Is a "Family Medicine" doctor appropriate as a PCP?

June 6, 2018 8:52 PM

I need to find a new PCP. I have an HMO, so I'm restricted in my choices. It looks like I can choose someone in Internal Medicine (only 2 choices) or Family Medicine (30 choices). I'm a single woman who does not plan to have kids. What is "Family Medicine," and is that an appropriate specialty for a PCP for me? Additional advice about selecting a PCP appreciated, as I've done this multiple times on this insurance plan and none of them seem to stick.

I have chronic medical issues, really like my specialists, and need a PCP to manage yearly referrals to those specialists.

posted by lazuli to Health & Fitness (16 answers total)

My grandpa was a "Family Medicine" doctor; all it means is that he did primary care for adults and children. "Internal Medicine" doctors do primary care for adults only.
posted by Pandora Kouti at 9:04 PM on June 6, 2018 [3 favorites]

Yes. Family medicine is the new term for general practitioner. They see all ages, supposedly, though in my experience not a lot of kids and teens.
Don’t hesitate to keep changing PCPs until you find one that you work well with. That is seriously my best tip. I f you keep one that you dread seeing, you will postpone visits that you need to make and will waste energy trying to figure out how to manage your doctor, instead on manage your conditions.
posted by SLC Mom at 9:06 PM on June 6, 2018 [8 favorites]

A family medicine doctor (or a family nurse practitioner, for that matter, if your insurance covers it) practices general internal medicine for all age ranges, and is a perfect choice for a primary care provider.
posted by jesourie at 9:17 PM on June 6, 2018

I recently had this same dilemma and selected Internal Medicine. The doctor was ok but the waiting room was 100% filled with elderly people. Not sure if this was just a coincidence or if Internal Medicine doctors really do primarily treat the elderly.
posted by acidic at 9:18 PM on June 6, 2018

I am not an MD, but I work in academic Family Medicine research and support a residency. Family Med docs are trained fully from labor/delivery to palliative care. As medicine (at least in the US, which may or may not be pertinent to you) gets more specialized and Med School gets more expensive, most folks that go into Internal Med tend to go into a subspecialty (or spend a few years as a hospitalist which pays more but is a very hectic life) so there are fewer GIM practicing Docs around these days. If you can find a PCP in either that you're comfortable with, go for it.

Anecdotally, the FM residents I work with have a strong focus towards mental health/behavioral health cross-training and referrals that way, but they primarily treat underserved populations.
posted by Ufez Jones at 10:09 PM on June 6, 2018 [4 favorites]

So long as you like one of your two choices - I would vote for internal medicine. That's who you want if you have a chronic illness or were to become very sick, need to be admitted to a hospital, etc. Acidic's point above about the waiting room sort of tells the story - filled with elderly people who very often have a lot of serious things in play. There are many family medicine practices that are funded mainly from required physical exams for employers and docs, flu shots, maintenance prescriptions, etc.... all of which is fine and good but I would want the person who deals with a sicker clientele. I've used several of each and the difference between them was noticeable.
posted by machinecraig at 3:44 AM on June 7, 2018 [1 favorite]

I've been to both. The best way I've heard it described is that internal medicine doctors assume you're sick, and family medicine doctors assume you're well. The IM doctor was uncomfortable dealing with my birth control; my FM doctor does it routinely. I prefer having a family medicine doctor as my primary care physician at this point.
posted by Ms Vegetable at 4:31 AM on June 7, 2018 [6 favorites]

I go with the family medicine doctor as my "primary care doctor", and I say this as a guy who spends a lot more time with my oncologist and neurologist.

If one is looking for general doctor contact then the family medicine doctor can cover a bit of everything (as it were) and if a more focused level of knowledge or equipment is required they will recommend an applicable physician/office.
posted by mr. digits at 6:24 AM on June 7, 2018 [2 favorites]

I switched from a Family Medicine to an Internal Medicine PCP a couple years ago, when I moved.

I liked my old doctor, but the practice had terrible wait times and lots of teens/younger people because of the location, and lots of sick visits. My physicals there felt a little more "ok, and you've had your flu shot? Bye!"

I love my new doctor as well, and I'm one of her younger patients. She generally deals with a lot more chronic issues, and takes my (generally mild) symptoms more seriously. I've also seen a nurse practitioner at the office when I needed a referral, and she said it was nice to see a young face because she'd been dealing with old people problems all day!
posted by DoubleLune at 6:59 AM on June 7, 2018

Response by poster: In looking at the list again, the two internal medicine doctors are in a location that would be a major pain to get to in an area I never go; while that specialty is kind of my preference, I'm going to try one of the family medicine doctors first and see if that works out. I think I've found a practice where they don't all sound like they're going to thrust supplements and herbs on me when I walk in the door -- my hesitation had been in part because the bio/descriptions of the first dozen family medicine doctors I read were all really heavy on the "alternative medicine" side of things, which I'm not against in theory but I want to make sure my doctor is also willing to give me actual medications and such when appropriate. Ms. Vegetable's comment that "internal medicine doctors assume you're sick, and family medicine doctors assume you're well," helped me understand a bit of the philosophy behind the bios, at least, and I'm going to hope that this particular medical practice finds some sort of middle ground with that. And also that they can see me before late September, which is my current PCP's earliest appointment date.

Thank you all!
posted by lazuli at 7:56 AM on June 7, 2018

I find that family medicine providers are more open to doing home visits if that is something you might need.
posted by WeekendJen at 8:38 AM on June 7, 2018

I see a family medicine practitioner who is in an integrative practice. Every doctor I've seen in that practice prescribes conventional pharmaceuticals when needed.
posted by FencingGal at 10:54 AM on June 7, 2018

My experience was that my internal medicine docs referred me elsewhere for Every Single Thing while me family medicine docs only refer me elsewhere for half the things, which is at least an improvement.
posted by metasarah at 11:54 AM on June 7, 2018

Response by poster: So I'm booked with my first-choice family-medicine doctor for late July. Which is better than being booked with my current PCP, whom I don't really like, for late September. Keeping my fingers crossed that this one sticks!
posted by lazuli at 12:05 PM on June 7, 2018

I'm a primary care internal medicine doc and totally support you seeing a family medicine doc. Family medicine doctors get less inpatient training than internists do (although there are "primary care tracks" in internal medicine that offer more outpatient work). Between two primary care doctors the differences between individual doctors (in terms of particular interests, personality, and workflow preferences) are likely to be much more important than the difference between training programs.
posted by The Elusive Architeuthis at 2:05 PM on June 7, 2018

Both my son and I use the same family medicine doctor and I love her. She's been my doctor for 10+ years and my son's doctor since he was born (he's 3). In addition to being a great doctor, she's also a mom and I really appreciate her been-there-done-that approach to things. I also used a family medicine doctor (not the same one, as my regular doc doesn't do births) for my pregnancy and birth rather than an OB/GYN, and I would do it again in a heartbeat.

Not only is the care great, but at least with my insurance (YMMV), my co-pays are significantly lower when going to a family medicine doctor than when going to "specialist" like an OB/GYN or internal medicine doctor or ENT or dermatologist. Especially when I was pregnant and going to the doctor biweekly and weekly for months, those co-pays added up.
posted by aabbbiee at 3:08 PM on June 7, 2018