Family Practice vs. Internist: which is best for me?

January 4, 2007 2:42 PM

DoctorPickingFilter: I have just changed health plans, and need to find a new doctor for me & my pre-schooler.

There is a family practice very close (5 minute walk), and this is an advantage as we have no car during the day. (My husband needs it for work.) Family practice seems fine for my son, as he's generally healthy and just needs checkups, immunizations, and general sort of normal kid things. What are the advantages of/differences between a pediatrician and a family doc?

I, however, have many chronic illnesses (PCOS, diabetes, hypothyroidism (and depression which may or may not be related), asthma, famililal hypertriglyceridemia, carpal tunnel) and because of that I have had an internist as my PCP since these conditions began to develop.

My question is: do I really need an internist? Will I be okay with a family doctor, provided that I also see the applicable specialists such as an endocrinologist or an allergist? Or are family doctors basically just for generally healthy people who have occasional minor illnesses/injuries? Do I even need a PCP, or would it just save time to get myself an assortment of specialists? The internists always sent me to specialists anyway, so is there a real difference? Will a family practice doc see multiple family members at the same time, for instance-- if the kid needs a checkup and I need to talk about continuing the scrips given to me by my Kaiser docs?

Also: I am basically just picking this practice based on location, because I can't really access any information that's very useful to me. The plan website tells me when and where each doctor went to med school... but, so? I know how to look up disciplinary actions from the state medical board, and none of the doctors in this practice have any. Previously, I've not had a lot of choice in doctors, being on either MedicAid or Kaiser, so what are signs that I should find someone else? What are signs that I've got a good doctor I should keep?

posted by Shoeburyness to health & fitness (3 comments total)

Signs of good doctor: S/he listens. S/he then responds to what you have asked. S/he gives you more than five minutes. For convenience sake, see if they have a lab on premisis, and how many nurses/nurse aids they have, because it increases the productivity of the office.
As for just seeing specialists, that's probably not a great idea. You need one contact person who knows all of your health conditions and your symptoms so they know when a new one comes up. Also, depending on your insurance, you might need referrals (typically an HMO type thing). Diabetes especially needs someone who sees you often (not a specialist) to check for new symptoms and aggravated ones. Also, your PCP can be your advocate when it comes to getting good care from specialists.
I will assume you are female, as you mentioned your husband (although I hate assuming), so I suggest that you keep seeing an internist. Family doctors, bless them for their amazing work, do not always know as much about "female" issues.
posted by nursegracer at 5:29 PM on January 4, 2007

I agree with nursegracer. And you also need to check out a few family doctors. After mine reitred, I got one that was picked for me by my ex-doctor's practice. She was terrible, no bedside manner, didn't send me results of my tests until I called her a month later. Now, after checking around with colleagues and friends, I have a GREAT doctor. If you are in/around the Boston area, I would be happy to give you his name, but since you are probably not, trust the folks around you and ask.
posted by WaterSprite at 6:18 PM on January 4, 2007

Find a doctor that comes highly recommended by trusted friends. Then do whatever necessary to become a part of their practice.

Male/female/FP/internist does not matter. If you are unlucky enough to contract something truly unusual, you'll be in the hands of a specialist. PCOS, diabetes,asthma, etc. are so common nowadays that any decent physician will be working with the same toolkits and algorithms as any other. I work/have worked with many in all categories. Bedside manner, person to person, cannot be predicted by the doctor's sex. Guaranteed. The conditions you have enumerated are also ones that require, generally, a fair amount of effort on your part to manage, so you ought to be comfortable with your doctors mandates to take good care of yourself as well, and a poor fit will only exacerbate the inevitable frictions that arise if you feel like your doctor doesn't fit well with you. There's no such thing in America as a practice of "generally healthy people". Internists do generally manage more patients who are elderly, as a rule.

Does the FP clinic have lab and xray on site? That would be a fairly important factor in my decision.
posted by docpops at 8:42 PM on January 4, 2007