I want to quit

[Fatalis]

I honestly wish I never got into FM... clinic is a f*cking joke; literally every other specialty thinks you are a joke and just dumps crap on you.
Gen surg does a surgery and pnt hasn't had a BM in a week? f/u with pcp
pnt doesn't know what meds they were d/c home with for a life threatening injury? np, the pcp will run the gauntlet
pnt sees pain management and ortho for their back? my back hurts today....time to see my pcp and waste their time
or pnt doesnt want to do jury duty and wants you to fill out a form regarding why they cannot sit...why the Eff is this a doctors job!?
Honestly, it is EVERY day 90% of what I see is complete BS/waste of time/ patients just not doing what they are told or trying to manipulate the system! So damn tired of it and moreover it feels like I only know how to treat a handful of stuff. Sure I can dx more complex things but can I treat or manage it...nope! I guess it is from my lack of comfort in it as my residency program had a boner for clinic and all of our rotations with specialists were just shadowing an 0 teaching.
I don't mean to knock on anyone in FM but I feel like we just get crapped on by everyone and anyone and I am not even getting into insurance companies and the stacks of forms we have to fill out.
I do enjoy hospital work as I like the acuity and treating when they are there to see if my treatment plan actually works. Sorry for the disjointed thinking here, it has been a rough day and needed to vent. As it stands I can't get out of my job which is mostly clinic. Clearly for my next job I am doing hospital work only. Thank you all for listening!

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[5150man]

Preach on!!!

 

[VA Hopeful Dr]

I honestly wish I never got into FM... clinic is a f*cking joke; literally every other specialty thinks you are a joke and just dumps crap on you.
Gen surg does a surgery and pnt hasn't had a BM in a week? f/u with pcp
pnt doesn't know what meds they were d/c home with for a life threatening injury? np, the pcp will run the gauntlet
pnt sees pain management and ortho for their back? my back hurts today....time to see my pcp and waste their time
or pnt doesnt want to do jury duty and wants you to fill out a form regarding why they cannot sit...why the Eff is this a doctors job!?
Honestly, it is EVERY day 90% of what I see is complete BS/waste of time/ patients just not doing what they are told or trying to manipulate the system! So damn tired of it and moreover it feels like I only know how to treat a handful of stuff. Sure I can dx more complex things but can I treat or manage it...nope! I guess it is from my lack of comfort in it as my residency program had a boner for clinic and all of our rotations with specialists were just shadowing an 0 teaching.
I don't mean to knock on anyone in FM but I feel like we just get crapped on by everyone and anyone and I am not even getting into insurance companies and the stacks of forms we have to fill out.
I do enjoy hospital work as I like the acuity and treating when they are there to see if my treatment plan actually works. Sorry for the disjointed thinking here, it has been a rough day and needed to vent. As it stands I can't get out of my job which is mostly clinic. Clearly for my next job I am doing hospital work only. Thank you all for listening!

XR to r/o obstruction/ileus, give linzess if normal. 99214

Review records, address problems. 99205

If they aren't on an NSAID or muscle relaxer, give them one. If they are, change to a different one. 99214

Listen to why they think they shouldn't go to jury duty. Write the note if you feel its legitimate, if not address whatever pathology they have. 99214

Train your staff to fill out those forms so all you have to do is sign them.

Find some good CME/resources so you can manage more complex things if you want to.

You can do hospital work if you'd like, but per my former-hospitalist wife the dumping is way worse there. She gave that up because she was tired of being treated like a resident.

 

[Fatalis]

XR to r/o obstruction/ileus, give linzess if normal. 99214

Review records, address problems. 99205

If they aren't on an NSAID or muscle relaxer, give them one. If they are, change to a different one. 99214

Listen to why they think they shouldn't go to jury duty. Write the note if you feel its legitimate, if not address whatever pathology they have. 99214

Train your staff to fill out those forms so all you have to do is sign them.

Find some good CME/resources so you can manage more complex things if you want to.

You can do hospital work if you'd like, but per my former-hospitalist wife the dumping is way worse there. She gave that up because she was tired of being treated like a resident.

1) yes, that is standard management however why am I dealing with an issue the surgeon should deal with
2) "none of that works" is always what they say when I offer that treatment
3) it is always "my back hurts and I dont want to sit for that long"....legit? prob not, so no
4)my staff refuses to do it and my employer takes their side
5) it is not that I can't, more fear of bad outcomes/ side effects with medication
Yes, I plan on doing hospital work; the grass is not greener on that side however from when I have worked in the hospital, to me, the pathology is more interesting and I have more job satisfaction.
I appreciate your insight; esp with the coding however my employer has a tendency to fudge my RVUs so that I can't make my bonus; when I call them out on it I get "oh...we will look into that" and nothing comes of it. It is a huge reason why I am GTFO of this place the second my contract is up. Like others have said, being just on salary gives no incentive to work hard.

 

[VA Hopeful Dr]

1) yes, that is standard management however why am I dealing with an issue the surgeon should deal with
2) "none of that works" is always what they say when I offer that treatment
3) it is always "my back hurts and I dont want to sit for that long"....legit? prob not, so no
4)my staff refuses to do it and my employer takes their side
5) it is not that I can't, more fear of bad outcomes/ side effects with medication
Yes, I plan on doing hospital work; the grass is not greener on that side however from when I have worked in the hospital, to me, the pathology is more interesting and I have more job satisfaction.
I appreciate your insight; esp with the coding however my employer has a tendency to fudge my RVUs so that I can't make my bonus; when I call them out on it I get "oh...we will look into that" and nothing comes of it. It is a huge reason why I am GTFO of this place the second my contract is up. Like others have said, being just on salary gives no incentive to work hard.

You're salaried? OK now this makes more sense.

Find a new job. If you're up to moving, my group is always hiring. I think @Blue Dog 's group usually is too.

 

[FrustratedFamDoc]

After residency, you will have your own flock that you mold, and they will learn your expectations or they will go find someone else. Don't make their problems your problems! Set clear expectations of what you can and what you can't/won't do for them or be prepared to be run all over.

Know what I call a visit that didn't really need to come in but did anyway? Revenue. I'm grateful to not have a day full of serious stuff. It's overrated.

Managing people's anxiety in it's various manifestations is one of the biggest parts of our job. The earlier you recognize that, the better off you will be.

 

[Sushirolls]

Open your own practice.

You have an amazing professional gift as Primary Care MD/DO. Open your own practice control the flow of scat rolling in. Set your clinic up the way you desire. Regain some professional control.

 

[sloh]

You're salaried? OK now this makes more sense.

Find a new job. If you're up to moving, my group is always hiring. I think @Blue Dog 's group usually is too.

I rarely ever hear good things about W2 FM jobs. It's like running on a treadmill but not even getting rewarded for it.

 

[Fatalis]

You're salaried? OK now this makes more sense.

Find a new job. If you're up to moving, my group is always hiring. I think @Blue Dog 's group usually is too.

@VA Hopeful Dr unforunately I am stuck here for the next 1.5yrs, on a visa contract and cant leave no matter what...it is so discouraging that I have worked so hard, jumped through numerous hurdles to be hard stuck at a dead end job
@mark v I did set the expectations when I first started [no chronic pain meds, xanax, etc if NOT indicated] this lead to plenty of patients seeing other providers and the admin got super pissed off at me; I still stood my ground bc it is my license and since then the admin has been acting really crappy towards me, not that I care but crap, we are here to help people not have petty squabbles. Yes I agree that a useless visit = revenue, however I never see that revenue. My RVUs are obtainable [saw more in residency] however, as stated above, around here they excel at not paying the bonus/extra and excel at fudging numbers so that bonus becomes a phantom bonus. Not to mention that there is no growth for me here; want to read ekgs/pfts at the hospital? I would love to but that just gets "added to my RVUs" i.e pro-bono. Want to take weekend call? Sure, we pay by the hour but cap it at 10hrs a day...yes works 72hrs but get paid 30hrs MAX. Oh and you must take call once a week; no pay bc it is "built in your contract which is built in a medical bylaw" ...again pro-bono and we don't pay you for rounding on hospital pnts because "it gets added to your RVUs".
@Sushirolls I have a few job offers waiting for me when I am done here, all have autonomy in their own way. The way I see it, this job is rock bottom so it can only get better. I walk out of this place much much wiser when it comes to reviewing contracts/ red flags.
I do appreciate all of the positive feedback from you guys! My wife and myself really do think it comes down to the place I am working at. I had to deal with similar issues [dumped on, etc] in residency but I enjoyed it so it wasnt that bad. Thanks again to everyone who has listened!

 

[FrustratedFamDoc]

Sounds like you've found yourself in to a hard to fill job that is taking advantage of you due to your visa status. They feel at liberty to abuse you because they know they own you for 1.5 more years.

If doing extra work doesn't result in extra compensation then it's not worth it. If it were me:

1. Above all, do good medicine.
2. Do just enough to pay bills and to not get fired
3. Have something else lined up to begin the MOMENT my 1.5 year commitment is up.

It does take a while to build a good practice so some of what your describing is pretty common, but I'm getting the feeling that there is more to it than that.

 

[Splenda88]

You gotta have it in you to do outpatient primary care.

Outpatients PCP should not work for < 250k/yr (40 hrs/wk). You guys have a tough job

 

[Fatalis]

Sounds like you've found yourself in to a hard to fill job that is taking advantage of you due to your visa status. They feel at liberty to abuse you because they know they own you for 1.5 more years.

If doing extra work doesn't result in extra compensation then it's not worth it. If it were me:

1. Above all, do good medicine.
2. Do just enough to pay bills and to not get fired
3. Have something else lined up to begin the MOMENT my 1.5 year commitment is up.

It does take a while to build a good practice so some of what your describing is pretty common, but I'm getting the feeling that there is more to it than that.

You hit the nail on the head, there is a lot of bs that they pull strictly bc they know I am there and can’t leave.
Doing 1 and 2 and 3 is taken care of. It’s just really discouraging that I have to settle for bs.

 

[Nevergiveupok]

You gotta have it in you to do outpatient primary care.

Outpatients PCP should not work for < 250k/yr (40 hrs/wk). You guys have a tough job

Those who chose to do solo outpatient PCP practices (and wanted to) are arguably the happiest people I know in medicine. Make a solid 230K (working legitimately 50-55 hour work weeks with paperwork/administrative work) and not having to spend a limited amount of minutes per patient. Thing is - most outpatient practices I know of that aren't solo are often paired with a hospital system. For that reason, they have certain patient volumes that need to be hit.

Independence of an outpatient solo office can be understated. The outpatient PCP I'm particularly thinking of doesn't plan to retire until their late 60s (by choice). Well-connected with a hospital system where he was offered 300K+ for an administrative position that would be even cushier than his life now. But he's over admin politics (used to be a teaching attending part-time while establishing his outpatient solo practice in the 90s) and enjoys the flexibility of spending 30 minutes with patients (new and old).

 

[Splenda88]

Those who chose to do solo outpatient PCP practices (and wanted to) are arguably the happiest people I know in medicine. Make a solid 230K (working legitimately 50-55 hour work weeks with paperwork/administrative work) and not having to spend a limited amount of minutes per patient. Thing is - most outpatient practices I know of that aren't solo are often paired with a hospital system. For that reason, they have certain patient volumes that need to be hit.

Independence of an outpatient solo office can be understated. The outpatient PCP I'm particularly thinking of doesn't plan to retire until their late 60s (by choice). Well-connected with a hospital system where he was offered 300K+ for an administrative position that would be even cushier than his life now. But he's over admin politics (used to be a teaching attending part-time while establishing his outpatient solo practice in the 90s) and enjoys the flexibility of spending 30 minutes with patients (new and old).

FM seems to attract cool people that are easy to work with. Maybe the FM PD at my university program do a better job in screening these people as opposed to IM. Again my sample size may be low (~30).

 

[Nevergiveupok]

FM seems to attract cool people that are easy to work with. Maybe the FM PD at my university program do a better job in screening these people as opposed to IM. Again my sample size my be low (~30).

Well this PCP is my current one (IM trained). Doesn't see peds pt but tends to practice very similarly with my former PCP (a FM doc).

 

[Keona]

1) yes, that is standard management however why am I dealing with an issue the surgeon should deal with
2) "none of that works" is always what they say when I offer that treatment
3) it is always "my back hurts and I dont want to sit for that long"....legit? prob not, so no
4)my staff refuses to do it and my employer takes their side
5) it is not that I can't, more fear of bad outcomes/ side effects with medication
Yes, I plan on doing hospital work; the grass is not greener on that side however from when I have worked in the hospital, to me, the pathology is more interesting and I have more job satisfaction.
I appreciate your insight; esp with the coding however my employer has a tendency to fudge my RVUs so that I can't make my bonus; when I call them out on it I get "oh...we will look into that" and nothing comes of it. It is a huge reason why I am GTFO of this place the second my contract is up. Like others have said, being just on salary gives no incentive to work hard.

Get a new job!!!! We are always looking for mds. Family med is very sought after. Preferably in a physician owned practice where you’ll be your own boss once you’re a partner. I am so glad I went with that option. I will be the employer and my nurses answer to me. (The partners also want me happy! And have reminded me at times I’m ultimately so and sos boss and to tell the nurse to change whatever I’m not happy with). If they say they don’t know how to fill out a form I’ll help them do it first few times but I do expect them to do them. My one nurse filled in my diabetic foot exams with calligraphy for me to just sign and document findings. Looks beautiful and professional.

 

[robellis]

Get a new job!!!! We are always looking for mds. Family med is very sought after. Preferably in a physician owned practice where you’ll be your own boss once you’re a partner. I am so glad I went with that option. I will be the employer and my nurses answer to me. (The partners also want me happy! And have reminded me at times I’m ultimately so and sos boss and to tell the nurse to change whatever I’m not happy with). If they say they don’t know how to fill out a form I’ll help them do it first few times but I do expect them to do them. My one nurse filled in my diabetic foot exams with calligraphy for me to just sign and document findings. Looks beautiful and professional.

This is exactly how medicine should be practiced

 

[Fatalis]

Get a new job!!!! We are always looking for mds. Family med is very sought after. Preferably in a physician owned practice where you’ll be your own boss once you’re a partner. I am so glad I went with that option. I will be the employer and my nurses answer to me. (The partners also want me happy! And have reminded me at times I’m ultimately so and sos boss and to tell the nurse to change whatever I’m not happy with). If they say they don’t know how to fill out a form I’ll help them do it first few times but I do expect them to do them. My one nurse filled in my diabetic foot exams with calligraphy for me to just sign and document findings. Looks beautiful and professional.

As above, visa job so Iam locked in

 

[Keona]

As above, visa job so Iam locked in

Can another job get you a new visa? I’m not sure how that stuff works.

 

[Splenda88]

Can another job get you a new visa? I’m not sure how that stuff works.

Not easy. The FMG got taken advantage of. One my co-residents contract got changed (30k less) unilaterally by his employer and he could not do a damn thing about it.

 

[Sushirolls]

Visa jobs have restrictions that they need to be within norms of practice standards. If they swing too far in sweat shop direction they can talk with a labor lawyer to review. Big fines for sponsoring entities that become sweat shops. Lawyers can tell you more.

 

[Fatalis]

Not easy. The FMG got taken advantage of. One my co-residents contract got changed (30k less) unilaterally by his employer and he could not do a damn thing about it.

I have heard about this so many times, it is quite sad

 

[TableMD]

Survive this, for the sake of your future patients.

You have it in you as a board certified family doc to do great things for your patients, have a satisfying professional career and earn a good salary.

Treat this as a sweat shop, cost of being an FMG/residency extension and not reflective of the real world.

Have your new job and every component of the logistics for getting the hell out of there set up so you can run as far from that place as possible.

Do everything possible to take advantage of your current employer, Such as scheduling interviews and doing other personal work while on the clock.

 

[Moose A Moose]

I feel for ya, OP.

However you sound like a doormat. Stop letting people walk all over you. You have the ability to punt back, as well as refuse the jury duty paperwork/medical clearance.

As long as you’re comfortable with the protocol you can medically treat whatever you want. Whether it be endo, cards, pulm, etc. There’s a fine line of when you need to refer, and it’s based on your confidence/acumen. Plenty of outpatient internists and family physicians in rural America accomplish those feat daily.

One final word: lol @ you thinking a hospitalist deals with less b/s. They are the peasants of the inpatient world and have to deal with everything - from admissions, to discharges, to case management and social work, and the list goes on. Grass is greener syndrome.

Find yourself a niche… and maybe a new job.

 

[icykelp]

… and maybe a new job.

Gosh darn it. Now why didn't the OP think of that.

 

[Fatalis]

I feel for ya, OP.

However you sound like a doormat. Stop letting people walk all over you. You have the ability to punt back, as well as refuse the jury duty paperwork/medical clearance.

As long as you’re comfortable with the protocol you can medically treat whatever you want. Whether it be endo, cards, pulm, etc. There’s a fine line of when you need to refer, and it’s based on your confidence/acumen. Plenty of outpatient internists and family physicians in rural America accomplish those feat daily.

One final word: lol @ you thinking a hospitalist deals with less b/s. They are the peasants of the inpatient world and have to deal with everything - from admissions, to discharges, to case management and social work, and the list goes on. Grass is greener syndrome.

Find yourself a niche… and maybe a new job.

I don't think you really even read my posts; as I stated that the grass isn't greener on the other side as a hospitalist however I would enjoy it more. Also as stated above, I cannot just "find a new job" due to my visa. Lastly, calling me a "doormat", ya meet me in real life and you would change your tune quickly. Thanks for playing tho.

 

[emergentmd]

Truthfully, unless you own the business, all docs are some form of doormats. When admin tells a doc to jump, typically most will jump or risk losing their jobs. This is the reality of medicine

 

[FamilymedMD]

FM doesn't suck. Outpatient practice doesn't suck. Your job and your employer suck.

Happy solo DPC FM for 6+ years. Never leaving independent practice or going back to hospital work.

 

[Prehealth1011]

FM doesn't suck. Outpatient practice doesn't suck. Your job and your employer suck.

Happy solo DPC FM for 6+ years. Never leaving independent practice or going back to hospital work.

How often are you on call?

 

[FamilymedMD]

I'm always on call except on vacation. Almost never an issue. My small (600) stable DPC panel is respectful of my time off and , other than some 5:01 pm refills , I usually only get a few calls per week. I see about 1-2 patients per month in the office after hours or on weekends for things that can't wait but would be a shame to dump in the ER.

 

[SXMMD]

Truthfully, unless you own the business, all docs are some form of doormats. When admin tells a doc to jump, typically most will jump or risk losing their jobs. This is the reality of medicine

This is probably true for most jobs in most industries. I think we’re just not used to the idea that we’re higher paid blue collar America like the rest of our patients… yet

edit: I am using hyperbole just FYI

 

[simpler2]

Not knowing all the details of the OPs current employ, the original post certainly doesn't suggest abuse. Described patient behaviors seem very common to me for outpatient FM. I always find when I'm getting excessively bothered by what is requested of me in the office, its more a problem of my own fatigue, burn out, need for vacation, etc. I've yet to bear witness of the work that leads to content for all those who pursue it, but I can think of people that appear very happy in almost every type of work.

 

[Fatalis]

FM doesn't suck. Outpatient practice doesn't suck. Your job and your employer suck.

Happy solo DPC FM for 6+ years. Never leaving independent practice or going back to hospital work.

I agree, a lot of my friends are enjoying their outpatient gig. I do not. Jus knowing that I deal with all this crap and get no compensation makes it that much difficult. 14 more months of this BS and I’ll be free.

 

[Sushirolls]

I agree, a lot of my friends are enjoying their outpatient gig. I do not. Jus knowing that I deal with all this crap and get no compensation makes it that much difficult. 14 more months of this BS and I’ll be free.

Cheers to the Freedom day!

Whatever your game plan is after Freedom day, start planning and prepping for it now. Don't just walk into Freedom Day thinking what now, be ready to board the metaphorical yacht and sail into the next chapter.

 

[Fatalis]

Cheers to the Freedom day!

Whatever your game plan is after Freedom day, start planning and prepping for it now. Don't just walk into Freedom Day thinking what now, be ready to board the metaphorical yacht and sail into the next chapter.

Already have 3 job offers lined up. Reviewing the contracts and what the exact job will be (now that I am wiser to bs), hopefully it will make things easier

 

[Splenda88]

Already have 3 job offers lined up. Reviewing the contracts and what the exact job will be (now that I am wiser to bs), hopefully it will make things easier

Are they all inpatient since it appears from you original post that you like inpatient better?

I am IM and one would have to pay me 275k+/yr to see 10-12 patients/day from 8-5 pm Mon-Thurs to do outpatient. Unfortunately, these jobs do not exist.

 

[Sushirolls]

Are they all inpatient since it appears from you original post that you like inpatient better?

I am IM and one would have to pay me 275k+/yr to see 10-12 patients/day from 8-5 pm Mon-Thurs to do outpatient. Unfortunately, these jobs do not exist.

Open your own practice and it will.

 

[Fatalis]

Are they all inpatient since it appears from you original post that you like inpatient better?

I am IM and one would have to pay me 275k+/yr to see 10-12 patients/day from 8-5 pm Mon-Thurs to do outpatient. Unfortunately, these jobs do not exist.

Yup all inpatient, one involves teaching which is awesome

 

[nexus73]

This may be an unpopular opinion. And may not apply to OP. However, in my experience with docs on visa, they're coming to the USA after training at a foreign medical school where tuition is either completely free, or dirt cheap. Residents I trained with from India (great doctors by the way) told me about school costing something like $10,000 in total, which their parents could easily pay because parents were doctors or had other high paying jobs.

Then the doctors come to the USA, which is great because we need doctors, and they can make a lot more in the US than they could back home, and they have no medical school debt to speak of. So to me it seems like paying your dues in a visa job that has some annoyances is a fair trade off. Would you trade your visa job for $400K in school loans? Would you rather go back to your home country to make less money? I'm guessing not. So you spend the time required at the visa job and then can go wherever you want. I'm just saying life isn't fair and we have choices to make. You're in a job that is annoying and not rewarding, but it allows you to practice in the US, earn a good living, and it's not forever.

 

[Prehealth1011]

OP is a Caribbean grad I think. They're likely in the same-ish blackhole that we're in when it comes to loans with the added perk of being J1-abused

It's just rough all around. I wish OP the best

 

[Fatalis]

This may be an unpopular opinion. And may not apply to OP. However, in my experience with docs on visa, they're coming to the USA after training at a foreign medical school where tuition is either completely free, or dirt cheap. Residents I trained with from India (great doctors by the way) told me about school costing something like $10,000 in total, which their parents could easily pay because parents were doctors or had other high paying jobs.

Then the doctors come to the USA, which is great because we need doctors, and they can make a lot more in the US than they could back home, and they have no medical school debt to speak of. So to me it seems like paying your dues in a visa job that has some annoyances is a fair trade off. Would you trade your visa job for $400K in school loans? Would you rather go back to your home country to make less money? I'm guessing not. So you spend the time required at the visa job and then can go wherever you want. I'm just saying life isn't fair and we have choices to make. You're in a job that is annoying and not rewarding, but it allows you to practice in the US, earn a good living, and it's not forever.

Canadian, Carib grad with 250k in loans probably just like yourself.
Yes I realize I must pay my dues for a greencard however paying dues should not mean getting exploited. And for several of us, we have families/ S.Os so we cannot just pick up and go back to our home countries.

 

[nexus73]

Canadian, Carib grad with 250k in loans probably just like yourself.
Yes I realize I must pay my dues for a greencard however paying dues should not mean getting exploited. And for several of us, we have families/ S.Os so we cannot just pick up and go back to our home countries.

I wonder what would happen if the US and Canada allowed each others citizens to travel across the border for work. Especially physicians. I wonder if there would be a net loss or gain of physicians from Canada. As a psychiatrist in the northern US, I'd strongly consider moving to Canada to work, but the process seems kind of involved.

 

[Fatalis]

I wonder what would happen if the US and Canada allowed each others citizens to travel across the border for work. Especially physicians. I wonder if there would be a net loss or gain of physicians from Canada. As a psychiatrist in the northern US, I'd strongly consider moving to Canada to work, but the process seems kind of involved.

Would love that, honestly would make life easier.
There are tons of hoops to jump through, especially from the area I am from

 

[scharnhorst]

my first job after residency
med director : how did fm become your passion
me : it is not
med director : when did medicine become your passion
me : never was
lots of ??? faces in the room
medicine is my profession and trade, i try to be as good as it as I possibly can
patients are my clients and I try to provide them the best possible service [ and I DO NOT treat them like family]
my passion is military history and model building [ and i knew damn well there is no job that pays more than min wage in that field so no I will not make it my profession ] . I never wanted to be in the military though just for ideological reasons

treat it like a profession and always have an outlet for frustration , dont let it consume you

 

[scharnhorst]

This may be an unpopular opinion. And may not apply to OP. However, in my experience with docs on visa, they're coming to the USA after training at a foreign medical school where tuition is either completely free, or dirt cheap. Residents I trained with from India (great doctors by the way) told me about school costing something like $10,000 in total, which their parents could easily pay because parents were doctors or had other high paying jobs.

Then the doctors come to the USA, which is great because we need doctors, and they can make a lot more in the US than they could back home, and they have no medical school debt to speak of. So to me it seems like paying your dues in a visa job that has some annoyances is a fair trade off. Would you trade your visa job for $400K in school loans? Would you rather go back to your home country to make less money? I'm guessing not. So you spend the time required at the visa job and then can go wherever you want. I'm just saying life isn't fair and we have choices to make. You're in a job that is annoying and not rewarding, but it allows you to practice in the US, earn a good living, and it's not forever.

agree 100 percent
i never complain of any discrimination as an IMG
we should be thankful US gave us a chance at such a great life
i think system is really fair , i had zero loans and I have GREAT RESPECT for my US grad colleagues who were brave enough to take such high student loans.

 

[scharnhorst]

Open your own practice.

You have an amazing professional gift as Primary Care MD/DO. Open your own practice control the flow of scat rolling in. Set your clinic up the way you desire. Regain some professional control.

i want to do that in like ten yrs or so
do you think private practice will be around that long ?

Can a FP/FM tailor their practice so they can only focus on a few conditions and refer out all the vague symptoms /things u dont want to treat to other FP/IM docs ?

 

[Splenda88]

my first job after residency
med director : how did fm become your passion
me : it is not
med director : when did medicine become your passion
me : never was
lots of ??? faces in the room
medicine is my profession and trade, i try to be as good as it as I possibly can
patients are my clients and I try to provide them the best possible service [ and I DO NOT treat them like family]
my passion is military history and model building [ and i knew damn well there is no job that pays more than min wage in that field so no I will not make it my profession ] . I never wanted to be in the military though just for ideological reasons

treat it like a profession and always have an outlet for frustration , dont let it consume you

Boy! You got some cojones to say that to US physician. It's when I moved to the US I learned that I must be passionate about my job.

 

[VA Hopeful Dr]

Boy! You got some cojones to say that to US physician. It's when I moved to the US I learned that I must be passionate about my job.

Meh, outside of academics that goes away within 3 years of finishing training.

 

[VA Hopeful Dr]

i want to do that in like ten yrs or so
do you think private practice will be around that long ?

Can a FP/FM tailor their practice so they can only focus on a few conditions and refer out all the vague symptoms /things u dont want to treat to other FP/IM docs ?

You absolutely can, but there are a few issues you'll need to be aware of. First, this limits your patient pool a good bit. Meaning it will take longer to get a full patient panel. Second, you're going to be essentially trying to function as a specialist which means you're competing against those specialists.

What I've seen that works better: do regular FM with an emphasis on whatever area you want specifically.

 

[scharnhorst]

Boy! You got some cojones to say that to US physician. It's when I moved to the US I learned that I must be passionate about my job.

in residency i was the same but in 3rd yr i realized americans respect sincerity more than anything else
plus they really needed someone to fill that spot so there was not much competition
it was a fqhc bro , no US grads go there