When you’re choosing a primary care practitioner, you might wonder if you should look for an internal medicine practice or a family medicine practice. What is the difference between the two, and how do you know which one is best for your circumstances?
PRIMARY CARE PRACTITIONER
Internal medicine and family medicine physicians are both considered primary care practitioners (PCP). Your PCP is your main healthcare provider who provides continuity of care, and it’s a good idea to have one. In fact, many insurance companies require it. PCPs are the ones who partner with you to help you manage your healthcare.
If you look at your healthcare providers as a team, your PCP is the coordinator or team captain. If you see multiple specialists, who all provide tests and medications, your PCP is the one who keeps the big picture in view, so your care is efficient. They will make sure testing or prescriptions aren’t duplicated or interfering with one another.
Additionally, the role of your PCP includes the following:
- Provide preventive healthcare such as immunizations and yearly check-ups.
- Identify and help you manage chronic medical issues such as high blood pressure, acid reflux, and thyroid issues.
- Identify and treat common health problems such as ear infections, etc.
- Refer you to medical specialists, if needed.
- Coordinate your healthcare if you need multiple specialists.
- Provide testing and prescription medications.
- Depending on the circumstances, they often direct your healthcare if you’re hospitalized.
TYPES OF PRIMARY CARE PRACTITIONERS
In the past, the term “PCP” was an abbreviation for primary care physicians. But as healthcare has progressed to meet the needs of patients, PCP now refers to several types of licensed healthcare professionals, including:
Family Medicine Physicians
Family medicine physicians (FPs) are board-certified family medicine doctors who have completed a three-year residency specifically in family medicine after medical school. During their residency, they receive training to care for adults of all ages, children, and pregnant women, hence the term “family medicine.” They also train to perform minor surgeries and obstetrics, but most FPs choose not to offer pregnancy care as part of their practice. They provide long-term care in wellness, disease prevention, and less complex conditions.
Older adults often have complex medical needs and choose geriatricians for their PCPs. Geriatricians are doctors who have board-certification in geriatric medicine to care for the elderly. After medical school, they typically complete a residency in either family medicine or internal medicine followed by a one to three-year fellowship program in geriatrics.
Internal Medicine Physicians
Internal medicine practitioners (internists) are physicians who complete athree-year intensive residency program in internal medicine after medical school. They receive extensive training in internal body systems and often get more specialized training in subspecialties.
Similar to family practitioners, they also provide preventive healthcare and treatment for common illnesses. Additionally, internists are trained to manage more complex medical problems. Unlike family practitioners, they usually focus on the long-term care of adults of all ages and most often don’t provide primary care for children.
Nurse Practitioners and Physician Assistants
The U.S. has a growing shortage of family practice and internal medicine physicians, and many states are allowing nurse practitioners (NPs) and physician assistants (Pas) to serve as primary care providers to fill in the gap.
Nurse practitioners are advanced practice registered nurses. They earn either an MSN (master of science in nursing) or DNP (doctor of nursing practice) — plus national certification in a patient population focus and state APRN licensure. They are qualified to perform physical assessments, diagnose illnesses, order and analyze diagnostic tests and procedures, and manage patient treatment. NPs can also prescribe some medications.
Physician Assistants are licensed healthcare professionals who receive a master’s degree from a PA program. They have similar roles to NPs that include: performing patient exams, assisting in surgery, ordering and interpreting laboratory tests and x-rays, diagnosing illnesses, prescribing some medications, developing and managing treatment plans, and providing preventive healthcare.
Obstetricians/gynecologists (OB/GYNs or OBGs) are board-certified doctors who specialize in treating diseases of the female reproductive system. OB/GYNs complete a residency in obstetrics and gynecology after medical school. They often serve as a PCP for women of childbearing age.
Pediatricians are doctors who have completed a three-year pediatric residency after medical school. They have specialty board-certification to care for newborns, infants, children, and adolescents. Pediatricians serve as PCPs for children but not adults.
INTERNAL MEDICINE VS. FAMILY MEDICINE
It’s common to be unclear about the difference between internal medicine and family medicine because a large portion of their patient population overlaps. According to the American College of Physicians (ACP), children make up approximately 10%-15% of a typical family medicine practice, which means 85%-90% are adults — people who are also seen by internists.
One of the primary differences is in their training, which provides each with unique skill sets and strengths to care for their patients. Internists are not trained in pediatrics unless they continue on to a fellowship program after their internal medicine residency. This intensive focus on adult care throughout their education prepares them well to provide primary care to adults and particularly for medically complex adults.
The training for family medicine is broader than internal medicine since it includes learning to provide care for children as well as other services. Family physicians may not receive the same depth of training in adult medicine that internists do, but they make excellent primary care physicians. Their emphasis on outpatient medicine, coordination of care, and preventive health are invaluable to their patients.
FACTORS TO CONSIDER WHEN SELECTING YOUR PRIMARY CARE PROVIDER
Once you’ve decided what kind of primary care practitioner is best for you, there are other factors you may want to consider in your selection. These factors may include:
- Communication style: friendly or formal, accessibility
- Focus of practice: wellness and prevention or disease management
- Treatment approach: conservative or aggressive
- Involvement: authoritative decisions or patient involvement
- Reputation: get recommendations from other patients or health practitioners
- Office: location, responsiveness of staff and convenience hours, patient portal, online scheduling
- Billing model: public or private and acceptance of health insurance
- Other qualities: gender, age, ethnicity due to religious or cultural beliefs
At MCR Health, we have many healthcare provider options, including internal medicine and family care medicine, to meet your individual and family needs. Contact us today for an appointment. We’re still here to partner with you during COVID-19 with protective precautions in place. Please visit our Coronavirus Resource Center online for more information.