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medisforme last won the day on August 31

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About medisforme

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  1. In my limited experience, when family doctors discuss "what they make," it's always after overhead is taken into consideration, not gross billings. Most clinics deduct the overhead every paycheque. The overhead is a major determining factor on overall income. I have seen it range from 15-35% in BC, that is a massive range. The larger overheads tend to be closer to Vancouver.
  2. I am a family doc in BC, one year out of residency, working about 1 hour from Vancouver. I do office FM, residential care, OAT and youth clinic sessionals (no hospital, no evenings and about 3-4 weekend hours every 5 weeks at nursing home "on call") and will make well over 300k this year post overhead but before taxes and I am still learning the ropes about maximizing my billings etc.. I work in my primary office on average 3.5 days week and will see about 30 patients per full day. You can make a lot more money in BC if you are willing to work outside of Vancouver.
  3. Probably as important as everything that has been posted is what type of contract you sign with your clinic re: overhead and what types of duties are included in the overhead. The contract I signed at my own clinic, only in office visits and anything done during an office day from the office (ie. phone calls) is required to be paid into the overhead. I do out of office visits to semi-assisted living care homes and residential care and get to keep 100% of the income (I do organize the scheduling of these places by myself and do all my own billing on a separate billing platform, though get to use the EMR free of charge). My partner gets to keep 100% of hospital work. Some clinics you get to keep 100% of private payments after a certain amount etc... So things that are average income can be very good income if you don't have to pay overhead.. If you look around at how desperate some clinics are to attract docs, these types of things can be negotiated into the contract. On a final note, here in BC, your income goes up significantly once you attach yourself to a clinic and have your own practice (vs. walk in , locuming et...) because at that point you have access to all the chronic care and complex care fees.
  4. Agree with above, I would suggest letters from family medicine related specialities. For reference, I got FM letters from peds, psychiatry and internal medicine. You just have to be up front with preceptors about your intentions.
  5. I would have to respectfully disagree with that. At least from personal experience in family medicine. A lot of patients are already experts, already knowing what they need before the appointment even starts.
  6. If all it took for the liberal party to win an election is get all liberal supporters to vote for them, they would constantly be in power. In reality, major political parties are trying to appease swing voters as they are the ones that determine election outcomes. In the case of the liberal party it is swing voters from both the left and the right. I can't see how a swing voter/undecided voter would vote liberal after the events of the last 3 days.
  7. You still didn't answer the question. PGY1_FM asked if you thought most conservative were racist.
  8. The benefit of not getting hospital privileges in FM is you get all your evenings, weekends and holidays off.
  9. I do residential care in the Fraser Valley on top of regular family practice and addictions work It is much more lucrative than many people think provided you have enough residential care patients. Benefits 1) Very straightforward medicine, low pressure, team oriented work environment. Most of the medicine is actually deprescribing and simplyfing care. 2) Still can bill chronic care fees on all residents with HTN, DM, COPD, CHF 3) Care conference fees pay decently well, when you book a bunch back/back 4) You can bill every single phone call/fax you respond to giving medical advice 5) I do "call" (if you can call it that) 0800-1700, one day a week and every 5th weekend for the community. Get paid $125 for weekday and $250 for each weekend/holiday, then you can still bill anything you do on top of that. It is extremely straightforward, can still work a regular clinic day and then head to care home after the day and still be home by 5:50-6. I use my call day to follow up on any of my resident issues that need follow up. 6) Able to bill palliative care fees if appropriate As a caveat, the money is a little better for me as I negotiated in my clinic contract the ability to use my clinics EMR while at the same time, not having any expectation of paying my nursing home billings into the overhead (this means you do all your own billings on separate billing platform) with the exception of office calls and fax responses during clinic hours (which is a very small percentage). Cons 1) Dealing with family's who aren't ready to accept their loved one is in decline and who have unrealistic expectations of treatment (vs focus on QoL)- admittedly a large part of the job 2) There is a lot of allied health care staff turnover, many of whom do not have a good understanding of medication prescribing principles and approach to dementia and agitated behaviour for the elderly/residential care (you get numerous requests for anti-psychotics, zopiclone, ativan etc...). Hope that helps
  10. Memorize all the billing codes including all the extras (chronic care, complex care, personal health risk assessment, mental health planning, counselling etc.. for BC) and do all of your own billing. You can increase income 25-30% by just doing your own billing (though this does mean you are attaching patients to yourself for longitudinal care, most of those codes don't apply to walk in style medicine).
  11. That's just for FM year 1 seats. I am guessing the rest are for FM R2's who haven't written, FM R2 re-writes, and specialty residencies writing and re-writing.
  12. UBC chilliwack also has an excellent track record of matching residents to ER. If you perform well and impress during residency, you can work in CGH ER post-residency without +1
  13. I did FM Residency. There were slots for about a quarter of the FM residents (done by lottery) to do LMCC 2 as R1, the rest did as R2. I think it would be ideal if everyone would do it as R1. In FM, not much study is actually needed. I can see how some specialty residencies would want to set aside time to study, which I have heard would be difficult as R1 given how intense a lot of first year residencies are.
  14. There are a variety of sessional positions you can sign up for with your health authority, most allow mixed billing. I do OAT clinic and mental health work this way. If it is a slow day, you make $133 and change/hr for surfing the internet (or catch up on paperwork etc...), if it is busy, you bill and make more than that (all without overhead!). Granted, these are easier to come by in places outside of major cities. Also, one of my colleagues does group obesity and diet counselling, and makes a lot of money doing it. He has now hired a nurse to carry out the curriculum he developed. Finally, looking at the fee codes here in BC, it doesn't seem like lumps/bumps/joint injections pay particularly well. Unless you are ultra efficient, it is probably hard to increase your income (vs seeing regular office patients) doing these type of procedures.
  15. I think it's around $650, and I guess this would be mandatory given you have to report your credits. for an extra $350/year I guess it makes sense to just pay it. I still think it's a massive cash grab. It's a little sad to think that in some jurisdictions obtaining hospital privileges is dependant on paying for the CCFP designation.
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