question regarding the FRCP EM programs

[michaelm]

I was thinking of applying to some EM programs. I loved my ER rotations, the thing is, I want to have the ability to practice in the community, not in a hospital in X amount of years (say in 15-20 years). What private practice opportunities are there for FRCP EM physicians other than walk in clinics? Has anybody heard of anyone ? How well are EM docs trained to take care of patients outside of the ER?

 

I have no interest in FM, so CCFP (EM) is out of the question. Also, not interested in working in "consulting" or corporate jobs, i am more interested to hear about clinical opportunities.

[A-Stark]

I'm not really sure what you're asking. There is certainly no shortage of community hospitals that an FRCPC emerg physician can work in.

[michaelm]

what practice opportunities are there outside of hospital settings

[A-Stark]

what practice opportunities are there outside of hospital settings

 

Emergency medicine outside the emergency department? There are some opportunities in wilderness medicine and toxicology, I suppose, but this is generally a hospital-based specialty. You could work in an urgent care centre, but probably not a walk-in. If you want those kinds of opportunities, the CCFP-EM route would make a lot more sense.

[cardiomegaly]

I don't really understand your question either. You ask about community practice opportunities but you have no interest in FM - outpatient community is either walk in, family medicine clinic, or outpatient subspecialty clinics. Some options for FRCP EM include ICU, pre-hospital care (flight, EMS), toxicology...but for most of those opportunities you will be tied to the hospital.

[cheech10]

5 year emerg docs can work in walk-ins?? are you sure about this?

 

Anyone can staff a walk-in clinic (essentially a general practice clinic), at least in Ontario, but you can only bill the general practice codes, which are much less lucrative than specialty codes (billed when a patient is referred to you for consulation).

 

Eg. General assessment A003 pays $77.20, but as an internist who has a patient referred to me I can bill a Consultation A135 pays $157.00. Similar examples for other specialties.

[Dino]

I was thinking of applying to some EM programs. I loved my ER rotations, the thing is, I want to have the ability to practice in the community, not in a hospital in X amount of years (say in 15-20 years). What private practice opportunities are there for FRCP EM physicians other than walk in clinics? Has anybody heard of anyone ? How well are EM docs trained to take care of patients outside of the ER?

 

I have no interest in FM, so CCFP (EM) is out of the question. Also, not interested in working in "consulting" or corporate jobs, i am more interested to hear about clinical opportunities.

 

Rural hospitals, mostly.

You still have to do 2 years FM before taking the 3rd in EM, FRCP route.

If you like living in a remote location, it sounds pretty good. You can also build a fan base at the hospital, which can help your private practice.

[olecranon]

Anyone can staff a walk-in clinic (essentially a general practice clinic), at least in Ontario, but you can only bill the general practice codes, which are much less lucrative than specialty codes (billed when a patient is referred to you for consulation).

 

Eg. General assessment A003 pays $77.20, but as an internist who has a patient referred to me I can bill a Consultation A135 pays $157.00. Similar examples for other specialties.

 

1. i highly doubt it. definitely not in BC, i would say almost certainly not in ontario either.

 

2. lucrative per consult but for the time it takes to see a consult as a specialist you can probably see 3 patients as a GP.

[cheech10]

Olecranon, I'm a practicing internist and intensivist, so I know pretty well what I can and can't practise.

 

Internists can absolutely start a walk in clinic and bill as general practitioners in Ontario. Not many would want to, because it doesn't reflect our training as closely as other practice models, but there is nothing stopping us in the legal or regulatory framework in Ontario. An independent practice licence says you may practise only in the areas of medicine in which you are educated and experienced, and it's pretty hard to argue an internist or emerg doc is not qualified to do general practice in the form of a walk in clinic.

 

As a related example, I and many intensivists provide anaesthesia for minor procedures done in the ICU, and can and do bill for these services even though our base specialties are not usually in anaesthesia. Again, this would be well within my scope of practise. The real limit is in malpractice coverage; if you practise outside your usual scope and have a bad outcome, you won't be covered by the CMPA and the College will also probably come looking for you.