The NP will certainly be able to document and discover everything, but typically the doctor would be the one to put it all together and recognize when a collection of findings is concerning or not. 2. My decision to leave clinical medicine was complex. 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. Medscape 2018 reports family medicine average salary to be $219,000 nationwide—a very big change over just around five years. Media Contact. They rated their FMIG involvement at 2.07 on the 4-point scale. In that respect I don't think they are going to be replaced by NP anytime soon. In 2002, the Future of Family Medicine project developed a strategy to transform the identity of the family medicine specialty as well as meet the needs of both patients and physicians in the ever-changing health-care environment. Jenny Noonan. Some people will do a 1 year fellowship in sports medicine, geriatrics, palliative care, or additional training in obstetrics. Hours have likely plateaued. The future of Family medicine is unknown, but what I know that family physicians can't be replaced by a Nurse practitioners. Now that number is closer to 20. 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. Enhance your residency experience with the latest medical news, expert advice, and tools to help you prepare for a career in family medicine. That's fair. "Physician Extenders" will be more of a part of it, but that means more time for you to reddit. And having all the tasks passed down to you that are unattractive, don't pay well or don't pay at all (ie. Please read the rules carefully before posting or commenting. I am one of 3 physicians in an independent Family Medicine practice. “I was shocked at the offers I received,” recalls Samantha. I think its safe to say that there will always be a need for family med physicians. Primary care PA here. Will FP salaries go down closer to the level of mid level or will FP be relegated to seeing only the more complicated cases? I'm indebted to you guys for my education and skill. I do not see NPs taking over for Family doctors. MS4. If I went into it, I wouldn’t be an attending until 5 years from now. So there's more to think about than availability and salary. Compensation is going to keep going up. I didn't think I would want to go into FM, but now that I work in FM, I love it. Just because someone can practice in FP doesn't mean they are anymore likely than the physicians who choose to go into specialty. 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. First time posting on this Reddit. 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. Spann SJ. If outcomes are similar between NP and FP why would insurance pay more to FP? I don't actually think patients want more. Unusual constellation of findings suggesting malignancy or autoimmunity? I’m strongly considering FM, but what do you believe to be the long-term outlook, as in 20-30 years? 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. That’s why naturopathic medicine is a great option for those who want to have a direct impact on the health of others. They know when something is too complex and ask us questions at least hourly regarding management, which we absolutely encourage. We have two nurse practitioners, and if we continue to grow at our current rate, may need a third within 2 years. I will say that both the physicians I described seem happy, but also worn out. Family medicine is changing with the times. Ann Fam Med . 2004;2:S3–S32. New comments cannot be posted and votes cannot be cast. We’ve identified five states where the typical salary for a Family Medicine Physician job is above the national average. The demand for family medicine doctors is extremely high right now, and they are very large income generators for consolidated healthcare systems. The FM section in particular has a compensation discussion basically on a weekly basis. 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. Either the education is worthwhile or it is not. (besides just saying quit or go to med school). I make great money and have one of the cushiest schedules out of anybody I know. 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. Posted by. Nurse practitioners can apply guidelines and protocols, but patients want more than this. (Family physicians were the most requested specialty among all of those tracked, for the 13 th year in a row.) Vermont beats the national average by 4.9%, and New York furthers that trend with another $29,863 (14.4%) above the $208,024. We know that the future of Family Medicine lies in the students who train with us. I do think that there is a place for mid level providers to work in conjunction with physicians to provide superior healthcare. They are vital to our practice, and treated like equals, but they certainly know when to ask for help. 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. Would appreciate any insight. Most of the patients that they see are more acute than the ones the doctors see -- URIs, UTIs, BP or DM checks etc. The resident seemed happier than many of my other rotations, the work was interesting, and I could see myself doing it. Press J to jump to the feed. Fast-forward to 2013 and you’ll find that family medicine and the role of family physicians have changed drastically. That one patient with the very rare disease you saw in the ER at 3 in the morning 15 years ago? TL;DR NPs are a fantastic asset, but unless training is longer/more intense, they will always need a supervising doctor. Quite possibly one of the highest in demand if you’re willing to live in certain areas that are in high demand for docs. 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. Everyday brings something new. It would not lead to cost containment and isn't the solution to the family practice dilemma. They just are not exposed to nearly as much as doctors are over the course of their training. None of this has ANYTHING to do with intelligence, of course -- it is all a matter of experience. /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. Nobody knows but the most common sentiment echoed is that the FP isn't going anywhere. For context I'm a 3rd year who recently finished and enjoyed my family rotation. I know with potential ACA changes the future is in flux. The future of Family Medicine. It sucks seeing all the hate around here when some/a lot of us completely recognize and respect the authority and expertise of physicians and just want to do what we can to make the system work smoothly for the patients and the docs. 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". It's time for another update on Family Medicine for America's Health: Future of Family Medicine 2.0. 81. Topping the list is New York, with New Hampshire and Vermont close behind in second and third. 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. Anecdotally, for graduating family medicine residents whom I have trained, the job offers look even better than most reports. Definitely not limited to primary care, but it seems like they don't as much sway with the administration since they generate less income, are easily replaceable, etc. You also didn't mention knee injections, pap smears, abscess I&D, elliptical excisions, punch and shave biopsies, suturing, etc... some FP docs find these procedures pretty satisfying, and a good way to mix up the humdrum of listening to complaints all day. The Future of Precision Medicine. Ann Fam Med. 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. New M4 planning on family and this is the exact setup I would like. Welcome to /r/MedicalSchool: An international community for medical students. Although we pay well, they still allow us to make a profit. firstname.lastname@example.org. Press J to jump to the feed. I would be willing to bet family medicine continues to be a safe bet. 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. Want to collaborate and work together, not encroach. The Nurse Practitioners, however, know their limits. This is a highly moderated subreddit. These are the types of things I'm wondering. 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. As a current med student that wants to go into Family Med, would you consider your situation to be the exception or do you think that just the negative voices are louder? Average income increased 17% from 2015 to 2017 according to a Merritt Hawkins survey. ... help Reddit App Reddit coins Reddit premium Reddit gifts. This week alone I was able to teach our NPs what Bullous Pemphigoid and Livedo Reticularis were during a patient visit to them. 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). Most of SDN is cancer, but the professional sections (like FM) are full of practicing docs. We have fantastic NPs in my office. 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. Your hypothetical scenario is already happening, and physicians aren’t just seeing complex cases. More time to reddit is the big picture and end goal. I concede that probably noone finds filling out disability paperwork stimulating. We will do our best to teach them in both inpatient and outpatient settings and will model the best of the specialty. Medicine may be a science, but even scientists will gaze into a crystal ball. Honestly just want to do the best I can for the patients and for my physician colleagues. 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. Personally, I see mostly adults, and only see patients in an office. 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. In fact, naturopathic medicine is now rated as having an “excellent” career outlook. The rest of the report can be found here: https://www.merritthawkins.com/news-and-insights/blog/healthcare-news … Family Medicine Resident. When you’re having to see 20-30 pts a day you’ll be thankful for whatever help you can get. No one can predict the future, but family medicine physicians and leaders have high hopes for their specialty over the next several years. 2004;2(suppl 1):S3–32. The Society of General Internal Medicine (SGIM) is dedicated to improving patient care, education, and research in primary care and general internal medicine. Press question mark to learn the rest of the keyboard shortcuts. The future of family medicine: a collaborative project of the family medicine community. Primary care is often responsible for cleaning up the messes that the various midlevels of the world create. The future of Family medicine is unknown, but what I know that family physicians can't be replaced by a Nurse practitioners. The fact that NP's can practice independently is BS, very special cases such as practicing out in the sticks should be taken on a case by case basis and have significant enough evidence to prove this. 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