bj89 Posted July 15, 2012 Report Share Posted July 15, 2012 Hey folks, i'm just wondering if someone knows about what kind of office procedures rural family docs perform? I am interested in family medicine but I also want a specialty that performs some procedures for the technical aspect of it. Thanks! Link to comment Share on other sites More sharing options...
frozenarbitor Posted July 16, 2012 Report Share Posted July 16, 2012 Hey folks, i'm just wondering if someone knows about what kind of office procedures rural family docs perform? I am interested in family medicine but I also want a specialty that performs some procedures for the technical aspect of it. Thanks! I shadowed a rural gp for a weekend in southern alberta. i think most if not all gp/family doctor there take turns covering the emergency and icu at the community hospital there. The gp i shadowed isn't even the 2 plus 1 er. Just ccfp. He did quite a number of suturing for minor cuts to the scalp, arm, leg, and so on. Im not sure about office procedures, but you do get to do procedures like that in rural emergency room. Link to comment Share on other sites More sharing options...
HycrestJIT Posted July 16, 2012 Report Share Posted July 16, 2012 In the office, a rural FM practitioner and urban FM practitioner perform most of the same procedures depending on comfort level. Rural FMs tend to perform more themselves due to the impracticality of referring a patient for a 4 hour winter drive for an IUD insertion, local skin excision, etc. It basically depends on your comfort level as a practitioner and your training. Where rural and urban FMs tend to differ is when ER and hospital work comes into play. Link to comment Share on other sites More sharing options...
Mandibular Posted July 16, 2012 Report Share Posted July 16, 2012 vasectomies!!! kyste/ lipoma excisions Link to comment Share on other sites More sharing options...
bj89 Posted July 16, 2012 Author Report Share Posted July 16, 2012 Thanks for the replies everyone. So it really seems like you can do what you feel proficient in depending on what you learned in residency. Thats why I love rural med - you really are the jack of all trades (kind of) Link to comment Share on other sites More sharing options...
tooty Posted July 16, 2012 Report Share Posted July 16, 2012 circumcisions Link to comment Share on other sites More sharing options...
Dream Big Posted July 17, 2012 Report Share Posted July 17, 2012 Hey, I did most of my clerkship in a rural town in Southern Alberta. There were 12 GPs in the town to give you a sense of the size of it. The docs there did many procedures in the office and while doing impatient/emerg work. Procedures included: -Skin biopsies - excisional and punch -Laceration repairs including tendon repairs -Vasectomies -Chest Tubes -LPs -Deliveries and vaginal tear repairs -Paracentesis -circumcision -IUD The list goes on. One of the docs had a special interest in GI and did some extra training and does all the scopes in town. Another doc did some extra training in surgery and does appendectomies, c sections, hydroceles, tubal ligations, and some laparoscopic stuff. Basically if you have an interest/additional training if needed and there is a need in the community you are working in you can do it. PM me if you have specific questions. Link to comment Share on other sites More sharing options...
A-Stark Posted July 17, 2012 Report Share Posted July 17, 2012 The docs there did many procedures in the office and while doing impatient/emerg work. Freudian slip? Link to comment Share on other sites More sharing options...
thebouque Posted July 17, 2012 Report Share Posted July 17, 2012 One of the docs had a special interest in GI and did some extra training and does all the scopes in town. Another doc did some extra training in surgery and does appendectomies, c sections, hydroceles, tubal ligations, and some laparoscopic stuff. Hey, What kind of laparoscopic interventions were the GPs doing ? I have to say that I'm quite surprised to hear that GPs perform lap surgeries. Link to comment Share on other sites More sharing options...
A-Stark Posted July 17, 2012 Report Share Posted July 17, 2012 Presumably they did additional training? Lap appes and choles aren't necessarily that complicated, but what if there is a need to convert to open and there's no surgeon at that centre? Link to comment Share on other sites More sharing options...
leviathan Posted July 17, 2012 Report Share Posted July 17, 2012 Presumably they did additional training? Lap appes and choles aren't necessarily that complicated, but what if there is a need to convert to open and there's no surgeon at that centre? There are GPs that do regular open appys + choles etc so I imagine to do lap you would also have to learn the open technique. But to be honest are there really rural hospitals that have laparoscopic equipment available for a GP to use? I remember even in a community hospital in metro Vancouver, they were doing their inguinal hernias open whereas when I did my surgery training in the US it was almost everything being done laparascopically. Link to comment Share on other sites More sharing options...
NLengr Posted July 17, 2012 Report Share Posted July 17, 2012 Lap equipment costs much more than the set up for an open hernia repair. It's also much more difficult. I can't imagine a rural hospital paying for an expensive lap set up without an honest to goodness surgeon. Also, what happens when you put a trochar into the bowel? Is a GP going to be able to anastomose a bowel or pull up a colostomy/ileostomy? No surgery is simple. Complications rapidly make even the easiest operation a nightmare. Link to comment Share on other sites More sharing options...
Lactic Folly Posted July 17, 2012 Report Share Posted July 17, 2012 I have seen lap choles being done by GP-surgeons in rural hospitals (not sure of the extent of their background/training). Complications would be shipped to the academic centre 2-3 hours away. Link to comment Share on other sites More sharing options...
NLengr Posted July 18, 2012 Report Share Posted July 18, 2012 I have seen lap choles being done by GP-surgeons in rural hospitals (not sure of the extent of their background/training). Complications would be shipped to the academic centre 2-3 hours away. That's hardly ideal from a surgical perspective. Link to comment Share on other sites More sharing options...
tooty Posted July 18, 2012 Report Share Posted July 18, 2012 dream big, would you PM me the name of that GP surgeon? I'd like to look into it. I thought only Sask allowed GPs to do lap procedures. Link to comment Share on other sites More sharing options...
Lactic Folly Posted July 18, 2012 Report Share Posted July 18, 2012 No kidding. Rough times in those rural areas. But some patients said they chose the rural OR because of shorter wait times. Link to comment Share on other sites More sharing options...
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