frustrated

[faith100]

Third year med student here. I'm currently doing core rotations and have an especially adamant attending discouraging me from family medicine, which is my dream job - family med with obstetrics (plan to do ob fellowship). Anyways, he said that it's not a viable career since mid-levels (PA's and NP's) can and will replace me.

I'm going into FM regardless since I don't see myself happy doing anything else, but it's still discouraging and frustrating constantly having attendings be so negative about FM...anyone else experience this? How did you respond or rebut these claims?

Thanks!

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[AtlasMD]

I completely understand your frustration but don't let them get to you. I heard the same things when I was a medical student and everyone asked why would go into Family medicine residency. In fact I even wrote my personal statement about the fact that everyone said family medicine was a dying specialty.

Have you heard about direct primary care? It is a unique model that is hoping to revive especially the family medicine. I believe it will help to make family medicine one of the top specialties within the next few years because of the decreasing stress, improvement in patient care, and fair reimbursement.

 

[faith100]

Thanks for the encouragement, AtlasMD! I'll definitely be looking more into DPC!

 

[AtlasMD]

Thanks for posting about your frustration b/c there's hundreds of students out there just like you.

I used to think i wasn't smart enough for a "specialty"....now i know i should have done something simple like cardiothoracic surgery....b/c family medicine tests all of your skills on a broad range of topics. I care for countless specialists and their families who respect my expertise as a specialist in family medicine.

here's a link to my personal statement, http://atlas.md/wichita/content/upload/files/Personal Statement.pdf

don't lose your heart through it all. Atttendings rarely know what its like in the real world. Let them talk their noise.

Believe that you can have it all. 100% of my attendings told me that the DPC model would never worked. One even laughed at me.

Now 4.5 years later, i've been talked nationally on the subject, helped over 60 docs launch their own dpc practices, been in TIME, NPR, Bloomberg, etc.

cheers!

 

[deleted6669]

Speaking as a long-time PA who works with family physicians in several rural facilities, I would encourage you to continue on your path to a career in family medicine. The PAs and NPs out there who work in primary care do not have the inpatient and specialty exposure you will have as a family physician, especially if you do an OB fellowship. The flexibility of family medicine is incredible as you know. You can do inpatient, outpt, a variety of procedures typically done by other specialties (scopes, treadmills, vasectomies, etc). You can cover a rural emergency dept or ICU. I have a world of respect for family medicine docs. Whenever I looked at going back to medschool, the plan was always to do full scope rural family medicine with ER and Inpt coverage and OB.
The future will see many more PAs and NPs working in primary care, but they will need good physicians to work with. Stay the course.

 

[deleted87716]

Third year med student here. I'm currently doing core rotations and have an especially adamant attending discouraging me from family medicine...anyone else experience this? How did you respond or rebut these claims?

I ignore them, just like I did back in 1994, when I started medical school. It's nothing new.

 

[deleted87716]

Have you heard about direct primary care? It is a unique model that is hoping to revive especially the family medicine. I believe it will help to make family medicine one of the top specialties within the next few years because of the decreasing stress, improvement in patient care, and fair reimbursement.

Concur. I predict that I will retire from a direct primary care practice. If I were just starting out, there's no question that I'd go that route.

 

[styphon]

Ignore them - I do not do Direct Primary Care, instead I am a salaried employee and I do peds/OB/adults. I also work weekends at an Urgent Care not connected to my main job.

With Family Med you can do what YOU want - as long as you are willing to move.

 

[cabinbuilder]

Third year med student here. I'm currently doing core rotations and have an especially adamant attending discouraging me from family medicine, which is my dream job - family med with obstetrics (plan to do ob fellowship). Anyways, he said that it's not a viable career since mid-levels (PA's and NP's) can and will replace me.

I'm going into FM regardless since I don't see myself happy doing anything else, but it's still discouraging and frustrating constantly having attendings be so negative about FM...anyone else experience this? How did you respond or rebut these claims?

Thanks!

Oh how they lie. Ignorance is NOT bliss. It up to you to live your own life and be happy with your choice. Because ultimately you are the one who has to live it.

 

[deleted480308]

I've looked a lot into FM and if I go that route I'll do everything I can to go dpc....we just had a policy speaker come and talk about the aca and medicaid changes. I'm not trying to deal with that but atlasmd's model sounds liberating. Atlas, I keep sending my classmates to check out your model an they are liking it

 

[CardiacLion]

I completely understand your frustration but don't let them get to you. I heard the same things when I was a medical student and everyone asked why would go into Family medicine residency. In fact I even wrote my personal statement about the fact that everyone said family medicine was a dying specialty.

Have you heard about direct primary care? It is a unique model that is hoping to revive especially the family medicine. I believe it will help to make family medicine one of the top specialties within the next few years because of the decreasing stress, improvement in patient care, and fair reimbursement.

Don't hesitate to contact me anytime, [email protected] and my cell phone is 316.734.8096

And our podcast itunes.apple.com/us/podcast/atlas-md/id674138661 And our blog http://atlas.md/blog/tag/how-to/

This is amazing! Great work! I'm sure the more traditional physicians opposed this idea when it first started, but are now gawking at the value you provide to your patients and community overall. Congratulations on changing medicine - it is what every doctor dreams of.

 

[apoptoaster]

Third year med student here. I'm currently doing core rotations and have an especially adamant attending discouraging me from family medicine, which is my dream job - family med with obstetrics (plan to do ob fellowship). Anyways, he said that it's not a viable career since mid-levels (PA's and NP's) can and will replace me.

I'm going into FM regardless since I don't see myself happy doing anything else, but it's still discouraging and frustrating constantly having attendings be so negative about FM...anyone else experience this? How did you respond or rebut these claims?

Thanks!

Honestly, those conversations are just awkward and not really worth getting into with people who say that. Strangely, it was usually the MAs or nurses that would tell me stuff like that, which kind of makes sense because they have a less global view of medicine and probably have a hard time wrapping their head around FPs doing anything other than treating colds and ear aches. That's just ignorance on their part. Surprisingly, the surgeons I worked with tended to have a lot of respect for my decision to go into FM. Attendings that discourage any specialty are often just trying to justify their own decision, or they're just jerks and the last thing you want to do is give their opinions more than a passing thought.

Sure, you want to know what you're getting yourself into, but it sounds like you do, so don't let them get you down. As far as PA's and NP's go, the reality is that well-trained FP's are in huge demand and if you train and practice at the broadest scope you can, you will be indispensable to whatever community you serve.

 

[dorothyntoto]

I just met with several family docs who have been practicing for years, they are not concerned about the midlevel practitioners. There are a few who are, but mostly not. I did have one doc make a comment about FM docs just pushing further into specialties, but he doesn't have a lot of agreement from his peers. PAs are going to need MD/DO supervision, and NPs don't do surgery (or at least none of the NPs I've ever worked with have)... It sounds to me like this doc is just very bitter, and chose the wrong career... I hear that from docs frequently... that they just don't love their job because they thought it would lead to riches and women galore... (that's only a slight exaggeration)

 

[Psyche Estrelle]

I felt the same as you in that I KNEW I would regret it if I chose anything other than FM. I still feel that way. I can literally get a job wherever I want (not true of many specialties) and it is the only specialty that teaches you how to be a true generalist. NP/PA are present in every specialty, but in my experience the grand majority in primary care are a pleasure to work with and very much needed in primary care. I've never felt that I had to fight for a job even though I make twice the salary of an NP/PA doing the "same work" (I put "same work" in quotation marks because you are really being paid more for the value of your extra training and your ability to supervise). As long as you are ok living with a relatively lower salary, trust me, you will be fine. Ignore the fear mongering.

 

[cabinbuilder]

Family Practice right now is THE HOT COMMODITY. Every place that I go to work in urgent care in rural areas there is a HUGE shortage in PCP's. There just aren't enough of us out there to take on the masses. I don't have an office so I don't do primary care but it has served me well doing work-ups out of urgent care because if I don't do it, then nobody will and patients don't have an advocate to get them to the specialists. As an FP these days you can pretty much name your price and get the contract you want. DO NOT sell yourself short.

 

[chicagochildpsych]

As a specialist I would say FM has my utmost respect, and your talents are needed.

 

[simpler2]

I don't think it is often that an individual who is happy with their path in life strongly discourages others from paths they are pursuing. I've also never understood why people try to talk others out of a field of medicine (or any career path) that they themselves did not pursue or are not currently a part of. The anti family practice bug seems to also thrive at medical schools in urban centers where there is less demand for all doctors.
I will say that the FM/OB option does have its limitations. As a 3rd year, you have a while before you have to commit to that and the practice environment will likely be drastically different from what it is now. If trusting your instincts gets you this far, I would keep listening to them, not the unsolicited opinions of wannabe grand mentor attending.

 

[HooliganSnail]

FM rocks.

In medical school everyone rips one it. You must have choose it because you scored so low on the Step exam, blah blah blah.

In practice, all the other docs kiss your ass because you are the supervising physician. This is largely true in residency too. When you rotate through other specialties the attending is (usually) exceptionally welcoming because they know where consults come from.

Hmmmm, what GI doc should I send my patient too? The one who came to give my residents a lecture during didactics, or the obnoxious know-it-all who never sends us a letter back.......

 

[cabinbuilder]

FM rocks.

In medical school everyone rips one it. You must have choose it because you scored so low on the Step exam, blah blah blah.

In practice, all the other docs kiss your ass because you are the supervising physician. This is largely true in residency too. When you rotate through other specialties the attending is (usually) exceptionally welcoming because they know where consults come from.

Hmmmm, what GI doc should I send my patient too? The one who came to give my residents a lecture during didactics, or the obnoxious know-it-all who never sends us a letter back.......

Exactly..... In urgent care I completely control the flow of consults to specialists. You treat me bad, you get no patient referrals and THAT is the name of the game.