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Fortress

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  1. Are you aware how do some family physicians become competent in interventional pain management (e.g ultrasound-guided nerve blocks, bursa injections etc.)? Also have you ever heard of a family physician running an infertility clinic as a focused scope of practice?
  2. Can you please clarify what you mean by medical ophthalmology? My understanding is that it means clinic only and no OR time. Yet you are saying you can operate without OR privileges?
  3. Okay. But what about those 4-storey eye care centers where there is a certain floor reserved for cataract surgeries and the rest of the building is clinics. Of course such a center is run by a group of ophthalmologists who share OR time, but I mean this model is not tied to the hospital in any way, right? And if a recent graduate cannot find a job in a hospital or in one of those eye care centers, then perhaps a group of recent grads can come together and open up such a center. Please point me to where I am wrong.
  4. The question is: what are those people doing to make that kind of money? Definitely not sore throats and common colds.
  5. Hey everyone. I have a question about the ophthalmology job market. How difficult it is for a recent graduate to find a job? I am under the assumption that since ophtho surgeries are primarily outpatient based, it shouldn't be hard to find a job just like any other outpatient specialty. Does the concept of "surgeons fighting for OR time" hold true in ophthalmology? Isn't it true that in ophtho you could do your surgeries outside of the hospital system?
  6. Thanks for all the info. What are some of the more high-paying jobs in internal medicine in general? I have heard that interventional cardiologists are some of the highest paid physicians within internal medicine, but of course there is additional years of training and tight job market. Do you know of anything else?
  7. Gotcha. Makes more sense now. I would like to know more about how to maximize income in GIM. I guess one thing is to take less time off work for vacation. Another thing I presume is to pick up ER shifts outside regular hours (evenings, nights, weekends). Can you please confirm that ER shifts in those hours pay better than morning weekday ER shifts and if so, what is the mechanism (like are there special premiums for that?). Another thing is to perhaps maximize non-MRP work because as you said MRP work doesn't pay as much. Question here: is it possible to just do the bare minimum of MRP weeks required and fill up your practice with the other stuff e.g clinics? Does the hospital "allow" it? Apart from all of the above, is there anything else that one can do to maximize income in GIM? What are the people billing more than 500K doing, other than simply working harder? I have heard that opening a cardio-diagnostics clinic can be lucrative. Is that true? What other lucrative opportunities are out there?
  8. This is the pivotal point for me right here. If a family doc can do the same work as GIM and receive the same pay, then why would anyone go through an IM residency and spend 2 extra years in training? I know you said FM only do MRP and can't do other stuff, but I am comparing here the pay of FM MRP vs. GIM MRP. Are you sure the FM codes amount to the same as the GIM codes? When I look up the ontario fee schedule, it seems that FM consultation is $77.20 while a GIM consultation is $157. For me I know I like IM more than FM, but if I am going to go through a more demanding residency and spends more years in training, it has to make financial sense.
  9. Hey! Sometimes people say that family doctors can bill using specialist codes e.g for family doctors working in EM or hospital medicine. Is this true?
  10. Thanks again for your reply. It is good to know that there is adequate work-life balance as a GIM. One thing that I would like your insight on is FM hospitalist vs. GIM. From your post, it seems like FM do MRP and also do a bit of consults. Do they do ER consults and clinics as well? Would you happen to know if family docs who work as hospitalists are able to bill using specialist codes? What does their schedule look like (they seem to get the 6 pm-11 pm pages, which are less life-style friendly but more lucrative)? I am basically looking for anything that would justify doing 2 extra years of training as a GIM instead of going through the FM shortcut. Another topic that I would like your insight on is people doing a fellowship (e.g nephro) and still doing GIM work. Why do people do that?
  11. First, thank you so much for your detailed reply. I would like to clarify what I meant by call schedule. You said you are only responsible for patients until 6 pm when doing MRP work. My question is who is responsible for the patient after 6 pm? What happens if a patient deteriorates overnight and needs to be assessed? I was under the assumption that as a GIM staff you have to be physically present in the hospital until 5-6 pm and then go home and on some nights you are on call i.e if the patient deteriorates the hospital would call you and you would have to come to the hospital to assess the patient. And so I assumed there would be like a call schedule where all GIM staff share the burden of being on-call overnight for admitted patients. Same question with regards to med consults. What happens if a patient on the surgical ward develops an IM problem (e.g chest pain, dyspnea) at 11 pm. Who is responsible for that patient? Are there evening, night and weekend MRP and Med consults shifts to take care of patients who need help outside of regular hours? Please correct any misconceptions that I may have. Another question is: why is an academic job so competitive, even though it isn't as financially rewarding as community medicine? Are there any perks associated with being academic other than the fact that you have residents and fellows doing the work for you? Is it because of presumed "prestige"? Is it simply the ratio between number of people interested in research/teaching and available spots?
  12. Thanks a lot for doing this. I am a medical student with an interest in GIM. 1. Could you please elaborate on what the typical schedule looks like for GIM in a community hospital vs. academic hospital? What time do you have to be at the hospital and what time you usually leave? Also what the call schedule is like, and is it an in-house call vs. home call? It would be great if you can as detailed as possible as I want to picture how life looks like as a GIM staff. 2. Income of GIM in community hospital vs. academic hospital vs. outpatient clinic? Just if you could mention what the typical average income is for those 3 as well as respective overhead. 3. How hard is it to get a job at an academic site? Like is the 5-year GIM enough or do you have to be research-oriented and committed to publishing?
  13. Can you please elaborate on the fact that billing depends on the amount of time spent with patient? Is that only for mental health or for any type of visit? Can you give us some actual numbers, cuz if thats the case then why do family doctors rush patients.
  14. Thank you for doing this. Sometimes people say that family doctors can bill using specialist codes e.g for family doctors working in EM or hospital medicine. Is this true? It doesn't make sense to me that the government would be pay both the same.
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