发信人: docrockville (docrockville), 信区: MedicalCareer
标 题: Primary Care IM: pro and con
发信站: BBS 未名空间站 (Thu Jan 8 14:57:57 2009)
I just chatted with a internal medicine doctor who used to practice as a PCP
in Beverly Hill, CA. She is in clinical research right now.
As a PCP in Beverly Hill, CA, she saw patients who are paying out of pocket.
She felt that the patients are sometimes very demanding and ask doctors to
do whatever they want them to do. Some patients are hypochondriac and would
stop showing up, if you, as a PCP, tell them that they are not sick.
Instead, she feel that poor patients are more amenable to her medical advice
and appreciate her help more. Therefore she devoted some of her time seeing
patients in a free clinic.
She told me that most of her classmates in residency in UCLA system went for
fellowship or hospitalist. She feel that most PCPs these days are underpaid
, since primary care needs a broad knowledge base, so that you do not miss
things when seeing patients. The point is to know when to refer patients to
specialists. If you do not recognize the disease, you get liabilities. Also
she said that PCPs do not often get chances to make important decisions on
difficult cases. So if you like bread and butter outpatient care like COPD,
not-too-serious CHF, lipid disorders, HBP, and DM, PCP is good for you. She
says HMO doctors are less stressed out in comparison to solo practice
She eventually quit her fancy Beverly Hill job and went to Africa to treat
HIV patients. Now she is back in clinical research of HIV. She desires to
pursue something different than other people. Like she is interested in
public health and epidemiology.
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