Hey everyone,
I'm not sure if there are already some threads about this, but I'm a 3rd year medical student starting to schedule my audition rotation for next year and I'm still undecided exactly what I want to be when I grow up. I LOVED my pediatrics clerkship, but I'm also really passionate about women's health and know that I'd find a practice that included adults fulfilling. Thinking of possibly pursuing FM to this end, but I'm wondering if it would be possible to tailor an FM practice toward higher numbers of peds/Obgyn patients? Or am I better off just choosing one if I really want a large portion of my practice to be one of these two groups?
Thanks!
You sound a lot like me, I love peds, but I also like family planning and women’s health.
I think it’s really easy to customize a practice to this end. It takes planning and being selective about the job you take, but I’ve done it quite well.
I took a job in a small town, the entire county I’m in has less than 30k people. My town has about 7k.
There’s a college here, and there are tons of young families.
When I interviewed, they needed docs in 3 clinics in this county. I had my pick. I toured each clinic, and observed a few hours. The town just north of where I am seemed full of the stereotypical rural crowd. Lots of Skoal can rings, big trucks, and lots of meth.
The town just south of where I am had mostly geriatrics, tons of hyper-conservative 80’ish year olds with strange ideas about healthcare. You know the type, they come in with a folded up 8.5x11 paper with a list of items they’d like to discuss during their visit; then proceed to tell the doc they don’t like to take meds, and they think they have a salve at home for that. I wasn’t excited about that crowd either.
The town I’m in had the college, tons of young folks. The college also brings a different demographic to the town in terms of college professors etc. People took better care of themselves, people were a bit more open-minded, and so I came here.
I take inpatient call, we have no pediatricians In our hospital so I do almost all the newborn rounds. There are two FM’s doing OB here, but with the OBGyn nearby, most women see him for their pregnancies. More often than not, the mother and father have no established PCP, and have just seen the OBGyn. So when I see the baby, I invite them all into my practice. 99% of the time they gladly accept. I get a kid to care for, and a young couple. Which means I can talk about family planning at the peds follow-up visit with mom since our OBGyn isn’t very good about doing that, he also isn’t very interested in Gyn, seems to only want to do deliveries. Most women just come back to me with any Gyn complaints, even if they’ve seen him for Obstetrics.
I also frequently admit and manage peds on the inpatient floor when I’m covering the inpatient service because again, there aren’t any Pediatricians here. Some of our FM’s are afraid of these cases. But I got excellent peds training and it’s been fine.
I also have the college students, I have hundreds of young (18-23yo) females on my panel. This crowd really appreciates a frank discussion about sexual health and contraception. Usually it’s a UTI or an STD scare that gets the conversation started. I must’ve placed 100 Mirena’s already in the 18months I’ve been here. I keep a large jar of condoms and paper bags in all my exam rooms for patients to take too. Word spreads fast on campus, and now it’s not at all uncommon for a young woman to show up for her first visit requesting an IUD or nexplanon because her friend already got one and told her it was a good experience.
I don’t even do obstetrics, at all, and I’ve got just the practice I was looking for. My panel skews overwhelmingly toward the 40 and under crowd and is probably 65-70% female or pediatric.
So yes, FM can set you up for a practice you want. It’ll just take some “recruitment” on your part. I work pretty hard to find and recruit the patients I want. It doesn’t mean I don’t have some people outside the demographic I’m most interested in, but I definitely have stuff I’m Excited about doing almost every day.