ACOM-IMIG Club
Meeting Minutes
May 8, 2014
I. Call to order
Zach Mansell called to order the regular meeting of the ACOM-IMIG at 5:40 on May 8, 2014 at
Multi-Purpose Room at ACOM
.
II. Roll call
John Roberts conducted a roll call (written). The following persons were present: See Attached Excel
Sheet.
III. Approval of minutes from last meeting
John Roberts read the minutes from the last meeting. The minutes were approved as read.
IV. Open issues
a) None
V. New business
1. Dr. Jim Robeson—Internal Med Presentation
- Intro to the area, and general information about internal med
- Doctors for adults issue
- Intro to internal med path to sub-specialties
- Brief discussion of procedures
- Internal vs. Family Med.
- Preventative care
- Internal med: Rural vs. Urban practice—advantages vs. disadvantages
- Continuity of care
2. Dr. Robeson—Q & A
- Challenges of practice
o Use of scribe to save time
- Path to practice
o Keeping your perspective in medical school
o 3rd year brings life back to perspective
o Finding a good mentor makes a huge difference, but experience is the ultimate
deciding factor
§ How happy are you at then end of each visit? Each day? Each week?
- A day in the life
o Day start 7:00a, usually start with rounds on in-patient
o 8:00-11:00 scheduled pts clinic visit
§ most pt over age 65.
o 12:00-1:30 lunch/hospital admits
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o 1:30-4:30 afternoon apt.
o 4:30àrounds on new admits.
o Spends time once weekly w/ hospice pt’s (moonlighting)
Palliative care?
Issues of solo practice
o Hard to learn business of medicine as new doc.
o Groups will split and change depending on many issues, but experience for ~10
years is key to learning the trade and the business.
o Makes call really difficult if you value life-style outside medicine.
What is your practice like?
o 2 partners—do in-patient and out-patient, cover their own call (split call for the
group)
Dx and Tx of conditions you have never seen?
o Rare due to Extensive exposure during school/residency
o When in doubt figure out who to consult (you can always find someone who can
help)
How has affordable care act affected your practice?
o Not much due to medicare pts
o However, it is driving up the cost to pt due to high deductible
o Newly enrolled people carry risk of non-payment on business front.
Things that you were glad that you did or wish you would have done?
o Religion kept during school (glad he did)
o Kept a hobby outside of medicine during school (piano)
o Stay involved w/ the periphery of medical world
o He wishes he would have kept up his shadowing during school to keep his
perspective as to why he is working so hard on non-clinical course work
What did you do with your summer between 1st and 2nd year?
o Research, Alzheimer’s disease
§ Regretted it b/c he had to come up with a presentation during 2nd year
What would you advise we due over our summer break?
o Get some shadow experience in fields that you are interested in.
§ Pt contact hrs
o Make sure you keep an open mind and try different things
o Enjoy your summer, it’s the last one you will ever get
What were the deciding factors for Residency choice? Why come back to Dothan?
o Enjoyed the hospital during his clinical years, also wanted to stay in Birmingham.
§ It was just the right fit.
§ Internal med, many people get their first choice.
o The residencies personal contact with you will be one of the driving forces in the
you getting selected for residency
o Came back to Dothan due to his father retiring, and the hospital he worked at had
a lot of problems and was bleeding money.
o Father handed the practice down to him.
o Dothan has an odd medical community b/c of long travel time to nearest major
medical center.
§ Big medical center in a small town atmosphere.
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New emphasis on primary care is making internal medicine more attractive
o Financial incentive is getting better, and hospitals are starting to cater to them
more.
Why is internal med a bad option for people
o Most of your work is cognitive, and for some reason procedures pay better, and
you don’t do many procedures.
o It is becoming more attractive because the system has realized the value of
keeping people out of the hospital
o Things like checking on people after hospital discharge is starting to pay more,
annual wellness exam
o A thinking physician has began to become more valuable.
Have you had a pt w/ Wilson’s?
o No, but other things
How has Dothan affected the variety of patients that you see?
o Here you see mostly primary and secondary disease specialties
o Tertiary disease are typically sent to UAB or Major medical centers.
o Finding the odd diseases for certain demographics is satisfying.
One thing in next 5 years that excites you about internal med
o More disease prevention and health maintenance involved in the medical system.
o Medicine is a numbers game, and its good that health prevention is becoming
more involved in the system
o Ex. Hired a Scribe to increase his productivity during his day.
§ Scribe has allowed him to go through charts and find people that are
behind on preventative care and remind them to come in.
§ Scribe is increasing patient care
What do you know about loan repayment for internal med
o Its more based on need for geographic area, repayment can be found where
physicians are lacking
Advantages to doing a fellowship Geriatrics
o Hard to say…
o If anything, pharmacology specific to geriatric population maybe one thing, not
real sure.
What is malpractice insurance like for internal medicine doc?
o 12-15k a year if you pay for it your-self.
o If employed by the hospital, it is typically covered, but it is job specific.
Do any of your physicians to just out-patient or just in-patient
o Some do, but it varies, and compensation will vary
What is your typical work schedule, now and right out of residency?
o Right out of residency—4 ½ days a week
o Now—2 ½ or 3 ½ days a week, nobody runs clinic on Friday.
o Some set-up a day doing nothing but procedures
How is job satisfaction among people you knew during residency?
o The ones he keeps up with seem to be pretty happy.
o People find ways to make things work for their life-style
VI. Adjournment
Zach Mansell adjourned the meeting at 6:50.
Minutes submitted by: John Roberts
Minutes approved by: Zach Mansell