We have two nurse practitioners, and if we continue to grow at our current rate, may need a third within 2 years. (besides just saying quit or go to med school). Medscape 2018 reports family medicine average salary to be $219,000 nationwide—a very big change over just around five years. 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. Family medicine is changing with the times. And having all the tasks passed down to you that are unattractive, don't pay well or don't pay at all (ie. 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. 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. “I was shocked at the offers I received,” recalls Samantha. I’m strongly considering FM, but what do you believe to be the long-term outlook, as in 20-30 years? Primary care is often responsible for cleaning up the messes that the various midlevels of the world create. 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. There is the threat of midlevel encroachment -- totally valid threat. First time posting on this Reddit. If you talk to them, they are actually perplexed at the idea of practicing alone. "Physician Extenders" will be more of a part of it, but that means more time for you to reddit. I know with potential ACA changes the future is in flux. The Future of Precision Medicine. Either the education is worthwhile or it is not. It's time for another update on Family Medicine for America's Health: Future of Family Medicine 2.0. [Article revised on 25 April 2020.] This week alone I was able to teach our NPs what Bullous Pemphigoid and Livedo Reticularis were during a patient visit to them. Before hiring our NPs, we would see 30+ patients each per day. I would hope residency could be reformatted to help with the debt and money aspect. 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. Ann Fam Med . Press J to jump to the feed. That's fair. 2. The demand for family medicine doctors is extremely high right now, and they are very large income generators for consolidated healthcare systems. As far as I can tell, it is a win-win to have them. These are the types of things I'm wondering. Press J to jump to the feed. What are these common and/or preventable mistakes you are noticing? 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. 81. They hope that health insurance companies and other payers will align their payments and reimbursements to family medicine physicians and other primary care providers … 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. 2004;2(suppl 1):S3–32. They rated their FMIG involvement at 2.07 on the 4-point scale. I'm indebted to you guys for my education and skill. METHODS A national research study was conducted by inde- Family is the link between the individual and society. It would not lead to cost containment and isn't the solution to the family practice dilemma. 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. Mainly asking about the availability of jobs and the salary. ... help Reddit App Reddit coins Reddit premium Reddit gifts. They are vital to our practice, and treated like equals, but they certainly know when to ask for help. Family medicine because it was broad, all-inclusive, and promoted an ethos of family- and community-centered care that aligned with my ideological predispositions. 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. 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. Average income increased 17% from 2015 to 2017 according to a Merritt Hawkins survey. 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. We know that the future of Family Medicine lies in the students who train with us. I have some concerns. The rest of the report can be found here: https://www.merritthawkins.com/news-and-insights/blog/healthcare-news … Posted by. /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. My decision to leave clinical medicine was complex. That's fair but with independent practice is that not already the first step towards replacement? The clinic I’m at now is staffed by 3-4 docs and 2 PA’s and they’re still overflowing with patients. I concede that probably noone finds filling out disability paperwork stimulating. 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. I think the long-term outlook is actually quite good compared to other medical specialties. 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. 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. 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. firstname.lastname@example.org. 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. Just because someone can practice in FP doesn't mean they are anymore likely than the physicians who choose to go into specialty. Everyday brings something new. Unless they really change their training, I cannot see this changing for the most part. I have quite a bit of autonomy. They know when something is too complex and ask us questions at least hourly regarding management, which we absolutely encourage. This is a highly moderated subreddit. In that respect I don't think they are going to be replaced by NP anytime soon. I would be willing to bet family medicine continues to be a safe bet. Long term future for family med is amazing. The future of family medicine: a collaborative project of the family medicine community. 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. 5 years ago. Spann SJ. 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. The Nurse Practitioners, however, know their limits. When you’re having to see 20-30 pts a day you’ll be thankful for whatever help you can get. New M4 planning on family and this is the exact setup I would like. They’re the most in demand field at the moment. There's a LOT more to think about than just availability of jobs and salary. That being said many states currently allow for unsupervised PA NP practitioners. I am one of 3 physicians in an independent Family Medicine practice. We’ve identified five states where the typical salary for a Family Medicine Physician job is above the national average. Very true, there's a such thing as doing more harm than good. I really think it could go either way. 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 … The Society of General Internal Medicine (SGIM) is dedicated to improving patient care, education, and research in primary care and general internal medicine. Removal of sutures, wound care, ear syringing, government forms, etc). I've done some reading about this question however I haven't been satisfied with what I've found so far. family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. 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. None of this has ANYTHING to do with intelligence, of course -- it is all a matter of experience. 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/. Please, don't take what I said as an insult to your intelligence. And this is in a suburban/borderline rural area. The future of Family Medicine. If outcomes are similar between NP and FP why would insurance pay more to FP? Hi all! Nobody knows but the most common sentiment echoed is that the FP isn't going anywhere. Fast-forward to 2013 and you’ll find that family medicine and the role of family physicians have changed drastically. Medicine may be a science, but even scientists will gaze into a crystal ball. In fact, naturopathic medicine is now rated as having an “excellent” career outlook. I don't actually think patients want more. What this does mean is that on average, the complexity of the patients that the doctors see has gone up. Ann Fam Med. 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 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. Anecdotally, for graduating family medicine residents whom I have trained, the job offers look even better than most reports. Quite possibly one of the highest in demand if you’re willing to live in certain areas that are in high demand for docs. Any insight will be appreciated. Honestly just want to do the best I can for the patients and for my physician colleagues. Please read the rules carefully before posting or commenting. I do not see NPs taking over for Family doctors. Topping the list is New York, with New Hampshire and Vermont close behind in second and third. Some people will do a 1 year fellowship in sports medicine, geriatrics, palliative care, or additional training in obstetrics. I think its safe to say that there will always be a need for family med physicians. Although we pay well, they still allow us to make a profit. Unusual constellation of findings suggesting malignancy or autoimmunity? Does your office have a preference for this? Personally, I see mostly adults, and only see patients in an office. They envision that more people and organizations will recognize and embrace the value of primary care--and its providers. Or is it really more augmentation of the existing workforce? Average income increased 17% from 2015 to 2017 according to a Merritt Hawkins survey. Become a preceptor. The efforts of every family physician and family medicine ally are necessary to meet the ambitious goal of America Needs More Family Doctors: 25x2030. A little bit of context: I have had testing accommodations through undergrad, grad school, and now medical school. It's soul crushing at times. 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. More time to reddit is the big picture and end goal. The future of Family medicine is unknown, but what I know that family physicians can't be replaced by a Nurse practitioners. Your hypothetical scenario is already happening, and physicians aren’t just seeing complex cases. Some family physicians like doing those minor procedures you mentioned. 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. Zeeshan Ahmed, director of the new Ahmed Lab at Rutgers Institute for Health, Health Care Policy and Aging Research Date. 2004;2:S3–S32. They just are not exposed to nearly as much as doctors are over the course of their training. Its really unwise and hazardous for the public to let mid level encroachment continue. 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). Out of curiosity, why do you have just NPs and no PAs? Now that number is closer to 20. They had neither seen or heard of these diagnoses before. Want to collaborate and work together, not encroach. 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. Midlevel careers have such a low barrier to entry compared to what med students had to go through. Media Contact. Nurse practitioners can apply guidelines … No one can predict the future, but family medicine physicians and leaders have high hopes for their specialty over the next several years. The nursing board has guidelines regarding what they can and can not prescribe, and they are very aware of this. My dad is one of them. These predictions famously missed their mark — though not for want of trying. However. NPs are a wonderful asset to the office. Family Medicine Resident. That being said, the ANA and others are unwisely pushing for this and they are loud and funded. 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. MS4. So there's more to think about than availability and salary. Would appreciate any insight. The future of Family medicine is unknown, but what I know that family physicians can't be replaced by a Nurse practitioners. It is dangerous for patients who should be taken care of under supervision. 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. They’re seeing both, because there aren’t enough healthcare workers to go around. 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. In the future will this lead replacement of FP with mid levels? 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. Nurse practitioners can apply guidelines and protocols, but patients want more than this. 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. NPs aren't likely to have that experience. I make great money and have one of the cushiest schedules out of anybody I know. A team approach includes naturopathic doctors who can help treat a variety of health issues. Vermont beats the national average by 4.9%, and New York furthers that trend with another $29,863 (14.4%) above the $208,024. I also think its logically contradicting to have MDs and NPs providing near the exact same services with vastly differing education. We will do our best to teach them in both inpatient and outpatient settings and will model the best of the specialty. That’s why naturopathic medicine is a great option for those who want to have a direct impact on the health of others. 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 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). 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They still allow us to make a profit my Physician colleagues just seeing complex cases said, the offers... Anytime soon changes in the students who train with us fair but with practice... The national average to them one can predict the future is in flux received, ” recalls.! And hazardous for the patients that the FP is n't going anywhere but the professional (... ’ m strongly considering FM, but now that I work in FM, but do!
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