Family practice or internal medicine?

On the note of me preparing to find a doctor and schedule a physical, which is the better choice (internal med or family practice doctors)? Any one care to share which they think does a better job/is the general choice for exams?

thanks

I can't exactly say why, but I'd be more inclined toward a Family Practitioner. I've been treated by both, in fact my internist is the son of my FP! Frankly, I think that my FP explains things in a way that I can understand, whereas my internist is all about explaining the chemical reactions of this, that, and every other thing. That's all well and good, and I am actually a student of anatomy and physiology so it's not like I don't understand why that's important. Three years ago, I was almost on my deathbed and the last thing I wanted to hear was why macrophages and cytokines were doing their thing, I just wanted it fixed!

If I'm dealing with a medical issue, I always start with my FP and let him refer me to whomever he thinks is best.

Play On!

LadyDoc

I would say family practitioner for all the reasons ladydoc articulated and for one other. When you have a complex issue, a family practitioner can coordinate among all the specialists, who are looking only at their specific area and who often don't see a medical conflict in another area. A good family doc is worth his / her weight in gold.

So it sounds like it may not matter, it just depends on the individual doctor?

The only real difference between the two is that Internal Med doc's dont see kids. There may be a bigger difference between male and female providers than between family Med and internal med: female providers spend more time with their patients and tend to be better listeners than their male counterparts.

There are a few considerations in response to this question. The first consideration is whether your health coverage, if you have any, covers one over the other. Many health care insurances will pay for a Family Practitioner but not for an Internal Medicine physician. You must remember that, technically, Internal Medicine is a "specialty" and effectively can charge more. In many places one would see an IM phys. if they were having heart problems as many IM phys. are also Cardiologists or just as qualified.

I can tell you that any physician can do a full physical regardless of their specialty. When I was in medical school I trained with FPs, IMPs, Neuro's, and bone cutters, there wasn't a difference when we were trained in basic physical examination. I could give you as thorough of a physical exam as a family physician or Internal Med. even though I am an Ob/Gyn. I know what an enlarged prostate feels like and can accurately diagnose it as well.

Your choice may come down to coverage and/or physician available. Also, if there is one that you would prefer due to their sex, etc. that would be another consideration to make.

Hope that helps a bit.

Janet

[quote author=DrJanetDelveccio link=topic=31995.msg292526#msg292526 date=1273551298]

There are a few considerations in response to this question. The first consideration is whether your health coverage, if you have any, covers one over the other. Many health care insurances will pay for a Family Practitioner but not for an Internal Medicine physician. You must remember that, technically, Internal Medicine is a "specialty" and effectively can charge more.

[/quote]

I don't know where you practice, but where we are Primary Care pays the same regardless of whether the physician is Family Medicine or Internal Medicine, and NO insurance company discriminates one way or the other. Also, the fee schedules for all primary care E&M (Evaluation and Management, for all the non-medical folks out there) codes are the same, bill the same, and are paid the same.

Family Medicine is just as much a "specialty" - both according to the American Board of Medical Specialties and every insurance carrier I've ever had to deal with - as Internal Medicine is. Postgraduate training for both is three years.

To become a "specialist" in the context of a referral specialist in a medical specialty requires fellowship training in the specialty after completion of an Internal Medicine residency program.

Doc

I would say family practice. Internists are probably more into complex diagnostic issues that general physicals. I think the family practitioner will be more interested.

I would think it has to do somewhat with age. A young healthy person may want to start with a family practice doc. An older person may want to see a doc of internal med.

My doc is a internal med type (I'm 69) and she gives me a complete phys each year. Have you asked your doc for a complete phys?

I have been to both family medicine doctors and internal medicine doctors. I have gotten more thorough exams from internal medicine doctors. From my experience, the family medicine doctors don't have as much time to do a physical exam as the internal medicine docs. I never had to fully undress for a physical at a family doctor after I became an adult. The most that I remember doing was dropping my jeans and briefs for a hernia check. At least one time, I only had my shirt off and never dropped my pants.

I always had to undress for a physical by the internal medicine docs, either to my underwear or completely and wear an exam gown (or one internal medicine doc who had me stripped to my shorts and then wear a gown). Always had a rectal exam, too, even when I was in my 20s.

As an adult, I have been both to a family practitioner and an internest, and they are pretty much the same for routine exams. I received 2 proctoscopic exams from the FP and digital rectal/prostate checks from the internist .

Like many golden agers I grew up with a general practitioner who required only one year of internship before setting up a practice. He very much approved of enemas, and Mom took that as a standing order to give the remedy when she thought it needed. It was the same with a friend of the same "vintage" and I suspect millions more.

Family for sure. Much more friendly and easy going. More likely to cooperate with you too if your refusing (not sure why you'd refuse but...)or have much much much more patience. Would you rather talk to someone you've been to maybe for 1 visit and just leave without much checking on prior to years of going to your family doctor and your siblings/cousins went to. Its not exactly an issue but more reccommended by people your close to is alot more comforting.

When I was little, I never went to a pediatrician. My mom always took me to her general practitioner (a guy). As a young adult, I always went to internists (all men) because my parents said that they thought that the internist was better trained.

For the past 9-10 years, I've been going to a Family Practitioner who is also the first female "regular" doctor I've ever been to. I can not say enough good things about her. Besides being one of the nicest people that I know, she gives very thorough exams. While the other doctors, for example, would check for hernias, I don't think I ever received a testicular exam until I started going to her. I also had never had my prostate checked until I started going to her, and she does both tests for me annually now.

I also like her because she spends a generous amount of time at the beginning of the exam just talking with you. She reviews your chart while you are there and asks about past problems and gives you plenty of time to ask any questions or report on any problems that you may have had over the past year (I'm basically pretty healthy and mostly just see her for annual physicals).

And not just for medfet purposes, I like her because she always wants you basically naked for your physical (until this year, she used to have you put on a gown, but the gown was always completely off by the end of the exam anyway...). She probably does a better job, for example, of doing mole checks than my dermatologist does, simply because she sees ALL of me and dermatologists are very skittish about looking beneath your underclothing and in your butt crack.

I also like her because she asks questions about lifestyle like exercise and diet and generally trying to practice good preventative medicine in between annual exams.

My point being that if she is a typical example of a family practitioner, I would take her any day over an internist.

I genuinely look forward to my exams every year. Simply outstanding.

I dont think it matters. I saw a ped until age 19 and now see an interist.