Why I am skipping residency

[Party]

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Residents are exploited. They are worked HARD and paid a fraction of what the hospital receives to let them practice there.

Ridiculous.

After I graduate med-school I'm going to do an intern year and immediately start my own doc-in-a-box-type practice.
I'm going to get a small business loan to rent a small office in an area with few doctors and start seeing patients.

I will take cash only. I will not have to hire people to deal with collections or fight with insurance companies.
That is a tragic waste of time/money.

I will not hire a receptionist. That's a waste of money. I will use an online scheduling service.

Boo-yah.

 

[ArcGurren]

cool story bro

 

[VenusinFurs]

Thanks for the giggles.

 

[Party]

Thanks for the giggles.

You won't be giggling when you are pulling 14-hour shifts in residency getting paid <$50k when I'm bankin' and have no boss. Oh yee-uh.

 

[tkim]

Residents are exploited. They are worked HARD and paid a fraction of what the hospital receives to let them practice there.

Ridiculous.

After I graduate med-school I'm going to do an intern year and immediately start my own doc-in-a-box-type practice.
I'm going to get a small business loan to rent a small office in an area with few doctors and start seeing patients.

I will take cash only. I will not have to hire people to deal with collections or fight with insurance companies.
That is a tragic waste of time/money.

I will not hire a receptionist. That's a waste of money. I will use an online scheduling service.

Boo-yah.

When you could two more years and not be limited. At all.

Or never be able to take insurance or get privileges at a hospital, or get decent malpractice. Ever.

Deep thinking there, boss.

 

[VenusinFurs]

You won't be giggling when you are pulling 14-hour shifts in residency getting paid <$50k when I'm bankin' and have no boss. Oh yee-uh.

So residency isn't worth anything in your opinion?

 

[salim271]

cool story bro

👍

 

[MedicineMike]

Residents are exploited. They are worked HARD and paid a fraction of what the hospital receives to let them practice there.

Ridiculous.

After I graduate med-school I'm going to do an intern year and immediately start my own doc-in-a-box-type practice.
I'm going to get a small business loan to rent a small office in an area with few doctors and start seeing patients.

I will take cash only. I will not have to hire people to deal with collections or fight with insurance companies.
That is a tragic waste of time/money.

I will not hire a receptionist. That's a waste of money. I will use an online scheduling service.

Boo-yah.

Because you didnt know that when you applied to med school...

 

[Party]

When you could two more years and not be limited. At all.

Or never be able to take insurance or get privileges at a hospital, or get decent malpractice. Ever.

Deep thinking there, boss.

I'd rather not have to take insurance and I don't like working in hospitals. Zing.

 

[ArcGurren]

I'd rather not have to take insurance and I don't like working in hospitals. Zing.

Good luck making bank in that practice without insurance or inpatient privileges as essentially an underqualified family doc.

 

[Party]

Good luck making bank in that practice without insurance or inpatient privileges as essentially an underqualified family doc.

When patients go to a doc-in-a-box they are not expecting a cream of the crop neurosurgeon to treat them, they want a quick fix fast (they'll accept a "underqualified family doc"). They won't be expecting their doc-in-a-box doctor to round on them in the hospital if they have to go, duh!

 

[ArcGurren]

When patients go to a doc-in-a-box they are not expecting a cream of the crop neurosurgeon to treat them, they want a quick fix fast (they'll accept a "underqualified family doc"). They won't be expecting their doc-in-a-box doctor to round on them in the hospital if they have to go, duh!

Most people are not going to want to pay 150 dollar copay up front or even half that amount if they don't have insurance

 

[Stixman28]

When patients go to a doc-in-a-box they are not expecting a cream of the crop neurosurgeon to treat them, they want a quick fix fast (they'll accept a "underqualified family doc"). They won't be expecting their doc-in-a-box doctor to round on them in the hospital if they have to go, duh!

So you're ok with being this underqualified family doc?

 

[peppy]

If it were that easy to skip residency, everyone would do it.

I would suggest looking for a specialty you can tolerate and trying to find the most benign programs within that specialty.

 

[Party]

Most people are not going to want to pay 150 dollar copay up front or even half that amount if they don't have insurance

Not everyone will. But those who find paying a $150 copay once or twice a year for the minor medical problems cheaper than paying $150 every month in health insurance will.

 

[Party]

So you're ok with being this underqualified family doc?

Basically. Within medicine there are many levels and lengths of training. An ER doc and a neurosurgeon have big differences in this length. Both specialties are needed.

Don't look down on those who choose paths that require less training.

 

[Party]

If it were that easy to skip residency, everyone would do it.

I would suggest looking for a specialty you can tolerate and trying to find the most benign programs within that specialty.

Why do you doubt my plan will succeed?
And yes, your second sentence is my backup plan.

 

[Everglide]

Not everyone will. But those who find paying a $150 copay once or twice a year for the minor medical problems cheaper than paying $150 every month in health insurance will.

Versus going to someone who is more qualified than you and will cost the same or less? I'm not sure why someone would choose you, there are plenty of "urgent care" places that could provide a better quality of care.

You should have went to PA school and worked under someone... Make more money with less debt and schooling too 👍

 

[ArcGurren]

Not everyone will. But those who find paying a $150 copay once or twice a year for the minor medical problems cheaper than paying $150 every month in health insurance will.

... have you even been to an outpatient doc's office? The majority of people will complain about a 25 dollar copay let alone a 150 dollar one.

Also our population is one where everybody has chronic problems which require regular checkups (HTN, DM2, hyperlipidemia, etc) and will inevitably lead to further more complex medical problems. They are not going to a doc's office which does not take insurance to cover these regular visits.

 

[Party]

Versus going to someone who is more qualified than you and will cost the same or less? I'm not sure why someone would choose you, there are plenty of "urgent care" places that could provide a better quality of care.

You should have went to PA school and worked under someone... Make more money with less debt and schooling too 👍

The truth is that few patients know how "qualified" their doctors are--and they're unlikely to research where (and if) their doc-in-a-box doctor did residency. They are going to have a simple medical problem, see my nearby urgent care facility, and take care of the issue.

I don't like working under people.

 

[Party]

... have you even been to an outpatient doc's office? The majority of people will complain about a 25 dollar copay let alone a 150 dollar one.

Also our population is one where everybody has chronic problems which require regular checkups (HTN, DM2, hyperlipidemia, etc) and will inevitably lead to further more complex medical problems. They are not going to a doc's office which does not take insurance to cover these regular visits.

People with chronic medical problems usually have to have insurance to pay for their huge medical bills. These would not be typical patients for me.

My typical patient would be someone who just sliced their hand open with an exacto knife or got an upper respiratory infection with no other PMH.

 

[Gigantron]

I'm calling troll on this one.

 

[VenusinFurs]

People with chronic medical problems usually have to have insurance to pay for their huge medical bills. These would not be typical patients for me.

My typical patient would be someone who just sliced their hand open with an exacto knife or got an upper respiratory infection with no other PMH.

No one would pay that much money to get such minor problems taken care of.

 

[Party]

No one would pay that much money to get such minor problems taken care of.

What are their alternatives?
1.) Suffer through the bleeding/scary fevers and/or vomiting?
2.) Buy health insurance: $1800/year vs. $300 for 2 visits the few times a year they would actually get sick and would come to see me
3.) Sit in an ER with homeless people for 5 hours

My urgent care clinic is suddenly looking like a pretty sweet deal.

 

[Perrotfish]

Why do you doubt my plan will succeed?

1) Because the cost of your insurance as and independent practicioner without a residency will eat up the majority of your income.

2) Because starting a 'doc in a box' is probably still going to require a loan, and you're going to have a hard time getting one

3) Because, like it or not, Intern years are no longer designed to produce independent practicioners. You'll be underqualified, and hopedully you won't want to practice feeling out of your depth.

4) Because anyone with money would demand a real doctor, and the only way anyone poorwould pay cash for your services is if they didn't live within a hundred miles of an ER because otherwise they'd go there for 'free' care.

Ways to be a doctor with just an intern year:

1) move to the ass end of nowhere rural flyover red state country, where doctors are so scarce they make it impossible to sue you OR

2) work for the military as a GMO OR

3) practice uber s***** medicine. Should be illegal medicine like pill mills, or CAM, or whatever.

Or you can suck it up and get through it. Yes they're taking advantage of you. For three years,for 80 hours a week (really less), and they're compensating you with a low but definitely middle class income. Don't cut off your nose to spite your face, suck it up and get through it.

 

[Iswhatis]

I'm calling troll on this one.

Brilliant.

I will open up a place across the street from your doc-in-a-box and wreck you. Doc-King comes to mind, maybe McDoctor's. I hope you're prepared for a turf war, son.

 

[Guillemot]

I am also considering doing this, but I was thinking of going into orthopaedic surgery without doing a residency.

 

[FunnyCurrent]

Residents are exploited. They are worked HARD and paid a fraction of what the hospital receives to let them practice there.

Ridiculous.

After I graduate med-school I'm going to do an intern year and immediately start my own doc-in-a-box-type practice.
I'm going to get a small business loan to rent a small office in an area with few doctors and start seeing patients.

I will take cash only. I will not have to hire people to deal with collections or fight with insurance companies.
That is a tragic waste of time/money.

I will not hire a receptionist. That's a waste of money. I will use an online scheduling service.

Boo-yah.

You know some guy on SDN that goes by SharkyMD is posting about you in another thread:

http://forums.studentdoctor.net/showthread.php?t=834299

 

[Iswhatis]

You know some guy on SDN that goes by SharkyMD is posting about you in another thread:

http://forums.studentdoctor.net/showthread.php?t=834299

 

[pfaction]

You know some guy on SDN that goes by SharkyMD is posting about you in another thread:

http://forums.studentdoctor.net/showthread.php?t=834299

Not gonna lie, I went through that entire thread and went, what? where?

Then I came back and saw iswhatis' post and went...maybe I need some of that

 

[ozzi22]

Residents are exploited. They are worked HARD and paid a fraction of what the hospital receives to let them practice there.

Ridiculous.

After I graduate med-school I'm going to do an intern year and immediately start my own doc-in-a-box-type practice.
I'm going to get a small business loan to rent a small office in an area with few doctors and start seeing patients.

I will take cash only. I will not have to hire people to deal with collections or fight with insurance companies.
That is a tragic waste of time/money.

I will not hire a receptionist. That's a waste of money. I will use an online scheduling service.

Boo-yah.

this has to be the most ridiculous thing i have ever read on SDN 😱

 

[ArcGurren]

1) Because the cost of your insurance as and independent practicioner without a residency will eat up the majority of your income.

2) Because starting a 'doc in a box' is probably still going to require a loan, and you're going to have a hard time getting one

3) Because, like it or not, Intern years are no longer designed to produce independent practicioners. You'll be underqualified, and hopedully you won't want to practice feeling out of your depth.

4) Because anyone with money would demand a real doctor, and the only way anyone poorwould pay cash for your services is if they didn't live within a hundred miles of an ER because otherwise they'd go there for 'free' care.

Ways to be a doctor with just an intern year:

1) move to the ass end of nowhere rural flyover red state country, where doctors are so scarce they make it impossible to sue you OR

2) work for the military as a GMO OR

3) practice uber s***** medicine. Should be illegal medicine like pill mills, or CAM, or whatever.

Or you can suck it up and get through it. Yes they're taking advantage of you. For three years,for 80 hours a week (really less), and they're compensating you with a low but definitely middle class income. Don't cut off your nose to spite your face, suck it up and get through it.

This, so so hard.

 

[CarlATHF]

Everytime I think SDN has lost its entertainment value, I am pleasantly surprised.

Let's keep it going, people.

 

[justaregularmed]

I find the responses kind of funny. This thread certainly wont be complete without bringing up the OP would have more training then a NP who could practice independently would. Minute clinics do this all the time, where's the beef? He basically wants to run a minute clinic.

 

[alwaysaangel]

I find the responses kind of funny. This thread certainly wont be complete without bringing up the OP would have more training then a NP who could practice independently would. Minute clinics do this all the time, where's the beef? He basically wants to run a minute clinic.

Actually most NPs would have more clinical experience than a doc who did med school plus an intern year. By quite a bit.

 

[artemis680]

:troll:

 

[DrCoffeeBean]

An under qualified ortho surgeon?.. If I were a patient I would run like a wind in the opposite direction!

An entertaining thread to brighten one's morning 🙂

 

[paul411]

I am also considering doing this, but I was thinking of going into orthopaedic surgery without doing a residency.

The doctor from the Simpsons already does this.

 

[myhandsarecold]

well ya, all you need is some triplicates, an equally sketchy pharmacist partner, a handful of bodyguards, a nondescript "clinic" outside of town and you're good to go.

 

[Dr Love]

Brilliant.

I will open up a place across the street from your doc-in-a-box and wreck you. Doc-King comes to mind, maybe McDoctor's. I hope you're prepared for a turf war, son.

Haha, nice 👍

 

[cowme]

I find the responses kind of funny. This thread certainly wont be complete without bringing up the OP would have more training then a NP who could practice independently would. Minute clinics do this all the time, where's the beef? He basically wants to run a minute clinic.

Minute clinics have people legally accredited to practice medicine. You practice medicine without a license in the US (a medical degree is not a license), you go to jail.

 

[TexasPhysician]

Minute clinics have people legally accredited to practice medicine. You practice medicine without a license in the US (a medical degree is not a license), you go to jail.

While I am not advocating this, an intern year is often all the time that is required for a license to practice medicine. You just won't be board certified, and you will have trouble purchasing malpractice insurance.

 

[TexasPhysician]

Actually most NPs would have more clinical experience than a doc who did med school plus an intern year. By quite a bit.

No they wouldn't. I would actually agree with the OP. A graduating intern has many more clinical hours involving med management than a graduating NP.

 

[Isoprop]

Good luck with malpractice.

 

[WellWornLad]

I know a guy who did the same thing. I know him because he was applying for my pre-med school research job after losing his medical license for malpractice.

Best of luck to you.

P.S: He didn't get the job...

 

[Law2Doc]

I find the responses kind of funny. This thread certainly wont be complete without bringing up the OP would have more training then a NP who could practice independently would. Minute clinics do this all the time, where's the beef? He basically wants to run a minute clinic.

First, an NP who works at the minute clinic has finished their training. A person who skips out of residency after intern year hasn't. That's part of the reason medmal insurance companies are not going to be friendly in providing coverage to a GP with a year of training as compared to an NP. Thus the NP will be far more profitable in this setting. Also the minute clinic is a setting fraught with unacceptable conflicts of interest (you have a practitioner that freely gives out questionable prescriptions and then sells you the prescriptions in the same store), that could get looked into by an attorney general at some point in the not too distant future. Not the kind of business model I would want to bet my career on.
I have to echo perrotfish that you really don't know what you need to to provide comprehensive care to patients after just completing an intern year. Residencies work you into this, but generally you start to feel like you know what you are doing toward the later years of residency, not at the outset.
Finally, the folks who are going to pay cash above and beyond what they already get in terms of insurance (because the OP won't be able to accept insurance if he doesn't meet the insurers provider requirements) are going to have to be rich, and in the current economy folks who cater exclusively to the rich aren't doing so well.
It's just a bad plan all around. Bottom line, the person who sucks it up and completes a 3 year residency is going to have a good career, and someone with ideas like the OP likely will face nothing but hurdles.

 

[alwaysaangel]

No they wouldn't. I would actually agree with the OP. A graduating intern has many more clinical hours involving med management than a graduating NP.

NP is going to be 4 years for a BSN. AT LEAST 2 of which is clinicals.
Then usually at least 2 years of actually working.
Then 1-2 years for the masters or doctorate of nursing, which I'm told is very hands on.
So at least 5-6 years of clinically working.

Graduating intern has 3rd year of med school which is pretty darn useless for real world practice, 4th year - half of which is spent on easy electives or time of for interviews and 1 year of internship where they are finally actually doing work on their own and understanding a lot of the clinical issues (med dosing, imaging details, etc).
Saying a finishing intern has 3 years of clinical experience is GENEROUS.

The NP has DIFFERENT clinical training. But she has more. Its why many nurses know more than a 4th year med student and most interns when they first start out. Not about the concepts in medicine or the diseases, but about the actual practice of medicine - basic stabilization, first steps in treatment, medication dosing, etc. But overall the NP would have more clinical experience than an MD with ONLY an intern year.

 

[alwaysaangel]

Finally, the folks who are going to pay cash above and beyond what they already get in terms of insurance (because the OP won't be able to accept insurance if he doesn't meet the insurers provider requirements) are going to have to be rich, and in the current economy folks who cater exclusively to the rich aren't doing so well.

Not to mention that the people who are going to pay cash for this type of services are going to be sophisticated enough to care what the doc specialized in, where he went to school, etc. They won't want someone who didn't complete training.

 

[Maybeknot]

I love, love, L😍VE this idea, Party. I have a similar plan that's been cooking for a few months now. I've decided to open my own botox clinic. I'm not a sucker and won't pay $700 for a tiny vial of medical-grade botox, so I'm going to create my own. I have several dented cans of honey brewing but I need a few patients to test this out on. For every patient you send me, I'll send you $30. Just give me your full name, social security number and bank routing and account number and we'll be in business!

 

[OMG Lizards]

The nurse has DIFFERENT clinical training. But she has more. Its why nurses know more than a 4th year med student and most interns. Not about the concepts in medicine or the diseases, but about the actual practice of medicine - basic stabilization, first steps in treatment, medication dosing, etc.

And they all wear those goofy white hats.