What a bizarre recent string of comments. Is there really a major difference between an outpatient internist and family medicine doctor?
Absolutely.
Main thing is that FM is trained and equipped to see all patients in all stages of life. It’s cradle to grave medicine (or as I like to joke: Diaper to Diaper medicine).
I see newborns, children, adolescents, adults. I do office (and some operative) gynecology, Obstetrics, a wide variety of office procedures, I admit patients to the hospital, I manage patients with multiple chronic conditions. And yes, I’m in a major metro area.
I my residency training I’ve maintained a patient panel of a few hundred patients. I started off being asked to see 3 patients per 4 hour clinic session. Within a couple of months this was increased to 6, and now is between 10 and 14 (depending on how many 30minute slots I have booked). I’ll have on average, 3 sessions per week, sometimes more, other times less depending on that rotation block I’m on. Those visits are a mixture of adults and children, women and men, sick and well. I’ll see acute issues, and chronic problem follow-ups.
I’ve also been trained in Inpatient Medicine, with 6 months of Hospital, and 2 ICU. I’ve done 4 months of EM, 2 of Ortho, 6 of OB, 1 of inpatient peds, 1 NICU, 1 neonatology (though FM OB months have neonatology mixed in since we take care of moms and babies), and multiple months with sub-specialists both med and surg.
I’ve been BLS, ACLS, PALS, NRP, ALSO, ATLS trained. And Data2000 waived as well.
In downtime, I’ve moonlighted as a consultant in obstetrical medicine, helping OB’s with medical issues among their pregnant patients (which is like normal stuff for a FM doc, but my bosses are fellowship trained internists).
Conversely. The IM residents, many of whom I’ve come to know and be friends with, have Had a consistent ½ day per week in their continuity clinic, and here at the end of 3rd year are now seeing 6 per half day. They don’t see kids, they don’t do women’s health beyond the ABIM minimum (they only have one faculty member who feels comfortable teaching them to do pelvic exams/pap smears) they refer to Gyn for any abnormal paps, for DUB, contraception, etc. They don’t do office procedures, they refer them to Derm or Ortho. In a class of 30, only 3 are staying in primary care. Most are either going to work as hospitalists, because that’s where they feel most adequately trained, or go on to some form of subspecilty training.
Family medicine is a lot different than Internal Medicine. If it wasn’t, I would have stayed with my original plan to go into IM, because I could have been a PCP that way too. But I knew I didn’t want to practice primary care in the way IM does it, so I switched about a month after residency apps went out. It made for a bumpy ride into residency, but I’m extremely happy where I am and have no regrets.
