- Joined
- Jul 26, 2003
- Messages
- 981
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Hello all. allow me to explain a dilema I have come to find in my life. I am a third year medical student that has discovered that he likes everything. Ask me what I want to do a residency in, I don't know because I like it all, I like FP, IM, Peds, OB,surgery, rads, I could go on, I like everything. I am particurlay bias to surgical specialties because I like working in the OR and enjoy fixing things, but I could not imagine doing just surgery only!
Now I realize that there are two fields were I can do almost everything, that is IM and FP. I do like the fact that in IM you can specialize if you want, but I do not like the fact that in IM you cannot see patients under 12 years of age and you cannot do OB.
This almost makes me want to go out and do FP, then do an OB fellowship so that I can do C-sections, tubal ligations, etc.
I am a firm believer in the FP philosophy of taking caring of the whole families needs, peds, gyn, ob, adolescents, adult, and geriatrics. However, I do find one big problem with FP.
FP's don't get any respect from other docs, especially specialist. And you might say so what? Well the problem with that is that FP residents will not get well trained. My wife started her FP residency at a hospital that only had an FP program. I will make an example of her here. When she did her surgery month, she had to round on the surgeon's patients, do his consults, and yes, even scrub in and help out on cases. Unfortunately, her program closed and she is now doing her PGY-2 year at a different hospital. At her new hospital, during a surgery month, she is bored! The surgeon told her there is no need for her to round on his patients, or even demand to be first assist on cases because she is only an FP resident. I feel that at a lot of bigger hospitals, this is how FP residents are treated, especially those hospitals that do have other programs. No respect!
I suppose the problem is, FP's CAN do a broad range of things in their office but will not. Many people think that in FP all you do is see the common cold and write prescriptions. Unfortunately, this can be true, this is what some FP's do, even though they can do much more. And yes, the least competitive go into FP. Sorry, but if I had a dollar for every time I heard, "Why do I care I just want to be an FP" "So what if I failed my boards, I just want to be FP" " I didn't get into the program I wanted so I'll just do FP and apply later", I'd be rich. These are the people that do sit around and see common colds and write prescriptions when they become attendings, its unfortunate.
My view of FP is this. The "true" FP has a role only in rural areas. I mean think about it, in the world of up and coming PPO's why would a person in the city go to an FP to have a mole cut off when they can go to their choice of a hundred or so dermatologist without a referal? Why would you want an FP to deliver your baby, do a colposcopy, etc when their are many OB/GYNS in your city and you again, don't need a referal?
In my opinion, the role of primary care managers is about to die and in the world of PPO's, its just might. The only thing an FP in the city can really do is be a primary care manager. The only way I see and FP office in the city working out is if the office is part of a residency program, and we all know the bulk of these offices see medicare and medical assistance patients. If these offices were not be funded with grant money because of their residents, they could never survive.
I see the rural side of FP being much different. You will go to your FP to get your mole cut off if the nearest dermatologist is fifty miles away!
So in my opinion, for a guy that likes to do it all, I could see myself doing rural FP. In a rural setting, I could deliver a woman's baby, why, because the nearest OB/GYN is miles away. And when her baby is born, I could do pediatrics for her kids, why because the nearest pediatrician may be the only within 100 miles and is too swamped with patients. I could do the womens complete gyn care, do her husbands care, do adult medicine, etc. And all because the nearest specialist are miles away.
Anyways. I do not want to upset anybody, these are just my opnions. But I would like your input, expecially those that are already FP's
Now I realize that there are two fields were I can do almost everything, that is IM and FP. I do like the fact that in IM you can specialize if you want, but I do not like the fact that in IM you cannot see patients under 12 years of age and you cannot do OB.
This almost makes me want to go out and do FP, then do an OB fellowship so that I can do C-sections, tubal ligations, etc.
I am a firm believer in the FP philosophy of taking caring of the whole families needs, peds, gyn, ob, adolescents, adult, and geriatrics. However, I do find one big problem with FP.
FP's don't get any respect from other docs, especially specialist. And you might say so what? Well the problem with that is that FP residents will not get well trained. My wife started her FP residency at a hospital that only had an FP program. I will make an example of her here. When she did her surgery month, she had to round on the surgeon's patients, do his consults, and yes, even scrub in and help out on cases. Unfortunately, her program closed and she is now doing her PGY-2 year at a different hospital. At her new hospital, during a surgery month, she is bored! The surgeon told her there is no need for her to round on his patients, or even demand to be first assist on cases because she is only an FP resident. I feel that at a lot of bigger hospitals, this is how FP residents are treated, especially those hospitals that do have other programs. No respect!
I suppose the problem is, FP's CAN do a broad range of things in their office but will not. Many people think that in FP all you do is see the common cold and write prescriptions. Unfortunately, this can be true, this is what some FP's do, even though they can do much more. And yes, the least competitive go into FP. Sorry, but if I had a dollar for every time I heard, "Why do I care I just want to be an FP" "So what if I failed my boards, I just want to be FP" " I didn't get into the program I wanted so I'll just do FP and apply later", I'd be rich. These are the people that do sit around and see common colds and write prescriptions when they become attendings, its unfortunate.
My view of FP is this. The "true" FP has a role only in rural areas. I mean think about it, in the world of up and coming PPO's why would a person in the city go to an FP to have a mole cut off when they can go to their choice of a hundred or so dermatologist without a referal? Why would you want an FP to deliver your baby, do a colposcopy, etc when their are many OB/GYNS in your city and you again, don't need a referal?
In my opinion, the role of primary care managers is about to die and in the world of PPO's, its just might. The only thing an FP in the city can really do is be a primary care manager. The only way I see and FP office in the city working out is if the office is part of a residency program, and we all know the bulk of these offices see medicare and medical assistance patients. If these offices were not be funded with grant money because of their residents, they could never survive.
I see the rural side of FP being much different. You will go to your FP to get your mole cut off if the nearest dermatologist is fifty miles away!
So in my opinion, for a guy that likes to do it all, I could see myself doing rural FP. In a rural setting, I could deliver a woman's baby, why, because the nearest OB/GYN is miles away. And when her baby is born, I could do pediatrics for her kids, why because the nearest pediatrician may be the only within 100 miles and is too swamped with patients. I could do the womens complete gyn care, do her husbands care, do adult medicine, etc. And all because the nearest specialist are miles away.
Anyways. I do not want to upset anybody, these are just my opnions. But I would like your input, expecially those that are already FP's
