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Non profit Community health centers??

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Hello! I am graduating in December and am starting to look around at jobs a little. 

I have seen a few jobs for family medicine at non profit community health centers (not free clinics but lower income health centers) and was wondering if anyone had worked in these before? 

What I am wondering is if that would be a job a new grad could excel in? Was there a good amount of training? Was there a lot of burnout associated with this sort of site or population? Were there other PAs (this center doesn't have PAs but has many many NPs)? How close did you work with the other providers?

They offer loan repayment through NHSC so I am assuming the salary is lower  (which I am completely fine with but wondering if that is a correct assumption?) 

Were there any other pros and cons that you experienced?

I am really just looking and I know many questions can be answered if I apply/ interview, but I was curious of experiences because as a new grad, I am afraid of burning out quickly and not getting the training I might get at a hospital/ office. 

Anything would be helpful! Thank you in advance!

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I've never been employed at one, but I did my FM rotation at a place like this is Queens, NY. The patient population was from homeless and domestic violence shelters, and I loved it! They had in-house dental, therapy, social work, health educators - it was awesome to be able to set the patients up with all of those resources. 

The medical group was 3 docs, a PA and an NP. The PA had her own clinic at a satellite site and was there with a nurse and MA every Monday and Friday, so she had a great amount of autonomy (she previously worked in pediatrics for 4 years). Each provider had their own panel. From what I understood, the turnover wasn't high as the least tenured person had been there about a year and a half.

There was a huge team environment which was nice. The census was high and charting ran late every so often, but I loved the rotation and even got a verbal job offer afterwards. This is a big(ger) system in NYC so I'm not sure if others are similar. I'm hoping to move to the city in the future, and this place is still on my list for potential employers. I hope this helped somewhat.

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IMHO it would not  be a great position for a new grad unless you have a lot of support and other providers to lean on. I worked in one in one of the 100 poorest counties in the US. The patient population can be very challenging.

Their problems are often very complex because of their situation. They have no resources so it can be a struggle to prescribe any treatments they can't get free. They tend to have very bad lifestyles and habits making their problems considerably worse (or it is what makes their problems). Talking lifestyle modification is almost pointless. They generally either lack the desire or the means to make lifestyle changes. They also tend to be less educated so teaching can take a long time and often just doesn't stick or resonate. There is a fair amount of untreated mental illness that was beyond my comfort zone and we had no psych resources. Some clinic do along with dental and some specialty care. We had an Ob-Gyn in our group but she was such a psycho I hated dealing with her.

Most patients are grateful. Some will rail at you for not fixing their problems or because they don't have any money for anything related to their health care. I have had a few call be stupid or an asshole for suggesting they quit smoking or eat better or walk 20 minutes a day.

It can be very rewarding to help people who need so much. It can be very frustrating. I don't think it is a new grad job without a big safety net.

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Ask a TON of questions about loan repayment. There are often limits or job commitment requirements. I have seen it go south quickly when a PA was hired with student debt and then filed for the reimbursement only to find out a limit for that clinic had been reached or the clinic really wasn't eligible, etc. There is likely fine print about length of job commitment in the job contract or the loan repayment contract.

Ask questions about metrics - is this a medical home model or whatever the current verbiage is? There are some sneaky issues with what you can and cannot do based on who is funding it. 

Find out exactly WHO will be in the building with you at all times. I was alone in a rural area with one MA, no RN and a receptionist who needed tinfoil in her hat. I had the experience to handle it but not the staff or equipment. As a new grad - you will need support and a mentor.

Not trying to be Debby Downer but the reality sinks in when you have a super challenging patient or a whole slew of them and suddenly need resources you don't have.

If you get a good mentor - be a sponge and start filling your career toolbox with good things.

Good Luck!


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