I am a Radiologist so in a different milieu.
Telemedicine is ideal for most of diagnostic radiology.
you say money isn’t an issue. That really expands your options.
seems like family and rocket building are important to you.
as a calling, sounds like you want to provide great care to each patient , which is very laudable.
questions:
do you PERSONALLY have to see each patient to get that warm fuzzy feeling of satisfaction, or can you find excellent PAs or NPs who you can supervise (likely chart reviews you can do from your home office) and still feel like you are making the difference in people’s health you feel called to do? This maximizes the number of people blessed by your care, but definitely lacks the personal involvement. You also have to be able to find GOOD PAs and NPs you can trust. That’s tough. It is likely relatively lucrative as you are taking care of far more patients, sort of like the Dentist makes money when his techs clean and fluoride teeth without lifting a finger himself.
telemedicine is kind of in the middle. Much of primary care is voice and facial expression, so you DO see individual patients. You can’t do the hand holding or shoulder touching which can be a big part of communication, but Covid is messing with that anyway. You also are limited to visual inspection for physical exam (patients can get their own Blood Pressure cuffs and often can get pulse ox, pulse rate, and even a short rhythm strip off their phones! Many docs are kicking physical exams off to imaging anyway, not good for patients or costs but often more accurate and reduces liability. My wife sees a specialist at Vanderbiltvia Telerad and loves it. So depends on how it fits your personality.
if you DO decide you want to physically see patients, first God Bless You! Second, unless you REALLLLY like listening to audio books, podcasts, or music, remember every minute on the road is time you aren’t spending with your family, building rockets,, seeing patients, or making money. So finding a place near to home (or if moving is an option, moving to a place near your practice site) was (at least to me, I DO work at a hospital although ironically most of what I read is networked in from OTHER hospitals. But I have a 10 minute drive to work) a BIG factor for me. Unless you can find a job that pays for your travel.
locums? Depends on personality and home situation. Can your significant other and pets come with you? Can you transport your hobby materials? Are you okay with seeing patients on a one time basis, vs developing long term relationships? God bless the ER and urgent care “Docs in the Box”, they are definitely essential, as most primary care docs are booked out months and in advance and many acute diseases are unkind enough to NOT. make appointment schedules with patients and crop up suddenly at the most inconvenient times, like Friday afternoon before a 3 day weekend . When I grew up, if I got sick my Mom could usually get me in the next day with our FP. Not anymore.
anyway, best wishes for you, my main point is that travel time for daily drives or locums has a significant and often underappreciated cost.
whatever you do, find a coworker or some mentor who can help you avoid burnout,
oh yeah, not sure it fits your personality, but sounds like your administrative and leadership skills have been finely honed. As much as many physicians “poo poo” the paper jockeys, the need for good COOs and CEOs who truly UNDERSTAND basic medicine AND can work with the system to provide the resources for the frontline nurses, NPs, PAs, and Docs to do their jobs well and feel empowered and appreciated is great. Having worked for a couple of places where the hospital leadership was in desperate need of a cranio-anal extraction, you may find your best contribution to patient care to be at the executive level.
"Amateurs talk about tactics, but professionals study logistics."Gen. Robert H. Barrow, USMC (Commandant of the Marine Corps) noted in 1980
