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ALL the ups and downs of family medicine


MDinCanada
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I don't feel like I'm informed enough about family medicine, I would like to know everything that you wish you knew before starting residency and/or your practice.

How difficult is it to get a job in a city, what is overhead like, are there any lucrative opportunities, how much paperwork is there (and compared to specialties), is it possible to modulate how much clinic/walk-in/hospit you do? how much control do you have over your schedule

and one aspect that worries me the most about family medicine is that in one day, you can see a mental health patient, then a patient with a cold, then a patient with a toe fungus. Let's say you do a +1 in mental health for example, are you able to modulate your practice enough so that the majority of your patients are mental health patients?

If your patients make an appointment for a new reason for consult, is it considered a consult or a follow-up visit?

 

 

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You shouldn’t need a +1 in mental health as a family doctor ...because a large chunk of your patients will have mental health Issues, and many that won’t need a psychiatrist just need longitudinal care. 

This is a big pool of your chronic illness patients. 
 

you’d have no problems limiting to this patient group, but remember that you’d be expected to manage their basic primary care too! Through your longitudinal training in family med you should develop adequate skill to start practise with these patients. 
 

cant comment on the rest since I’m not a family doc.

 

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52 minutes ago, LostLamb said:

You shouldn’t need a +1 in mental health as a family doctor ...because a large chunk of your patients will have mental health Issues, and many that won’t need a psychiatrist just need longitudinal care. 

This is a big pool of your chronic illness patients. 
 

you’d have no problems limiting to this patient group, but remember that you’d be expected to manage their basic primary care too! Through your longitudinal training in family med you should develop adequate skill to start practise with these patients. 
 

cant comment on the rest since I’m not a family doc.

 

I didn't even think there was a +1 in "mental health" - theres already so much mental health being done in regular family practice!  

I think there is a +1 in psychotherapy, but not sure if most provinces let you bill differently for that anyways. YMMW

 

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11 hours ago, JohnGrisham said:

I didn't even think there was a +1 in "mental health" - theres already so much mental health being done in regular family practice!  

I think there is a +1 in psychotherapy, but not sure if most provinces let you bill differently for that anyways. YMMW

 

You would obviously have to take more than 15min per visit right? Is this practice compensated accordingly?

I can't imagine getting payed for a normal 15min visit while spending triple the time with a mental health patient... You wouldn't even make enough to afford running a clinic.

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40 minutes ago, MDinCanada said:

You would obviously have to take more than 15min per visit right? Is this practice compensated accordingly?

I can't imagine getting payed for a normal 15min visit while spending triple the time with a mental health patient... You wouldn't even make enough to afford running a clinic.

Most provinces should have a seperate fee code for mental health related counselling. Some provinces are better than others and have time-based modifiers. 

Why not look at your provinces fee guide and see? 

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Again I am not a GP, but I understand there is a separate psychotherapy code and it pays relatively better than a routine visit (at least in AB).

there is no need for a plus one to be able to bill this. Psychiatrists also have this code, ours pays more than the generalist code.
 

If you really want to do psychotherapy and see mental health patients...what I’ve seen happen is family doctors go back to residency to retrain as a psychiatrist. 
 

food for thought. 

 

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