Family med good/bad

[supafield]

^^^

 

..... Even after some of the nonsense I've read on these boards, periodically I'm still blown away by some posts.

 

Thanks for that Titanic.

[A-Stark]

1. that the pay is improving. NO. it is going to a team model wchich makes pay standardized and salaried. LO AND BEHOLD the salary is WAY LOWER than everyone elses.

 

2. that it is rewarding. EVERY MEDICAL FIELD is rewarding in some way. to say tht FP Is MORE rewarding is full of HUBRIS

 

3. that it is portable. if ur in ac ity you refer eerything and cant do any procedures, so you get even less $$. u could go rural but that sucks if u want to b urban. and now the homeodinks are getting rx power?! WTF!!!!

 

4. that u can do obs, em etc. SURE YOU CAN. but 1. you cant work in cities as much as the 5year guys 2. obs is limited to bread butter obs and 3. they both pay less than the 5 year cooutnerparts.

 

5. that there are debt forgivenss agreements in place. is your career and lifestyle worth your debt? bvecause if you agree to this, then it is, because ull be stuck in a crap FP job out in the stixf or years. EFF THAT! THIS AINT THE ARMY

 

ther eare more but im donetyping.

 

1. That may be true of *gross* pay, but salary means no direct pay of overhead or equipment or all the other trappings that can make private FM practice overly like running a small business.

 

2. It will be more rewarding for some and less for others. Isn't that true of everything?

 

3. I'm not clear on why referring is problematic...

 

4. Everything I've heard about why FPs are moving away from any obstetrics derives from the awful hours and the lack of interest in being on-call for it.

 

5. I agree that such return-of-service agreements in exchange for debt forgiveness are something of a Faustian bargain.

[Nonpremed]

"It seems to be improving in terms of pay, respect, etc to me at least. Or is this just the propoganda the med schools are feeding us."

 

So the primary reasons of going into medicine are to make money and be addressed as "Dr X", right? I think that even before you get in you should've had an inkling of what you intend to specialize on based on your passion--not solely based on the salary range. . If money is going to bother you that much, then some of your potential patients are in trouble :eek: .

[Satsuma]

"It seems to be improving in terms of pay, respect, etc to me at least. Or is this just the propoganda the med schools are feeding us."

 

So the primary reasons of going into medicine are to make money and be addressed as "Dr X", right? I think that even before you get in you should've had an inkling of what you intend to specialize on based on your passion--not solely based on the salary range. . If money is going to bother you that much, then some of your potential patients are in trouble :eek: .

 

This seems an idealistic post.

 

Most med students change their minds about their interests MANY times during school. We are forced to make a decision about specialization far too early...reflected in the substantial number of residents who end up changing programs.

 

It is hard to even maintain your passion about anything when you spend a good portion of your time pre-call, on-call or post-call. And when you have acquired a large debt, and have worked hard for many years...you WILL be upset that someone else is billing more for the very same work you are doing.

[boodog]

"It seems to be improving in terms of pay, respect, etc to me at least. Or is this just the propoganda the med schools are feeding us."

 

hey nonpremed, sorry if it seems like my primary motivation in medicine is for money and respect. they are definitely not. I do however, find it interesting that the primary way that Rural Groups and Family Practise Info sessions try and recruit students is by hyping the great life, great money, great recognition, etc.

[A-Stark]

How does that differ from how other careers in medicine are promoted? I've never been to a "Lifestyles in Medicine" or Career Night session in which this wasn't done.

[Jewels1986]

1. that the pay is improving. NO. it is going to a team model wchich makes pay standardized and salaried. LO AND BEHOLD the salary is WAY LOWER than everyone elses.

 

2. that it is rewarding. EVERY MEDICAL FIELD is rewarding in some way. to say tht FP Is MORE rewarding is full of HUBRIS

 

3. that it is portable. if ur in ac ity you refer eerything and cant do any procedures, so you get even less $$. u could go rural but that sucks if u want to b urban. and now the homeodinks are getting rx power?! WTF!!!!

 

4. that u can do obs, em etc. SURE YOU CAN. but 1. you cant work in cities as much as the 5year guys 2. obs is limited to bread butter obs and 3. they both pay less than the 5 year cooutnerparts.

 

5. that there are debt forgivenss agreements in place. is your career and lifestyle worth your debt? bvecause if you agree to this, then it is, because ull be stuck in a crap FP job out in the stixf or years. EFF THAT! THIS AINT THE ARMY

 

ther eare more but im donetyping.

 

This seems pretty biased. You can definitely do plenty of obstetrics or emerg. I know of a family doctor who's director of the obstetrics department at a rural hospital. The emerg docs in London - some of whom are FM + 1, and it's a major tertiary care centre - say there's only a few centres in the entire country that require the 5 year emerg residency. And the people who've come in to speak to us say that the difference in pay for the same procedure / treatment in family compared to people who did residencies in obstetrics, emerg, or psychiatry is something like $20-30 / hour, which isn't that huge considering you start earning full rates 3 years earlier. For those who are salaried, many do great, especially with EM or surgical assist thrown in. (Some communities are advertising for $300 000 - 500 000 salaried positions - that's hardly shabby.) Generally, family docs who focus on psychotherapy don't make as much. But I concur with whoever said the pay shouldn't matter anyways!

 

I agree that family is more fun in a rural location than in a major city. There's still flexibility, though - there are family docs in London who work in hospital-based palliative care, refugee health, and so on. You can definitely have an amazing career in family.

[boodog]

How does that differ from how other careers in medicine are promoted? I've never been to a "Lifestyles in Medicine" or Career Night session in which this wasn't done.

 

I have never heard any other specialty promoted to the same extent as family practise.

[The_B]

I have never heard any other specialty promoted to the same extent as family practise.

 

There is a simple reason for this, Family Medicine as a specialty in of itself is relatively new in Canada. It wasn't long ago that most primary care physicians were General Practitioners with no special training it ""Family" medicine. The specialty is still trying to gain recognition within medicine (at least in Canada) as a unique entity, with it's own merits and benefits.

 

So when you see all the promotion, part of that is to sell something that is new. Also, you have to remember, everyone is acutely aware of the large deficit in numbers that is currently abound, and that those numbers are soon to be very inflated, so there is a feeling that it should be pushed a little harder.

[Satsuma]

There is a simple reason for this, Family Medicine as a specialty in of itself is relatively new in Canada. It wasn't long ago that most primary care physicians were General Practitioners with no special training it ""Family" medicine. The specialty is still trying to gain recognition within medicine (at least in Canada) as a unique entity, with it's own merits and benefits.

 

 

You know, in my view, I can see alot of benefits to the old system. You could specialize after you had actually practiced and learned what you liked and didn`t. Everyone could "practice family med"....so I actually think that would help with the shortage...if someone could do part practice is a specialty and part in general practice...or practice a specialty for some time and then go back to a general practice. Since everyone would have passed through as a general practitioner, there might be more respect from specialists for GPs.

 

And this brings me to the point of respect. Most of the time when people promote respect given to family docs...they are trying to change the perception that they are not respected within medicine...not the general public. So whoever posted earlier about wanting to choose medicine to be called "Dr" kind of missed the mark. The concern is about respect from your colleagues. And I am not sure where family med stands right now on this...some specialists have alot of respect for family docs and some don't. Some family docs also don`t have alot of respect for specialists...so it goes both ways. I think you just have to be internally happy with your work and know you are doing good. Then it won`t matter what other people think.

[BlackJack]

You know, in my view, I can see alot of benefits to the old system. You could specialize after you had actually practiced and learned what you liked and didn`t. Everyone could "practice family med"....so I actually think that would help with the shortage...if someone could do part practice is a specialty and part in general practice...or practice a specialty for some time and then go back to a general practice. Since everyone would have passed through as a general practitioner, there might be more respect from specialists for GPs.

 

And this brings me to the point of respect. Most of the time when people promote respect given to family docs...they are trying to change the perception that they are not respected within medicine...not the general public. So whoever posted earlier about wanting to choose medicine to be called "Dr" kind of missed the mark. The concern is about respect from your colleagues. And I am not sure where family med stands right now on this...some specialists have alot of respect for family docs and some don't. Some family docs also don`t have alot of respect for specialists...so it goes both ways. I think you just have to be internally happy with your work and know you are doing good. Then it won`t matter what other people think.

 

 

The old system was far superior to our current American-styled system. Since everyone went through the gauntlet of being a general practitioner, specialists could not only manage the general pathology, but also could respect the work done by the community GPs.

 

Currently the system is two-tiered - family med vs specialization. Or, two years of funding vs five. Or, community vs academic medicine. Or, 99k vs 180k...you get the picture.

 

The respect issue is deep-seated. Currently, there exists far less respect for family practitioners than that of specialists. This can be seen by society, regarding the pay a family practitioner recieves as well as by the whole naturopathic fiasco in BC, and by the medical profession, where many doctors can be downright insulting when talking about family medicine. How many times have you heard the phrase "you're too smart to be a family doctor" uttered to a med student? I have a few times.

 

The major advertisement that family medicine exhibits is an attempt to convince medical students that, hey, FM ain't so bad after all. But medical students aren't stupid. They know that, compared to specialists, family doctors are more limited in terms of geographic location of work(anyone can work rurally, not anyone can work urban), pay, and respect both inside and outside of medicine. Furthermore, the current trend of the medical climate both in Canada and the USA is towards specialization, and medical students are aware of this. In my opinion, and I'm not alone in this, the constant advertising of family medicine is an attempt to sell a lemon.

 

Remember, it is not absolute income or absolute respect that is important. It's relative income, and relative respect to your peers. Sure, being an FP in a small community will likely make you the most respected and most wealthy individual there. However, when compared to every doctor in Canada, including those you graduated with, you will be at the bottom quartile for both pay and respect.

 

The problem is that our system is completely broken and needs to be reverted.