Can PCPs be the “ mid levels “ of some specialists

[Zaphod]

I have never entertained it, but isnt this basically what they are?

*throws grenade, runs*

[Zaphod]

Less jokingly, I would take a mid level or helper role for less money for sure. Even in residency I was jealous of the first assist.

The perfect life, always operating, never taking call, no clinic, no talking to pts, etc

If you could somehow decrease liability, it would be perfect. Would love to operate, go home and if the phone goes off, never have it be a pt.

I could handle that.

[VentAlarm]

Yeah, but I don't think the question is intended to be a general question. I interpreted it like, "Would you change from neurosurgery if being a plumber made more money?".

Or in this case, "If being a mid-level made you more money (or was more desirable in some other way), could you be one if you possessed PCP credentials?"

I’d give up medicine tomorrow to be a plumber if it paid more. I’m on my last nights of a >80h work week this week, which might have something to do with it.

[CordMcNally]

Yeah, that's the question. Is it "can't" or "won't"?

It's both.

[Tim]

Less jokingly, I would take a mid level or helper role for less money for sure. Even in residency I was jealous of the first assist.

The perfect life, always operating, never taking call, no clinic, no talking to pts, etc

If you could somehow decrease liability, it would be perfect. Would love to operate, go home and if the phone goes off, never have it be a pt.

I could handle that.

Definitely sounds like you might want to consider military service. A few other issues, like where is home.

[AR]

It's both.

Great. Now all you have to do is elaborate on the reasons for the can'ts and we'll have the answer OP was looking for.

[nastle]

No I didn’t mean same pay as midlevel
but consider then
3 days you do your regular FP stuff
2 days you jam pack your schedule with initial work up visit for a plethora of nephrology orthopedic rheumatoid etc illnesses
then you pass them on to the specialist ONLY when they go in to get a specific procedure /

step down care
same do the post op assessment and other routine issues , if complications arise then send back to specialist
these 2 “specialist “ days you can do at that consultant office maybe so curbside’s are easier

[nastle]

Obviously that was a general statement. There’s plumbers that make more than neurosurgeons but I think most people would prefer the average salary of the neurosurgeon.

Only if you are plumber onboard a SSBN otherwise I’m not sure it’s deserved

[nastle]

Several FM/IM docs embedded within subspecialties already we're cost efficient AND operate higher level for complex cases. Remember, we're a quaternary academic center so it's a bit different there too.

For vertically integrated systems, primary care docs function as many mid-levels to the subspecialists via coordinated service agreements.

Please tell me more about this , which healthcare system is this ?
thanks

[PedsCCM]

We have some of this in peds. PICU and NICU “hospitalists” who are gen peds trained and work under intensivists or neos are kinda common. I’ve seen GI groups hire general pediatricians to work through likely simple GI or non-GI problems. Kinda similar to sports med in Ortho groups.

They generally function a little above most mid levels, more like a fellow. Better question that I think we’ve discussed before is why can’t MD/DO’s who can’t match (but have passed boards) function exactly like PA’s?

[nastle]

We have some of this in peds. PICU and NICU “hospitalists” who are gen peds trained and work under intensivists or neos are kinda common. I’ve seen GI groups hire general pediatricians to work through likely simple GI or non-GI problems. Kinda similar to sports med in Ortho groups.

They generally function a little above most mid levels, more like a fellow. Better question that I think we’ve discussed before is why can’t MD/DO’s who can’t match (but have passed boards) function exactly like PA’s?

MDs who don’t match are different issue altogether, do we really want doctors without residency to be managing patients ? Let’s save that for another thread

[SerrateAndDominate]

MDs who don’t match are different issue altogether, do we really want doctors without residency to be managing patients ? Let’s save that for another thread

We already have midlevels without residency managing patients.

Hard to discuss docs working in midlevel style roles without bringing up the obvious labor supply. Sure, there are some less than stellar docs in that pool, but they've mostly undergone a standardized, more rigorous training than midlevels who can just change specialties.

[Zaphod]

We already have midlevels without residency managing patients.

Hard to discuss docs working in midlevel style roles without bringing up the obvious labor supply. Sure, there are some less than stellar docs in that pool, but they've mostly undergone a standardized, more rigorous training than midlevels who can just change specialties.

Yeah, how is that not different and on average better than?

[Zaphod]

Definitely sounds like you might want to consider military service. A few other issues, like where is home.

I dont know how one can miscontrue something like that, but oh well.

[nastle]

We already have midlevels without residency managing patients.

Hard to discuss docs working in midlevel style roles without bringing up the obvious labor supply. Sure, there are some less than stellar docs in that pool, but they've mostly undergone a standardized, more rigorous training than midlevels who can just change specialties.

I’m not defending the role of midlevels but that’s not something which you or I can change but I don’t see how adding more less qualified candidates ( than residency trained MD DO ) will improve this situation