u/No_Injury_464

My partner and I have a wonderful relationship, and she is my person. I want to have kids with her. We had a discussion recently that bummed me out a little and I’m curious what you all think.

We are discussing having kids. My partner has always wanted to be pregnant, though she is also unsure about putting in the extra effort because there are so many kids up for adoption. I think adoption is an incredible thing to do, but I’m not sure it’s for me for a variety of reasons. I am concerned about rolling the dice of the genetic lottery with adoption, which feels wrong admittedly. I also am scared that I wouldn’t be equipped to help my child heal from the inherent trauma of adoption.

I asked if she would feel this ethical pull to adopt as much if she were in a straight relationship, and she said she would probably have less guilt about getting pregnant (though would still be interested in adoption). This made me feel sad, because the majority of straight people do not feel guilt about procreating or wanting a kid genetically related to them. It seems like she would have a different ethical standard if she were in a hetero relationship, which feels unfair. She is bisexual, and I am not, and I feel myself becoming jealous of a theoretical man with a conversation like this. What if she decides she wants an easier life to have kids? We are both in our thirties and have been together for years now.

Is this insecurity I’m feeling unreasonable/biphobic? Has anyone else had conversations like this in their relationship?

Hi everyone,

I am a Pgy-2 FM resident who has now had 2 patients find another PCP. Both were older patients with some mild cognitive impairment which made our visits a little more challenging. I know patients all have their reasons for why they would find another doctor. However, I feel tremendous guilt that maybe I’m a bad PCP and that’s why my former patients sought care elsewhere. I am not the most organized resident with inbox management, so I wonder if that played a role. I am so scared of the fact that “it’s easy to be a bad PCP and difficult to be a good one”. How do you all deal with this when it happens?

Hi everyone! Sorry if this topic has been discussed to death. I am looking to get a credit card that maximizes rewards while staying low effort. I work 60-80 hours a week and do not want to spend time thinking about how to get the best rewards. it seems like a cash back card would be a good option? I spend most of my money on gas, restaurants, gym membership, and sigh instacart grocery deliveries. Any cards you’d recommend?

For primary care training residents (FM, IM please weigh in): How big are your panel sizes each year? I feel like my program gives us large panels but unsure what average is. New Pgy-2 FM, ~350 patients

Hi fellow FM residents!

I want an informal poll about panel sizes. I am a new Pgy-2 with almost 350 patients and it feels like a lot.

Our program has residents take “clinic” call for at least a week and sometimes multiple weeks during any outpatient month. This entails being on call anytime after operating hours; all nights during the week and 24/7 saturday + sunday. Obviously over half of the calls are for non-urgent bullshit. There is minimal learning to this, and my sleep is getting fucked up. Do other family med or primary care programs have this? I think it’s ridiculous.

Ob-gyns have a unique skill set and are completely overworked. That still isn’t an excuse to be mean to other specialties when they ask for your expertise! I am at an opposed family medicine program where the ob residents constantly talk shit about us or our colleagues right in front of us. This trickles down to nursing, who also like to treat us like we’re idiots and will question our plan right in front of patients, even when it is completely evidence-based and following ACOG guidelines. Also some of the OB attendings here do whack shit sometimes too. The Ob team gets mad when we consult them “for not managing our own patients” and get mad when we consult them “too late”. I also feel like the culture at my hospital is to talk shit and never tell our FM attendings when they disagree with our management. If there is an evidence-based reason why we should or shouldn’t do something, we should be told so we can learn. This could be a program-specific thing, but I hear about this kinda vibe at a lot of programs. L&D is stressful enough without behind-the-scenes bullying. Interprofessional collaboration is key to dealing with our horrific maternal/fetal morbidity/mortality crisis in the US, so this toxicity is totally misguided and unhelpful.

Has anyone ever tried to change a culture like this? how? and how did it go?

Hi everyone,

This may be a family med program specific dilemma. Does anyone else’s program schedule them mostly for continuity clinic sessions during their elective? Many of us are only getting 4 half days of elective time in a month- it infuriates me and feels like an acgme violation, though I’m not sure it is. We see so many patients in clinic (often up to 2000 by the end of residency) and never have issues meeting the continuity requirement of 40 weeks with a clinic session.

Is this particularly fucked up or just a typical FM program?