u/DrSelfish

PGY6 so have experience but coming back from acute care work. Shout out to u/invenio78 for the offer guide.

Low to medium COL, 20 min from downtown if mid-major city

Base $315,483 guarantee x2 years then productivity
34 patient facing hours, one day of admin
Call for a week Q7 weeks and every provider there says it’s very light (2-3 calls per)
30 days (6weeks) PTO
$25,000 sign on bonus
Expected 16-22 patients per day
$50/rvu with 5,964 rvu threshold

Hello all, been lurking here a long time and truly appreciate everyone's insight and helpful information. I have been considering returning to PCP life after being in acute care 7 years. Immediately after residency, did EM work and Urgent Care. Did not practice FM as an attending. I am now settled down with family and young kids and considering a Family Med offer. My concern was the inability to disconnect from work that people complain about, doing notes from home, burnout etc... Efficiency and computer/charting literacy has never been an issue for me. I am really struggling with going back to something other than shiftwork but I figured a "likes and dislikes" might help with insight.

Cons of acute care shiftwork:

- Really getting tired of getting slammed with patients on a 12 hour shift. They're getting sicker and more complicated. I get paid the same for getting my a** kicked seeing 50 people in a day versus 25. And my boss just changed the calculation to get RVU bonuses and I have not gotten one since the change.

- I now have small children and working on weekend and holidays for the last 7 years is getting old. I'd love a more fixed sched

- Absolutely can not stand my boss or the management. Truly a "no one has your back" feeling. Revolving door of brand new midlevel grads to oversee and MAs that don't stay longer than 1-2 years. Understaffed, call outs mean that your 2nd provider is gonna be pulled to a different site and leave you to see everyone, hasn't gotten any better in almost two years.

Pros:

- Shiftwork, flexible schedule, leaving work at work and being fully present at home

Concerns for family med:

- Constant inbox work, notes from home, all the uncompensated work etc

- Honestly biggest concern is billing and coding. I haven't had to worry about that since residency. Will need thorough training on doing this adequately to ensure fair compensation

Pro for FM:

-Initial offer of base salary is $56k above my total compensation at current job. I'm not absorbing a patient panel. I'm having a ramp up period building my own for 2 years. 34 pt facing hours required a week. Good sign-on bonus. Company has "inboxology" to help with inbox burden, call is Q7 weeks a week at a time and I'm told maybe 2-3 calls actually come thru each period. Weekends and 7 paid holidays off. 6 weeks PTO. Physicians there 10 years or longer, seem happy, good vibe. I have thoroughly weighed with the "Guide to Job Offers" posted here and I'd put this job offer in the "good" category

I made this because I just mentioned to an ex-FM doc of 20 years that does PRN here in urgent care about considering going back to FM and he absolutely blew up. Very disheartening things like "you'll hate it and you'll be back", "you're a slave to your patients", "you're off on weekends but doing all your notes then", "of course your wife will love having you home but it's bc you'll be holding a baby in one hand for her while you work from home for free." I know take it with grain of salt and it's just one person's opinion but he listed everything I'm kind of worried about.

To further explain, I have ADD (that has gotten a lot more manageable off meds in the last few years) and the acute setting just seemed to work for me more. Also this aforementioned older colleague is borderline computer illiterate which isn't an issue for me (I'm 38yo M), so some of that I suspect is related to that. I see all the time here now that being efficient and using AI makes it so that people aren't even taking notes home anymore. It's important to me to be home for weekends and holidays as my kids keep coming and growing up, but I'm also off quite a bit to be at home now (only 15 shifts a month), though it's very scattered including weekends and holidays.

I'm sincerely sorry for the length. I just hope for some helpful insight or words of encouragement that can help me with this decision as to what the FM primary care corporate medicine landscape is like now, as I'm truly struggling. Thank you in advance