Is Family Medicine a Waste of Talent for New Doctors?

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There are many things medical students interested in family medicine hear from other students, residents, and attending physicians when bringing up their desire to go into the specialty.

Here are some things I have heard recently

"Family Medicine is a Back-Up Plan"
"Sub-specialize until you can't specialize anymore"
"The IOM sold out on primary care & now want ANPs to pick up the slack"
"Aww family medicine? That's so nice of you."
"You're Too Smart For Family Medicine"

First, I will start out by saying that every time I hear this or read it, I get an acidic taste in my mouth, probably signifying vomit encroaching on my pharynx (5-yard penalty on the vomit).

When I look back on reasons for going into family medicine, I would consider myself a student who was "on the fence" about the specialty. In its current state, going into primary care is a decision that my financial planner would probably strangle me over.

The primary care loan forgiveness programs provide financial relief over several years that could be made up over 1/2 to 1 year in most specialties. Nursing leaders are advocating that they can provide the same care just as good as I will while lobbying for equivalence in pay but deny they are trying to replace primary care physicians. Then there is the SGR, the RUC, hospital network/ACO-wannabes taking over private practice....

I initially wanted to go into orthopaedics - not because I wanted to hit the "ROAD" (though it must be nice), but because of my love for sports and desire to have a niche in something. It was not until my first time rotating with a family medicine physician with a CAQ in sports medicine that I realized it was possible to help athletes and non-athletes with musculoskeletal issues, not go through an ortho residency that could potentially ruin my marriage, and continue to see patients without sports medicine issues as a primary care physician.

After $280,000 of student loan debt it may seem crazy but with these past 4 years of medical school with a graduate degree thrown in-between an undergraduate degree, I feel like specializing would only hurt the non-financial gains I have made in my education. I have learned so much about pathology, disease-processes, prevention and clinical practice, that specializing would only end up wasting all of the talent I have accumulating along the way. Family medicine allows me to continue to provide healthcare to everybody - newborns, children, women regardless of hCG status... what we usually refer to as "womb-to-tomb" or "all stages and all ages".

It also allows me to "specialize" in any area at any point no matter where I am in my career. The CAQ in sports medicine is going to be a given in my case - but if one day I decide that I want to be more proficient in cardiac health, I do not need to take a pay cut to do a fellowship in cardiology to focus my attention on that area. If I want to have a niche in diabetes management, I do not need to do a fellowship in endocrinology. And even though those with fellowships are getting paid more to provide these services (note: current tense), this flexibility will keep me from burning out, maintain my interest and desire to further my education as a life-long student, and keep me from losing the huge investment I made which I will be reminded about each month as I make my student loan payments.

Family Medicine - Make the Most of Your Talent, Make the Most of Your Investment - It Is Impossible To Be Too Smart For Family Medicine


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