Why is family medicine viewed as a low quality field?

[Crayola227]

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I’ve done this before.

Generally speaking, if you’re dumb enough to piss off your referrings, you’re probably not a stellar physician. At least, that’s been my experience.

sometimes you can have your cake by doing all 3, what's best for the patient, is good utilization of resources, and pisses off another doc that deserves it

those are the best days

 

[Crayola227]

There is a lot of ego in medicine... I would prefer these ego to be directed at NP, but unfortunately they are often directed toward other docs..

when I want to get into a pissing match pitting my ego against another doc, I just come to SDN instead

isn't that what SDN is for?

#stewardship

 

[IMreshopeful]

I’ve done this before.

Generally speaking, if you’re dumb enough to piss off your referrings, you’re probably not a stellar physician. At least, that’s been my experience.

Yeah in practice you can’t be a dick. You have to be nice and charming to your referrings. I feel like that’s why some people end up in academics as well - they can’t handle the social interaction or need to be nice to referrings outside of academics so they stay there.

 

[Crayola227]

I was nitpicking that med school is really as expensive as it's made out to be, but, who gives a frak. To me it's a vocation and I'd rather know I was doing the best job I could, not that of an NP or PA's. That's not to say I hate on them or I don't tell a lot of students not to bother going MD.

What I don't get are docs that sit there wishing they were NPs or PAs. No ****ing way. Put on your big boy pants. If you didn't want to be the go-to expert on human health and leader of the healthcare team for being such, then yeah, wtf did you go to med school for, exactly? Also, did no one tell you it would be expensive and hard? Did no one tell you to consider pathways besides the MD?

I see where NPs and PAs are at, and their practice looks similar to the untrained eye, and financially it's not a bad gig. It's nice how they can change practice specialties, even if it's a bad idea for optimizing quality of care. Knowing what I know, I wouldn't want to be in those shoes. No way.

 

[IMreshopeful]

I was nitpicking that med school is really as expensive as it's made out to be, but, who gives a frak. To me it's a vocation and I'd rather know I was doing the best job I could, not that of an NP or PA's. That's not to say I hate on them or I don't tell a lot of students not to bother going MD.

What I don't get are docs that sit there wishing they were NPs or PAs. No ****ing way. Put on your big boy pants. If you didn't want to be the go-to expert on human health and leader of the healthcare team for being such, then yeah, wtf did you go to med school for, exactly? Also, did no one tell you it would be expensive and hard? Did no one tell you to consider pathways besides the MD?

I see where NPs and PAs are at, and their practice looks similar to the untrained eye, and financially it's not a bad gig. It's nice how they can change practice specialties, even if it's a bad idea for optimizing quality of care. Knowing what I know, I wouldn't want to be in those shoes. No way.

Yeah I know at least four former NPs who are now residents or fellows in various fields. They find this talk absolutely ridiculous. I mean this with the utmost respect - there’s a lot of nonsense that nurses have to deal with on a daily basis which makes the troubles of a lot of MDs look like a joke.

Also, doubt the average medical student wants to go through nursing school and work as a clinical nurse...that is not a glamorous calling. Also good luck working as a hospital PA the rest of your life - the idea of being an intern for the rest of my life gives me nausea

 

[IMreshopeful]

Yeah, a cards fellowship use to be 1 year long after internal medicine

Just wanted to make a comment here
Cardiology has changed a ton since it was a one year fellowship. There are far more procedures, better drugs and more guidelines, sicker patients (mostly because they survive due to more complex drugs and procedures), more imaging modalities, and now transplant/VAD etc. I think at a minimum two years of fellowship is necessary. Granted, some of it is redundant (do you really need to have 8 months of research?) but the three years allows you to refine your skills immensely in whatever sub-field you’re going into or for going into practice.

Things evolve and sometimes for the better

 

[VA Hopeful Dr]

I mean, ideally you're actually doing what's right for the patient, not just use them in your petty vendetta against another doctor. And you would be a good steward of limited healthcare resources.

Or just glory in abusing your power, whatevs floats your boat, I guess.

The nice thing is, with rare exceptions, one surgeon/cardiologist/whatever is about the same as another. So if Cardiologist A is a jerk and you instead send all of your patients to Cardiologist B, the odds of that resulting in any harm is pretty darn small.

 

[VA Hopeful Dr]

Nope. Public MD. But not a cheap one.

I would have saved a ton of money at the private acceptance I had, actually.

Man, that sucks. Whole reason I didn't apply to any private schools was because of cost. My undergrad had a guaranteed acceptance program with GW that I turned down specifically because at the time tuition was 2.5X as high as the 3 public places I applied, and that didn't factor in COL of DC compared to the rest of the Southeast.

 

[It's lupus!]

Man, that sucks. Whole reason I didn't apply to any private schools was because of cost. My undergrad had a guaranteed acceptance program with GW that I turned down specifically because at the time tuition was 2.5X as high as the 3 public places I applied, and that didn't factor in COL of DC compared to the rest of the Southeast.

Yeah. The average debt of 200k that's thrown about is also taking into account those who are largely paid for by scholarship, rich parents, and the like which shifts the number to the left. Not to mention I think the 200k estimate was from a few years ago and medical school costs continue to rise faster than the rate of inflation. It hasn't become an unwise investment yet but that point is fast approaching. There are many private MD schools that are cheaper than public ones. Most DO schools however typically are more expensive and most are private and fit that assumption. Debt for those who are paying their way are most certainly stretching above 200k. Sad reality I just recently came to grips with.

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[It's lupus!]

This helps but does not fully support my assertion.
https://www.aamc.org/download/276596/data/thehighpriceofadreamjob.pdf

 

[trobinsonmd]

I have several friends in family med and they love it, but you have to realize that medicine is comprised of basically all type A people who are used to being the best and the brightest and we all want to be the best, and a lot of us like to have our intelligence validated in different ways. One of the big draws to derm for me initially was just how exclusive and competitive it was to get into, as a hyper competitive person, I just loved the challenge... there are med students who don't think like that and they are happy with family med, and there is nothing wrong with the speciality... but then some of the super competitive students who match NS, IR, rad onc, etc like to validate their perceived superiority by putting down specialties that are perceived as lesser.

TLDR: there is nothing wrong with the speciality, but it is easy to hate on, so it gets hated on... it is not low quality if you are okay with low comp

 

[QueenJames]

Well...

DPC is about to change the game.

SO...

All the FM haters can ssuuuccck itttt.

Not to mention the billion dollar industry of "alternative" medicine that some FM docs can employ in their practices... which OMM/OPP for my DO brethren fall right into.

Cash-based baby...

cold hard frickin' cash.

Plus.. the medicare reimbursement for OPP is LEGIT for less than 30 minutes amount of work.

 

[plasticsday1]

Your reward is the problem.

When your vocation is medicine then all else is tertiary.

I worked as an orderly in an OR turning over rooms after surgeries. I had an Ortho Surgeon, Chief of Admissions at the state university SOM where I was applying at the time, who helped me haul red bags full of bone chips, guts and more after he wiped down the OR table. He was studying to be a Jesuit in a prior life and decided to be a physician in his later years. I had a heart surgeon help me clean a room after a bloody ascending AAA case. He had been a Lutheran minister seminirian in his earlier years. Indignities are relative

When medicine is a vocation, the journey is the thing. Arriving is no where on the horizon.

Indignities are part of life be it as an Attending, an OR Orderly, a prisoner, a priest, or a prostitute. Pope Francis receives indignities daily by thousands of enemies. Mother Teresa of Calcutta is still vilified and she has been dead for years.

The word Vocation is rarely mentioned these days. It should be part of the selection criteria for medicine otherwise we have this

This naive line of thinking is why NPs and PAs are able to take over our jobs. While I'm sure it's certainly good for your patients that you feel this way, this kind of altruistic attitude is childish and harmful to physicians as a whole. My reward for going through 10 years of hell as a medical student and resident is being able to, for the next 40 years, walk through the OR doors, operate, walk out, and bank half a million. It's being able to never again have to wheel a patient from the preop area, never again have to wipe a patient down after I put the knife down, never again have to wait on my a$$ for anesthesia to wake the patient up, and certainly never again have to listen to or take **** from any nurses or other non-attending staff members. Again, good for you and your coworkers/patients that you're willing to get down and do all this cr@p, and maybe even do it for low pay because it's a "vocation." But people like you are why physicians get taken advantage of by everyone in the hospital/healthcare system and why our job is trending in the wrong direction more and more every year/why fewer people are satisfied with it and want to do it

 

[It's lupus!]

This naive line of thinking is why NPs and PAs are able to take over our jobs. While I'm sure it's certainly good for your patients that you feel this way, this kind of altruistic attitude is childish and harmful to physicians as a whole. My reward for going through 10 years of hell as a medical student and resident is being able to, for the next 40 years, walk through the OR doors, operate, walk out, and bank half a million. It's being able to never again have to wheel a patient from the preop area, never again have to wipe a patient down after I put the knife down, never again have to wait on my a$$ for anesthesia to wake the patient up, and certainly never again have to listen to or take **** from any nurses or other non-attending staff members. Again, good for you and your coworkers/patients that you're willing to get down and do all this cr@p, and maybe even do it for low pay because it's a "vocation." But people like you are why physicians get taken advantage of by everyone in the hospital/healthcare system and why our job is trending in the wrong direction more and more every year/why fewer people are satisfied with it and want to do it

This to me sounds more like the arrogance that patients hate about many physicians. Don't get me wrong your due some respect when you finish training but what I hear is that you want society to worship the ground you walk on. I'm struggling to see at what point your statisfaction for being a physician is helping anyone. It sounds more like you want the power, prestige, and respect. Advocating is one thing, in the matter of avoiding being taken advantage of, expecting absurd privilege like God forbid you actually get your hands dirty is not. I get your point to some extent and I REALLY hope the post is hyperbolic but as it stands I find it jarring.

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[IMreshopeful]

This naive line of thinking is why NPs and PAs are able to take over our jobs. While I'm sure it's certainly good for your patients that you feel this way, this kind of altruistic attitude is childish and harmful to physicians as a whole. My reward for going through 10 years of hell as a medical student and resident is being able to, for the next 40 years, walk through the OR doors, operate, walk out, and bank half a million. It's being able to never again have to wheel a patient from the preop area, never again have to wipe a patient down after I put the knife down, never again have to wait on my a$$ for anesthesia to wake the patient up, and certainly never again have to listen to or take **** from any nurses or other non-attending staff members. Again, good for you and your coworkers/patients that you're willing to get down and do all this cr@p, and maybe even do it for low pay because it's a "vocation." But people like you are why physicians get taken advantage of by everyone in the hospital/healthcare system and why our job is trending in the wrong direction more and more every year/why fewer people are satisfied with it and want to do it

You’re in for a hell of a shock when you enter practice if you don’t think you’re gonna get your hands dirty beyond operate - then leave. This is bordering on pretty hard arrogance. Nobody loves scut but a little humility goes a long way.

 

[IMreshopeful]

I have several friends in family med and they love it, but you have to realize that medicine is comprised of basically all type A people who are used to being the best and the brightest and we all want to be the best, and a lot of us like to have our intelligence validated in different ways. One of the big draws to derm for me initially was just how exclusive and competitive it was to get into, as a hyper competitive person, I just loved the challenge... there are med students who don't think like that and they are happy with family med, and there is nothing wrong with the speciality... but then some of the super competitive students who match NS, IR, rad onc, etc like to validate their perceived superiority by putting down specialties that are perceived as lesser.

TLDR: there is nothing wrong with the speciality, but it is easy to hate on, so it gets hated on... it is not low quality if you are okay with low comp

Correction: medicine is composed of type A best/brightest who haven’t experienced life outside of school. Your priorities change a lot once you start having a life outside of your work.

 

[VA Hopeful Dr]

I have several friends in family med and they love it, but you have to realize that medicine is comprised of basically all type A people who are used to being the best and the brightest and we all want to be the best, and a lot of us like to have our intelligence validated in different ways. One of the big draws to derm for me initially was just how exclusive and competitive it was to get into, as a hyper competitive person, I just loved the challenge... there are med students who don't think like that and they are happy with family med, and there is nothing wrong with the speciality... but then some of the super competitive students who match NS, IR, rad onc, etc like to validate their perceived superiority by putting down specialties that are perceived as lesser.

TLDR: there is nothing wrong with the speciality, but it is easy to hate on, so it gets hated on... it is not low quality if you are okay with low comp

Common misconception. Yes, FM isn't likely to make ortho or neurosurgery money, but we can do quite well.

I just saw RVU numbers for my group of 20-ish FPs. Of the full time docs who have been here at least 2 years, the lowest I'm seeing for the year is 240 and both those guys are over 65 so are slowing down (one just gave up his DEA number and so lost probably 20% of his patients). We have several who are going to break 300. 3 on track to break 400. This is all 8-5, M-F, no holidays, no rounding, phone call 2 days/month.

 

[VA Hopeful Dr]

Correction: medicine is composed of type A best/brightest who haven’t experienced life outside of school. Your priorities change a lot once you start having a life outside of your work.

This many times over.

 

[It's lupus!]

This many times over.

Yeah. When I was in the military the leaders we respected most enlisted and officer a like we're the ones that never had to ask for it. Those guys weren't afraid to get in the mud and dig with us when they could. They didn't shy away from tasks that even we would deem beneath them or tedious or any other similar descriptor. Those were the guys I went out of my way to do my tasks right and the guys I felt comfortable leading me into some rough stuff. The arrogant leaders we often made their lives a living hell by doing the bare minimum, just getting by, and forcing them to get dirty with us. A respected leader that deserves to avoid the mud is the one that voluntarily gets in it because he cares more about who he is leading than what he is owed by those that follow him.

Sent from my Pixel XL using SDN mobile

 

[Crayola227]

This naive line of thinking is why NPs and PAs are able to take over our jobs. While I'm sure it's certainly good for your patients that you feel this way, this kind of altruistic attitude is childish and harmful to physicians as a whole. My reward for going through 10 years of hell as a medical student and resident is being able to, for the next 40 years, walk through the OR doors, operate, walk out, and bank half a million. It's being able to never again have to wheel a patient from the preop area, never again have to wipe a patient down after I put the knife down, never again have to wait on my a$$ for anesthesia to wake the patient up, and certainly never again have to listen to or take **** from any nurses or other non-attending staff members. Again, good for you and your coworkers/patients that you're willing to get down and do all this cr@p, and maybe even do it for low pay because it's a "vocation." But people like you are why physicians get taken advantage of by everyone in the hospital/healthcare system and why our job is trending in the wrong direction more and more every year/why fewer people are satisfied with it and want to do it

you totally missed the point of that post

it was brought up that people can't handle the "indignities" of medical training as well later in life compared to early in life

mentirita was pointing out that indignities exist everywhere for everyone, and when you follow your vocation, you just deal with them whenever and wherever they arise

they were giving examples of physicians that work hard and get their hands dirty

I don't agree that a lot of the "indignities" of medical training are necessary to train physicians, but nor do I agree that they should be stop you from committing to medicine at any age, if you are truly committed, in fact, I think a lot of my older classmates who had had careers and such before, or those that chose to start over BECAUSE it was their vocation, handled "indignities" that other classmates might have seen as such, much better

I think with our current health system, the pressure on docs to provide care, for which there is greater demand than supply, that yes, it doesn't take a frakking MD and 11+ years of advanced schooling/training to call for records to be faxed, and my concern with doing anything like that is more that it takes away time I could be teaching patients or holding their hands or holding a family meeting

I'm more resentful that I don't have time to get my patients ice chips or pillows when I'm in the room, or wipe their ass while I'm there, than some idea I'm above any aspect of patient care

I like wheeling patients but it's more important I do tasks as a physician that can't be delegated anywhere else and as such fall on me

people that feel like me or mentirita or the others are not the reasons it's going in the shytter, actually

the people that only care about money might do more to protect reimbursements, but it's exactly the people that aren't doing this for money that will see to it that the vocation isn't sold out, to preserve its mission to care for patients above the bottom dollar, the value people put on what we do and pay us is directly related to the trust placed in us and how well we do that job

it's not mutually exclusive no matter what your stance is for why you're doing this, money or vocation, to protect what we do or the living we deserve to make for doing it

 

[Crayola227]

Common misconception. Yes, FM isn't likely to make ortho or neurosurgery money, but we can do quite well.

I just saw RVU numbers for my group of 20-ish FPs. Of the full time docs who have been here at least 2 years, the lowest I'm seeing for the year is 240 and both those guys are over 65 so are slowing down (one just gave up his DEA number and so lost probably 20% of his patients). We have several who are going to break 300. 3 on track to break 400. This is all 8-5, M-F, no holidays, no rounding, phone call 2 days/month.

the idea that money or lifestyle is what makes FM not attractive, is unbelievably stupid

 

[VA Hopeful Dr]

the idea that money or lifestyle is what makes FM not attractive, is unbelievably stupid

Agreed. There are lots of reasons to not want to do primary care, but we've easily got one of the best lifestyles and the money is pretty good.

 

[bizdr]

I'm definitely not going into family med but why is the field disliked? The money really isn't bad. 250k is easily doable if you're anything close to efficient. And if you can see more patients, 300k+ is as well without insane hours. The job market is excellent including saturated areas (unlike specialties). And every single field has bread and butter cases that bore you to death if you don't like it, can't pick on FM for its bread and butter.

So... why the hate exactly?

This idea of Fm being looked down on, it's much more prevalent during your education years. Once out in private practice you will almost never feel any sense of inferiority. The only time may be if you are consulting on a complicated inpatient case, you will have to defer treatment to specialists. It's really only when people are immature medical students and residents, that FM gets looked down on.

 

[MedicineZ0Z]

There is a lot of ego in medicine... I would prefer these ego to be directed at NP, but unfortunately they are often directed toward other docs..

Exactly! Fight those who are fighting the whole profession.

 

[smq123]

Dont hold back, now, tell us how you really feel.

I love your chutzpah. We need more of it in medicine

take a look at this Miami Herald article

Desperate Venezuela HIV patients, unable to get life-saving drugs, try DIY remedies

I forwarded the article to the Infectious Disease Director, as well as the Director of Family Medicine and Population Health at my school, both who lead a program for medical students to do medical work in Latin America. My first gut reaction was: “we need to go”

Don't go to Venezuela.

I see a lot of patients who are in Miami from Venezuela. The situation there is bad and is not safe. It is not uncommon for people to get shot in the middle of the day. As an American, who clearly has money, you will be a walking target. I have several patients who left after they were mugged at gunpoint in the elevators of their own apartment buildings. One patient was distraught because his elderly mother was carjacked at knifepoint and he does not have the resources to get her out.

Do NOT go to Venezuela.

There is "chutzpah," and there is helping people, and then there is just plain stupid. Don't put yourself in a dangerous situation where you will only be able to help temporarily. Great, you gave some HIV patient meds for 3 months. What are they going to do after those meds run out?

 

[smq123]

Then there is Dr Pedro Joe Greer who embodies the word vocation and look at what he did in Miami for the homeless. NB: he graduated from one of those medical schools in the Caribbean that SDNers love to trash, but it did the yob!

Also, no, he did not go to one of those "medical schools in the Caribbean that SDNers love to trash."

He went to med school in the country that he is from. He did not go to SGU or Ross, which are the "medical schools in the Caribbean that SDNers love to trash."

Also, he went to med school in a different country many years ago, when it was not so difficult to get into residency as it is now. This was well before the US med schools had expanded as quickly as they did.

 

[smq123]

As for Venzuela, I am not American by birth, have family in Venzuela, my family in Miami hasnt heard from those in Vz, and if there are viable ways to go to Venezuela safely, then it wont be a problem. Nicaragua, Mexico, Brazil, etc are all in turmoil. There are ways to work with these countries either by visiting or providing assistance from afar. We did it with Cuba for decades

That's great.

However, you haven't answered the main crux of the question. So you go and provide care for two weeks. What about after that? What will they do for HIV meds after you're gone? Are you going to keep sending them meds every month? Why just them, and not everyone else?

If you want to help, that's great. Come to Miami and I will be happy to point you in the direction of people who also need help here. That's not a problem; I work in a community health center in south Florida and help the underserved and uninsured every day at work. But swooping in to save a handful of sick Venezuelans for 3 months will do nothing to help them long term.

 

[IMreshopeful]

It is a burning question for you, not me

Feel free to help whomever you wish and I shall follow my passions likewise

buena suerte

Do you have some sort of schizoid personality disorder? Because that would be the only way to explain the bizarre non sequitor posts you make

 

[Matthew9Thirtyfive]

Please post that list of perfectly acceptable medical schools in the Caribbean approved by SDN so that future applicants will know where to apply and where not to apply in the Caribbean.

Looking forward....

Thanks

You really don’t understand why SDN doesn’t approve of predatory schools who target US students who fail to get into US med schools? The ones who charge an absurd amount of tuition but only give a 50% chance of actually returning to the states to practice? The ones with an absurd attrition rate that they count on since they admit far more students than they can accommodate?

Or are you being deliberately obtuse? I totally get your deal with medicine being a vocation and agree, but these posts about the Caribbean schools borderline on the absurd.

 

[atomi]

SDN doesn't like Caribbean medical schools that:
- specifically target American students who couldn't cut it to get into a US school and have a low likelihood of success in medical school
- fail those students out and/or leave then unmatched in large percentages
- provide sub-par clinical experiences for their students
- lie to applicants about these statistics and make it sound like they can come back to practice in the US
- are for profit & quite literally prey on students who don't know better, leaving them hundreds of thousands in debt with no feasible job.

SDN seems to be fine with their money though because every other ad I see on this site is for a newly sprung up sewer-tier fly by night Caribbean school trying to poach a dumb 19 year old premed. Honestly guys WTF do you allow this?

 

[atomi]

List of medical schools in the Caribbean - Wikipedia

The “perfectly acceptable” ones are the ones that mostly admit students from the country in which they are located and prepare them for practice in said country. There are no acceptable offshore medical schools that train American students for profit. There is no unmet need in America for medical training. These “schools” are parasites in the system. Again, there are none. Zero.

 

[michaelrack]

Do you have some sort of schizoid personality disorder? Because that would be the only way to explain the bizarre non sequitor posts you make

Schizoid pesonality patients are not usually disorganized

 

[Piglet2020]

I didn’t realizs FM was a less-than-desired specialty until I talked to physicians in my area. 2 family docs told me to stay away from FM b/c insurance is killing primary care rn. They have a bucketload of paperwork but they dont have the funds to hire scribes to at least help them a bit. Even a specialty doc I worked for told me to avoid FM at all costs b/c his FM friends are all regretting it... they said that IM would have been a better choice. I used to be interested in FM, but after hearing all the horror stories, I’m a bit hesitant.

 

[VA Hopeful Dr]

I didn’t realizs FM was a less-than-desired specialty until I talked to physicians in my area. 2 family docs told me to stay away from FM b/c insurance is killing primary care rn. They have a bucketload of paperwork but they dont have the funds to hire scribes to at least help them a bit. Even a specialty doc I worked for told me to avoid FM at all costs b/c his FM friends are all regretting it... they said that IM would have been a better choice. I used to be interested in FM, but after hearing all the horror stories, I’m a bit hesitant.

My MA does 99% of my insurance paperwork.

Most of the FPs I know are pretty happy doing it. I still enjoy my days quite a bit.

 

[Perrotfish]

I didn’t realizs FM was a less-than-desired specialty until I talked to physicians in my area. 2 family docs told me to stay away from FM b/c insurance is killing primary care rn. They have a bucketload of paperwork but they dont have the funds to hire scribes to at least help them a bit. Even a specialty doc I worked for told me to avoid FM at all costs b/c his FM friends are all regretting it... they said that IM would have been a better choice. I used to be interested in FM, but after hearing all the horror stories, I’m a bit hesitant.

If you hate insurance stuff that much you can always work for the VA or Kaiser.

 

[smq123]

I didn’t realizs FM was a less-than-desired specialty until I talked to physicians in my area. 2 family docs told me to stay away from FM b/c insurance is killing primary care rn. They have a bucketload of paperwork but they dont have the funds to hire scribes to at least help them a bit. Even a specialty doc I worked for told me to avoid FM at all costs b/c his FM friends are all regretting it... they said that IM would have been a better choice. I used to be interested in FM, but after hearing all the horror stories, I’m a bit hesitant.

Insurance is killing medicine, period. It is not just primary care.

 

[Crayola227]

I didn’t realizs FM was a less-than-desired specialty until I talked to physicians in my area. 2 family docs told me to stay away from FM b/c insurance is killing primary care rn. They have a bucketload of paperwork but they dont have the funds to hire scribes to at least help them a bit. Even a specialty doc I worked for told me to avoid FM at all costs b/c his FM friends are all regretting it... they said that IM would have been a better choice. I used to be interested in FM, but after hearing all the horror stories, I’m a bit hesitant.

Every doctor everywhere has reasons to bitch about their specialty and tell people not to go into it. There's always some study showing the huge number (not the majority, I digress) that if they had a time machine would be doing something different, whether that was a different specialty or outside medicine altogether.

Every FM doc hates that part of their job. That part of the job is hated everywhere. The real question is what else do they hate about their job and can it be escaped outside the specialty. In that case going outside FM would be well-served. Leaving FM to leave the administrative woes behind is not reasonable. If only it were that easy.

 

[IMreshopeful]

I didn’t realizs FM was a less-than-desired specialty until I talked to physicians in my area. 2 family docs told me to stay away from FM b/c insurance is killing primary care rn. They have a bucketload of paperwork but they dont have the funds to hire scribes to at least help them a bit. Even a specialty doc I worked for told me to avoid FM at all costs b/c his FM friends are all regretting it... they said that IM would have been a better choice. I used to be interested in FM, but after hearing all the horror stories, I’m a bit hesitant.

Yeah nobody likes paperwork. That’s a big part of any job. Unfortunately there’s no way around it other than having good office staff who can streamline it to the point where all you need to do is sign a bunch of electronic orders or get a stack of paper that says “sign here”. But it can be a fulfilling career if you like longitudinal care of patients, the clinic setting, etc. if you like the OR or reading radiology studies then it probably is not the career for you.

 

[Piglet2020]

Well to quote the docs I talked to, it’s not only the amount of paperwork, but also the type of paperwork. Lots of patients come in for work notes or worker’s comp (which gets tedious & messy rl fast). More so than other specialized fields apparently.

On another note, Kudos to FM docs for working hard every day. Preventative care is rlly underrated.

 

[IMreshopeful]

Well to quote the docs I talked to, it’s not only the amount of paperwork, but also the type of paperwork. Lots of patients come in for work notes or worker’s comp (which gets tedious & messy rl fast). More so than other specialized fields apparently.

On another note, Kudos to FM docs for working hard every day. Preventative care is rlly underrated.

I mean I don’t know of any paperwork that is fun. Just saying.

 

[charleskay]

I guess is not as lucrative as other fields like plastic surgery for example. Apart from that, it also not mentally tasking compared to the other fields like neurosurgery.

 

[iqe2010]

Is FM even the lowest paying specialty?

I thought out patient IM, infectious disease & peds all made less.

 

[It's lupus!]

Is FM even the lowest paying specialty?

I thought out patient IM, infectious disease & peds all made less.

At least according to the medscape report, but that survey really only gives a rough glimpse based on the people who respond. I'm willing to bet the salary lines are much more blurred between the lower quarter specialties.

Sent from my Pixel XL using SDN mobile

 

[IMreshopeful]

Is FM even the lowest paying specialty?

I thought out patient IM, infectious disease & peds all made less.

ID makes less. Outpatient IM can have a setup similar to outpatient FM so the salary is similar. It depends on also the other things you can do to increase income - joint injections, minor procedures etc. Peds usually does make less.

 

[workaholic181]

FM docs in private practice can make a lot of they're willing to work extra hours. During my gap year I worked for a practice and one of the physicians there was making 300+. He worked late and was always on call though.
Like pretty much anything in medicine it depends what you enjoy. The docs I worked for were very well credentialed and could have done a lot of different specialties but just loved FM and saw it as the apex of medicine. Working there for a year killed my interest in it personally, but it's a rewarding and much needed line of work, if you enjoy it.

 

[Danny Wang]

So this is a multifaceted response with a simple answer. Take an RN who has been an RN for a while and make them an NP. They are more than qualified to provide primary care services (time and time and time and time again this has been proven, despite what you might say). Primary care is the entry to healthcare. If you take an RN and have them work to the TOP of their abilities and take an MD and have them work as bottom feeders (family medicine), it isn’t so attractive. Those who graduate last in their class, or internationally, are often FM docs. The evolution of healthcare has put FM docs or “GPs” as basic referring agents, so APRNs have overtaken the field. If FM had more merit and managed more it would be different, but no FM doc wants to even manage a bipolar patient anymore and defers care to psychiatry. You’ve dumbed down your own profession to allow high achieving RNs to easily replace you and perform better than you. It’s only medicine’s fault.

I hung out of helicopters and worked in adult and peds ICUs for over 20 years before I decided to become an APRN. My life experience and exposure is obviously always going to be more advanced than any FM doc. This explains why I teach you in school and supervise you during residency.

 

[LucidSplash]

So this is a multifaceted response with a simple answer. Take an RN who has been an RN for a while and make them an NP. They are more than qualified to provide primary care services (time and time and time and time again this has been proven, despite what you might say). Primary care is the entry to healthcare. If you take an RN and have them work to the TOP of their abilities and take an MD and have them work as bottom feeders (family medicine), it isn’t so attractive. Those who graduate last in their class, or internationally, are often FM docs. The evolution of healthcare has put FM docs or “GPs” as basic referring agents, so APRNs have overtaken the field. If FM had more merit and managed more it would be different, but no FM doc wants to even manage a bipolar patient anymore and defers care to psychiatry. You’ve dumbed down your own profession to allow high achieving RNs to easily replace you and perform better than you. It’s only medicine’s fault.

I hung out of helicopters and worked in adult and peds ICUs for over 20 years before I decided to become an APRN. My life experience and exposure is obviously always going to be more advanced than any FM doc. This explains why I teach you in school and supervise you during residency.

Was it super necessary to bump a 6-year old thread that already had some comprehensive responses to share this?

 

[Nontrad_FL_LGBT]

Was it super necessary to bump a 6-year old thread that already had some comprehensive responses to share this?

Totally necessary to self-fellate at the expense of dumb FM docs. Duh. 🫡

 

[Splenda88]

I did not know that FM was viewed as a low quality field.

That is news to me.

 

[Med Ed]

So this is a multifaceted response with a simple answer. Take an RN who has been an RN for a while and make them an NP. They are more than qualified to provide primary care services (time and time and time and time again this has been proven, despite what you might say). Primary care is the entry to healthcare. If you take an RN and have them work to the TOP of their abilities and take an MD and have them work as bottom feeders (family medicine), it isn’t so attractive. Those who graduate last in their class, or internationally, are often FM docs. The evolution of healthcare has put FM docs or “GPs” as basic referring agents, so APRNs have overtaken the field. If FM had more merit and managed more it would be different, but no FM doc wants to even manage a bipolar patient anymore and defers care to psychiatry. You’ve dumbed down your own profession to allow high achieving RNs to easily replace you and perform better than you. It’s only medicine’s fault.

I hung out of helicopters and worked in adult and peds ICUs for over 20 years before I decided to become an APRN. My life experience and exposure is obviously always going to be more advanced than any FM doc. This explains why I teach you in school and supervise you during residency.

Shoulder, meet Chip.