Question for anyone who has transitioned from primary care to hospice. I’m about 10 years into my primary care career. I’ve always had an interest in hospice care and strongly considering a switch to hospice at some point. For those who have made this change, did you find hospice care to be less stressful? Although I don’t see myself making any big changes now, I also don’t think I’ll make it to retirement age in primary care without getting burned out. Thanks for any advice from those who have made this transition!

Just wondering what the situation is internationally. In my country of training, the road to an independent license to practice is as follows:

1. Study medicine for 6 years. Final 1 - 1,5 years is usually a "student internship".
2. Work as a junior doctor "Intern" for 2 years. Need to apply through a central system and get allocated your post by a computer algorithm. Get a salary from here on at least. No more tests or exams.
3. One year of compensated "community service" in a rural location. Again, apply via a central system and get allocated by the computer. In most locations no supervision/senior support and minimal resources. It's a way of trying to offer medical care in remote locations.
4. Only then can you get an independent license to practice/go work in private/specialize.

That is 9 YEARS of your life before you can decide what you want to do and where you want to work.

What is the situation in other countries? Do some others also have 2 years postgraduate internship and then a form of rural service?

Dear Doctors... Just wondering what the situation is internationally. In my country of training (South Africa), the road to an independent license to practice is as follows:

1. Study MBChB for 6 years. Final 1 - 1,5 years is usually a "student internship".
2. Work as a junior doctor "Intern" for 2 years. Need to apply through a central system and get allocated your post by a computer algorithm. Get a salary from here on at least. No more tests or exams.
3. One year of compensated "community service" in a rural location. Again, apply via a central system and get allocated by the computer. In most locations no supervision/senior support and minimal resources. It's a way of trying to offer medical care in remote locations.
4. Congratulations, finally you can get an independent license to practice/go work in private/specialize.

That is 9 YEARS of your life before you can decide what you want to do and where you want to work.

What is the situation in other countries? Do some others also have 2 years postgraduate internship and then a form of community service in a rural area?

Hi all and happy new year! Would appreciate some advice from anyone who's accomplished anything similar.

Briefly, I resigned from my Family Medicine program in California in good standing due to wanting to pursue other career options about 4 years ago. I successfully completed 20 months of training. Within a few months, I was recruited by a consulting company and have been working with them ever since. I also started and currently run a medical coaching business. I am thankfully very happy with my life and career but recently, I've been looking at other career options which require a basic/GP medical license, e.g. telemedicine, some higher-tier consulting tracks require an active license, etc.

I've heard from a few colleagues and have read that I may be eligible to apply for a medical license in 6 areas (1 yr of residency training completed: Colorado, Georgia, Michigan, Minnesota, Puerto Rico, and Virginia).

I've went ahead and emailed each medical licensing board and am awaiting replies.

Has anyone done something similar? What should I be doing/prepping for this? Thanks so much everyone.

I know that Epic provides logins for personal physician use, does anyone have experience using this personal Epic login for themselves? Does having an Epic login for private practice use give you access to Care Everywhere? I would want to be able to see notes from other providers in my area who also use Epic.

This may be “controversial” but it shouldn’t be. Why is it no longer customary to call a doctor for what they are - doctors? Why are doctors called providers? Who’s feelings are we hurting?

The origin of the “provider” is from nazi Germany in order to discredit physicians. Specifically jewish. So why are we “provders?”

What’s your take on this?

So a few ppl I know at Duke said that the IM match for fellowship this year wasn't what ppl expected. For the first time, 3 residents did not match for fellowship and this is at a supposedly top IM program. Almost 10% of the class didn't match which is kinda strange. I also heard that many ppl dropped far on the list. Does anyone have further insight into why this is happening there? Would love to know since I am going through the residency application process right now. Seems that the quality of places Duke residents are coming from is declining too. Not sure if Duke is what it used to be. Anyone have insights?

Please let me know if this isn't allowed here -- I'm simply hoping to share some transparent personal finances to help early-career doctors and med spouses feel more comfortable with the craziness that is early-day-doctor-finances. I'm keeping this intentionally anonymous so I can share more!

Hey hey! I’m cashfirst and I (CPA & Med Spouse) share our real personal finances. We’re an early career MD/CPA couple living in Canada. All figures are CAD.

How early in our career are we?! 
- MD: finished med school in 2024, currently in first year of residency!
- CPA: finished CPA in 2024! 

Last update: December 1, 2024
Today's update: December 8, 2024

cashfirst Finances! 

First: cash position (these are actual cash amounts, post-tax etc)

• Opening balance: $6,008.45
• Inflows: $10,036.56
• Outflows: ($11,112.74) 
• Ending balance: $4,932.27

Second: total investment contributions (cash contributions only, not market price)

• TFSA: $0.00
• RRSP: $23,350.00
• FHSA: $32,000.00
• Non-Reg: $0.00

Third: Debt balances

• Medical LoC: ($150,000.00)*
• Student Loans: ($61,164.96)
• Credit Cards: $0**

Busy week as expected! It was almost a perfect forecast for the week missing by only ($107.10). This was due to us cancelling a cash subscription effective Jan 1, not Dec 1 as I initially thought.

We're projecting our ending balance next week to be $1,963.35 with a few planned outflows from a quick trip we took :)

*Monthly interest payments flow through the cash section.
**No balance carried period to period, payments flow through the cash section.

I often struggle with explaining complex conditions or treatment plans to patients in a way that sticks. Sometimes diagrams or slides help, but I feel like there’s got to be a better way to make sure they really get it.

What’s been your most effective method or tool for breaking down medical information? Any tips for making explanations more visual, simple, or memorable?

Im a provider and just got offered a new job by a new medical company. They're a small company and are out of network with insurance (so patients pay out of pocket only). Its a 1099 gig and they require clinicians"opt out" of Medicare/aid. I havent responded to the job offer yet. I also work for my current company and see some patients that are on medicare, other insurances, and some out of pocket pay. My questions are:

Why would this new company want clinicians to "opt out" of Medicare/Medicaid? Is this so these clinicians dont have to see patients with lower paying insurance in case their circumstances change? Im trying to understand why formally "opting out" is necessary and why you cant just say you don't take Medicaid/care. Is this a legal thing?

How would this "opting out" (if I did this) affect my job at my current company if I wanted to keep both gigs. My current company is actually in the process of credentialing me with various insurances now (including medicare/medicaid). Would I have to quit?...or could I see clients with other insurances instead at my current place?

A bit confused about all of this so any tips, resources, types of people or lawyers to consult with also welcome.

I'm a General physician 29M, with clinical practice experience, pharmacovigilance experience (freelance) and currently working in insurance sector as Physician Reviewer. Do you guys have any Idea about remote work that pays in dollars/Euros for a general physician, with a limitation that I don't have a license to practice in US or EU. Or can you suggest some roles where doctors will be hired without the need for the license to practise in the country of hire. I am ready for relocation if needed.

https://www.nytimes.com/2024/11/19/us/politics/trump-dr-oz-medicare-medicaid.html

Hello,

My name is Arielle Zionts, I'm a journalist who covers rural health care for KFF Health News, a national, award-winning nonprofit media outlet focused on in-depth healthcare reporting.

I'm working on a story about the recent trend of state legislation that would let certain international doctors work in U.S. states without re-doing their residency within the U.S.

I'm curious how U.S.-trained MDs/DOs feel about such proposals. For example, would this change impact existing and aspiring US-trained physicians? Would it help shrink physician shortages in rural areas?

Please send me a DM or email me at ariellez@kff.org if you're and MD/DO and interested in sharing your opinions in a phone interview. If you aren't sure if you want to participate you can still reach out and I can answer any questions you have before you decide if you want to continue or not. Also, I will not use any information/names from any written responses to my posts.

Thank you!

I’m sorry if this is a stupid question, but… Given the results of the election and the wording of the laws that will inevitably be passed in some states, do you think the revision of ICD-10 will change “spontaneous abortion” to just “miscarriage” to protect patients? We’ve already seen cases of women being jailed for miscarrying. Do you suspect this, and upcoming laws, will create a change in the language in the ICD-11 to protect doctors and their patients from being persecuted?

Source: https://www.bbc.com/news/world-us-canada-59214544

How will things be different for doctors?

What's your experience with charging for "no-shows?"'

I keep getting hammered with no shows. Our practice does not charge for no-shows, but calls our patients the day before, leaves VMs if they don't answer, and sends email and text reminders to our patients. Still so many just don't show up.

If we started asking for a card on file when they make an appointment, and then charge if they no-call, no-show, will that help? I think it will decrease no-shows, but my supervisors think it will drive patients away, to which I reply "That's fine, let the competitions' offices fill up with patients that don't show up!"

But, I'm worried just asking for card info up front will drive away patients.

Also to know, I'm a newer Allergist/Immunologist and looking for more new patients. I'm not a bursting PCP's office with a 2-3 months wait to get in.

Current resident thinking about taking my first job abroad. A few questions for those that have done it in the past or are still abroad:

• What country did you take a job in?
• How long did you stay abroad?
• Are you happy with your decision?
• Do you feel the decision was worth the pay cut?

I was wondering if there were any doctors here from Florida and what they thought about the current abortion law in Florida, and the abortion amendment 4 that we will be voting on.

You always hear about the pro-choice/pro-life arguments- such as doctors are afraid to Perform abortion procedures because not knowing the law simply says like doctor can perform abortion if women’s life is at risk, but the risk isn’t defined. So, that’s one of the reasons people want amendment 4 passed, and also to allow for a less strict abortion law (I believe?¿) then the pro-life say this amendment is too extreme, and will allow for late term abortion, and not require a doctor to approve the abortion - just any healthcare provider which could be just a staff member at a clinic.

I am not very good with politics/law nor with medical world. But i just wanted to see it from the point of view of a doctor since ads never seem to include that

Thanks!