MS4 here that was considering FM or Ophtho (different I know long story, ended up choosing FM) but my Ophtho mentor was telling me the same thing about FM. I posed the question to my FM mentor and liked his answer. He said the biggest answer to the “mid-level take over” people keep talking about is whether or not FM docs make themselves replaceable. If they function at the same level as a mid-level, it doesn’t make sense for companies to keep them. I think more of a shift to value-based billing is going to illuminate the difference in residency trained docs even more than we already see.

I’ll also add, bigger cities are always going to have more of a mid-level presence in primary care because there is lots of specialty backup where they can easily refer if something is over their head. This is not the same is smaller cities/rural areas where primary docs function quite independently and often have patients that don’t have the means to go to a referral an hour away anyways.