Internist vs FM docs in outpatient medicine

[scharnhorst]

Increasingly I'm seeing a lot of internist opting solely or mostly for outpatient medicine

My question is what differnces have you guys/girls observed in the practice of outpatient adult medicine between an internist and FM docs?

I hope everyone here can be fair and objective considering the opinions here may be a bit biased

---

Members don't see this ad.

 

[deleted87716]

My question is what differnces have you guys/girls observed in the practice of outpatient adult medicine between an internist and FM docs?

Internists tend to refer more. I've seen this in some of my colleagues, and in new patients who transfer care. New patients to my practice who were previously seen by internists are far more likely to be pan-consulted vs. those seen by family physicians.

 

[scharnhorst]

Internists refer more.

but i thought they would be LESS likely to refer given that they get more training in core specialties like cards nephro rheum etc

 

[deleted87716]

but i thought they would be LESS likely to refer given that they get more training in core specialties like cards nephro rheum etc

Not in my experience. It may have something to do with the relative lack of outpatient and procedural experience in IM programs vs. FM programs. Dunno.

 

[scharnhorst]

FM docs are defiantely more comfortable with
pediatrics ( obviously)
MSK problems
prenatal/womens health

 

[deleted87716]

FM docs are defiantely more comfortable with
pediatrics ( obviously)
MSK problems
prenatal/womens health

Psych, too.

 

[scharnhorst]

Not in my experience. It may have something to do with the relative lack of outpatient and procedural experience in IM programs vs. FM programs. Dunno.

I believe the outpt experience part its minimal in IM

I'm not so much concerned with procedures here but more with advanced stage illnesses CHF CKD COPD DM HTN etc
I see there is a HUGE variation even within FP and IM docs depending on their comfort level

 

[scharnhorst]

Psych, too.

I think its impossible to survive in outpt practice w/o reasonably good psych skills

 

[deleted87716]

I'm not so much concerned with procedures here but more with advanced stage illnesses CHF CKD COPD DM HTN etc
I see there is a HUGE variation even within FP and IM docs depending on their comfort level

That's probably true with internists, as well.

 

[FrustratedFamDoc]

I think its impossible to survive in outpt practice w/o reasonably good psych skills

Piece of cake. Tid alprazolam 0.5 mg "prn of course, right" #90 R:3. All your patients will sing your praises.

But definitely, good psych skills and setting realistic expectations are crucical. Had ample psych training as a resident and really am thankful for it now.

 

[deleted87716]

Piece of cake. Tid alprazolam 0.5 mg "prn of course, right" #90 R:3. All your patients will sing your praises.

I know a guy who does exactly that. He also writes a buttload of opioids (including Dilaudid). His online reviews are better than mine.

 

[SLC]

There’s the obvious ability (I wouldn’t call it lack of comfort, more lack of training) to see kids.

But IM guys generally don’t do much (if any) women’s health.

And I do notice they tend to refer more.

 

[FrustratedFamDoc]

I know a guy who does exactly that. He also writes a buttload of opioids (including Dilaudid). His online reviews are better than mine.

Oh, I'm sure they are. I bet his waiting room resembles that of many pain clinics as well with "a good mix of cigarette odor, mtn Dew and despair" (can't take credit for that one, heard it somewhere else before).

 

[septoplasty]

but i thought they would be LESS likely to refer given that they get more training in core specialties like cards nephro rheum etc

Inpatient probably, not as much outpatient?

 

[Hamhock]

Are IM docs better hospitalists?

HH

 

[VA Hopeful Dr]

Are IM docs better hospitalists?

HH

All comers? Probably. But FM hospitalists are going to be a self-selected group so I'd suspect in actual practice the difference would be small.