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Birdy

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Birdy last won the day on October 23

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About Birdy

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    Kinda Bossy
  • Birthday 03/15/1987

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    Female
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    Hamilton, ON for now

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  1. https://www.carms.ca/data-reports/ Pick a year, go to town analyzing the data. Looks like last year there were 9 CMG spots and 8 people ranked it first.
  2. Birdy

    What do you think about this blog?

    Honestly I don’t know the averages off the top of my head. I don’t imagine they’d represent more than 30% or so of their overall revenue, but that’s just a very rough estimate. We’re talking $5-ish for the majority of visits (intermediate visit) with a few additions like smoking cessation, psych work, or diabetes visits thrown in there. But I’m estimating based only on a very incomplete understanding myself. Back home, as a contrast, family docs have the option of being straight FFS or having a salary plus 31% of shadow billings. To be eligible for a salary, you have to shadow bill at least 85% of your salary’s equivalent, so the minimum earnings for a salaried doc is actually 1.26x the salary (most make more. They don’t pay overhead when they’re salaried, and there is paid vacation and defined benefit retirement, so it’s equivalent to a lot more than it looks at first glance.) NS offers a straight salary option (no one has been able to actually clarify for me whether they have shadow billings on top of that) which they call their “alternative payment plan” since it’s an alternative to FFS. There are a couple setups for academic docs too that are slightly different. Making heads or tails of FM income is... not a straightforward proposition.
  3. Birdy

    What do you think about this blog?

    Capitation models (there are several different kinds) are common in Ontario but not so much elsewhere. Average per patient annual rostering fee is $144 last I recall. But they still bill per visit. There are “in-basket” services - things that are expected to be part of the basic services a family doc should offer - for which they receive usually 15% of the standard fee on top of the rostering fee, and then they have “out of basket” services that they receive the full fee for. Those are usually things that are being incentivized or are specialized FM services. And that’s just touching on the basics of it in Ontario. A straight up salary from the province isn’t an option here for community practice but it is elsewhere. Family docs often have multiple revenue streams; it’s not just their capitation payments or just FFS.
  4. Birdy

    What do you think about this blog?

    I would expect he’s talking after-tax and after overhead take home, assuming no tax-saving measures are used.
  5. And for McMaster you don’t actually have to live in the province at the time of application to be considered in-province. I hadn’t lived in Ontario for eight years when I applied and was still considered IP for Mac.
  6. Birdy

    On Podcasts...

    Bedside Rounds is great!
  7. Ah, what can’t be blamed on “kids these days” and the lazy parents raising them. Nonsense like that has been said about every generation, and it will be said about every generation in the future. My oldest does absolutely have issues with his fine motor skills, but he’s autistic, it kind of goes with the territory. It’s something we work on. My second oldest wants to be a surgeon and has been able to do simple interrupted and running locked sutures since she was six.
  8. Several of the things I found difficult about clerkship have largely been fixed by becoming a resident. I love that as a resident I have things like employee protections, vacation days I can book, a contract I can refer to for resolving disputes, actual maternity leave, a paycheque, and a signature that actually does something. That’s all pretty cool. I’m far more accustomed to being an employee than a postsecondary student, so the fact that I’m now the former instead of the latter is considerably more comfortable. One thing I do absolutely think clerkship could use is some sort of floating time off for personal use, like doctor’s appointments. I found the difficulty scheduling time off in clerkship for self care - as there is no built in time off outside of scheduled vacations, so all missed time must be made up, which makes it effectively impossible to actually take time off - to be very frustrating and I was not able to adequately attend to my own health, which became an issue.
  9. Some of the smaller hospitals have newer family doctors who do ED coverage without the +1 who do not handle CTAS 1/resus patients and always work with a seasoned EDP who handles those. Some do mentorship programs to help prepare family docs to challenge the CCFP EM exam after four years of practice.
  10. Birdy

    Stress level

    Currently, absolutely 0 but I’m on mat leave. There have been a few periods here and there when things have been rough, but the overall trend has been that I haven’t found my training terribly stressful. It’s been quite enjoyable for the most part. Good time management goes a long way, and keeping going with your life outside of medicine as much as possible. I’m someone who thrives with a lot to do, though. Everyone else seems to think I’m busier than I feel like I am. I’m a family med resident, though as I said I’m currently on leave so only had a few months before I was off.
  11. If a med student can pick up a murmur, it’s either not there or very obvious. Quite honestly, lots of staff docs aren’t great at picking them up either. I’m by no means an expert at auscultation but I’ve caught several that staff missed just because I take time with listening. Youre there to learn. If you were already good at clinical things, you wouldn’t need clerkship.
  12. 1. Read around my cases and made sure I met the learning goals of the particular rotation. Didn’t really study much more than that. 2. Watch out for yourself and your fellow clerks. Ensure you’re sleeping, eating, and resting when you can. Find a task organization system that works for you and stick to it so that you’re staying on top of the things you should be doing. Get to know allied health professionals and don’t be afraid to ask them questions. 3. Be polite. Be honest - ESPECIALLY if you screw up/forgot to do something. Show up on time. Help out where you can. Respect your allied health care staff. Basically, be professional and don’t be a jerk.
  13. I was very interested in OB and family med and (later on) emerg as well. I still love OB and in some ways there are aspects of it I am sad about not being able to do - like infertility medicine and gynae surgery - but I eventually chose family medicine (I did not apply to any other specialties) because of the flexibility, and because I can integrate a lot of the stuff I love about OB into my practice. Plus I can do emerg too, which I really enjoy OB residency is pretty brutal and, honestly, I just don’t think I’m up for five years of working like that. Lots of people told me ‘oh it’s only five years, then you have the rest of your career!’ But I’m tired. I don’t want to be almost forty before I’m earning staff income, and I’d be paying off my student debt until my oldest kid is in university. That wasn’t what I wanted for myself or my family. Family med - which I legitimately like because I can do a bit of whatever strikes my fancy - gives me the flexibility I need, a shorter, less brutal, and somewhat customizable residency (especially my program, which is amazing and I love it,) and it means I’ll be able to pick up and go work where I want. If you’re interested in such a variety, I strongly encourage you to consider family med.
  14. Not many OBs deliver all of their own patients. They typically work in groups and there is a call schedule and whomever is on call delivers. That’s not to say that OBs who deliver all of their own patients don’t exist, but they’re not as common these days.
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