OT: Family medicine in the US?

Jyoti

This is wildly off-topic, but I seem to be having a lot of trouble finding information on this topic, and I'm pretty sure, judging by recent WIWs that there are some doctors kicking around on YLF. xD

I live and go to medical school in Canada, but my boyfriend lives in the Los Angeles area, and I would really love some information on family medicine in that area, or more broadly, in America, as I think I might like to move down there eventually. Can anyone chime in on their experiences? How's the job security and job market in the US (specifically in the LA area if anyone is able to comment) for family medicine? The lifestyle and the money? I feel like many doctors are quite biased in Canada in regards to the health care system in the States and it's hard to get a straight answer out of lots of them. xD

Other questions:

- What about medical genetics? Does anyone know any medical geneticists or refer to them? How's the job market?
- For everyone, do you have a family doctor? Do they dress well/have a good lifestyle that you are aware of? Do they complain about their job a lot? Do you tend to just self refer yourself to a specialist?
- Really personal and I know you may not want to answer, but what can I expect to make as a family doctor in the LA area?

Feel free to PM me if you would like!

And thank you in advance to anyone that answers my strange, strange questions. xD

13 years ago

General

11 replies

Latest reply was from Jyoti

christieanne

Veteran

I can't really answer your questions but i live in California and have received 80% of my medical care from a large, well known HMO that I have been very happy with.
My doctors don't really stand out as fashionable. Even under the white lab coats, they are in basic slacks or nice jeans and pretty simple tops.
My favorite drs (both young and both have left for other practices) complained about about the patient load (with humor) and also one told me she was only employed part time and had two other part time jobs just to live and pay back her student loans. She was such a great dr.too!
Is there info on any medical society bulletin boards?

Good luck to you in whichever path you choose

13 years ago

fashionista

Veteran

Sorry wanted to help but I don't know anything about this. So sorry.

13 years ago

Anonymous

I can't answer your questions, either. I can tell you that my DH and I have really good HMO insurance coverage through the university where we both work. We've been happy with that insurance and are glad we have it.

13 years ago

lyn*

(website)

Veteran

I may be wrong; but I believe that americans have a slightly different "family medicine" system than us - so they see an "internist" for certain things (i.e.: instead of being a purely consult service). Maybe you could consider doing internal med?

BTW; all of my classmates who have matched to the USA (1 out of 110 - lol); and people who plan to do fellowships there in the future (10 of 110) have written their USMLE CK and CS Step 2 before graduating med. I don't know where you are in your medicine journey, but this might be something you may consider doing as well.

13 years ago

Sona

Veteran

I'm an internist and I can tell you that I'm in this because I LOVE my job. We are all overworked, overstressed and underpaid for the most part ( in primary care- i.e family practice, internal medicine or pediatrics). Most physicians would tell you in the US that they would highly dissuade their kids from entering this profession unless they LOVE medicine. I manage a lot of complicated issues on my own but yes living in a litiginous society speciality referral is often inevitable for many reasons.
I've had my Canadian friends try to recruit me over the years and the numbers they have quoted me as a lure are more than twice I could ever make.
No matter what you choose, make your choices for the right reasons. Whatever those may be for you!

13 years ago

Vicki

(website)

Veteran

Jyoiti, how exciting if you can relocate to be closer to your boyfriend. I am not part of the medical field, but speaking as someone who just made an appointment with an internist for an appointment to establish myself with an internal medicine, family practice type of doctor, I can say that at University of California, Irvine, Medical Center, they do have both family practice and internal medicine. Here's a link to the former:

http://www.healthcare.uci.edu/.....octor.aspx

If your bf is in the L.A. area, you may want to investigate UCLA, USC, Cedars-Sinai, etc.

Just think, if you move here, then we can meet you at our next YLF meet-up!

13 years ago

Anonymous

Maybe this will help. My Primary Care Physician (PCP) specialized in internal medicine but practices family medicine, which is why I chose her. (Not all family doctors have specialties.) I also go to her for all of my gyn care. With my HMO plan, I can see certain specialists such as dermatologists without a referral, but most of the time I have to have a referral from her to see a specialist. This has never been an issue. Also, my HMO stipulates that the doctors, hospitals and labs that treat me must all be "in network." If I visit an out-of-network provider, I'm not covered and have to pay the full bill. Thus, every time I have a procedure done or whatever, I be sure that all involved are in network so I only have to pay the co-pays I'm responsible for. The doctor, hospital or lab accepts a certain pre-determined amount from my insurance company, and the rest is "written off."

13 years ago

Eva

Active Member

California is different than most other states (what a surprise) in that they do not allow the "corporate practice of medicine". Physicians may not be employed by the hospital. That is not to say that there are not ways around that. Some healthcare organizations form "foundations" for the physician group which are then tied to the hospital.

The good news is that there is some limited liability for medical suits in California, but losses can still be big. California is a very litigious state.

Send me a PM if you want to chat more.

13 years ago

goldenpig

(website)

Veteran

Hi Jyoti, exciting that you may be coming to the US! I'm a specialist so I can't comment on being a family doctor. I don't know a whole lot about the differences between Canadian and US medicine. But here in the US, you can go into family practice, which treats both children and adults (and sometimes even does OB but mainly in rural areas), or internal medicine which treats adults only. Internists can also do hospitalist practice (only hospitalized patients), or outpatients whereas family medicine tends to concentrate on outpatients only. I know I tend to recommend internists to older patients or those who have more complicated medical problems whereas family medicine can be better suited for for routine care of generally healthy younger patients. (Breadth vs. depth, if you know what I mean). So it all depends on what interests you the most. I think internists get paid a little more than family practitioners, but not by much.
Here's a link I found online that discusses average salaries for the different specialties including FP/internal med:
http://mdsalaries.blogspot.com/
Hope this helps!

13 years ago

DonnaF

Veteran

Not an MD but a member of No. Cal Kaiser Permanente which is an HMO. I think many women choose to work for Kaiser because it enables them to work part-time and raise families and transfer to other clinics. An old gyn moved because she kept getting hit with $5/minute penalties from her kid's day care because she would get stuck in traffic on her way there, so she moved to a Kaiser closer to home.

You are at the other end of the spectrum, but a high school classmate of mind moved from his group practice to Kaiser in his early to mid-fifties in order to shore up his retirement. He seemed very happy, esp. since he no longer had to deal with the insurance end of things.

13 years ago

Jyoti

(website)

Veteran

Thanks for all the great replies guys!

@christieanne: Thanks for the good wishes and your experiences with your doctors. The anecdotes really do help! I haven't found much information for people in Canada wanting to move down to the US on medical boards-- it's either non-existent or really outdated!

@Ruth: Thank you for relating your experiences! That really helps to illuminate the HMO/billing/referral mechanics in the US. Thanks!

@lyn: Yeah, I'm probably gonna write the USMLEs at least. I'll have to see if I can figure out the differences between internist and family med care... that looks important to know. xD

@Sona: Well, I'm already going to be some kind of doctor at this point, I just have to decide which one. xD Thank you very much for your honest answers-- I really appreciate it! What kinds of things would an internist look after versus a family doctor? How do you divide the scope of practice between the two?

@Vicki: At this point, I am so sick of long distance and just counting down the days until we can be closer (which is sad, but true!). Thanks for the link! And I would absolutely love to attend a YLF meetup-- that would be so awesome!

@Eva: That's really interesting. Of course California is different. xD I will be sending you a PM!

@goldenpig: A big reason I am looking at family practice are two of the things you mentioned-- treating both adults and children and dealing with outpatients. xD Thank you very much for the link! I'm not concerned too much about being paid a little less than I would if I chose another specialty-- my biggest fear is that the salary I would make in Canada is really, really different than that I would make in the US, and that I would not be prepared for it. I'm reading the page you linked right now!

@DonnaF: Really good to know. We don't have HMOs in Canada so I'm still rather confused about them. xD I know that I want to be able to have a life outside medicine and am rather scared of insurance/billing/etc. xD It's also good to know that people move around-- at my end, it seems like every choice you make is forever! xD

13 years ago

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