Lack of respect in FM?

[grasshopper2005]

I am seriously thinking alot about FM but every time i mention it to a classmate or somebody in the healthfield (other MDs, residents, etc.), I feel like there is lack of respect for my decision and they quickly start listing reasons why I should choose IM over FM. Oh, you can make more money as an IM....There is no place for FM in today's world, esp. in urban settings....Only those not smart enough for another speciatly choose FM......, etc. Anybody else have the same problem? Is it discourging you from choosing FM?

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[deleted6669]

I am a practicing pa contemplating medschool so take this for what it is worth......
as an fp doc you have a much wider scope of practice than most general im docs. you can see kids. you can do ob. you can do a variety of very billable outpt procedures(sigs, vasectomy,skin biopsies, etc) that most im docs don't do. fp docs work much better in urgent care settings than im folks because of this broad background and are recruited most heavily for this type of work.
you could not pay me enough to do im...too boring...old sick pts all day long...great...gomerology...
if I go back to school it will be fp or em only....
best of luck in whatever you decide....

 

[Pilot]

I'm doing a rural hospital rotation currently with the only internist in the town. 2 weeks ago, I had 13 patients on my service. All but one was over the age of ninety. The other was eighty-nine.

Count me out for plain IM. I am still ranking a Med-Peds program, but there is now way I would do general IM. Old people with multiple complaints, grossly long PMH, and family members who don't want DNR's. Not my favorite rotation, needless to say.

 

[dksamp]

Hello,
The reason IM's might make a lil more than FP is because IM is adult medicine ONLY with a big proportion >65 y/o, that means HIGH proportion of MEDICARE patients. In my state, medicare is the BEST payer, and all managed care plans pay a PERCENTAGE of the medicare rate (ex. Blue cross between 70-80%, NHP heath plan 89% of medicare).
Since FP's see kids also, and since the BULK fo the kids you are gonna see are MEDICAID, which is a CRAPPY payer (roughly HALF of what medicare pays), if you have a mixed service (adult and kids), the pay is gonna be lower than that of IM.
As far as the respect factor goes, it is all based on the INDIVIDUAL. If you practice good medicine and "get along well with the other kids in the sandbox", then you will be respected. If you are a PUTZ, then no one will respect you, no matter what your specialty. Just my $0.02...PEACE!!

-Derek

 

[CambieMD]

I have to agree with dksamp. depending on what you ultimately want to do fp may be more suited to you than im. The choice varies among individuals.
The payer mix does make a difference.Also, some payers may pay fp docs less for their services. The difference is not that great.

CambieMD

 

[MacGyver]

Originally posted by dksamp
In my state, medicare is the BEST payer, and all managed care plans pay a PERCENTAGE of the medicare rate (ex. Blue cross between 70-80%, NHP heath plan 89% of medicare).

Thats a pathetic situation. Watch your earnings fall every year as inflation and malpractice increases continue to outpace Medicare/Medicaid reimbursement.

 

[secretwave101]

As long as I have enough patients to keep me busy - and they respect me - I don't really care what the rest of the medical world thinks.

Every specialty thinks it's smarter and cooler and better than the others. Try to ignore the hype and go with what suits you.