Med/Peds in a Changing Marketplace and the Rise of Hospitalist Programs
by Norman Toy
April 2006

A Letter to residents

by Norman Toy
Vol.2 No 2
Winter 2000

What is a MP Physician?
by Norman Toy
National Med/Peds Resident's Association Newsletter
Vol. 1 Number 3
December 1997/January 1998


What is a Med/Peds Physician?
by Norman E. Toy
Med/Peds Recruiter

During the course of any given day, I am asked that question numerous times. I am the recruitment director for a national physician search firm, and my particular focus is Med/Peds. That means, my job is marketing Med/Peds nationwide. I have had the rare opportunity of observing first hand the emergence of the Med/Peds specialty in the employment marketplace. Almost every resident I have spoken to has told me of the many experiences they have had with people who have never heard of their specialty. I, too, have had my share of experiences with administrators, hospital and group recruiters, and office managers who have never heard of Med/Peds. I cannot tell you how many times I have had to explain myself when presenting Med/Peds candidates. "No, I didn't say 'Ped', I said 'Med/Peds"...dually trained...internal medicine and pediatrics...board eligible in both...a four year residency..." ,etc. Invariably, their interest, like a red glow on the horizon, begins to rise. I can almost feel them imagining the possibilities. Before I know it, they want to see a CV, go to the board, or some such authority. That is exactly how this specialty has grown. And it is growing!

Several years ago, about 80% of the people I talked to asked me, "What is a Med/Ped?" Each year, the question is asked much less frequently. Now, the percentages have reversed themselves, and about 80% have heard of Med/Peds. Not everyone knows what to do with them yet, however, and that poses the next problem, and it can get a bit complicated. It is often necessary to get the approval, whether formal or otherwise, of local internists, pediatricians, and/or family practitioners, before bringing a MP physician into the community (which, for various reasons, is not always a given). If there are no MP physicians there already (and, lets face it, there are a limited number out there in practice), then the new MP will need the cooperation of the existing primary care providers, or they might find themselves on call every night. In addition, the patients need to be educated. How aggressively and effectively will the hospital market the new addition? Will the Med/Peds be willing to share call with internists and pediatricians, not to mention family practitioners? In the case of the former, how will that be structured in order to avoid a double call group? These are some of the questions and issues that arise when a M/P appears on the scene for the first time.

Fortunately, I am happy to say, there are some very creative solutions being sought and implemented allowing for the transition of this relatively new specialty into mainstream primary care networks. Flexibility is the key -- on the part of both the hiring facility, as well as the incoming physician. When I can, I try to encourage hospitals to form Med/Peds groups, promising them they will achieve a primary care coup in the process. This simple solution to some complicated issues surrounding bringing in this specialty, however, is usually either too simple, too costly, or just premature.

In any case, with the 100+ programs generating several hundred Med/Peds residents per year, the medical community will have no choice but to notice -- there is a new wave in primary care called Med/Peds, and it is time to put a roof over their heads, welcome them into our midst, and let them loose in our communities. The patients will come....