Saturday, May 29, 2004

From Medical Economics: Jobs 2004: Primary care outlook . It seems that not all primary care is created equal, and general internists are benefiting:

The San Francisco Bay Area used to be an intensely competitive job market for physicians. But Douglas C. Tong, who recently graduated from an internal medicine residency program at UCLA, had no trouble finding a position there. He joined the Camino Medical Group, a multispecialty practice in Sunnyvale, after turning down an offer from Kaiser Permanente and interviewing with a number of other West Coast groups, including the Palo Alto Clinic.
Why was it so easy to find a position in an area that was saturated with physicians only a few years ago? Tong notes there's a large turnover of internists in the region, partly because of the high cost of living there. But the strong demand for general internists across the country points to other factors as well.
Of the 30 residents who graduated from UCLA's internal medicine program last year, about half went on to fellowships, five became hospitalists, and just 10 entered private practice. Those 10 were "highly recruited," notes Teresa Roth, house staff coordinator for the residency program. One reason, she says, is that the pool of internists going into primary care has diminished greatly in recent years as more and more doctors have chosen higher-paying specialties.

But this doesn't seem to apply as much to FP's looking for a job....

Physician recruiters say their clients—mostly hospitals and midsized and large group practices—are more interested in internists than in family physicians or pediatricians. According to Mark Smith, executive vice president of Merritt, Hawkins & Associates in Irving, TX, this is partly a byproduct of employers' current focus on recruiting specialists. "If you're having trouble recruiting cardiologists or can't afford them, you can recruit an internist to relieve some of the demand for cardiology."......

In contrast, large multispecialty groups are reportedly reluctant to hire family doctors. "We see groups who are interested in having higher-end primary care physicians—the ob/gyns and the general internists, not the FPs," says Steve Messinger, a practice management consultant in Arlington, VA. "It's because the value they bring to the practice is much higher: There's more spinoff of ancillary revenue and referrals to the surgeons."

There isn't a similar situation going on with surgeons that I'm aware of for mainly two reasons, there are fewer surgeons overall and given the longer "sentence" of a surgery residency there is more "training fatigue" than may be seen in an internal medicine program. The desire to do a fellowship certainly waned for me as my training progressed.

I did learn today while 1250 pounds of sand is a pain to load and spread, doesn't go very far.
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