Is it possible to become a family doctor and also specialize in something else?

[coolcucumber91]

---

Members do not see this ad.

Can a family doctor also treat acne, for example, and be able to give prescription drugs that a dermatologist usually prescribes? I know they can do it for skin conditions such as rosacea but I never heard of one for acne...

If so, I would love to be a family doc! 😀

 

[venacontracta]

It is largely up to the family doctor's discretion what conditions they will treat on their own. In other words, a primary care doctor whose patient has a simple skin condition that the doctor recognizes could at his/her discretion either try prescribing something or just tell the patient that they will have to see a dermatologist. Another example would be primary care doctors prescribing drugs for ADHD, in most cases without doing all the specialized tests that a psychiatrist or psychologist would do to confirm an ADHD diagnosis. That might be a little bit shady ethically, depending who you ask, but it's done all the time.

Obviously if they don't refer something to a specialist that they should have and things go terribly wrong, you could make a case for malpractice quite easily. I don't think there is the oversight you are imagining, it's more up to the professional discretion of the doctor themselves.

 

[LizzyM]

Primary care providers including family medicine doctors, general pediatricians and general internists will treat some of the common chronic diseases (yes, including acne) and acute illnesses (flu, pneumonia, bronchitis, urinary tract infection, kidney infection, ear infection, sinus infection, etc) with first line treatment. If the patient doesn't respond to the standard treatment, then the patient might be referred to a specialist or subspecialist.

 

[SouthernSurgeon]

Can a family doctor also treat acne, for example, and be able to give prescription drugs that a dermatologist usually prescribes? I know they can do it for skin conditions such as rosacea but I never heard of one for acne...

If so, I would love to be a family doc! 😀

Well yes and no. Any doctor with a medical license can write a prescription for anything they want to write a script for. It isn't like dermatologists have exclusive prescribing power for acne meds.

But it is a question of comfort level and appropriate scope of practice. A family med doctor isn't going to do advanced-level dermatologic care because they won't be comfortable with going much past the first or second line treatments.

I guess I don't really know what you are asking - are you asking about prescribing powers, or asking if a FM trained doc could "fake it" to try and have the scope of practice of a specialist?

 

[familyaerospace]

My family doctor writes scripts for acne, ADHD, hormones, stuff for surgery, HIV, and lots of stuff. The only thing I don't trust him to write for is anti-epilepsy meds.

Although he only is officially a "family doctor," he does specialise in certain communities (LGBT and deaf) and their particular health problems.

 

[KTownGT]

The Allergy/Imm. doctor I'm shadowing is triple specialized. He also has certs in acupuncture, hypnosis, nuclear medicine, and a million other things it seems...

 

[sonia1177]

Yes. I am shadowing a cardiologist right now and he first became a doctor of internal medicine and then specialized in interventional cardiologist. A lot of people take this route. I hope I am answering your question.

 

[LizzyM]

Yes. I am shadowing a cardiologist right now and he first became a doctor of internal medicine and then specialized in interventional cardiologist. A lot of people take this route. I hope I am answering your question.

The pathway for all of the internal medicine subspecialties is to do a residency in internal medicine and then a fellowship in the subspecialty. This covers everything from Allergy, through Gastroenterology, Cardiology, Rhematology, and about 20 others.

This is a little different than the OPs question about the types of problems that are treatable by a primary care physician.

As physicians subspecialize, they tend to shy away from treating primary care patients... it is just too hard to keep up with the broadness of internal medicine at the primary care level and the depth of a subspecialty although when starting out, some docs who have finished a fellowship will take on primary care patients as a way to grow their private practice.

 

[ThaliaNox]

Yes. I am shadowing a cardiologist right now and he first became a doctor of internal medicine and then specialized in interventional cardiologist. A lot of people take this route. I hope I am answering your question.

This is more the route of subspecializing. Through family med similar "official" specialties are things such as sports medicine. I don't think this kind of formal subspecializing is what the OP was referring to.

 

[sonia1177]

This is more the route of subspecializing. Through family med similar "official" specialties are things such as sports medicine. I don't think this kind of formal subspecializing is what the OP was referring to.

I must have misunderstood. I did not know he meant simply to subspecialize. Thanks for that clarification.

 

[Superman DO]

A family physician, like any other physician, can write scripts for anything he or she chooses; however, I don't think any doctor in their right mind would do so in today's world. A family physician really focuses on the more "simple" and common acute and chronic diseases. Treating anything outside of the doc's expertise is just asking: "Hey! Please sue me!" Therefore, instead of treating the infection or disease that the doc is unsure about, the doc is just going to cover his or her ass and refer them out to a specialist and let them write the script if needed.

 

[coolcucumber91]

But it wouldn't be much of a problem if it's just acne, right? Acne isn't really a life-threatening condition or anything. Nor is it complicated compared to other skin conditions derms treat (I'm saying this b/c everytime I go to my derm, I rarely see anyone w/ acne, all older ppl). My dermatologists don't really do much; they just prescribe medication and I know for certain I can do that when I become a doctor. Of course, medication such as Accutane is a different story....

If you haven't noticed, I rreeeaaallyy want to help kids w/ acne 😀

 

[Superman DO]

But it wouldn't be much of a problem if it's just acne, right? Acne isn't really a life-threatening condition or anything. Nor is it complicated compared to other skin conditions derms treat (I'm saying this b/c everytime I go to my derm, I rarely see anyone w/ acne, all older ppl). My dermatologists don't really do much; they just prescribe medication and I know for certain I can do that when I become a doctor. Of course, medication such as Accutane is a different story....

If you haven't noticed, I rreeeaaallyy want to help kids w/ acne 😀

Well, a Family Physician knows a bit about everything out there. For simple, teenage acne, then the doc should be able to write scripts for some basic acne medication. What happens if what you think is acne is not really acne though even though it may look like it? What happens if someone has some serious acne going on, you try to use some drug that you may not have a full knowledge about and then the poor soul ends up looking worse or have some other complication? I guess if you are a family physician, and you really were interested in a particular infection or disease, you could become an expert in it. But what happens when you screw up and you didn't get some kind of consult from a certified expert? Simple acne should be fine to treat as a family physician, but always best to consult the expert if it gets worse or you are unsure imo.

 

[Asyouwereatrio]

Not to confuse the OP, but 1) to answer the question in your post...a family doctor can prescribe medication for dermatological problems as he/she sees fit (meaning as comfortable as they are with it.

2) To answer the question posited in your post title, you can become a family doctor (internal medicine) and enter most specialties (see LizzyM's informative post). This is the pathway for MOST specialties...

3) If I remember correctly, there are a few specialtiies that do not require internal medicine...or don't require the full 3 year internal medicine residency timeframe. (IE: Anesthesia requires 1 year IM, surgery/ER are not IM based, paediatrics, and family practice, etc.)

 

[familyaerospace]

Asyouwereatrio,

"Family medicine" is different from "internal medicine," they are not the same as you seemed to imply in your #2. Internal medicine specialise in health problems of adults and don't treat kids. Family is supposed to be "cradle to grave" and treat kids too.

Also neurology only requires the 1 year internship in internal medicine unless, I assume, one wants to do pediatric neuro then I guess it would be an internship in peds.

 

[Asyouwereatrio]

Asyouwereatrio,

"Family medicine" is different from "internal medicine," they are not the same as you seemed to imply in your #2. Internal medicine specialise in health problems of adults and don't treat kids. Family is supposed to be "cradle to grave" and treat kids too.

Also neurology only requires the 1 year internship in internal medicine unless, I assume, one wants to do pediatric neuro then I guess it would be an internship in peds.

Sorry I misworded that..what I meant by family doctor was "the doctor you generally see as your PCP"...everyone I know goes to see an internal medicine for that...Hence what I said in the third point, which was family practice/medicine is different from internal medicine in terms of specialisation process.