why are fp look down upon?

[goldfish85]

---

Members don't see this ad.

Sorry i did not know where to post this but i think it might fit well here....

so why are there such negative attitudes towards fp's? is it because they get paid less? dont the peds/fp's who are self-employed make a lot? easy to get into residencies? easier job? i always see ppeople talk about fp as being easy....???



im confused.

any input appreciated....

 

[Mike59]

I think it depends who's looking down on them. Odds are it's a premed, snobby medical student or a specialist (likely an idiotic one) that makes broad generalizations. There are some BAD FPs out there, but there are also just as many BAD surgeons, ER docs or radiologists. Regarding it being "easy", it can be if you want it to be, but if one is dedicated to family practice it requires being on call now and then, managing your sick patients in the hospital, and running an efficient office. All of these require time and energy and I don't see why it's any different than any other specialty in that respect (you get paid for what you do, bottom line).

From my experience in rotations, good FPs actually get respected by their colleagues in other fields since they are the ones on the front line dealing with psychosocial issues and all the medical problems that the specialists don't want to handle. Not to mention, who has the power to control referrals? It's the FPs that receive the bottles of wine and nice gifts from their colleagues at Xmas time 🙂 Average figures are simply averages, and FPs often pull in more money than psychiatrists/peds/general internists so salary isn't an issue in any stigma.

As the population gets older and supply/demand forces come full circle to increase salary, I agree with analysts that say FP will be a hot career in the coming years. 👍

 

[matthew45]

One of the better things I heard on this board regarding fp (a while ago).

Fps are specialists, they are specialists at keeping people healthy.

 

[TIGER STYLE]

Anyone who says family medicine is "easy" doesn't know what the heck they are talking about. Family medicine is very challenging ang rewarding. Coming from a general surgery intern, I can tell you that most surgeons respect FPs very much, and the ones that don't...well, let's just say they are very mediocre physicians themselves.

 

[TruTrooper]

I noticed that, In general, any specialty that is not yours is looked down upon in medicine. I have a lot of respect for FP. They must maintain a broad range of medical knowledge and like said before, they are on the frontline. They are the Marines of medicine. Patients generally respect all of the medicla professions and don't look down on any particular one, it is just seem to happen within the profession. And besides Internal Medicine, they seem to get the most attention form drug reps and have many free breakfasts and lunches.

I ran into a few DOs who feel that they are looked down upon and must defend their medical education every so often. Unfortunately, they are not excluded from the bashing just as every other medical specialty isn't.

Radioly seems to be high profile area but I hear a lot of Docs complaining that they can't even interpret Xrays without a history. Like I say, no one is excluded.

 

[DownonthePharm]

Its not easy, its just not flashy. Sometimes the general public has a hard time telling the difference.

There is also bad stigma about everyone else (i.e. surgeons are self-centered arses).

I agree that FP's are the frontline. If everyone went to specialists for everything the system would fall apart.

 

[dynx]

being a GOOD FP is a damn hard job. I don't think I hear many people make fun of FP in general, but I do hear (and make) jokes about people going into FP because they couldn't do anything else. ITs kinda like being a dentist, its a great job and you gotta be smart to do it...not funny. But being a dentist cause you couldn't get into med school...funny as hell.

 

[goldfish85]

Its not easy, its just not flashy. Sometimes the general public has a hard time telling the difference.

There is also bad stigma about everyone else (i.e. surgeons are self-centered arses).

I agree that FP's are the frontline. If everyone went to specialists for everything the system would fall apart.

yea i agree that the general public probably doesnt know much... to them (as far as i can see) an MD is a flashy thing.
I know fp is not flashy or prestigeous to others in specialties but i think to the general public it is pretty impressive.

 

[goldfish85]

being a GOOD FP is a damn hard job. I don't think I hear many people make fun of FP in general, but I do hear (and make) jokes about people going into FP because they couldn't do anything else. ITs kinda like being a dentist, its a great job and you gotta be smart to do it...not funny. But being a dentist cause you couldn't get into med school...funny as hell.

yea, you made a good point. i never thought about it in that way... thanks for the insight.

 

[njbmd]

Hi there,

As a PGY-4 General Surgery resident, I have found that none of my colleagues or attendings "look down upon" any other medical specialty. Family medicine is quite vital to my practice and we appreciate the care that these practictioners provide for our patients. Many times, long after the patient no longer has surgical issues, it is the family medicine practictioner that manages anti-coagulation therapy that keeps grafts open or manages blood sugars that keeps limbs from being amputated.

In today's medical world, no consultant can afford to "look down upon" any primary care practictioner. This means that your referrals begin to dissipate. With no referrals, your practice takes a quick "nose-dive" along with your income.

njbmd 🙂

 

[YouDontKnowJack]

i've always wondered about referrals.

so there's an under-the-table deal between these docs eh? I wonder how much extra fp's get in monetary benefits...

 

[teedub]

One of the better things I heard on this board regarding fp (a while ago).

Fps are specialists, they are specialists at keeping people healthy.

i agree. aside from preventative medicine specialtists, fp's are usually the primary preventative providers, so really, fp's are the key in stopping this upward trend of chronic disease.

oh, and i just got into KU med. did you like it there??

 

[lotanna]

I dont know why anyone would think that, we all have to go thru so much isshh to get to that point, and fp's are great doctors, with a broad range of expertise. This view might be from an undergrad who doesnt know better, a 1st yr med student who thinks anatomy lab makes them a surgeon, cause even another physician, specialist or not wouldnt look down on a fp.

 

[sga814]

pfft- If my cadaver were alive (i.e. was actually having surgery), I'd have malpractice suits up to my supraspinatus.

 

[synapse lapse]

i've always wondered about referrals.

so there's an under-the-table deal between these docs eh? I wonder how much extra fp's get in monetary benefits...

Well we learned in the medical law elective I am taking that it is illegal to profit off a referall to another doctor, its called fee splitting. Yeah, BS, I know.

 

[primadonna22274]

Someone said FP is damn hard. I know...I've been doing it for five years. It's my first love but it's also difficult. You have to know a lot about a lot. You have to deal with the whole picture whereas the specialist can send the laundry list of complaints back to the FP.
It's no glamorous job to be expected to fix, in 15 minutes, the 22 y/o single mother with morbid obesity, fibromyalgia, pre-diabetes, depression/anxiety with bipolar features, migraine, history of sexual abuse, and hypothyroidism who complains of "pain all over" for the last week so severe that she can't do her job which entails sitting at the computer for two hours 4 days a week in the AFS office. We celebrate small victories, like the fact that she lost 7# since the last time she was in.
When I contemplate going back to med school, I think, will I be insane enough to go back into family medicine? I think not, but then, where else would I want to be? I dunno yet.
Lisa PA-C

 

[yeah_brah]

Radioly seems to be high profile area but I hear a lot of Docs complaining that they can't even interpret Xrays without a history. Like I say, no one is excluded.

i have to stick up for the radiologists since that's what i'm going into. i would say interpreting an image without a history is like doing a physical exam without a history. you would have no idea what you are looking for.

 

[noncestvrai]

I'm not sure about the situation in the US, but here in Canada, the FPs are at the base of the system. Without them the system crumbles. They are very well compensated too. In Quebec, their average salaries were 150K, compared to 200-250K for other specialties, in a 2002 survey. You can a do a bunch of things with an extra year, like emerg, anes, OB if you want. The job demand is likely to expand too. People here first see a GP, then they get to see other specialists.

Respect.

noncestvrai

 

[deuist]

Here's an example of why I frown on FP's. I once got a splinter deeply imbedded into my hand and could not remove it. I went to the infirmary on campus to get it cut out when two FP docs walk in. Both claimed that I did not have a splinter and that the white cone under my skin was scar tissue from my picking at the area. I tried to explain that scar tissue cannot form a hard, circular area in two days. They didn't believe me and insisted that I get an X-ray.

ME: An X-ray? An X-ray can't pick up a piece of cellulose that small.
FP: I think that it can. Look, if you are certain that you have a splinter and need it cut out, I can refer you an orthopedic surgeon.
ME: an orthopedic surgeon? No, I only need a splinter removed.

I then went to the MS-II office and found a student who is set on going into surgery. I told her about my splinter and she removed it in five seconds using her anatomy dissection kit.

 

[Flobber]

Here's an example of why I frown on FP's. I once got a splinter deeply imbedded into my hand and could not remove it. I went to the infirmary on campus to get it cut out when two FP docs walk in. Both claimed that I did not have a splinter and that the white cone under my skin was scar tissue from my picking at the area. I tried to explain that scar tissue cannot form a hard, circular area in two days. They didn't believe me and insisted that I get an X-ray.

ME: An X-ray? An X-ray can't pickup a piece of cellulose that small.
FP: I think that it can. Look, if you are certain that you have a splinter and need it cut out, I can refer you an orthopedic surgeon.
ME: an orthopedic surgeon? No, I only need a splinter removed.

I then went to the MS-II office and found a student who is set on going into surgery. I told her about my splinter and she removed it in five seconds using her anatomy dissection kit.

and none of this actually happened.

 

[deuist]

and none of this actually happened.

Actually, it did.

 

[OSUdoc08]

Sorry i did not know where to post this but i think it might fit well here....

so why are there such negative attitudes towards fp's? is it because they get paid less? dont the peds/fp's who are self-employed make a lot? easy to get into residencies? easier job? i always see ppeople talk about fp as being easy....???



im confused.

any input appreciated....

-Lowest Pay (on average)
-Shortest & Least Demanding Residency
-Least Competitive Residency
-Least Technical Skills Learned
-"Easiest Way" to become a board certified physician

 

[EctopicFetus]

Im not going into FP but I sure will defend them. The previous poster is an M2 which is what likely sways his opinion.

1) Lowest pay? check out http://www.alliedphysicians.com/salary-surveys/physicians/
FP with OB (which is a core competency) make more than Medicine and some of its subspecialties. They also make more than Peds (which by the way IS the lowest paid specialty if you look at a number of surveys), PM&R and a few other fields.
2) Shortest and least demanding? There are a number of 3 yr residencies, Least demanding.. well they DO rotate through Ob, L&D, and Surg.. So this is certainly up for debate but without hard figures it is hard to say.
3) Least Competitive... Well if you use the % filled criteria you are right but Psych and Neuro dont do too great. If you use the FMG factor Medicine isnt too hot either.
4) Least Technical Skills Learned.. Right... Where do you get this? They are trained to do basic surgery, L&D etc. this probably has to go to psych or medicine. They dont do procedures at all.. Esp psych..
5) "easiest" way to become a board certified physician.. Well this is an opinion, they are hard working. Easy is a term which is not easy to define. I would tend to disagree but thats just my OPINION.

 

[tigershark]

I think there is more of a negative attitude towards the specialty rather than the family med docs themselves.

1) It can be a thankless job with relatively poor compensation compared to the hell that you have to go through, most people who invest so much time in medical school want to be compensated for it. Insurance companies, hospital BS, government regulations, mid-level providers angling for more freedom all make it painful, from what I saw FM has it the worst of all specialties in this regard.

2) FM is in the technological stone age, most of us grew up during the tech revolution and want to be able to use the sexy new technologies. Walk through the halls of your FM department and look at the research projects on the walls....at my school it is worthless crap like aromatherapy, herbal medicine BS, now go to the rads department and you'll see projects in MRI, PET etc, all stuff on the cutting edge of technology. There just arent many revolutions coming out of FM, it seems to be in the same place it was 50 years ago as far as what a FM doc does on a daily basis.

3) Chronic patients who are unlikely to change the behaviors that are killing them....just spinning your wheels trying to educate and do anything to help these people, this is too frustrating to many people.

FM is a noble field but just too draining for most, I've got nothing against the FM docs and think for the most part they are great, but I would not practice medicine if my only option was FM, and I think many feel the same way.

 

[redgrover]

I'd go for FP over general IM. That's for sure.

General internists just have it bad. At least you get some age variation with FP.

 

[nabeya]

Least technical skills learned? As a 3rd year student, I'm working with many of the residents that are graduates from your school, in a MD/DO FP residency right now here in OKC. The residents are doing everything from dermatology, pediatrics, EGD, colonoscopy, OB/GYN/, ICU, code blues in the entire hospital, etc, etc. They are getting a well rounded knowledge of all the fields of medicine, so I wouldn't necessarily say they have the least technical skills learned. Easiest way to be become board certified? Well, I guess that depends on how hard you want to work. 🙂

-Lowest Pay (on average)
-Shortest & Least Demanding Residency
-Least Competitive Residency
-Least Technical Skills Learned
-"Easiest Way" to become a board certified physician

 

[thackl]

Generally, the "non-competitive" specialties are "looked down upon" by these people you are referring to. Some of these fields are quite challenging and it usually has nothing to do with difficulty. A$$holes out there are basically implying the the low end of the med class goes into primary care.

 

[OSUdoc08]

Least technical skills learned? As a 3rd year student, I'm working with many of the residents that are graduates from your school, in a MD/DO FP residency right now here in OKC. The residents are doing everything from dermatology, pediatrics, EGD, colonoscopy, OB/GYN/, ICU, code blues in the entire hospital, etc, etc. They are getting a well rounded knowledge of all the fields of medicine, so I wouldn't necessarily say they have the least technical skills learned. Easiest way to be become board certified? Well, I guess that depends on how hard you want to work. 🙂

They may learn those skills, but so does everyone else in the internship year. When it comes to practicing, FP's aren't hospitalists and won't be doing this sorts of things to the extent that hospitalists will.

 

[EctopicFetus]

They may learn those skills, but so does everyone else in the internship year. When it comes to practicing, FP's aren't hospitalists and won't be doing this sorts of things to the extent that hospitalists will.

You would have to agree that they do L&D and some other little procedures. They CAN do appys and chole's but usually dont in big cities because of malpractice. They do LEEPs and such though and minor skin procedures. Im still asking which procedures do your Pediatricians or psychiatrists perform? Anyways your attitude will change..

 

[pillowhead]

They may learn those skills, but so does everyone else in the internship year. When it comes to practicing, FP's aren't hospitalists and won't be doing this sorts of things to the extent that hospitalists will.

Family practitioners definitely do I&Ds, deliver babies, perform cryotherapy, suture, etc. Do they do as many procedures as a surgeon? Obviously not, but from what I've seen so far during third year (which admittedly isn't a huge amount), they certainly do more procedures and learn more technical skills than general internal medicine doctors. This is neither a good nor a bad thing--performing more procedures does not make your specialty better or worse than any other. But to say that practicing family practioners don't learn any more skills than an intern in any specialty does is just wrong.

 

[OSUdoc08]

You would have to agree that they do L&D and some other little procedures. They CAN do appys and chole's but usually dont in big cities because of malpractice. They do LEEPs and such though and minor skin procedures. Im still asking which procedures do your Pediatricians or psychiatrists perform? Anyways your attitude will change..

They may do these things in some rural county where they are the only doctor in town, but in a highly populated area, with readily available surgical and OB/GYN resources, you will not see them doing surgery or L & D.

 

[San_Juan_Sun]

They may do these things in some rural county where they are the only doctor in town, but in a highly populated area, with readily available surgical and OB/GYN resources, you will not see them doing surgery or L & D.

Do you ever see internists operating in an urban area? How about radiologists? Ever see derm folks doing C-sections? It absolutely blows my mind that you knock FM because they don't do surgery in the big city. What kind of disingenuous argument is this?

Have you ever rotated in a hospital? Or a family practice clinic? I've actually done both, and can verify that you can as little or as many procedures as you'd like in either setting. Neurosurgery? Probably not, of course, but plenty of stuff to challenge and satisfy you.

Your posting on this topic strikes me as someone who really doesn't know what hospitalist or family practice is really like. Not surprising considering your history.

Bottom line: some people like to knock FM. I have no idea why. I don't want to do it, but I'm thankful for the folks who do. It's a dang tough job, and I just wish I could be there when folks like OSUdoc08 said stuff like this in front of an actual physician. Nothing quite like 2nd year arrogance. Oh well, 3rd year will take care of that for you. 🙂

 

[nabeya]

Agreed.

Nothing quite like 2nd year arrogance. Oh well, 3rd year will take care of that for you. 🙂

 

[pillowhead]

They may do these things in some rural county where they are the only doctor in town, but in a highly populated area, with readily available surgical and OB/GYN resources, you will not see them doing surgery or L & D.

For argument's sake, even if they don't do surgery or labor & delivery, what's your point? Does that make a specialty less worthwhile and deserving to be looked down upon? Because all those psychiatrists, neurologists, pathologists, endocrinologists, infectious disease specialists, toxicologists, etc, etc, who don't do procedures might just disagree.

I'm on my family medicine rotation right now after coming off of surgery, and I really honestly have to say that the family practioners seem to have a much harder job or at least a busier day. They get 15 minutes to introduce themselves, get a history, perform a physical, review lab results, order new labs and tests, come up with a treatment plan, write and explain scripts, counsel the patient on exercise/diet/depression/tobacco/drug/alcohol abuse/domestic violence/birth control/STD prevention/immunizations/seat belt use, and then dictate and document all of the above while making sure everything is covered by this particular patient's insurancer plan. A surgeon gets hours to very carefully and meticulously take care of one patient at a time. Of course, a surgeon basically cannot make a mistake while the family practioner has a little more room for error but the family practioner is expected to do more overall in a day.

 

[DropkickMurphy]

Just as with all other specialties I would not do, no matter how much you paid me, my hat is off to those are FP's and those who will become FP's.

 

[teedub]

Do you ever see internists operating in an urban area? How about radiologists? Ever see derm folks doing C-sections? It absolutely blows my mind that you knock FM because they don't do surgery in the big city. What kind of disingenuous argument is this?

Have you ever rotated in a hospital? Or a family practice clinic? I've actually done both, and can verify that you can as little or as many procedures as you'd like in either setting. Neurosurgery? Probably not, of course, but plenty of stuff to challenge and satisfy you.

Your posting on this topic strikes me as someone who really doesn't know what hospitalist or family practice is really like. Not surprising considering your history.

Bottom line: some people like to knock FM. I have no idea why. I don't want to do it, but I'm thankful for the folks who do. It's a dang tough job, and I just wish I could be there when folks like OSUdoc08 said stuff like this in front of an actual physician. Nothing quite like 2nd year arrogance. Oh well, 3rd year will take care of that for you. 🙂

nicely said

 

[crys20]

My two cents would be that from my limited experience premeds/medstudents/physicians all the way through the continuum are overproportionately filled with tools and people 'look down' upon everyone else as part of their toolish nature. Why not be secure enough in yourself as a person and a professional to not resort to such childish silly things?

 

[OSUdoc08]

For argument's sake, even if they don't do surgery or labor & delivery, what's your point? Does that make a specialty less worthwhile and deserving to be looked down upon? Because all those psychiatrists, neurologists, pathologists, endocrinologists, infectious disease specialists, toxicologists, etc, etc, who don't do procedures might just disagree.

I'm on my family medicine rotation right now after coming off of surgery, and I really honestly have to say that the family practioners seem to have a much harder job or at least a busier day. They get 15 minutes to introduce themselves, get a history, perform a physical, review lab results, order new labs and tests, come up with a treatment plan, write and explain scripts, counsel the patient on exercise/diet/depression/tobacco/drug/alcohol abuse/domestic violence/birth control/STD prevention/immunizations/seat belt use, and then dictate and document all of the above while making sure everything is covered by this particular patient's insurancer plan. A surgeon gets hours to very carefully and meticulously take care of one patient at a time. Of course, a surgeon basically cannot make a mistake while the family practioner has a little more room for error but the family practioner is expected to do more overall in a day.

If you want to do FM, then do a 4-year med/peds residency. This will allow you flexibility in specialization, fellowship training, more hospital privileges, and much better pay.

 

[crys20]

OSUDoc you seem pretty in the know...can you elaborate on the mean compensation for FPs vs med/peds docs? I'm super interested in med-peds someday and was always wondering about the income differences.

 

[tigress]

They may do these things in some rural county where they are the only doctor in town, but in a highly populated area, with readily available surgical and OB/GYN resources, you will not see them doing surgery or L & D.

Hmm, so do you think Philadelphia is an area with readily available surgical and OB/GYN resources? Because I live in Philly, and my OB/GYN is also my primary care doctor, and she's in family practice. She delivers multiple babies a week. 3/4 of the doctors in her practice, which is part of the Penn Health system, do OB. She's also the best doctor I've ever had and I will be happy to have her deliver my children. Of course, she only takes low-risk pregnancies. At this office they will treat me for all the general medicine stuff, basic derm, basic anything really (she manages my rheumatological condition because it's not very active).

Yes, FP can involve OB/GYN if the doctor wants to, even in a city with an extraordinary level of healthcare availability like Philadelphia.

 

[OSUdoc08]

Hmm, so do you think Philadelphia is an area with readily available surgical and OB/GYN resources? Because I live in Philly, and my OB/GYN is also my primary care doctor, and she's in family practice. She delivers multiple babies a week. 3/4 of the doctors in her practice, which is part of the Penn Health system, do OB. She's also the best doctor I've ever had and I will be happy to have her deliver my children. Of course, she only takes low-risk pregnancies. At this office they will treat me for all the general medicine stuff, basic derm, basic anything really (she manages my rheumatological condition because it's not very active).

Yes, FP can involve OB/GYN if the doctor wants to, even in a city with an extraordinary level of healthcare availability like Philadelphia.

Does the FP work in the L&D department at the hospital?

I know that FP working in emergency departments are readily looked down upon.

I don't think I'd be comfortable with having my wife be treated by a physician that has not been fully trained in obstetric surgery.

 

[OSUdoc08]

OSUDoc you seem pretty in the know...can you elaborate on the mean compensation for FPs vs med/peds docs? I'm super interested in med-peds someday and was always wondering about the income differences.

Average for "In Practice + 3 years"

Family Practice 147,516-197,025

Internal Medicine 160,318-205,096

Pediatrics 149,754-201,086

Combined IM/Peds pays more.

Also, FP's cannot specialize like IM/Peds can, and they do not have near the hospital privileges---especially at large centers.