pavlovacloud Posted November 24, 2015 Share Posted November 24, 2015 So I interviewed at a place who wants me to see 20-25 patients a day within two weeks. I only saw ~10-15 during my rotation along with consultation with my preceptors on treatment plans. I'm very anxious about this amount. I'm also anxious that most of the patients are monolingual in Spanish and I will have to depend on a translator- is one able to build rapport with people you can't communicate with. They offered me the job with benefits, but I'm just a little hesitant about this. Link to comment Share on other sites More sharing options...
thinkertdm Posted November 24, 2015 Share Posted November 24, 2015 20-25 patients is a lot, especially when you are probably going to be looking stuff up, asking your SP, things like that. And working with a translator will double your time. My first job I saw 1-2 per day the second or third week I was there (the first couple of weeks I was basically shadowing my SP). I think I was up to maybe 25 per day after 9 months to a year. Link to comment Share on other sites More sharing options...
Reality Check 2 Posted November 24, 2015 Share Posted November 24, 2015 That isn't medicine - that is McDonalds........................ 25 is about my max in 8 hrs and I am in 25 years. Quality suffers after a certain quantity. As a new grad you should see SLOWLY increasing amounts - you will have to learn EHR, learn where the bathroom is, learn how to order things with the nursing staff, learn how to send rx's - IN SPANISH. No way you can go to 20 in 2 weeks, much less 25. I would not expect a new grad to see 25 unassisted for 9-12 months. This only makes sense for quality medical. My very old 2 cents. Link to comment Share on other sites More sharing options...
treejay Posted November 25, 2015 Share Posted November 25, 2015 too many patients, absolutely, for a new grad, especially if you need a translator. But it also depends on specialty. Pediatrics? You can see more. Complex IM patients with dementia and polypharmacy and absurd amounts of comorbidities? You need to most certainly see fewer patients. Link to comment Share on other sites More sharing options...
pavlovacloud Posted November 25, 2015 Author Share Posted November 25, 2015 I feel the same. I've gotten 3 job offers from family medicine clinics. First one wants 17+ patients within a month. 2nd wants 20+ in 2 weeks. Third one wants 25 to 50 per day and say I can start off slow but I dont know how long for. They say they do fast medicine. I've been hesitant in all of them. I'm not the fastest learner and feel I might get fired if I don't meet their productivity rate within my probation (all give me 3 month probation). Is FM supposed to be like this? I was in rotations doing good medicine and being very thorough. I get the sense I can't have that opportunity here and it is discouraging. Link to comment Share on other sites More sharing options...
CAAdmission Posted November 25, 2015 Share Posted November 25, 2015 Now that our government is essentially taking over healthcare, it's going to get a lot worse than all this. Link to comment Share on other sites More sharing options...
electric130 Posted November 25, 2015 Share Posted November 25, 2015 That is way too much in a day for new grads. Working with a translater really slows the process as well, I can tell you from experience. It is shameful that these practices are essentially only worried about how much money they will make on you. At 25 patients a day they will be making a lot off of your work at a new grad salary. Taking on a new grad is an investment and takes time for you to learn and practice in a safe and effective way, seems like that is just not a concern with these offers recently. I started 13 years ago and honestly there wasn't even any talk of how many patients I would see a day. I started by seeing patients along with my SP and then just slowly worked my way to having my own schedule. For a couple years I think I typically had maybe 15 patients a day. I am now comfortable at around 25 a day, I can be thorough and finish all my charting but that is after 13 years. If you want the position ask if you can have some flexibility with how many patients you have a day and ask for 10-15 for at least the first 6 months. Link to comment Share on other sites More sharing options...
Moderator ventana Posted November 25, 2015 Moderator Share Posted November 25, 2015 10 to start then work up nothing more or you might kill someone with out knowing it.. Link to comment Share on other sites More sharing options...
PACdan Posted November 25, 2015 Share Posted November 25, 2015 I don't want to see 25+ pts. in an 8-hour day...ever. I know some people are comfortable speeding around, but I am not. And I'll look for a practice that is conducive to that. There needs to be a realistic upper limit. At some point you'll be doing more harm than good. There's good reason (and studies) we don't keep residents up for 140 hours a week anymore. But as a new grad, that number sounds abusive to you and dangerous to your pts. Link to comment Share on other sites More sharing options...
TWR Posted November 25, 2015 Share Posted November 25, 2015 I don't think there is a hard number to give you starting out. I believe technically you need to do 2.5 times your salary to justify your working including good benefits. Over that is whip cream and cherries. As time goes on with decent mentoring you will be faster and still not "kill" someone. A practice that wants to know how many patients you can see is trying to figure out their margin of profit. Better to be a good practitioner. Link to comment Share on other sites More sharing options...
Miaow Posted November 27, 2015 Share Posted November 27, 2015 Well this explains why everything that can't be figured out in 5 minutes is dx as a urine infection and treated with antibiotics. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted November 27, 2015 Moderator Share Posted November 27, 2015 I was seeing 18 patients a day after 2 months. Could be as high as 22 depending on my department heads discretion or if I felt someone was really sick and needed to be seen. I could probably see 25 if I had the more efficient private practice versus the military system. Would I want to? No. I hate seeing even 18 people per day. There is little getting to know your patients, a toenail removal throws the schedule into chaos, and you often end up just walking from room to room without stopping for hours. 14-16 is a nice relaxing number. I should say even at 20 I have time to look things up, but it eats into my charting time. Link to comment Share on other sites More sharing options...
pavlovacloud Posted December 4, 2015 Author Share Posted December 4, 2015 Thanks for all the feedback. It made me seriously consider the lack of safety in these practices. I declined both offers and continued applying and interviewing. I finally got 2 amazing job offers both that took training seriously for a new grad and they want to build us up gradually to 17+ patients. I'm taking the one with my desired specialty. Thanks you guys for sharing your thoughts and wisdom to a new grad such as myself. It's valuable to have advice when we are making these big decisions. I appreciate it. Sent from my SCH-I545 using Tapatalk Link to comment Share on other sites More sharing options...
skyfall Posted December 7, 2015 Share Posted December 7, 2015 One of the FM practices I interviewed at saw 20-50 patient per day. One of things in the contract stated " Incentives are paid if you see over 30 patients on any given day you would get $20.00 per patient after that." I hope no new grads sign up for these practices, no matter what the pay is. Link to comment Share on other sites More sharing options...
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