some money. Maybe UC pays well up there, too? It's probably a regional thing, like everything else in FP practice, it seems.

 

[andwhat]

I want to echo this with an example from Bellingham, WA. A physician I was shadowing (DO in FP) last year mentioned that the urgent care center up the road was hiring a BC/BE FP. Pay: 80K. He told me this was a full time position, and that they were trying to recruit him (he laughed at the idea of giving up his PP for 80K salary). I was actually really surprised to hear that urgent care centers paid so poorly, but at least they do up here.

He said that I should move to Alaska after graduating because the pay is much higher up there - i.e. better reimbursement from Medicare and all the other insurance companies than down in the lower 48. He suggested that after a few years up there I could move back down and set up shop, after paying off my loans and saving up some money. Maybe UC pays well up there, too? It's probably a regional thing, like everything else in FP practice, it seems.

80K??? that is just insane, whats the point of even going to medical school, might as well do law or accounting or business... thats just a disgrace..
havent seen too many payscales, but yeah thats not lucrative at all and whatsoever, jeeezzz.... but other places pay more supposedly.. that must be some isolated thing, I have heard of a general surgeon in chicago working fulltime netting like 130 K.

 

[andwhat]

well this has turned into my personal blog lol.....
just started my preceptorship with a highly successful FM group. These guys work hard as hell and almost nonstop, I dont know how they maintain it. But thats life like this.
Well supposedly health care is going to make a new turn, to go away from "Quantity" -- being an Urgent care doc possibly seeing 40 to 50 patients per day and "bandaging" them up, as opposed to an Internist or Family Practitioner, seeing 15 - 20 "Quality" visits per day -- in the latter portion getting compensated substantially better -- and this is supposedly.
Supposedly theres going to be some reform, all that pretty much ever happens lately is reading about things like this.
I think that proportionately, Family Medicine does a heck of alot more quality work, and not so much seeing as many patients as possible, trying to get more and more numbers. Its tough to discern, but if were to put a pricetag on it monetarily so to speak, Family Medicine or Internal Medicine internist and subspecialist and pure Emergency Medicine (running codes and stroke alerts and so forth) work is much much much much more important proportionately and pertinent to quality of life. Urgent care seems to mop up patients too lazy to make an appointment with their regular doctors. I just dont see this as real medicine. Its nice, and you dont have to take call and work nearly as hard (hours wise, albeit Urgent Care is still pretty darn exhausting day in and day out if you do it enough), but I dont think that it should be considered a "real' specialty. That is just so weird how the Urgent Care salaries fluctuate throughout the country.

 

[timtye78]

I am an anesthesiology resident who moonlights in Urgent Care. I feel fairly comfortable working at these clinics, and I just wanted to comment on the pay aspect. If I extrapolated how much I would make if I worked full-time, it comes to over $200K. Not bad for seeing patients who's CC is:

a.it burns when I pee
b.I have this rash on my arm
c. I have ST, cough, congestion
d. Sports physical

hehe

 

[Doowai]

EM does not have enough OB/gyn or Pedes to really do urgent care justice. IM is not a good fit at all due to the complete lack of pedes, and IM/Pedes is not prepared to handle OB. Many of these patients are without insurance - and so they are paying cash for this visit, and to give them slipshod care with a cavelier attitude and trying to cover your own a** by just saying "follow up with your primary care" (when you and they both know they are not going to follow up with any primary care physician) is really immoral on the part of the doctors doing it. If a woman shows up at week 24 with an OB problem, the doctor needs to be familiar with it -

Psyche is not really a good fit for EM, but I have seen ads for rural EM centers saying their qualifications are "board certified in whatever" - so sure while an anesth doctor might work in urgent care, its really not the right fit for either the patient or the doctor. I mean turf wars aside, "board certified in whatever" running a geographically isolated ER and an Anesth running an urgent care is not suitable. Patients come in with conditions other than rash or it hurts when it pees - and even then can be indicative of serious conditions. Patients really deserve someone experienced and trained in the conditions that CAN occur in Urgent care and not just what happens on a slow night. This applies to all specialities -

 

[Miami_med]

EM does not have enough OB/gyn or Pedes to really do urgent care justice. IM is not a good fit at all due to the complete lack of pedes, and IM/Pedes is not prepared to handle OB. Many of these patients are without insurance - and so they are paying cash for this visit, and to give them slipshod care with a cavelier attitude and trying to cover your own a** by just saying "follow up with your primary care" (when you and they both know they are not going to follow up with any primary care physician) is really immoral on the part of the doctors doing it. If a woman shows up at week 24 with an OB problem, the doctor needs to be familiar with it -

Psyche is not really a good fit for EM, but I have seen ads for rural EM centers saying their qualifications are "board certified in whatever" - so sure while an anesth doctor might work in urgent care, its really not the right fit for either the patient or the doctor. I mean turf wars aside, "board certified in whatever" running a geographically isolated ER and an Anesth running an urgent care is not suitable. Patients come in with conditions other than rash or it hurts when it pees - and even then can be indicative of serious conditions. Patients really deserve someone experienced and trained in the conditions that CAN occur in Urgent care and not just what happens on a slow night. This applies to all specialities -

EM physicians ARE trained in urgent obstetrical care. What do you think happens when someone shows up to an ED with an obstetrical problem? Most physicians in most specialties should be competent to do urgent care. Many non BC/BE physicians do urgent care. Admittedly, FM and EM are probably best suited to it. As a career, it probably fails to encompass the breadth of knowledge in both specialties. The acuity is FAR too low for EM training, and the lack of follow-up really fails to encompass all of the chronic care training in FM. Can we all admit that 90% of urgent care complaints could be worked up successfully by a 3rd year medical student, and that the quality of the UC center is probably based on whether the physicians know which of the remaining 10% they are capable of working up and which patients to send to the local ED.

 

[awdc]

EM does not have enough OB/gyn or Pedes to really do urgent care justice.

I'm sure we see more than enough Ob/Gyn. That GYN room in our ED gets used a lot by us (not so much by OB/GYN). In addition, I don't think there's a single EM program where Ob/Gyn is not a required rotation. There's also plenty of peds in EM training... definitely enough to be able to do urgent care since most peds EM visits are pretty much urgent care complexity and severity. Most EM programs will have about a 20% exposure to the pediatric population. In my program, we do a month of peds EM (out of four EM months) in the intern year. During the 2nd and 3rd years, I think it's about 4 shifts (out of 19-20 shifts) per month in the peds ED. EM programs will also have a combination of PICU, NICU, and peds floor to be done as well.

 

[timtye78]

EM does not have enough OB/gyn or Pedes to really do urgent care justice. IM is not a good fit at all due to the complete lack of pedes, and IM/Pedes is not prepared to handle OB. Many of these patients are without insurance - and so they are paying cash for this visit, and to give them slipshod care with a cavelier attitude and trying to cover your own a** by just saying "follow up with your primary care" (when you and they both know they are not going to follow up with any primary care physician) is really immoral on the part of the doctors doing it. If a woman shows up at week 24 with an OB problem, the doctor needs to be familiar with it -

Psyche is not really a good fit for EM, but I have seen ads for rural EM centers saying their qualifications are "board certified in whatever" - so sure while an anesth doctor might work in urgent care, its really not the right fit for either the patient or the doctor. I mean turf wars aside, "board certified in whatever" running a geographically isolated ER and an Anesth running an urgent care is not suitable. Patients come in with conditions other than rash or it hurts when it pees - and even then can be indicative of serious conditions. Patients really deserve someone experienced and trained in the conditions that CAN occur in Urgent care and not just what happens on a slow night. This applies to all specialities -

I find it interesting that a medical student feels qualified to state the qualifications necessary for practicing medicine for several reasons. One, it is highly likely that this person does not have any state medical license. Two, has not completed a broad internship or completed any years of training. Third, is not certified in anything other than maybe ACLS.

Nevermind, that this anesthesia provider has spent the last 3+ years providing direct personal medical care to to some of the sickest and most deathly ill patients in the state. Just for giggles I have taken care of tons of transplant patients, almost 12 months of different ICU rotations, including cardiac, surgical, medicine, pulmonary, transplant, pediatric, neonatal, and trauma. I have run hundreds of codes, intubated premature dying neonates, and intubated everything up to 400 pounder pregos on the OB floor. Oh yeah, I have a state medical license.

Everyone in this forum is entitled to their opinions, but I am offended that someone, especially a medical student, feels entitled to comment on a licensed physician's clinical judgement. While he/she may not be commenting directly to me, it does apply.

What you need to understand, my friend, is that there are ALL types of licensed MD/DOs working in urgent care. There are board cert/non board cert. There are neurologists and there are ER residents. It goes on and on.
So far the state medical licensure may decide who practices, and where. If you think there should be a specific training program for urgent care, then you are going to find a lot of resistance.

I personally take every patient complaint very seriously, and I have multiple physicians available to me if I ever have questions.
Also, one of the main responsibilities of an urgent care provider, is not to necessarily provide thrombolytic therapy to a person with Acute Coronary Syndrome, but to recognize a patient who may be in trouble, or who needs further testing acutely.
OB: There is really not much OB in urgent care. Many local offices will refuse to see a patient if they are known to be pregnant. These people need to go to an ER or their primary OB if there is something going on in those departments.
Thank you.

 

[masterofnone]

After reading the good Dr. Tye's post I have this to add:

As a 4th year med student currently doing a rural family practice month, I can report that I have been able to correctly handle all of the patients that have come through the doors. I see >20 pts a day and these patients seem fairly representative of "typical" FM and urgent care patients

No, I don't know everything and I have no doubt that a board certified FM or EM physician could run circles around me in practice; however, if I can handle this setting it would be ridiculous to think that an anethesiologist (or any physician with 3yrs of residency experience) could not effectively and properly care for these patients.

On a side note...I have rotated in the OR with Dr. Tye and can say that I would happily refer my friends and family to him in an urgent care setting.
He knows his stuff.

 

[Doowai]

I'm sure we see more than enough Ob/Gyn. That GYN room in our ED gets used a lot by us (not so much by OB/GYN).

How many ED's have dedicated OB/delivery rooms? Like.....none. Okay may be a few do, but so few we can generalize and say none. In future years it will be even less. Pregnant women pass through the ED to a delivery room where OB takes over (or in facilities with FM residencys : where the FM resident takes over).

THAT is how important OB training is for EM.

 

[awdc]

How many ED's have dedicated OB/delivery rooms? Like.....none. Okay may be a few do, but so few we can generalize and say none. In future years it will be even less. Pregnant women pass through the ED to a delivery room where OB takes over (or in facilities with FM residencys : where the FM resident takes over).

THAT is how important OB training is for EM.

Not quite sure how this relates to ob/gyn for urgent care. Urgent care centers (at least the ones I'm aware of) don't exactly have L+D rooms either. People do go to the ED for things like vaginal bleeds, antepartum hemorrhages/spontaneous abortions, pelvic pain, infections/PID, foreign bodies, and ectopics.

 

[cabinbuilder]

anyone doing Family Medicine considering Urgent Care? Is it lucrative in big cities, smaller cities, financially as well as personally? I personally like the idea of no call, no pager and no hospital. Its alot of patients to see during a day, but it just seems perfect, a huge varienty of cases, and you can do as much as you want. Anyone have any input positive or negatively? I have found some sweet job offers out there for this.

I work urgent care exclusively, have for the past 4 years. Wouldn't do anything else. Feel free to ask me anything.

 

[cabinbuilder]

I'd also be interested to learn more about careers in Urgent Care. The concept seems appealing--kind of like doing Emergency Medicine minus the trauma (I know, probably the total opposite of why most people choose EM). I really enjoy the diagnostic aspect of primary care, and the variety you get in FM. I'm less excited about prev med and the management of chronic disease. The idea of shift work with no call is enticing.

Exactly!!!! I hate trauma, MVA work ups, strokes, and MI's. They come in the door you call the ambulance.

 

[cabinbuilder]

I would think EM trains you pretty well for Urgent Care. What do you think?

Urgent care is a huge step down from ER. I would think it would be a huge slap to expect an EM guy to do UC (unless they are tired of it and are on the retiring end of things) I have worked with some retired ER docs in UC but never a newer grad. The pay just doesn't compare.

 

[cabinbuilder]

80K??? that is just insane, whats the point of even going to medical school, might as well do law or accounting or business... thats just a disgrace..
havent seen too many payscales, but yeah thats not lucrative at all and whatsoever, jeeezzz.... but other places pay more supposedly.. that must be some isolated thing, I have heard of a general surgeon in chicago working fulltime netting like 130 K.

80K? That's what I pay in taxes every year. I'm close to 300K this year without even trying.

 

[cabinbuilder]

Many urgent care centers also do primary care, and EM training doesn't really prepare you very well for that. If urgent care is in your future, FM or IM/peds will prepare you better than anything else. Urgent care is basically primary care without an appointment.

The biggest turn-off for me is the schedule, which invariably includes lots of nights and weekends.

I work a set schedule: Thurs, Fri then Mon, Tues, Wed 10a-10p. Then I have 7 days off in a row and repeat.

 

[cabinbuilder]

Urgent care seems to mop up patients too lazy to make an appointment with their regular doctors. I just dont see this as real medicine.

I will have to beg to differ on this statement. I see urgent care as the "safety net" for people who don't have doctors or who have an acute issue and their PCP doesn't have appointments for 2-3 months. In one week alone I found 3 skin cancers, a throat cancer, and a neck mass. I had a guy with a heart attack and a lady with a perforated intestine who was rushed into surgery and lived. Lots of really bad stuff comes through the doors that otherwise would not be caught because people don't want to go to the ER. I love what I do and am good doing it. I don't have labs or CT, I have to diagnose with my hands and my experience from doing FP clinic, hospitalist, and ER. It's just a great time for me.

 

[VA Hopeful Dr]

I will have to beg to differ on this statement. I see urgent care as the "safety net" for people who don't have doctors or who have an acute issue and their PCP doesn't have appointments for 2-3 months. In one week alone I found 3 skin cancers, a throat cancer, and a neck mass. I had a guy with a heart attack and a lady with a perforated intestine who was rushed into surgery and lived. Lots of really bad stuff comes through the doors that otherwise would not be caught because people don't want to go to the ER. I love what I do and am good doing it. I don't have labs or CT, I have to diagnose with my hands and my experience from doing FP clinic, hospitalist, and ER. It's just a great time for me.

I would suggest that you are the exception that proves the rule

 

[deleted87716]

FWIW, this is a ten-year-old zombie thread...

 

[Pisiform]

I work urgent care exclusively, have for the past 4 years. Wouldn't do anything else. Feel free to ask me anything.

I liked the idea of urgent care but I hear from everyone that your doc skills get atrophied. Any truth?


Sent from my iPhone using SDN mobile

 

[cabinbuilder]

I liked the idea of urgent care but I hear from everyone that your doc skills get atrophied. Any truth?


Sent from my iPhone using SDN mobile

Yes to a certain extent. I haven't done primary care in 4 years so I'm not up on the new diabetes meds and HTN meds, etc. I still do locums in other parts of the country so I see different stuff. I don't think I would be good at hospitalist anymore but that's ok with me.

 

[YoungDoc25]

A couple of questions..

1) Is weekend coverage at an urgent care a thing? Say you'll cover a weekend or two every month for a group.

2) Is it hard to find an ED that will let you come in and manage level 3-5 patients? Leave the heavy stuff for the EM docs but relieve them of more of the urgent care cases? The ED where I work at lets the FM residents have some of these patients (especially if they have a feeling they'll be admitted). Our patient population pretty regularly doesn't have a PCP (~20-30%), so they network themselves in the ED and gain patients for their clinic. Seems like that would be a sweet opportunity for a FM doc and would relieve the EM docs to do the things they'd rather be doing.

Just trying to think of some possibilities to have a side income that could help really start putting a dent in loans when the time comes. Thanks!