Thread: internal medicine vs family practice

any knowledgeable people on this comparison of primary care specialities ? What are the differences between internal and family practice ?

I know that family practice people treat very young children < 5 yrs where as internits do not , but aside from that ..what are the pros and cons of each ? While they are both primary care , internists seem to be better compensated . Also , can family practioners work as hospitalists ?

anyone who can answer these questions . please post so that more people can be informed .

thanks

IM has more/better fellowship opportunities (ie. GI, cardio, pulm, neph, etc...) you can do an IM/Peds if you want to treat kids.

FP's often do ob/gyn which IM's don't do.

i worked with a couple of FP's in my home town that did work as hospitalists, but i think that is becoming more the domain of IM.

i think if you really want to do the family practice, and take care of kids, women, etc...than FP is better. if you want (or may want) to subspecialize, don't like ob/gyn or peds, then go IM.

the names really say it all. IM, specialize in the medical diseases. FP, take care of the family.

i don't know about the compensation. i think compensation issues would depend more on how the practicioners bill. ie, if you are doing lots of procedures, etc, you get better compensated. if you see kids with runny noses and other such type office visits, you will bill a bit less.

Family Practice tends to have a wider variety of types of patients than Internal Medicine.FPs will do general pediatrics,basic GYN care,adult primary care,in some places they do OB but this is usually in more rural locations.They are outpatient focused and I am not aware of FPs serving as hospitalists,as they are not trained for that.Internists tend to see mostly middle age and older adults for general medical care,focusing on diseases such as HTN,Diabetes,cardiovascular problems etc.They tend to have far more inpatient hospital experience,and usually see sicker patients.Specialists in internal medicine especially in GI and Cards tend to have much higher incomes because they have well paying procedures to perform.Family Practitioners also can do some procedures such as minor in office surgey, and some endoscopy.Of course there are lots of exceptions to the above.In general FPs who work in smaller towns/communities take on greater responsibility as there are fewer specialists to refer to.There is much variation in what various practitioners will do in their office and bill for and this will account for most of the income differential between FPs and Internists,I doubt there is a big difference between the two.

Nyphys summed it up nicely. FPs tend to be the "jack of all trades". They do some adults, some peds, some gyn, some OB (mostly in rural areas, as stated).

As an internist, all I know how to take care of are adults. Most of my residency experience was inpatient. In the future, residency programs will be requiring more outpatient experience, since most of us do primary care. FPs are very limited in terms of fellowship options. I think they can do sports medicine and a couple of others, but nothing like GI, Cards, etc. Fps cannot function as hospitalists. I am told that some hospitals won't grant privs to FPs. It really depens on what you want to do. If you never want to touch a kid or do gyn, then FP would waste a lot of your time. If being able to do a bit of everything appeals to you, then FP is great. Income is about the same between the 2. G

Fam Prac is a good idea if you want to have superficial knowledge in a couple of areas i.e you'll have general knowledge in ob/peds/im/pysh. You will not be considered an expert in any of those fields. You can include all those fields in your practice and your patient base will be very varied in terms of age and pathology. As far as I know, FP's do not work as hospitalists as they are not trained to do so.
IM docs are considered experts in medicine and can therefore do medical consults for ob's, surgeons, etc etc. There is a great amount of inpatient experience and thats why IM practitioners are best suited for being hospitalists. Internists can also function as good primary care MD's but mostly in adult medicine, office gynecology and pysch.
In terms of fellowships, FP's can do fellowships in Ob or sports medicine. Internists can do fellowships in many many fields - rheum, ID, allergy, endocrine etc etc...there is much wider scope for furthering your training if you wish to do so.
I think some FP's can really rake in the dough esp with ob but on average Internists make a bit more than FP's.
hope this helps a bit..
any other q's feel free to ask
HG

Originally Posted by teratos

Fps cannot function as hospitalists. I am told that some hospitals won't grant privs to FPs.

well, where i live, many of the hospitalists are FP's currently. i do live in a pretty small town (about 150000 folks in the county, 5 hospitals), but it seems that FP's "can" function as hospitalists. i don't know how much i like that, especially one of the docs. imagining them in charge of the ICU and all the inpatients was a bit of a strech. this doc seemed to be a bit frazzled when we had kids with sore throats and earachec....i can just imagine the ICU pts dropping thier pressures and some heave freaking out going on!

also, i worked with a lot of FP's in the ER, and the community guys do admit folks to the hospital.

what you can do seems to be determined regionally.

where i am at in the SE, IM are the only ones for hospitalist at our hospital. as for the big difference? we have a coupel guys in our program who switched over from FP. they said they didnt like the "broad but weak knowledge of everything" over the somewhat smaller but much more in depth required of IM.

i live in central california...

one reason FP's may be working as hospitalist is that there is a moderate shortage of docs around there. so, they need somebody in house, and no IM is available, they hire an FP. i don't know how common it is in other spots. but, i would assume that it is safe to say that if you want to be a hospitalist, IM is a better choice.

Thanks to everyone that responded . It seems as though most fmg end up with a primary care specialty . I was wondering - why is this ? does anyone know of the chances of an img obtaining a fellowship ? I cant seem to find figures about this . As a firefighter who risks his own life to save others for MINIMAl pay , i was quite astounded when i read an autobiography of a doc who related his exp with primary care docs as substandard . His fellow attendings , chief residents all referred to primary care docs as FLEAS" ... i dont understand this ..they said that primary care docs treat people who are not sick and if they do have a prob , primary care docs have to refer to specialist ...surgeons , etc ..
why is this ? i wouldnt mind being a primary care since considering my age starting med school , but i would like to be respected in the field that i serve and would realise that i do have to refer people to more qualified , specialized people . Also , do most people chose IM because they hope to do a fellowship and if not accepted , just settle for IM or do most people genuinely like being the " first line of defense "... also ..why do people scoff at FP ..i read that FP treats the MOST patients ..even more than IM..but why is it looked down upon ..finally when salaries quoted as "113,000 for FP , would that be roughly the same if u opened your Own private office ? .. to me it seems FP - most patients seen per day ...more $$..at $50 per vist , 40 patients per day ( 12 hr day ) ..would be 2000 a day times 300 working days ...600, 000 before expenses. I would say thats equiv to rougly 250,000 after tax , rent , malpractice , salary to employees , business loan payments etc ...what do u guys think ?

Could be that other doctors look down on FP only because it seems to be the easiest to get into. Doctors do get snobbish and elitist after all.