gogogo Posted January 31, 2022 Report Share Posted January 31, 2022 I've heard from many residents/staff that the first 5 years of practice in FM are a huge learning curve. Many also note gaps in their training, at least partly due to the short residency. My plan is to be a vanilla suburban GP with regular clinic (hopefully a roster, but we'll see). What could I do now (clerk) and during residency (starting in July) to prepare well for being staff? Some things I've already heard: Seek extra learning in MSK (apparently a weak point for many programs) Seek extra learning in dermatology and in-office procedures (lumps and bumps) Learn how to bill very well What else could be added to the list? On the other hand, there may also be topics that FM residents/residencies focus on, but which end up being of little use for most FM staff. For instance, I have no intention of doing any OB after residency. Any other tips would be very appreciated! Quote Link to comment Share on other sites More sharing options...
medigeek Posted February 3, 2022 Report Share Posted February 3, 2022 MSK and Derm are always high yield. The good thing is the algorithm is generally reasonable with a bulk of those complaints. Physical therapy/xrays/joint injections takes care of most MSK problems. With derm, you may do more biopsies for a while until you're more comfortable, but you often end up with some topical steroid. This is just my personal opinion, but I always thought younger family medicine staff could improve by referring less and working through the differential themselves more until they arrive at a diagnosis. This is usually better for the patient in the big picture too since you can probably get a diagnosis sooner vs waiting months for a consultation to happen. gogogo 1 Quote Link to comment Share on other sites More sharing options...
drake19 Posted February 20, 2022 Report Share Posted February 20, 2022 After few years as an attending in ont residency prepares your knowledge the issue is the managerial role as a fp...wouldn’t worry about knowledge...make sure you have uptodate and continue with your cme 1. learn to type fast and finish note and bill before you move on to next pt. learn to type while talking to patient....when I type the plan and note I also read it out loud with patient that way it reminds them and I finish my note you will have a mountain of notes and billing if you don’t master this and contributes to poor morale and burnout for Ex I can see 40-50 on a busy sat morning and full day upwards 100 pt ( since virtual codes started) 2. learn about billing 3. location/ resources for your pt - where does my child go for hearing screen if missed? Specialists in my area that see pt in timely manner, etc 4. I prob go through 100-200 msg in my inbox daily labs, etc I do few messages between patient otheewise you have 100s in your inbox at end of work day 5. Find a good practice good location (both my clinics within 2 min commute) - don’t waste time commuting good volume of patients good overhead - anything above 25% is too much ( you also pay hst).....most offices start 25-30% but you can negotiate like I did ....should be closet to 15-20 percent overhead... good ehr- Telus is the best system I’ve used....I’ve used about a dozen ,,,,some I,e. Oscar require 2-3 times time just to send referral or write Rx.. good management - organized, manage labs, secretaries, follow up on rejections for you, good work environment 6. learn to not work harder then the patient 7. Some services are not covered by ohip this is a significant amount, and when I first started didn’t know this - idoing things fo free .....can add up to 1000s a month....nsurance forms, doctor notes, certain Rx, driving exams, skin tags, ear flushing for example some insurance forms can take a while to prepare which is which charge is up to 150 plus. if you are paid for your time will be less annoyed at all the paperwork, 8. good mentor to ask questions 9. Facebook group for first five yr of practice. 10 .uotodate is useful for quickly finding things and have some resources...Toronto notes, monthly fam med journals 11. time management, setting boundaries for patients as a resident was seeing a small panel and every 15 min as a pn attending responsible for 1000s and your colleagues when they’re not here 12. avoid burnout gogogo, bellejolie and Dr. Octavius 2 1 Quote Link to comment Share on other sites More sharing options...
drake19 Posted February 21, 2022 Report Share Posted February 21, 2022 13. forgot to mention - be familiar with the models fho/fhg/ffs are main ones and bunch others and ask your preceptors pros/cons - will need to figure out which model works best for you locum - some ppl locum as try out for fho - the pay is is very low usually $500 per half day and usually an overhead for third party billing / shadowing billing and IMO you can't really settle down/disruptive if you have a family this youtube channel is helpful to explain billing models https://www.youtube.com/watch?v=X5uOkB0BuW0&t=1213s&ab_channel=BreakingBadDebt-Dr.Steph 14 .personal finance there is a facebook group for physician financial independence learn about incorporation, etc., good accountant can be shocking if you are making income in higher tax bracket and not incorporated and end up needing to pay the tax gogogo 1 Quote Link to comment Share on other sites More sharing options...
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