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Did Family Medicine Sell Out?

I get the feeling we sort of did. I was thinking about this today. My mind is a twisted fucked convoluted mess that thinks too much.

I was doing a phone shift today, and just witnessing my exhaustion from pretending to be this ‘doctor’ with all these patients.

The ‘doctor’ they called to get is supposed to be this confident, caring, understanding person who will help them. At the same time they want someone who will give them meds, give them work notes and somewhat kiss their ass, enough for them to give you a favorable review later.

So right there, this whole yelp review of my doctor, what an idiotic thing isn’t it? I mean, are we assuming that patients actually know what’s good for them and therefore would recognize it if they actually encountered it?

Fine, we sold out because we allow patients to review us online. And yes, I say allow because this shit happens when doctors individually allow it to happen. Soon these fucking pieces of shit groups like CMA and AMA roll with it and start issuing their thoughts on it.

Next, we sold out because well frankly, I make nearly $300k gross every year as a fucking family doctor. In a capitalist economy one’s paycheck is very efficiently tied to the value we bring.

I don’t deliver babies.

I don’t round in the hospital on my patients.

I don’t do any appendectomies.

I give work notes, cough syrup prescriptions, reassure and on occasion orchestrate the care and workup of a less common disease presentation.

I assure you that the above tasks are NOT worth $300k.

The value lies in the meds, services, imaging, and surgical equipment which I allow to exchange hands.

I mean, as family docs we make almost as much as specialists. And of course, In return we are seeing higher patient volumes, managing multiple issues as opposed to just 1 issue.

But to make as much as we’re making… it seems incongruent. I knew something was up when they offered me $163k straight out of residency to do urgent care back in 2009.

I know that doesn’t seem like much but I’m like wtf, for what? That year I started work in 5/2009 and I still ended up making $189k.

Why am I even bringing this up? How is this $ related? Hm, I don’t quite know. Right after I finished the phone calls with the patients, which was a 3-hour shift, I flopped on my bed and felt so fucking drained.

This shift bracketed by me doing it from home and making over $300 in 3 hours made me wonder why the shit I’m bitching about it.

I was prone on my bed, my face staring at the ground, eyeballing the giant fucking dust bunny behind the extension cord when realized that it’s a lot of work pretending, being a salesman and trying to meet all the metric by which I’m judged.

So, yea, primary care did sell out, that’s my conclusion. I did too, of course. I’m okay with it because I don’t want to pretend to myself that I’m doing something grand and noble here… to others yes, no problem. Girl asks me at a club what I do for a living? Doctor, baby! …. Hey wait, where you going?!

2 replies on “Did Family Medicine Sell Out?”

Good thoughts here. This was probably the most depressing realization to me coming out of residency. The thought that our field has literally become a glorified retail job that can earn you up to 300K is concerning to me. How did we get to this point?

I look at primary care docs now in these larger medical groups and they are doing an absurd amount of work.
If they continue doing it most likely they will burn out. If they stop doing it the affiliate clinicians will fill that hole up immediately.
I could see unions starting in the medical field out of this, mostly in primary care settings if the doctors aren’t willing to give up their generalist privileges.

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