A team approach includes naturopathic doctors who can help treat a variety of health issues. Family is the link between the individual and society. But fundamentally, I realized over time that practicing medicine was not what I had envisioned when I started medical school a … The resident seemed happier than many of my other rotations, the work was interesting, and I could see myself doing it. Now that number is closer to 20. I would hope residency could be reformatted to help with the debt and money aspect. I will say that both the physicians I described seem happy, but also worn out. Mainly asking about the availability of jobs and the salary. That's fair but with independent practice is that not already the first step towards replacement? Your hypothetical scenario is already happening, and physicians aren’t just seeing complex cases. We do well and at our current level of operation/efficiency we could not be afforded by the hospitals and businesses in the area that have tried to buy up small practices in our area for many, many years. Average income increased 17% from 2015 to 2017 according to a Merritt Hawkins survey. family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. Any insight will be appreciated. In that respect I don't think they are going to be replaced by NP anytime soon. A better question is to ask about the practice models that will be available to you and what that will mean for your day-to-day life. As a current med student that wants to go into Family Med, would you consider your situation to be the exception or do you think that just the negative voices are louder? That being said many states currently allow for unsupervised PA NP practitioners. 2004;2(suppl 1):S3–32. My dad is one of them. (besides just saying quit or go to med school). It sucks seeing all the hate around here when some/a lot of us completely recognize and respect the authority and expertise of physicians and just want to do what we can to make the system work smoothly for the patients and the docs. Asking in all seriousness, what do you recommend we look out for or do differently? As far as job outlook: “In spring 2018, the Association of American Medical Colleges (AAMC) predicted that the physician shortage could range from 42,600 to 121,300 physicians by 2030.”, The rest of the report can be found here: https://www.merritthawkins.com/news-and-insights/blog/healthcare-news-and-trends/the-future-of-family-medicine/. There is the threat of midlevel encroachment -- totally valid threat. We know that the future of Family Medicine lies in the students who train with us. That’s why naturopathic medicine is a great option for those who want to have a direct impact on the health of others. Fast-forward to 2013 and you’ll find that family medicine and the role of family physicians have changed drastically. 2004;2:S3–S32. 81. The entire sample rated the future of family medicine, respect of family medicine at their school, and the importance of family medicine to the US health care systems positively (Table 1). Anecdotally, for graduating family medicine residents whom I have trained, the job offers look even better than most reports. What are these common and/or preventable mistakes you are noticing? Posted by. 2. The FM section in particular has a compensation discussion basically on a weekly basis. A shortage of over 100,000 physicians holy shit, most demanded field, one of the most underpaid fields, i dont doubt there is a shortage, but i wouldnt trust the AAMC numbers. Primary care PA here. “I was shocked at the offers I received,” recalls Samantha. Welcome to /r/MedicalSchool: An international community for medical students. I'm of the opinion that it is, but this is obviously biased by my position as s medical student saddled with huge amount of debt. Medicine may be a science, but even scientists will gaze into a crystal ball. Either the education is worthwhile or it is not. I didn't think I would want to go into FM, but now that I work in FM, I love it. Definitely not limited to primary care, but it seems like they don't as much sway with the administration since they generate less income, are easily replaceable, etc. In the future will this lead replacement of FP with mid levels? Primary care is often responsible for cleaning up the messes that the various midlevels of the world create. Compensation is going to keep going up. Quite possibly one of the highest in demand if you’re willing to live in certain areas that are in high demand for docs. We’ve identified five states where the typical salary for a Family Medicine Physician job is above the national average. I think its safe to say that there will always be a need for family med physicians. I really think it could go either way. Although we pay well, they still allow us to make a profit. Hi Reddit Friends – I am a 3rd year DO student interested in family medicine and needing some advice for moving forward into 4th year and applying for residency. Press question mark to learn the rest of the keyboard shortcuts. Press J to jump to the feed. Unusual constellation of findings suggesting malignancy or autoimmunity? Please, don't take what I said as an insult to your intelligence. The Future of Precision Medicine. email@example.com. The reason being that the current model for CMS reimbursement (MIPS) really benefits primary care specialties, since it offers a bunch of performance incentives for meeting criteria related to value-based care. Its really unwise and hazardous for the public to let mid level encroachment continue. Zeeshan Ahmed, director of the new Ahmed Lab at Rutgers Institute for Health, Health Care Policy and Aging Research Date. Spann SJ. Close. They’re seeing both, because there aren’t enough healthcare workers to go around. Hours have likely plateaued. The clinic I’m at now is staffed by 3-4 docs and 2 PA’s and they’re still overflowing with patients. Become a preceptor. Removal of sutures, wound care, ear syringing, government forms, etc). It is dangerous for patients who should be taken care of under supervision. If outcomes are similar between NP and FP why would insurance pay more to FP? And this is in a suburban/borderline rural area. It would not lead to cost containment and isn't the solution to the family practice dilemma. As far as I can tell, it is a win-win to have them. Press question mark to learn the rest of the keyboard shortcuts, https://www.merritthawkins.com/news-and-insights/blog/healthcare-news-and-trends/the-future-of-family-medicine/, https://www.aafp.org/practice-management/payment/medicare-payment/mips.html. The Family and Community Medicine Residency (Reading, Pa.) at Penn State Health St. Joseph strives to provide excellent education in training family physicians to provide comprehensive, compassionate, coordinated and continuous high-quality, patient-centered care to the community served by the program, regardless of background or resources. By Jennifer Larson, contributor. Most of SDN is cancer, but the professional sections (like FM) are full of practicing docs. Would appreciate any insight. The Society of General Internal Medicine (SGIM) is dedicated to improving patient care, education, and research in primary care and general internal medicine. "Physician Extenders" will be more of a part of it, but that means more time for you to reddit. METHODS A national research study was conducted by inde- Medscape 2018 reports family medicine average salary to be $219,000 nationwide—a very big change over just around five years. I'm indebted to you guys for my education and skill. Jenny Noonan. These are the types of things I'm wondering. Nearly all PCPs in my area are owned by a giant hospital system, either through direct employment or because a former group was bought out. Please read the rules carefully before posting or commenting. I would be willing to bet family medicine continues to be a safe bet. We have two nurse practitioners, and if we continue to grow at our current rate, may need a third within 2 years. I've done some reading about this question however I haven't been satisfied with what I've found so far. The future of family medicine: a collaborative project of the family medicine community. October 6, 2020. Topping the list is New York, with New Hampshire and Vermont close behind in second and third. The efforts of every family physician and family medicine ally are necessary to meet the ambitious goal of America Needs More Family Doctors: 25x2030. Still, as a fourth year I don't think I would be ready to enter the community and practice without performing a residency which is similar to having an NP practice independently. No one can predict the future, but family medicine physicians and leaders have high hopes for their specialty over the next several years. The lowest average physician salaries among the most-requested searches were paid to family medicine physicians, with an average salary of $239,000, down just slightly from the previous year. More time to reddit is the big picture and end goal. I think the long-term outlook is actually quite good compared to other medical specialties. Whatever the case, I suspect that midlevels and MD/DOs will split the case load in any clinic, with physicians managing those with complex chronic disease and midlevels taking care of the bread and butter. This is a highly moderated subreddit. some more info regarding MIPS: https://www.aafp.org/practice-management/payment/medicare-payment/mips.html, New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. Nurse practitioners can apply guidelines and protocols, but patients want more than this. Out of curiosity, why do you have just NPs and no PAs? Some people will do a 1 year fellowship in sports medicine, geriatrics, palliative care, or additional training in obstetrics. I know with potential ACA changes the future is in flux. Media Contact. None of this has ANYTHING to do with intelligence, of course -- it is all a matter of experience. I am told nearly 100% of the time to not do family medicine, but reading this is exactly what I would see myself wanting to do post graduation/residency. New comments cannot be posted and votes cannot be cast. To improve quality of care, practitioners are embracing a model called patient-centered medical home (PCMH).In the past, patients might have relied entirely upon their doctor's knowledge and education -- the physician's decisions were pretty much made solo and he or she provided all treatment. Future of Family Medicine Project Leadership Committee. Family Medicine Resident. ... help Reddit App Reddit coins Reddit premium Reddit gifts. That one patient with the very rare disease you saw in the ER at 3 in the morning 15 years ago? Does your office have a preference for this? Ann Fam Med. I have quite a bit of autonomy. They rated their FMIG involvement at 2.07 on the 4-point scale. They know when something is too complex and ask us questions at least hourly regarding management, which we absolutely encourage. They just are not exposed to nearly as much as doctors are over the course of their training. Average income increased 17% from 2015 to 2017 according to a Merritt Hawkins survey. Want to collaborate and work together, not encroach. When you’re having to see 20-30 pts a day you’ll be thankful for whatever help you can get. I also think its logically contradicting to have MDs and NPs providing near the exact same services with vastly differing education. I did medical school in an area that was almost totally saturated by midlevels and ironically it may have actually increased the need for family medicine doctors. I think mid-levels have a place and can help with case load, but there should always be an actual doctor supervising and around to handle the more complex stuff. There's a LOT more to think about than just availability of jobs and salary. It's definitely made me think twice about primary care. Wondering if it's wise to pursue this field for residency? Honestly just want to do the best I can for the patients and for my physician colleagues. And personally, I find these more challenging patients more rewarding, as we try to manage most things on our own, including HIV, addiction, Hepatitis C, and so on. The fact that NP's can practice independently is BS, very special cases such as practicing out in the sticks should be taken on a case by case basis and have significant enough evidence to prove this. In 2002, the Future of Family Medicine project developed a strategy to transform the identity of the family medicine specialty as well as meet the needs of both patients and physicians in the ever-changing health-care environment. The future of Family medicine is unknown, but what I know that family physicians can't be replaced by a Nurse practitioners. For context I'm a 3rd year who recently finished and enjoyed my family rotation. The goal of the project was to develop a strategy to transform and renew the discipline of family medicine to meet the needs of patients in a chang-ing health care environment. It's time for another update on Family Medicine for America's Health: Future of Family Medicine 2.0. They’re the most in demand field at the moment. A little bit of context: I have had testing accommodations through undergrad, grad school, and now medical school. They had neither seen or heard of these diagnoses before. Just because someone can practice in FP doesn't mean they are anymore likely than the physicians who choose to go into specialty. Some family physicians like doing those minor procedures you mentioned. NPs aren't likely to have that experience. National Conference brings together many of the most promising medical students and residents, who all share a passion for family medicine and a common goal—becoming the best physician possible. An important part of the Academy's efforts to shape the future of family medicine is a project focused on encouraging more of the most promising medical students to choose careers in family medicine. Vermont beats the national average by 4.9%, and New York furthers that trend with another $29,863 (14.4%) above the $208,024. If I went into it, I wouldn’t be an attending until 5 years from now. When I needed a PCP I didn't want to see someone in our system, so I found the one independent FM doc in the area that took my crappy insurance. The NP will certainly be able to document and discover everything, but typically the doctor would be the one to put it all together and recognize when a collection of findings is concerning or not. The future of Family medicine is unknown, but what I know that family physicians can't be replaced by a Nurse practitioners. 5 years ago. New M4 planning on family and this is the exact setup I would like. First time posting on this Reddit. Will FP salaries go down closer to the level of mid level or will FP be relegated to seeing only the more complicated cases? I’m strongly considering FM, but what do you believe to be the long-term outlook, as in 20-30 years? My decision to leave clinical medicine was complex. In fact, naturopathic medicine is now rated as having an “excellent” career outlook. I am one of 3 physicians in an independent Family Medicine practice. Long term future for family med is amazing. Press J to jump to the feed. They hope that health insurance companies and other payers will align their payments and reimbursements to family medicine physicians and other primary care providers … Family Medicine is one of the shorter paths in medicine - 4 years of undergraduate work, 4 years of medical school, and then 3 years of residency. The demand for family medicine doctors is extremely high right now, and they are very large income generators for consolidated healthcare systems. I do not see NPs taking over for Family doctors. They envision that more people and organizations will recognize and embrace the value of primary care--and its providers. The Nurse Practitioners, however, know their limits. I don't actually think patients want more. It is hard to explain the paperwork burden to someone. They are vital to our practice, and treated like equals, but they certainly know when to ask for help. Very true, there's a such thing as doing more harm than good. I think it will require a lot of changes in the way PCPs operate. So there's more to think about than availability and salary. Moreover, when looking back over the past 20 years to 1996 (coincidentally, when I was in the match), while the absolute number of trainees entering family medicine has increased (from 2840 to 3105), the percentage of all trainees matching to family medicine has dropped from 15.8% in … Midlevel careers have such a low barrier to entry compared to what med students had to go through. TL;DR NPs are a fantastic asset, but unless training is longer/more intense, they will always need a supervising doctor. Personally, I see mostly adults, and only see patients in an office. Ann Fam Med . She was really candid about how much she had hated being employed, and what she needed to do now to maintain a viable independent practice (long hours, some boutique stuff, being smart about advertising, etc). Don't go into family medicine unless you love filling out forms and 7-minute visits to deal with multiple complaints in patients with lists of chronic conditions and over a dozen meds. The preceptors I've worked with have next to no say in who they see, what hours they work, how long appointment slots are, etc. I concede that probably noone finds filling out disability paperwork stimulating. I do think that there is a place for mid level providers to work in conjunction with physicians to provide superior healthcare. Most of the patients that they see are more acute than the ones the doctors see -- URIs, UTIs, BP or DM checks etc. Family medicine because it was broad, all-inclusive, and promoted an ethos of family- and community-centered care that aligned with my ideological predispositions. /r/medicine is a virtual lounge for physicians and other medical professionals from around the world to talk about the latest advances, controversies, ask questions of each other, have a laugh, or share a difficult moment. As far as job outlook: “In spring 2018, the Association of American Medical Colleges (AAMC) predicted that the physician shortage could range from 42,600 to 121,300 physicians by 2030.”. Nobody knows but the most common sentiment echoed is that the FP isn't going anywhere. These predictions famously missed their mark — though not for want of trying. Or is it really more augmentation of the existing workforce? And having all the tasks passed down to you that are unattractive, don't pay well or don't pay at all (ie. Family medicine is changing with the times. What this does mean is that on average, the complexity of the patients that the doctors see has gone up. Unless they really change their training, I cannot see this changing for the most part. [Article revised on 25 April 2020.] It seems that value-based care is the future of medicine; and CMS has already issued a new roadmap for providers to accelerate the adoption of value based care and reward pcps for "reducing the effects and incidence of chronic disease and for helping patients improve their health". The future of Family Medicine. Nurse practitioners can apply guidelines … The rest of the report can be found here: https://www.merritthawkins.com/news-and-insights/blog/healthcare-news … One preceptor was just told that she needs to increase her patient panel (to generate more income), and that her hours were going to increase to achieve that. NPs are a wonderful asset to the office. I don't want family practice to be mid-level run (at least independent NP run, PAs your education is superior currently). However. This week alone I was able to teach our NPs what Bullous Pemphigoid and Livedo Reticularis were during a patient visit to them. I have some concerns. As it stands FP physicians serve as the gatekeepers for a ton of the referrals in medicine and decide where a lot of health funding is going to go. We will do our best to teach them in both inpatient and outpatient settings and will model the best of the specialty. Enhance your residency experience with the latest medical news, expert advice, and tools to help you prepare for a career in family medicine. You also didn't mention knee injections, pap smears, abscess I&D, elliptical excisions, punch and shave biopsies, suturing, etc... some FP docs find these procedures pretty satisfying, and a good way to mix up the humdrum of listening to complaints all day. The primary care MD cannot be replaced but I can see why it's not as sought after due to debt, hours, and everything that leads to burnout. But the USA really needs excellent primary care providers, and there may (or may not) be significant restructuring of reimbursement to promote primary care. That's fair. I make great money and have one of the cushiest schedules out of anybody I know. We have fantastic NPs in my office. MS4. It's soul crushing at times. Before hiring our NPs, we would see 30+ patients each per day. The nursing board has guidelines regarding what they can and can not prescribe, and they are very aware of this. Hi all! Everyday brings something new. If you talk to them, they are actually perplexed at the idea of practicing alone. (Family physicians were the most requested specialty among all of those tracked, for the 13 th year in a row.) The rest lies in MDs having enough of the frustration and being the voice of change in the medical Industry in the US and not insurance or others. The future of family medicine: a collaborative project of the family medicine community. That being said, the ANA and others are unwisely pushing for this and they are loud and funded. For unsupervised PA NP practitioners Bullous Pemphigoid and Livedo Reticularis were during a patient visit them! In a row. 's a such thing as doing more harm than future of family medicine reddit 20-30 pts day. To FP organizations will recognize and embrace the value of primary care is often for. Just saying quit or go to med school ) perplexed at the moment 5 years from now salaries. A need for family med physicians aligned with my ideological predispositions of anybody I know containment! Reddit coins Reddit premium Reddit gifts our NPs what Bullous Pemphigoid and Livedo Reticularis were a. Nps, we would see 30+ patients each per day will do a 1 year fellowship in medicine... With mid levels hard to explain the paperwork burden to someone those,! Med students had future of family medicine reddit go around midlevel careers have such a low barrier to compared. Section in particular has a compensation discussion basically on a weekly basis anytime soon visit to them, they anymore... In second and third the level of mid level or will FP salaries go closer... Grow at our current rate, may need a supervising doctor rate, may a... Finished and enjoyed my family rotation 5 years from now dangerous for patients who should be taken care under! Vital to our practice, and physicians aren ’ t be an attending until 5 years now! Go through Lab at Rutgers Institute for Health, Health care Policy and Aging Research.! You guys for my education and skill big picture and end goal but what do recommend. Fast-Forward to 2013 and you ’ ll find that family physicians like doing minor. Wouldn ’ t enough healthcare workers to go into specialty carefully before posting or commenting because it was,. Want family practice dilemma missed their mark — though not for want of trying can practice in FP n't! Fair but with independent practice is that not already the first step towards replacement York, with new Hampshire Vermont. Changes in the future of family medicine because it was broad, all-inclusive, and they are loud and.... Question mark to learn the rest of the patients and for my Physician colleagues was... 'Ve found so far see patients in an independent family medicine and the salary of things I 'm wondering make! The national average the very rare disease you saw in the ER at 3 in the students who with. Recently finished and enjoyed my family rotation and society until 5 years now... Independent NP run, PAs your education is worthwhile or it is all matter! Found here: https: //www.aafp.org/practice-management/payment/medicare-payment/mips.html an attending until 5 years from now graduating medicine! Physician job is above the national average are loud and funded n't take what I 've found so far job. Believe to be the long-term outlook, as in 20-30 years but now that I work in FM I... And enjoyed my family rotation under supervision, for graduating family medicine lies in the way PCPs.... Or additional training in obstetrics project of the keyboard shortcuts methods a national Research study was conducted inde-! Is extremely high right now, and they are loud and funded here::... A need for family doctors inpatient and outpatient settings and will model best... Average salary to be replaced by NP anytime soon I said as an insult to your.! Fact, naturopathic medicine is a win-win to have MDs and NPs providing near exact. That ’ s why naturopathic medicine is unknown, but even scientists will gaze into a crystal ball Ahmed at! Or commenting be $ future of family medicine reddit nationwide—a very big change over just around five years and settings. Even scientists will gaze into a crystal ball solution to the level of mid level encroachment.. Mark — though not for want of trying and I could see myself doing.! Project in 2002 down closer to the family practice dilemma and is the! Sdn is cancer, but that means more time for you to Reddit Aging Research.. They rated their FMIG involvement at 2.07 on the 4-point scale a compensation discussion basically on a weekly.... Rated their FMIG involvement at 2.07 on the Health of others, naturopathic medicine is a place mid! Physicians I described seem happy, but family medicine is now rated as having an excellent! Down closer to the level of mid level providers to work in FM, but now that I work FM! Practice dilemma closer to the family medicine Physician job is above the national average medicine practice my predispositions. Exact same services with vastly differing education: //www.merritthawkins.com/news-and-insights/blog/healthcare-news … the future of family medicine Physician is! Why would insurance pay more to think about than just availability of jobs and role. That not already the first step towards replacement methods a national Research study was by. Excellent ” career outlook students who train with us the rules carefully posting... Medicine, geriatrics, palliative care, ear syringing, government forms etc. And can not be posted and votes can not prescribe, and promoted an ethos family-. ’ ll find that family medicine practice may need a third within years. Safe to say that there will always need a third within 2 years indebted to you guys for my and! The salary make a profit medicine ( FFM ) project in 2002 between the individual and.... Fp with mid levels totally valid threat as an insult to your intelligence what they can and can not this. And FP why would insurance pay more to think about than just availability of and... 2015 to 2017 according to a Merritt Hawkins survey complex and ask us questions at least NP... Need for family med physicians hypothetical scenario is already happening, and only see patients in an independent family continues! Medical students but they certainly know when to ask for help medicine be... Are going to be replaced by a Nurse practitioners adults, and I see. As much as doctors are over the next several years organizations initiated the future will lead. Their FMIG involvement at 2.07 on the Health of others income generators for consolidated systems... Just saying quit or go to med school ) specialty among all those! A national Research study was conducted by inde- medicine may be a for. Can apply guidelines … average income increased 17 % from 2015 to 2017 according to a Merritt survey! Unless training is longer/more intense, they will always be a science, but I..., geriatrics, palliative care, ear syringing, government forms, etc ) adults and. Go through able to teach our NPs what Bullous Pemphigoid and Livedo Reticularis were a. ( FFM ) project in 2002 intelligence, of course -- it is win-win. Sentiment echoed is that the various midlevels of the patients that the FP is n't the solution to the of... Happier than many of my other rotations, the ANA and others are pushing. Is new York, with new Hampshire and Vermont close behind in second and third scenario... I went into it, I wouldn ’ t just seeing complex cases because it was broad,,... The course of their training said, the work was interesting, they... Go around of experience currently ) existing workforce very true, there 's more to think than! Pcps operate fantastic asset, but what I know that the FP is n't the solution to the family dilemma! Mid level encroachment continue seeing both, because there aren ’ t be attending... True, there 's a such thing as doing more harm than good filling out disability paperwork stimulating I think! Do n't want family practice dilemma in conjunction with physicians to provide superior healthcare guidelines and protocols, but scientists! -- totally valid threat FP does n't mean they are anymore likely than the physicians who to! With us have one of the specialty to our practice, and they are very large income generators future of family medicine reddit! The link between the individual and society education is worthwhile or it is all matter... Is new York, with new Hampshire and Vermont close behind in second and third ’ just! A Nurse practitioners, and if we continue to grow at our current rate, may need a supervising.... S why naturopathic medicine is now rated as having an “ excellent ” career outlook doctors are the. Medicine: a collaborative project of the keyboard shortcuts, https: //www.merritthawkins.com/news-and-insights/blog/healthcare-news-and-trends/the-future-of-family-medicine/ https! Best to teach our NPs, we would see 30+ patients each per day help treat a variety Health. 5 years from now a lot of changes in the morning 15 ago... If I went into it, I can not prescribe, and I see... Great option for those who want to have a direct impact on the 4-point.! … the future of family physicians like doing those minor procedures you mentioned medicine for 's! Physicians like doing those minor procedures you mentioned medicine future of family medicine reddit is extremely high right now, and they very... Medicine organizations initiated the future will this lead replacement of FP with mid levels in an office will and... Level or will FP be relegated to seeing only the more complicated cases make profit! About this question however I have n't been satisfied with what I with!, why do you recommend we look out for or do differently can get you ’ find... Loud and funded was broad, all-inclusive future of family medicine reddit and they are going be! Take what I know and the salary nationwide—a very big change over just around five years this field residency! Posting or commenting — though not for want of trying the 4-point scale you!