Family Medicine and Career Decisions in Healthcare

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Dennis C. Stevens, MD, MS, shares his journey from family medicine residency to becoming a pediatrician and neonatologist, highlighting the training, certifications, and the scope of family practice. Explore the demanding yet rewarding aspects of family medicine, including salary, work hours, and the comprehensive care provided to individuals and families.

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Family Medicine Family Medicine and My Career and My Career Decisions Decisions Dennis C. Stevens, MD, MS Pediatrician and Neonatologist Director of Clinical Research Professor of Clinical Sciences, Chicago Medical School, North Chicago, IL Professor Emeritus of Pediatrics and Internal Medicine, University of South Dakota School of Medicine, Sioux Falls, SD

INTRODUCTION Dennis C. Stevens, MD, MS I am not a Family Practitioner! I did complete nearly two years of Family Medicine Residency prior to Pediatrics and Neonatology Training. This was nearly enough to sit for Family Medicine Boards at the time. I interviewed for positions in Family Medicine. I have worked with many Family Medicine physicians in rural South Dakota for many years.

4 years of college 4 years of medical school Neonatologist Neonatologist - - Training Training 3 years of pediatrics residency (I did 2 years of Family Medicine and 2 years of Pediatrics) 3 years of neonatology fellowship Certification examinations for Pediatrics and Neonatal/Perinatal Medicine

Family medicine: Also called family practice. The medical specialty which provides continuing and comprehensive health care for the individual and family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family practice encompasses all ages, both sexes, each organ system, and every disease entity. (From the American Academy of Family Physicians) Definition

Undergraduate college degree 4 years resulting in BS or BA degree Medical School 4 years resulting in MD (or DO) degree Residency Training 3 years, much in the outpatient setting, or clinic. Fellowship Training possible in Geriatrics, Sports Medicine, Adolescent Medicine, Sleep Medicine, Hospice and Palliative Care, Pain Medicine, Preventative Medicine, Rural Medicine, Research, Faculty Development, Maternal Child Health. Board Certification Examination Training Required for Family Medicine

Salary and Hours Generally, in the mid-west, Salary about $200,000/year. Workdays long 10-12 hours per day depending on location and case load. Depending upon your location, will probably involve night call and telephone calls for your patients or a group of patients.

Family Medicine GENERALLY, IS PRACTICED IN THE OUTPATIENT SETTING. MAY INVOLVE VARYING DEGREES OF OB-GYN AND PEDIATRICS INCLUDING PERFORMING DELIVERIES. GENERALLY, INVOLVES MUCH HEALTH MAINTENANCE AND ONGOING PREVENTATIVE MEDICINE. IS PARTICULARLY PROMINENT AND IMPORTANT IN SMALLER AND RURAL COMMUNITIES. A GOOD FAMILY DOCTOR NEEDS TO HAVE SKILLS AND KNOWLEDGE IN MANY AREAS AREAS WHICH ARE ADDRESSED BY MANY INDIVIDUAL MEDICAL SPECIALTIES E.G. INTERNAL MEDICINE, PEDIATRICS, OB-GYN, SURGERY, ER MEDICINE.

Things to Think About Each field of medicine has specific training lasting 3-4 years in each field compared with 3 years of training in all fields in Family Medicine. Each field of medicine has volumes of new material coming out each year to remain current on practice methods. A Family Practice physician must rely upon medical resources in a number of areas consultants in various specialties (all physicians do). In Family Medicine you are not generally the expert in any one field of medicine this can be frustrating to some people. This was a personal issue that I had with this field.

More Things to Think About In Family Medicine you are the family s first resort for health care services. In Family Medicine you will likely be very involved in preventative health care and health maintenance In Family Medicine, you may be a consistent person to help a family through difficult decisions such as placement in institutional care, and end of life decisions.

Medical Staff Committees and Offices Other Areas of Involvement Possible in Family Medicine Medical Administration Teaching - Medical School and Residency Research Public Health Issues

Primary care specialties Internal Medicine, Pediatrics, Ob-Gyn, General Surgery. Combined training in Internal Medicine and Pediatrics 6 years of training which emphasizes these two areas in detail. You gain skills in adult medicine and pediatrics , but does not include training in Ob-Gyn. Alternatives to Family Medicine

My Decision Family Medicine was my idea of a doctor (Marcus Welby, MD) I liked both Family Medicine and Pediatrics in Medical School. I attended a course in NICU care: It was a very new field There was a need for physicians skilled in this area There was the potential for academic pursuit research, etc. Life events easily took me to Pediatrics and NICU within months of going to the course. This decision had costs associated with moving, additional training and a second internship. I have enjoyed 40 years in academic practice and have done clinical care, administration, teaching and research and can not imagine another field in which to have worked.

My Advice DO WHAT YOU WANT TO DO! DON T BE AFRAID TO CHANGE YOUR MIND OR REDIRECT YOUR COURSE OF ACTION! DO NOT BE PUT OFF BY THE TIME IN TRAINING DO WHAT INTERESTS YOU AND WHAT YOU FEEL CALLED TO DO! TAKE IT ONE STEP AT A TIME AND ENJOY THE PROCESS.