Jump to content
Premed 101 Forums

Challenges of Family Medicine


brady23

Recommended Posts

11 hours ago, DermJuly2018PGY1 said:

Well, that shouldn't be allowed, and is an abuse of the system.

I agree. This is the cost-benefit way of doing things. Unfortunately, there aren't many health services researchers in Canada to guide our decisions.

Yes and no - it could be argued that psoriasis that simply requires clobetasol shouldn’t be referred to the dermatologist in the first place and doing so is a waste in the system. So maybe it’s their way of telling the GP: “pretty sure you should be able to take it from here, but if you don’t know or things change then send them back.”

 

the ophtho example is a bit different.  The annual eye checks for DM is one thing and probably they do keep those patients in the system for follow up. For other “chronic” things, maybe it’s not a given that it’s chronic. Like eye risks associated with certain drugs - the risk is dependent on the patient actually being on that drug, which may not be the case a year later. I don’t know a ton about ophtho but that would be my guess.

 

 

Link to comment
Share on other sites

  • Replies 52
  • Created
  • Last Reply
21 hours ago, goleafsgochris said:

Most of us are explaining WHY family docs typically don't do procedures.  Not placing a value judgement on it.  Also not to be harsh but people come on here to get information, not to hear constant re-affirmations of our commitment to patients (which for the record is often a given)--so I don't appreciate the judgment tbh 

This. So much this.

-----------------------------------------------------------------------------------------------------------------------------------------------------

OP - I just want to drive the point home, your practice is what you make it. The best part about family medicine is the breadth and flexibility, as many people have said before.

You're not somehow less than a doctor if you don't offer (certain) procedures. That's like saying CCFP-EM docs are somehow wrong for doing exclusively EM (which MANY do) and not doing traditional family practice, we are allowed to develop niches in our practice for a reason. Not everyone is good at everything or wants to do everything.

Some people I graduated residency with did 2 IUDs their entire residency, would you want that person offering that procedure to you?

Or how about the new grad that joins a practice that doesn't offer many procedures (not set up for it/exam rooms too small/inadequate lighting etc), is that new grad going to not accept the job? Or try to force their new colleagues to provide these services? 

What if you give up doing some procedures to focus on other aspects of family medicine like primary care psychotherapy, women's health or addictions?If a doctor has no interest in doing procedures and it pays poorly, what incentive do they have to provide it if their time and energy in patient care can be better spent? They could see 2-3 patients in the time it takes to do a procedure, shorten their appointment wait time and provide other care.

What if the wait times are short for radiology (they usually are where I am) and you can be certain that the subacromial injection is in the correct space instead of doing it blind in your office? Or there is a derm path you can refer to with a 2-3wk waitlist? Sometimes getting a specialist to do the job improves patient outcomes - better pain outcome, better cosmetic result etc. We all hear stories about brutal wait times but there are reasonable wait times too, sometimes if you are really worried about a patient being seen you can always pick up the phone and call someone, there are usually spots for urgent/semi-urgent problems in specialist offices.

I could go on forever with reasons not to do procedures or certain services, Bottom line, if you don't end up doing them OP - IT DOESN'T MATTER, so don't let any of that scare you away from family med. As you learn and experience more, you may find areas you didn't think you would like but now really enjoy, but if you shy away from FM at the off-set because of "some stuff you read on an internet forum" is making you anxious or scared of FM, you may never come to discover it!

 

 

Link to comment
Share on other sites

11 hours ago, mm88 said:

This. So much this.

-----------------------------------------------------------------------------------------------------------------------------------------------------

OP - I just want to drive the point home, your practice is what you make it. The best part about family medicine is the breadth and flexibility, as many people have said before.

You're not somehow less than a doctor if you don't offer (certain) procedures. That's like saying CCFP-EM docs are somehow wrong for doing exclusively EM (which MANY do) and not doing traditional family practice, we are allowed to develop niches in our practice for a reason. Not everyone is good at everything or wants to do everything.

Some people I graduated residency with did 2 IUDs their entire residency, would you want that person offering that procedure to you?

Or how about the new grad that joins a practice that doesn't offer many procedures (not set up for it/exam rooms too small/inadequate lighting etc), is that new grad going to not accept the job? Or try to force their new colleagues to provide these services? 

What if you give up doing some procedures to focus on other aspects of family medicine like primary care psychotherapy, women's health or addictions?If a doctor has no interest in doing procedures and it pays poorly, what incentive do they have to provide it if their time and energy in patient care can be better spent? They could see 2-3 patients in the time it takes to do a procedure, shorten their appointment wait time and provide other care.

What if the wait times are short for radiology (they usually are where I am) and you can be certain that the subacromial injection is in the correct space instead of doing it blind in your office? Or there is a derm path you can refer to with a 2-3wk waitlist? Sometimes getting a specialist to do the job improves patient outcomes - better pain outcome, better cosmetic result etc. We all hear stories about brutal wait times but there are reasonable wait times too, sometimes if you are really worried about a patient being seen you can always pick up the phone and call someone, there are usually spots for urgent/semi-urgent problems in specialist offices.

I could go on forever with reasons not to do procedures or certain services, Bottom line, if you don't end up doing them OP - IT DOESN'T MATTER, so don't let any of that scare you away from family med. As you learn and experience more, you may find areas you didn't think you would like but now really enjoy, but if you shy away from FM at the off-set because of "some stuff you read on an internet forum" is making you anxious or scared of FM, you may never come to discover it!

 

 

Thank you so much - it's promsing to hear everything you're saying. 

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.


×
×
  • Create New...