ratatat Posted October 15, 2013 Report Share Posted October 15, 2013 Has anyone come across any really interesting and unconventional family medicine practices? I'm thinking family medicine may be in my future, but I'd like to know what kind of things are possible to do besides prescribing metoprolol and ABx for pneumonia. Link to comment Share on other sites More sharing options...
rmorelan Posted October 15, 2013 Report Share Posted October 15, 2013 Has anyone come across any really interesting and unconventional family medicine practices? I'm thinking family medicine may be in my future, but I'd like to know what kind of things are possible to do besides prescribing metoprolol and ABx for pneumonia. well sure it can be quite sub specialized in effect. Unconventional doesn't necessarily mean interesting though of course - that is up to your interests There are OB variants, emerg, variants, hospitalist variants, sports medicine, community outreach, frequent international aid variants, derm focused variants, ones that focus on a particular population (I went to one that was 50% aids patients for instance), ones that focus on children, admins at medical school or hospitals, surgical assists (know a bunch that exclusively help in cardiac surgery)....... Link to comment Share on other sites More sharing options...
Birdy Posted October 16, 2013 Report Share Posted October 16, 2013 Not in med, but I've moved around a ton and have seen quite a variety... Where I am now, family doctors deliver around 10% of babies. Many, perhaps most, do at least some level of prenatal care for uncomplicated pregnancies plus the postpartum and neonatal follow up. Our ERs are heavily, though not completely, staffed by family physicians. I've heard of family physicians being involved in some surgeries in other rural areas as well. There's a couple that primarily deal with addictions patients. Ran into one once who works only in aboriginal health, and there's ones in public health policy making positions too. I work with ones who are consultants only. But, that's just my experience as a patient and things I've heard from others. It seems to be a pretty flexible field, varying quite a bit regionally from what I gather. Link to comment Share on other sites More sharing options...
medigeek Posted October 16, 2013 Report Share Posted October 16, 2013 well sure it can be quite sub specialized in effect. Unconventional doesn't necessarily mean interesting though of course - that is up to your interests There are OB variants, emerg, variants, hospitalist variants, sports medicine, community outreach, frequent international aid variants, derm focused variants, ones that focus on a particular population (I went to one that was 50% aids patients for instance), ones that focus on children, admins at medical school or hospitals, surgical assists (know a bunch that exclusively help in cardiac surgery)....... What location in Canada was this that had a high volume of AIDS patients in one geographic area? Link to comment Share on other sites More sharing options...
rmorelan Posted October 16, 2013 Report Share Posted October 16, 2013 What location in Canada was this that had a high volume of AIDS patients in one geographic area? Toronto as it happens. It wasn't the entire practice but over time, word got out of the doctor and the level of care, and the patient population was skewed as a result. Link to comment Share on other sites More sharing options...
medigeek Posted October 19, 2013 Report Share Posted October 19, 2013 Toronto as it happens. It wasn't the entire practice but over time, word got out of the doctor and the level of care, and the patient population was skewed as a result. Interesting. I guess toronto would be the only city that has the patient population to support such a practice. Link to comment Share on other sites More sharing options...
rmorelan Posted October 19, 2013 Report Share Posted October 19, 2013 Interesting. I guess toronto would be the only city that has the patient population to support such a practice. well Vancouver springs to mind Link to comment Share on other sites More sharing options...
aaronjw Posted October 19, 2013 Report Share Posted October 19, 2013 well Vancouver springs to mind Bigger drug problem too which leaks into HIV care Link to comment Share on other sites More sharing options...
seattle_best Posted October 19, 2013 Report Share Posted October 19, 2013 In order to improve access of case, in my hospital we have a family physician who works in the psychiatric wing. He manages cases and uses psychotherapy, must like a psychiatrist would. Link to comment Share on other sites More sharing options...
leviathan Posted October 19, 2013 Report Share Posted October 19, 2013 Bigger drug problem too which leaks into HIV care I think there is a much larger HIV population in Vancouver. Link to comment Share on other sites More sharing options...
aaronjw Posted October 19, 2013 Report Share Posted October 19, 2013 I think there is a much larger HIV population in Vancouver. Do you think there's high correlation between HIV population and drug use in Vancouver? It seems to reason that may be true but i've not really looked into it and think you're in or were in the Vancouver area so I'm curious... Link to comment Share on other sites More sharing options...
The Journey Man Posted October 19, 2013 Report Share Posted October 19, 2013 Has anyone come across any really interesting and unconventional family medicine practices? I'm thinking family medicine may be in my future, but I'd like to know what kind of things are possible to do besides prescribing metoprolol and ABx for pneumonia. Theres a family doc trained guy I know who now exclusively works as a GP-oncologist. I dont know if he did extra training or not, but he handles the Oncology ward by himself now. The Medical Oncologists prescribe chemo but he takes care of any complications that might occur inpatient and they go back to their Medical Oncologist on an outpatient basis. Link to comment Share on other sites More sharing options...
leviathan Posted October 20, 2013 Report Share Posted October 20, 2013 Do you think there's high correlation between HIV population and drug use in Vancouver? It seems to reason that may be true but i've not really looked into it and think you're in or were in the Vancouver area so I'm curious... Yea, it's definitely mostly the IV drug use. I once heard a statistic that the downtown eastside has the highest per-capita rate of HIV infection in the western world, and I wouldn't be surprised if that was true. I remember working one shift down there where literally every single patient I saw that day was HIV positive. Vancouver is also a very gay-friendly city but I'm not sure if that means there is actually a larger population of gay people, or if gay people still have the same prevalence of HIV that they used to. Link to comment Share on other sites More sharing options...
rmorelan Posted October 22, 2013 Report Share Posted October 22, 2013 Theres a family doc trained guy I know who now exclusively works as a GP-oncologist. I dont know if he did extra training or not, but he handles the Oncology ward by himself now. The Medical Oncologists prescribe chemo but he takes care of any complications that might occur inpatient and they go back to their Medical Oncologist on an outpatient basis. The thing is residency is only a few years really - I find the idea that any doc if they focused some how wouldn't be able to learn another area a bit strange. Once competency criteria kicks in this will be even easier to confirm/apply Link to comment Share on other sites More sharing options...
nosuperman Posted October 22, 2013 Report Share Posted October 22, 2013 There a GPO(ncologist) in Chatham who set up and presently half-runs the cancer center. I've met two GPs who do strictly psych, one of them even rarely prescribes drugs and mostly relies on cognitive behavioural therapy. There are the obvious +1's. There's a local doc who did +1 anesthesia who works a family practice, emergency, and anesthesia. There's one who handles the teen health center. Another who runs the HIV and methadone clinics. There's a local GP who does family, OB, and coroner. Pretty varied, especially if you work in smaller centers. Link to comment Share on other sites More sharing options...
aaronjw Posted October 22, 2013 Report Share Posted October 22, 2013 There's a local GP who does family, OB, and coroner. Strange question, if you're the HCP for a patient can you also be a coroner for them? That has to be hard mentally if so. Link to comment Share on other sites More sharing options...
rmorelan Posted October 22, 2013 Report Share Posted October 22, 2013 Strange question, if you're the HCP for a patient can you also be a coroner for them? That has to be hard mentally if so. Probably not a good idea I would think Link to comment Share on other sites More sharing options...
benhc911 Posted November 30, 2013 Report Share Posted November 30, 2013 A lot of different practices from my (small northern) community come to mind: A GP who has a focus on rehab and geriatric work A GP who does a lot of derm and cosmetic procedures (botox, laser etc) A GP who does most of the OB as well as doing sections A couple GP+A that mainly do OR plus ER GP's that do the full run: clinic, OB, ER, inpatients and even OR assist A GP+A that includes a focus on pain and addiction in his practice etc. Some of these people have taken it upon themselves to do extra courses and certifications, but some have simply made a name for themselves focusing locally. To be fair, the nearest center with a significant number of specialists is a 2hr drive, and outside of GP's, GP+A's, we only have a couple gen surg and a GIM. With other specialties being limited to visits and telehealth, this has left many niches to be filled. Link to comment Share on other sites More sharing options...
myriad Posted December 3, 2013 Report Share Posted December 3, 2013 I've met two GPs who do strictly psych, one of them even rarely prescribes drugs and mostly relies on cognitive behavioural therapy. I know one GP who only does CBT sessions and she's so busy that her waitlist is minimum 3-4 months. There's a huge need for it and she loves just seeing 6-8 patients a day. Link to comment Share on other sites More sharing options...
medigeek Posted December 3, 2013 Report Share Posted December 3, 2013 Do you think there's high correlation between HIV population and drug use in Vancouver? It seems to reason that may be true but i've not really looked into it and think you're in or were in the Vancouver area so I'm curious... Probably... I remember reading about how there's a much higher rate of HIV in hookers in Vancouver (relatively of course), so there isn't a much better explanation. Though homosexual activity in men continues to be the major cause (by majority) of HIV infections in north america and all sub areas as well. Link to comment Share on other sites More sharing options...
Renoir Posted December 7, 2013 Report Share Posted December 7, 2013 Environmental Medicine is really interesting... Few certifications in Canada, but some clinical research, counseling patients and diagnosing exposures. I'm not thinking occupational med either, from the two I've met, they're FM and OB along with environmental counselling at their clinics. They also work closely with the university in doing research like the amount of lead in tea or the effect of VOCs from carpets on some of their pts. Might be boring for some, but I love all the subclinincal dose stuff. Toxicologists probably find it 'hokey', but it's a pioneering field that's only going to expand in scope and definition. Link to comment Share on other sites More sharing options...
futureGP Posted December 8, 2013 Report Share Posted December 8, 2013 There's a good thread on the primary care specialties forum. Link to comment Share on other sites More sharing options...
pokemonyellow Posted December 8, 2013 Report Share Posted December 8, 2013 someone before posted a very thorough link on family medicine here actually. you can try to google family medicine specialty and pm101 perhaps I can't remember the link:confused: Link to comment Share on other sites More sharing options...
SaskUpstreamDoc Posted December 17, 2013 Report Share Posted December 17, 2013 Has anyone come across any really interesting and unconventional family medicine practices? I'm thinking family medicine may be in my future, but I'd like to know what kind of things are possible to do besides prescribing metoprolol and ABx for pneumonia. Really exciting stuff about Family Medicine in this book: http://healthbegins.ning.com/profiles/blogs/announcing-the-release-of-my-new-ted-book-the-upstream-doctors Link to comment Share on other sites More sharing options...
ratatat Posted December 20, 2013 Author Report Share Posted December 20, 2013 Really exciting stuff about Family Medicine in this book: http://healthbegins.ning.com/profiles/blogs/announcing-the-release-of-my-new-ted-book-the-upstream-doctors Thanks brother/sister. I'll read it. Link to comment Share on other sites More sharing options...
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