Who else is considering a career in Family Practice...?

[iambatman]

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Why or why not?

 

[8744]

Why or why not?

PM me.

 

[deleted87716]

PM me.

Gus, with all due respect, I really don't know why you feel compelled to advise people who are considering a career in family medicine. You have stated that the only reason you ended up as an FP intern is because you failed to match into Emergency Medicine last year. I think there are plenty of folks better qualified to give advice on this subject than you.

I would think, however, that your experiences would be very valuable to anyone considering emergency medicine. I wish you would concentrate your efforts there. 😉

 

[deleted87716]

Why or why not?

There's really no way to answer that, as it's way too broad a question. You'll find a lot of good, basic information on the Virtual FMIG site. If you have specific questions, I'll be glad to try and help.

 

[Rafa]

As a side note, I do wish people wouldn't say "PM me" as responses to threads. If you know something, share it with others. That's why this is a public forum, and not a private one. If you really want to discuss something with someone privately, why not simply take initiative and PM the person yourself, instead of publically asking the person to PM you? If you'd like to give, give freely. 🙂

 

[lilmo]

Gus, with all due respect, I really don't know why you feel compelled to advise people who are considering a career in family medicine. You have stated that the only reason you ended up as an FP intern is because you failed to match into Emergency Medicine last year. I think there are plenty of folks better qualified to give advice on this subject than you.

I would think, however, that your experiences would be very valuable to anyone considering emergency medicine. I wish you would concentrate your efforts there. 😉

SWEET! well, sweet for me b/c i'm hoping to go into emergency, but am also interested in family. let the advice begin.........

 

[8744]

Gus, with all due respect, I really don't know why you feel compelled to advise people who are considering a career in family medicine. You have stated that the only reason you ended up as an FP intern is because you failed to match into Emergency Medicine last year. I think there are plenty of folks better qualified to give advice on this subject than you.

I would think, however, that your experiences would be very valuable to anyone considering emergency medicine. I wish you would concentrate your efforts there. 😉

With all due respect I probably know a little about family medicine, at least enough to warn the OP to avoid big academic program in favor of small, unopposed programs.

And since I am critical of some of he assumptions of FM I thought I'd give the OP my opinion without starting a flame fest.

 

[8744]

As a side note, I do wish people wouldn't say "PM me" as responses to threads. If you know something, share it with others. That's why this is a public forum, and not a private one. If you really want to discuss something with someone privately, why not simply take initiative and PM the person yourself, instead of publically asking the person to PM you? If you'd like to give, give freely. 🙂

If they want my opinion, I'll give it.

 

[deleted87716]

With all due respect I probably know a little about family medicine, at least enough to warn the OP to avoid big academic program in favor of small, unopposed programs.

I fail to see why that can't be done publicly (in fact, you just did it). And, as it happens, I agree with you on that.

And since I am critical of some of he assumptions of FM I thought I'd give the OP my opinion without starting a flame fest.

I doubt that anyone making reasonable, informed statements would "start a flame-fest." If you find yourself being flamed a lot, there's probably a reason. 😉

 

[hunter1077]

I think yall need to kiss and make friends.

 

[deleted87716]

I think yall need to kiss and make friends.

No worries. If Gus passes through Virginia on his way from Durham to Lansing, I'll gladly buy him a beer. 😉

 

[8744]

No worries. If Gus passes through Virginia on his way from Durham to Lansing, I'll gladly buy him a beer. 😉

I'd take you up on that because you sound like a pretty decent guy. I certainly have nothing against you or Family Medicine Physicians.

And I'm serious about not doing FP at a big center like Duke. I have friends doing FP in small, unopposed programs in Louisiana and they get phenomenal training in many things that we automatically refer out.

Specialists are not your friends when you are training.

 

[BlondeCookie]

I'm considering a Family Prac career. I know the downsides, the long hours, the fact that it's not as well paying as the other specialties, but I find that I still am drawn to primary care.

I like the idea of being the doc that everybody sees. I like the idea of being a community doc. The fact that some specialties make 100k+ more doesn't bother me one bit. As a doctor (any doc), I still will be making more than 95% of the population, so how can a person complain about that? I still may change my mind, but I like the autonomy aspect of running a private practice. Right now, though, I think it would be neat to join a group practice. And I still think if you join the right group, your autonomy over your own business can still be had.

I haven't heard anything about this talk about avoiding the big academic programs, if you're going with Family Practice. I think programs vary all over the place and it's naive to say that all big academic programs are bad. Anyway, that talk is all new to me. I agree with everyone, if you have something to share, then please share so we can all discuss. 🙂

 

[deleted87716]

Specialists are not your friends when you are training.

I understand what you're trying to say, but it doesn't have to be that way.

I trained at a community hospital in a relatively unopposed (there's an OB residency and a transitional program there as well, but that's it) FP program, and feel that I got great training. The specialists I dealt with were, for the most part, happy to help teach us, and treated us as colleagues right from the start. Probably at least in part because they knew that those of us who remained in the area (as many of us did) would become their future referral sources. 😉

 

[YouDontKnowJack]

As a doctor (any doc), I still will be making more than 95% of the population, so how can a person complain about that? 🙂

with the average salary being $30000 or so, most people will be making more than 95% of the pop.

FP's are the guys who get kicked around in this industry. insurance companies rip them off, and pt's don't pay them much

 

[deleted87716]

FP's are the guys who get kicked around in this industry. insurance companies rip them off, and pt's don't pay them much

FPs are subject to the same market forces as anyone else. If you think we're getting "kicked around" then we're all getting kicked around. The difference is that as an FP, I can opt out of the insurance business and still maintain a viable practice, should I decide that's the way I want to go. Try doing that as a specialist.

 

[Paws]

Hi guys,

I will try and answer the op's question. I think about fp because I like the idea of a rural practice and being able to see hayfields out my back window. Also, I like the idea of getting to know my pts and their kids and grandparents, etc. I am trying to figure out how to 'opt out' like the previous poster, so I can do a solo practice and still remain viable.

I also like the idea of being able to do a little of everything, some radio. surgery, micro, oncology, peds, geriatrics, ob/gyn, etc.

So, I know I will get clobbered with the $$ stuff, big deal. If I wanted to go into cardio, then I would struggle, sweat and fight the competition to get a good cardio spot somewhere and STILL be clobbered by the insurance companies, blah, blah. I like EM but then I don't know if I could take the weird sh&t you have put up with like pts really trying to rip off the system, homeless, weird psych stuff.

As for fp being looked down on, well who cares what other people think? People always seem to want to look down at someone, and neurosurgeons look down on everyone, thoracic surgeons too maybe. But at the end of the day, do you love what you do? I say that's all that counts. I have heard of miserable anesthesiologists who did it for the $$, but always wanted to be a fp. Life is short.

 

[OctoDoc]

.....most people will be making more than 95% of the pop.

Huh? That makes no sense!

 

[fun8stuff]

Huh? That makes no sense!

the average income in the US is about $30,000. With an average salary approaching $200k, most docs will have a higher salary than 95% of the US population. 🙄

 

[OSUdoc08]

Why or why not?

CONS
-lower pay than specialties
-little opportunities for upward mobility & specialization
-calls in the middle the night
-no acute care and minimal complex procedures

PROS
-high demand
-care for the whole family
-get to know your patients

 

[deleted87716]

no acute care and minimal complex procedures

I don't think you really meant to say "no acute care." And I'd put "minimal complex procedures" under "Pros". 😉

As for your other "cons", what exactly is "upward mobility?" Is it any harder for an FP to become a cardiologist than it is for a cardiologist to become an endocrinologist? If anything, FM enjoys greater flexibility than most other specialties in terms of choosing how to practice.

As for calls in the middle of the night, that's no different from any other field, except for shift-work specialties like EM. If you don't go to the hospital, that's all they are...calls. You get to stay home. Again, I'd put that under "Pros." 😉

And the money's what you make of it. Nobody's handing out fat paychecks in exchange for no work.

 

[OSUdoc08]

I don't think you really meant to say "no acute care." And I'd put "minimal complex procedures" under "Pros". 😉

As for your other "cons", what exactly is "upward mobility?" Is it any harder for an FP to become a cardiologist than it is for a cardiologist to become an endocrinologist? If anything, FM enjoys greater flexibility than most other specialties in terms of choosing how to practice.

As for calls in the middle of the night, that's no different from any other field, except for shift-work specialties like EM. If you don't go to the hospital, that's all they are...calls. You get to stay home. Again, I'd put that under "Pros." 😉

And the money's what you make of it. Nobody's handing out fat paychecks in exchange for no work these days.

1. Complex procedures are fun.

2. A prerequisite to training in endocrinology is an internal medicine residency. A cardiologist has completed this residency and a family physician has not.

3. I'm going into EM. Exactly right. Even if you don't work in the hospital, you are called when your patients are admitted there.

 

[deleted87716]

A prerequisite to training in endocrinology is an internal medicine residency. A cardiologist has completed this residency and a family physician has not.

Realistically, though, how likely is that to happen? The cardiologist would have to complete an endo residency, and I'd have to do a good chunk of an IM residency in order to train in an IM fellowship. It's technically doable on both fronts. But most doctors don't switch specialties. They pretty much make their bed and lie in it, with rare exceptions.

Furthermore, specialists are far more constrained by the need to practice with expensive, high-tech gadgetry than are FPs. ER docs are dependent on hospitals. In family medicine, you can literally be your own boss and practice anywhere and any way you'd like. That's real freedom.

 

[OSUdoc08]

Realistically, though, how likely is that to happen? You pretty much make your bed and lie in it, with rare exceptions. Specialists are far more constrained by the need to practice with expensive, high-tech gadgetry than are FPs. ER docs are dependent on hospitals. In family medicine, you can literally be your own boss and practice anywhere and any way you'd like. That's real freedom.

The same can be said for IM, Peds, and EM (Urgent Care Medicine.)

 

[mysophobe]

And "complex procedures are fun" isn't a reason, it's a subjective view on something. Obviously they aren't the be-all, end-all for everyone. If they were, there would be no FPs.

 

[OSUdoc08]

And "complex procedures are fun" isn't a reason, it's a subjective view on something. Obviously they aren't the be-all, end-all for everyone. If they were, there would be no FPs.

Are we only allowed to provide objective views?

Is this SDN thing prohibitive of opinions?

 

[mysophobe]

Nope. I was just pointing out that what is a con for some is a pro for others. I think opinions are more than welcome on this site. 🙂

BTW, I agree with you. That's why FP is not for me (rhyme not intended).

 

[deleted87716]

And "complex procedures are fun" isn't a reason, it's a subjective view on something. Obviously they aren't the be-all, end-all for everyone. If they were, there would be no FPs.

Don't get me wrong, I like procedures. I just have a short attention span. 😉

 

[Ypo.]

I'm thinking of FP because I like to interact with pts of all ages, I like to get to know people over a long time, I like the idea of working in an office, one on one with a patient.

 

[YouDontKnowJack]

i heard that insurance companies rip off FP's more often. they like to pay $0 for something that cost $40, and they do that a lot. Is that true?

 

[deleted87716]

i heard that insurance companies rip off FP's more often. they like to pay $0 for something that cost $40, and they do that a lot. Is that true?

Insurance companies aren't doing anything to FPs that they're not doing to everyone else. You need to watch your receivables very closely no matter what field you're in. If you're a specialist, the stakes are even higher, as the average charge per visit/procedure is typically higher than it is in primary care. If a claim isn't paid correctly, a specialist stands to lose more money than I do.

 

[OSUdoc08]

Don't get me wrong, I like procedures. I just have a short attention span. 😉

Like Procedures?

Short Attention Span?

That sounds like the profile of an emergency medicine physician.

 

[deleted87716]

That sounds like the profile of an emergency medicine physician.

Yep...that was my first interest. Except for the work environment, the hours, and the patients, I liked EM. 😉

 

[funshine]

Is family medicine the same as primary care? If so, then read on...

I wasn't considering a career in primary care, but I'm starting to wonder if I should. Some schools offer full scholarships if you do a program that prepares you for a primary care residency. I'm afraid it might limit my opportunities in the future in case I hate primary care, but it is a good deal, and I figure I can always specialize later and do something else. Much of my reluctance to do primary care stems from all the negative opinions on SDN anyway...

Btw, can you do psychiatry in primary medicine?

 

[YouDontKnowJack]

Is there a convenient backdoor out of FP or IM should you decide that primary care sucks, or the pay isn't good enough? or is it another 3-5 year fellowship/residency you have to go thru?

 

[deleted87716]

Is family medicine the same as primary care?

Primary care is generally defined as comprehensive, continuing, first-line care to undifferentiated patients. Several specialties provide primary care, including family medicine, general internal medicine, general pediatrics, and (to a limited extent) obstetrics-gynecology.

Much of my reluctance to do primary care stems from all the negative opinions on SDN anyway.

That's unfortunate, as most of people commenting on family medicine in these forums are pretty uninformed. Would you make investment decisions on the recommendations of a bunch of anonymous message-board posters? If not, why would you make career decisions on that basis? Always consider the source.

can you do psychiatry in primary medicine?

Oh, yes. Some days, more than you'd like to. 😉

 

[deleted87716]

Is there a convenient backdoor out of FP?

Family physicians have many practice and career options, as well as greater flexibility and balance than almost any other specialty. A physician with broad, general training will always have more options than one with a very limited skillset.

is it another 3-5 year fellowship/residency you have to go thru?

There are a number of fellowship options within family medicine. If you want to change specialties completely, you'll be in no worse position than you would in any other field where you had to do another residency.

 

[OSUdoc08]

Is family medicine the same as primary care? If so, then read on...

I wasn't considering a career in primary care, but I'm starting to wonder if I should. Some schools offer full scholarships if you do a program that prepares you for a primary care residency. I'm afraid it might limit my opportunities in the future in case I hate primary care, but it is a good deal, and I figure I can always specialize later and do something else. Much of my reluctance to do primary care stems from all the negative opinions on SDN anyway...

Btw, can you do psychiatry in primary medicine?

Primary Care = FM, IM, Peds, and sometimes EM and OB/GYN

Psych is not primary care.

 

[deleted87716]

Psych is not primary care.

But a fair amount of primary care is psych. 😉

 

[OSUdoc08]

But a fair amount of primary care is psych. 😉

Correct.