Why not General Practice over Family Practice?

[OnMyWayThere]

If one is planning on going straight into private practice after residency, why not cut 2 years and become a general practionor? From my experience, you can bill the same, cover the same scope of medicine and do both inpatient and outpatient an FP does. So what's so bad about a GP?

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[cooldreams]

If one is planning on going straight into private practice after residency, why not cut 2 years and become a general practionor? From my experience, you can bill the same, cover the same scope of medicine and do both inpatient and outpatient an FP does. So what's so bad about a GP?

and as a gp you can legally perform brain surgery, however getting licensed/insurance to do it or any hospital privledges will be basically impossible to come by.

 

[OnMyWayThere]

and as a gp you can legally perform brain surgery, however getting licensed/insurance to do it or any hospital privledges will be basically impossible to come by.

The same goes for FP.

 

[DrMom]

But as a GP you'll be hard pressed to get hospital privledges for anything.

Also, many insurance companies will not contract with GPs if there are residency-trained/board certified FP docs in the area.

Basically, you're really limiting yourself.

 

[mamadoc]

Good God, what an appalling suggestion. I am completing my intern year as a family practice resident right now and while I have learned a lot, I sure don't feel ready to go out there and take care of whatever walks in my door without some backup. I look forward to two more years of intense learning so that when I graduate from residency, I WILL feel pretty prepared to handle most of what I encounter each day. And I'll still worry that I don't know enough, of course.

Don't know where the OP got the idea that FPs don't get hospital privileges or insurance contracts because that's just not accurate. An immediate problem I see for someone attempting to work without completing residency is that they won't be able to get patients who have insurance. (and those who can pay cash are usually more discriminating) And if you peruse job listings for physicians, you'll see the acronym "BC/BE" in virtually every listing - "Board Certified/Board Eligible." You can't be either if you haven't completed a residency training program.

Simply put, one year of residency training just isn't enough. Back in Grandma's day, perhaps, but not now. I guess it's possible to hang out your shingle after just one year if all you want to do is make some money without much regard for whether you're practicing medicine appropriately. If you want to do it right, though, you need waaay more training than one post-graduate year.

 

[SDN]

The same goes for FP.

Unless you're just trolling, then you're in need of some education.

Primary care physicians, such as those in Family Medicine and Internal Medicine both go through 3 years of residency training. 1 year of internship won't get you anything except a license to kill.

One must complete a residency to apply for board certification. Board certification is a requirement for many hospitals and insurance plans.

Additionally, the few docs that I've worked with that don't have board certification are not usually up to speed with other physicians. They can be downright scary.

 

[VentdependenT]

If you get your GP maybe you can work in an urgent care center in the bumpkins or perhaps move to a small island and provide death to injured tourists.

 

[OnMyWayThere]

I never thought I'd get responses with "trolling and death" involved. I know general practioners who are accepting all insurances and aren't killing their patients... and are doing VERY well financially. Nevertheless, your responses are always appreciated and taken into consideration

 

[Leukocyte]

Want to be a GP and you do want to feel like an outcast? Then look no further than Miami, FL. Many immigrant Cuban doctors who used to be Orthopods, Neuros, Opthalmos, Otolaryngos..... back in Cuba, are now in Miami practicing as GPs.

I was rotating once with a GP who used to be a Cardio-thoracic Surgeon in Cuba with 25 years experience. I remeber once when a lady came in complaining about a lump in her breast. So he did a 10 seconds breast exam, then told her that she has nothing to worry about. He then told me to examine her. I did a breast exam, and found a hard irregular mass in one of her breats, then I went looking for lymphadenopathy, and surely, there wasn't a lymph node in her entire body that wan't enlarged and hard as a rock. So I asked her if there was a hx of cancer in her family. She said that both her grandmother and sister had breast cancer. So I reported by finding to the GP, and what does he do? He re-assures her that there is nothing worng with her, and sent her home. !!!!!!!!!!!!!

I also rotated with another GP, who went to a U.S. medical school. I found his technique for measuring BP by wraping the cuff around the fore-arm next to the wrist very interesting!!!!!!!

 

[OnMyWayThere]

I guess board certified it is

 

[eddieberetta]

In my opinion, there should be nothing wrong with being a GP. I know this will be contentious; here is my reasoning:

We as physicians have shot ourselves in the foot by implying that only BC family physicians are qualified to provide primary care. I mean, what was medical school for? It is absurd that after four years of medicaltraining and an internship, we are not capable of providing safe primary care. Let us look at non-physiican PCPs. NPs, after a 2-4 yr nursing degree do a 1-2 yr NP training program and then are fully licensed to provide all services that an FP can provide. PAs, after a 3-4 yr undergraduate degree or a 2-4 yr post grad degree are able to provide primary care with minimal oversight by a FP (as little as 1/20 charts reviewed every month, remotely)

But the lowly physician, clearly not a bright as the nurses and PAs, requires 4 years of medical training and a 3 year residency, more time than any of the other providers! Obviously we are in the slow lane, and they are in the accelerated program

If the basic body of knowledge nesessary to function as a FP is not imparted during medical school, then the entire medical education system needs to be overhauled! Further, the notion that the FP must be able to handle "whatever walks in my door " is absurd. When have you seen that? We all have backup, we all refer.

The current system, creates an unnecessary long training program for FPs. This no doubt contributes to the declining popularity of FP, and may lead to its eventual downfall as a medical specialty (i.e. provided by physicians)

 

[CambieMD]

In my opinion, there should be nothing wrong with being a GP. I know this will be contentious; here is my reasoning:

We as physicians have shot ourselves in the foot by implying that only BC family physicians are qualified to provide primary care. I mean, what was medical school for? It is absurd that after four years of medicaltraining and an internship, we are not capable of providing safe primary care. Let us look at non-physiican PCPs. NPs, after a 2-4 yr nursing degree do a 1-2 yr NP training program and then are fully licensed to provide all services that an FP can provide. PAs, after a 3-4 yr undergraduate degree or a 2-4 yr post grad degree are able to provide primary care with minimal oversight by a FP (as little as 1/20 charts reviewed every month, remotely)

But the lowly physician, clearly not a bright as the nurses and PAs, requires 4 years of medical training and a 3 year residency, more time than any of the other providers! Obviously we are in the slow lane, and they are in the accelerated program

If the basic body of knowledge nesessary to function as a FP is not imparted during medical school, then the entire medical education system needs to be overhauled! Further, the notion that the FP must be able to handle "whatever walks in my door " is absurd. When have you seen that? We all have backup, we all refer.

The current system, creates an unnecessary long training program for FPs. This no doubt contributes to the declining popularity of FP, and may lead to its eventual downfall as a medical specialty (i.e. provided by physicians)

FPs are not respected like they should be, already. Shortening the training period would further errode confidence in FPs and also result in even lower salaries.

CambieMD

 

[cooldreams]

i thought the low salaries were a result of hmo's, working for other doctors, acting only as a "gate keeper" and do no procedures, etc.

less residency time i doubt would directly affect any of those

many of the procedures you might learn could come from seminars, or rotating with specific doctors for the knowledge.

go out away from a city to get away from hmo monopoly, or having to work for other doctors. and you would also be more relied upon by your patients and thusly get away from the "gate keeper" scenerio.

 

[teamcox]

In my opinion, there should be nothing wrong with being a GP. I know this will be contentious; here is my reasoning:

We as physicians have shot ourselves in the foot by implying that only BC family physicians are qualified to provide primary care. I mean, what was medical school for? It is absurd that after four years of medicaltraining and an internship, we are not capable of providing safe primary care. Let us look at non-physiican PCPs. NPs, after a 2-4 yr nursing degree do a 1-2 yr NP training program and then are fully licensed to provide all services that an FP can provide. PAs, after a 3-4 yr undergraduate degree or a 2-4 yr post grad degree are able to provide primary care with minimal oversight by a FP (as little as 1/20 charts reviewed every month, remotely)

But the lowly physician, clearly not a bright as the nurses and PAs, requires 4 years of medical training and a 3 year residency, more time than any of the other providers! Obviously we are in the slow lane, and they are in the accelerated program

If the basic body of knowledge nesessary to function as a FP is not imparted during medical school, then the entire medical education system needs to be overhauled! Further, the notion that the FP must be able to handle "whatever walks in my door " is absurd. When have you seen that? We all have backup, we all refer.

The current system, creates an unnecessary long training program for FPs. This no doubt contributes to the declining popularity of FP, and may lead to its eventual downfall as a medical specialty (i.e. provided by physicians)

OMG, you are so on the money, I could not have Sd it better. Thank you for a awesome post!!!

 

[deleted87716]

A GP has as much in common with a Board-certified FP as they do with a Board-certified internist, pediatrician, or any other specialty.

In other words, not much.

The fact that some choose to ply their trade in primary care is irrelevant. They could just as easily take a job doing something else...if they could find one.

Medical school does not prepare you to be a family physician. That's what residency training is for. The fact that you can legally practice as a primary care physician (or whatever) doesn't mean you'll be any good at it.

 

[VA Hopeful Dr]

We have a brand new 2nd year resident who had been working as a GP for 6 years that was recently told that no insurance would reimburse her (she worked in a county health clinic).

GPs are becoming less and less common, I don't think its wise to showcase this as a viable career anymore.

 

[deleted87716]

My group won't hire anyone who isn't ABMS BC/BE in their specialty.

 

[badasshairday]

We have a brand new 2nd year resident who had been working as a GP for 6 years that was recently told that no insurance would reimburse her (she worked in a county health clinic).

GPs are becoming less and less common, I don't think its wise to showcase this as a viable career anymore.

Ridiculous. So a solo (D)NP can open up practice and be reimbursed by insurance, but a physician who has completed internship cannot? I just think that is absurd.

 

[smq123]

The point about General Practice has been made, and belabored, on this forum already. Please DO NOT bump old threads or start new ones in this forum which is, after all, dedicated to Family Medicine (a distinct specialty in its own right, with its own board). If you want to discuss General Practice, go to Topics in Healthcare. Thanks.

Closing. After the above warning, any further initiation of new discussions about General Practice will be considered trolling, and will result in infractions.