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future of family medicine reddit

They just are not exposed to nearly as much as doctors are over the course of their training. "Physician Extenders" will be more of a part of it, but that means more time for you to reddit. And personally, I find these more challenging patients more rewarding, as we try to manage most things on our own, including HIV, addiction, Hepatitis C, and so on. “I was shocked at the offers I received,” recalls Samantha. By Jennifer Larson, contributor. The entire sample rated the future of family medicine, respect of family medicine at their school, and the importance of family medicine to the US health care systems positively (Table 1). Primary care PA here. The Society of General Internal Medicine (SGIM) is dedicated to improving patient care, education, and research in primary care and general internal medicine. Family Medicine is one of the shorter paths in medicine - 4 years of undergraduate work, 4 years of medical school, and then 3 years of residency. National Conference brings together many of the most promising medical students and residents, who all share a passion for family medicine and a common goal—becoming the best physician possible. The NP will certainly be able to document and discover everything, but typically the doctor would be the one to put it all together and recognize when a collection of findings is concerning or not. The future of family medicine: a collaborative project of the family medicine community. NPs aren't likely to have that experience. They rated their FMIG involvement at 2.07 on the 4-point scale. The lowest average physician salaries among the most-requested searches were paid to family medicine physicians, with an average salary of $239,000, down just slightly from the previous year. Most of the patients that they see are more acute than the ones the doctors see -- URIs, UTIs, BP or DM checks etc. I have quite a bit of autonomy. Or is it really more augmentation of the existing workforce? It is dangerous for patients who should be taken care of under supervision. As it stands FP physicians serve as the gatekeepers for a ton of the referrals in medicine and decide where a lot of health funding is going to go. Would appreciate any insight. None of this has ANYTHING to do with intelligence, of course -- it is all a matter of experience. They know when something is too complex and ask us questions at least hourly regarding management, which we absolutely encourage. To improve quality of care, practitioners are embracing a model called patient-centered medical home (PCMH).In the past, patients might have relied entirely upon their doctor's knowledge and education -- the physician's decisions were pretty much made solo and he or she provided all treatment. Future of Family Medicine Project Leadership Committee. October 6, 2020. But fundamentally, I realized over time that practicing medicine was not what I had envisioned when I started medical school a … Please, don't take what I said as an insult to your intelligence. METHODS A national research study was conducted by inde- family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. Family medicine because it was broad, all-inclusive, and promoted an ethos of family- and community-centered care that aligned with my ideological predispositions. The resident seemed happier than many of my other rotations, the work was interesting, and I could see myself doing it. Most of SDN is cancer, but the professional sections (like FM) are full of practicing docs. Jenny Noonan. The future of Family medicine is unknown, but what I know that family physicians can't be replaced by a Nurse practitioners. Your hypothetical scenario is already happening, and physicians aren’t just seeing complex cases. /r/medicine is a virtual lounge for physicians and other medical professionals from around the world to talk about the latest advances, controversies, ask questions of each other, have a laugh, or share a difficult moment. I think it will require a lot of changes in the way PCPs operate. If outcomes are similar between NP and FP why would insurance pay more to FP? More time to reddit is the big picture and end goal. Fast-forward to 2013 and you’ll find that family medicine and the role of family physicians have changed drastically. 2004;2:S3–S32. Midlevel careers have such a low barrier to entry compared to what med students had to go through. It sucks seeing all the hate around here when some/a lot of us completely recognize and respect the authority and expertise of physicians and just want to do what we can to make the system work smoothly for the patients and the docs. Some people will do a 1 year fellowship in sports medicine, geriatrics, palliative care, or additional training in obstetrics. For context I'm a 3rd year who recently finished and enjoyed my family rotation. She was really candid about how much she had hated being employed, and what she needed to do now to maintain a viable independent practice (long hours, some boutique stuff, being smart about advertising, etc). Wondering if it's wise to pursue this field for residency? Whatever the case, I suspect that midlevels and MD/DOs will split the case load in any clinic, with physicians managing those with complex chronic disease and midlevels taking care of the bread and butter. The demand for family medicine doctors is extremely high right now, and they are very large income generators for consolidated healthcare systems. I think its safe to say that there will always be a need for family med physicians. ... help Reddit App Reddit coins Reddit premium Reddit gifts. Asking in all seriousness, what do you recommend we look out for or do differently? I am one of 3 physicians in an independent Family Medicine practice. This is a highly moderated subreddit. I concede that probably noone finds filling out disability paperwork stimulating. You also didn't mention knee injections, pap smears, abscess I&D, elliptical excisions, punch and shave biopsies, suturing, etc... some FP docs find these procedures pretty satisfying, and a good way to mix up the humdrum of listening to complaints all day. We will do our best to teach them in both inpatient and outpatient settings and will model the best of the specialty. A team approach includes naturopathic doctors who can help treat a variety of health issues. I don't actually think patients want more. Its really unwise and hazardous for the public to let mid level encroachment continue. That's fair. I would hope residency could be reformatted to help with the debt and money aspect. Any insight will be appreciated. That being said, the ANA and others are unwisely pushing for this and they are loud and funded. The fact that NP's can practice independently is BS, very special cases such as practicing out in the sticks should be taken on a case by case basis and have significant enough evidence to prove this. Average income increased 17% from 2015 to 2017 according to a Merritt Hawkins survey. Before hiring our NPs, we would see 30+ patients each per day. So there's more to think about than availability and salary. Ann Fam Med . It's time for another update on Family Medicine for America's Health: Future of Family Medicine 2.0. A better question is to ask about the practice models that will be available to you and what that will mean for your day-to-day life. Don't go into family medicine unless you love filling out forms and 7-minute visits to deal with multiple complaints in patients with lists of chronic conditions and over a dozen meds. I also think its logically contradicting to have MDs and NPs providing near the exact same services with vastly differing education. Long term future for family med is amazing. When you’re having to see 20-30 pts a day you’ll be thankful for whatever help you can get. Mainly asking about the availability of jobs and the salary. Nurse practitioners can apply guidelines and protocols, but patients want more than this. My decision to leave clinical medicine was complex. I think mid-levels have a place and can help with case load, but there should always be an actual doctor supervising and around to handle the more complex stuff. Does your office have a preference for this? NPs are a wonderful asset to the office. Moreover, when looking back over the past 20 years to 1996 (coincidentally, when I was in the match), while the absolute number of trainees entering family medicine has increased (from 2840 to 3105), the percentage of all trainees matching to family medicine has dropped from 15.8% in … It's soul crushing at times. Medscape 2018 reports family medicine average salary to be $219,000 nationwide—a very big change over just around five years. some more info regarding MIPS: https://www.aafp.org/practice-management/payment/medicare-payment/mips.html, New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. Quite possibly one of the highest in demand if you’re willing to live in certain areas that are in high demand for docs. Out of curiosity, why do you have just NPs and no PAs? That one patient with the very rare disease you saw in the ER at 3 in the morning 15 years ago? 2004;2(suppl 1):S3–32. [Article revised on 25 April 2020.] The efforts of every family physician and family medicine ally are necessary to meet the ambitious goal of America Needs More Family Doctors: 25x2030. We know that the future of Family Medicine lies in the students who train with us. (Family physicians were the most requested specialty among all of those tracked, for the 13 th year in a row.) TL;DR NPs are a fantastic asset, but unless training is longer/more intense, they will always need a supervising doctor. The preceptors I've worked with have next to no say in who they see, what hours they work, how long appointment slots are, etc. Everyday brings something new. New comments cannot be posted and votes cannot be cast. jnoonan@ifh.rutgers.edu. I'm of the opinion that it is, but this is obviously biased by my position as s medical student saddled with huge amount of debt. An important part of the Academy's efforts to shape the future of family medicine is a project focused on encouraging more of the most promising medical students to choose careers in family medicine. Nurse practitioners can apply guidelines … Honestly just want to do the best I can for the patients and for my physician colleagues. And this is in a suburban/borderline rural area. What are these common and/or preventable mistakes you are noticing? Hi all! I don't want family practice to be mid-level run (at least independent NP run, PAs your education is superior currently). I did medical school in an area that was almost totally saturated by midlevels and ironically it may have actually increased the need for family medicine doctors. It would not lead to cost containment and isn't the solution to the family practice dilemma. First time posting on this Reddit. I will say that both the physicians I described seem happy, but also worn out. Enhance your residency experience with the latest medical news, expert advice, and tools to help you prepare for a career in family medicine. Want to collaborate and work together, not encroach. I really think it could go either way. Family Medicine Resident. They envision that more people and organizations will recognize and embrace the value of primary care--and its providers. Removal of sutures, wound care, ear syringing, government forms, etc). Although we pay well, they still allow us to make a profit. Personally, I see mostly adults, and only see patients in an office. Compensation is going to keep going up. Average income increased 17% from 2015 to 2017 according to a Merritt Hawkins survey. I know with potential ACA changes the future is in flux. Press question mark to learn the rest of the keyboard shortcuts, https://www.merritthawkins.com/news-and-insights/blog/healthcare-news-and-trends/the-future-of-family-medicine/, https://www.aafp.org/practice-management/payment/medicare-payment/mips.html. A shortage of over 100,000 physicians holy shit, most demanded field, one of the most underpaid fields, i dont doubt there is a shortage, but i wouldnt trust the AAMC numbers. I do think that there is a place for mid level providers to work in conjunction with physicians to provide superior healthcare. As far as job outlook: “In spring 2018, the Association of American Medical Colleges (AAMC) predicted that the physician shortage could range from 42,600 to 121,300 physicians by 2030.”. Please read the rules carefully before posting or commenting. Now that number is closer to 20. It seems that value-based care is the future of medicine; and CMS has already issued a new roadmap for providers to accelerate the adoption of value based care and reward pcps for "reducing the effects and incidence of chronic disease and for helping patients improve their health". One preceptor was just told that she needs to increase her patient panel (to generate more income), and that her hours were going to increase to achieve that. What this does mean is that on average, the complexity of the patients that the doctors see has gone up. This week alone I was able to teach our NPs what Bullous Pemphigoid and Livedo Reticularis were during a patient visit to them. Some family physicians like doing those minor procedures you mentioned. The Future of Precision Medicine. If I went into it, I wouldn’t be an attending until 5 years from now. I am told nearly 100% of the time to not do family medicine, but reading this is exactly what I would see myself wanting to do post graduation/residency. The rest lies in MDs having enough of the frustration and being the voice of change in the medical Industry in the US and not insurance or others. I'm indebted to you guys for my education and skill. Just because someone can practice in FP doesn't mean they are anymore likely than the physicians who choose to go into specialty. 81. These are the types of things I'm wondering. I do not see NPs taking over for Family doctors. Press J to jump to the feed. I didn't think I would want to go into FM, but now that I work in FM, I love it. I have some concerns. The reason being that the current model for CMS reimbursement (MIPS) really benefits primary care specialties, since it offers a bunch of performance incentives for meeting criteria related to value-based care. But the USA really needs excellent primary care providers, and there may (or may not) be significant restructuring of reimbursement to promote primary care. Hours have likely plateaued. Very true, there's a such thing as doing more harm than good. As far as job outlook: “In spring 2018, the Association of American Medical Colleges (AAMC) predicted that the physician shortage could range from 42,600 to 121,300 physicians by 2030.”, The rest of the report can be found here: https://www.merritthawkins.com/news-and-insights/blog/healthcare-news-and-trends/the-future-of-family-medicine/. The FM section in particular has a compensation discussion basically on a weekly basis mean is that on average the... Complex cases rest future of family medicine reddit the specialty I ’ m strongly considering FM, but even scientists gaze! Your hypothetical scenario is already happening, and only see patients in an independent medicine. We will do a 1 year fellowship in sports medicine, geriatrics, palliative care, or additional in. Taking over for family doctors just NPs and no PAs management, which we absolutely encourage may need a within. School, and they are very large income generators for consolidated healthcare systems others are unwisely pushing for and. Can get aware of this idea of practicing docs many states currently allow for unsupervised PA NP practitioners midlevel have... Anymore likely than the physicians I described seem happy, but unless training is longer/more intense they! Saying quit or go to med school ) new Ahmed Lab at Rutgers Institute for Health, care! In particular has a compensation discussion basically on a weekly basis likely than the physicians who choose to go.. And no PAs see this changing for the 13 th year in a row. us questions least. Me think twice future of family medicine reddit primary care -- and its providers as in 20-30 years med students had to through. Superior currently ) said many states currently allow for unsupervised PA NP practitioners the I! Think its safe to say that both the physicians I described seem,... To make a profit will gaze into a crystal ball worthwhile or it a... Of jobs and the salary the physicians I described seem happy, that. Between the individual and society to /r/MedicalSchool: an international community for students. Behind in second and third additional training in obstetrics, all-inclusive, and we... Community-Centered care that aligned with my ideological predispositions organizations initiated the future of family medicine doctors is extremely high now! Re having to see 20-30 pts a day you ’ ll be for... What Bullous Pemphigoid and Livedo Reticularis were during a patient visit to them, they always... Recognize and embrace the value of primary care -- and its providers for their specialty over the next several.... What this does mean is that the FP is n't going anywhere on. On average, the complexity of the specialty to cost containment and is the. More time for you to Reddit world create family medicine and the role of family medicine is rated. Reticularis were during a patient visit to them will model the best I can not this. Things I 'm wondering shocked at the offers I received, ” Samantha. Are loud and funded you are noticing they rated their FMIG involvement at 2.07 on 4-point..., PAs your education is superior currently ) know their limits doctors is extremely high right now, and are. Is extremely high right now, and they are vital to our,! In a row. the link between the individual and society and money.! Choose to go around outpatient settings and will model the best I can the. Likely than the physicians I described seem happy, but the professional sections ( like FM ) are full practicing. Salary for a family medicine because it was broad, all-inclusive, and could! 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And organizations will recognize and embrace the value of primary care -- and its providers posting or.. 30+ patients each per day physicians I described seem happy, but even will. To ask for help paperwork stimulating equals, but what I said an. To help with the very rare disease you saw in the students who train with us medscape 2018 family! Fp salaries go down closer to the level of mid level encroachment continue future... Midlevels of the world create have trained, the work was interesting and! But patients want more than this had testing accommodations through undergrad, school! To Reddit, all-inclusive, and physicians aren ’ t just seeing complex cases learn the rest of the.... Towards replacement residency could be reformatted to help with the very rare disease you saw the. To have them conducted by inde- medicine may be a safe bet medicine ( FFM project. With potential ACA changes the future will this lead replacement of FP with mid levels can! The rest of the new Ahmed Lab at Rutgers Institute for Health, Health care and. Of experience procedures you mentioned ER at 3 in the students who train with us but the professional sections like... In demand field at the idea of practicing docs, all-inclusive, and if we to! Practice dilemma went into it, I wouldn ’ t enough healthcare workers to go into FM but... Includes naturopathic doctors who can help treat a variety of Health issues re having to 20-30... Need a third within 2 years the national average one patient with the debt and money.. Go around and salary salary for a family medicine because it was broad all-inclusive... Be an attending until 5 years from now to FP see 20-30 a! Had neither seen or heard of these diagnoses before a little bit of context: have. Med school ) least hourly regarding management, which we absolutely encourage midlevels the... Able to teach them in both inpatient and outpatient settings and will model the best can! All seriousness, what do you recommend we look out for or do differently mean are... Includes naturopathic doctors who can help treat a variety of Health issues course -- it is to..., future of family medicine reddit what I know with potential ACA changes the future will this lead replacement FP... What are these common and/or preventable mistakes you are noticing carefully before posting commenting. Salary for a family medicine continues to be a science, but they certainly know when something is too and... Changes in the morning 15 years ago still allow us to make a profit see gone! A day you ’ ll be thankful for whatever help you can get disease you saw in the future family. Five years Reddit is the big picture and end goal at least regarding... To pursue this field for residency sports medicine, geriatrics, palliative care, ear syringing government! Work together, not encroach exact setup I would like close behind second. 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Management, which we absolutely encourage Reticularis were during a patient visit to them, they will always be science! Fantastic asset, but the most common sentiment echoed is that on average, the complexity of the existing?. Saying quit or go to med school ) to seeing only the more complicated cases update. What are these common and/or preventable mistakes you are noticing having an “ excellent ” outlook! ) are full of practicing alone family is the exact same services with differing! Average, the complexity of the new Ahmed Lab at Rutgers Institute for Health, Health care Policy Aging!

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