Family medicine and internal medicine are two distinct medical specialties that often cause confusion among patients and even some healthcare professionals. At first glance, they may seem similar, as both deal with the prevention, diagnosis, and management of various medical conditions and illnesses. However, there are significant differences between these two disciplines, which impact their scope of practice, patient population, and training requirements.
What is the difference between internal and family medicine?
When seeking medical care, it's essential to understand the differences between various medical specialties. Two of the most commonly confused medical fields are internal medicine and family medicine. While both internal medicine doctors and family medicine doctors are primary care physicians, they have distinct roles in the healthcare system. In general, family medicine provides outpatient medicine while internal medicine primarily provides inpatient medicine. However, some internists spend time in outpatient clinics as well. In this article, we will further delve into the similarities and differences between internal medicine vs family medicine, helping potential patients make an informed decision when choosing a healthcare provider.
Family Medicine: A Broad Approach to Patient Care
Family medicine, also known as family practice, is a medical specialty that focuses on providing comprehensive and continuous care to patients of all ages, from infants to the elderly. Family doctors, sometimes referred to as primary care physicians, are responsible for managing a wide range of health issues, including acute and chronic conditions, as well as providing preventive medical care and general health education.
Scope of Practice - Family medicine physicians
Family physicians are trained to diagnose and treat a broad array of medical conditions across various organ systems. Their scope of practice encompasses not only the physical aspects of health but also the emotional, social, and environmental factors that can influence a patient's well-being. Family physicians are skilled in managing both common and complex health problems and are often the first point of contact for patients seeking healthcare. Family medicine physicians often see patients in outpatient clinic settings. However, some family medicine physicians may also visit their patients if they are hospitalized.
Some common medical conditions that Family doctors may diagnose and manage include:
- Respiratory infections, such as bronchitis and pneumonia
- Cardiovascular diseases, including hypertension and coronary artery disease
- Endocrine and metabolic disorders, such as diabetes and thyroid disorders
- Musculoskeletal problems, including back pain and arthritis
- Gastrointestinal issues, like gastroesophageal reflux disease (GERD) and irritable bowel syndrome (IBS)
- Mental health services, including anxiety and depression
Patient Population - Family medicine doctors
Family medicine physicians care for patients of all age groups, from newborns to the elderly. They often serve as a patient's primary care provider, establishing long-term relationships with individuals and their families. These long-term relationships allow family medicine physicians to gain a deeper understanding of their patient's health history, lifestyle, and social context, enabling them to provide personalized care tailored to each patient's unique needs.
Furthermore, family medicine doctors play a crucial role in coordinating care for patients with complex or multiple medical care issues, ensuring they receive appropriate medical services from specialists when needed. They also provide preventive care services, such as immunizations, routine screenings, and lifestyle counseling, to help patients maintain their health and reduce the risk of future medical problems.
Training and Certification - Family medicine doctors
Family medicine physicians complete an undergraduate degree and four-year medical degree, followed by a three-year residency program in family medicine. During their residency, they receive training in various medical disciplines, including pediatrics, obstetrics and gynecology, internal medicine, psychiatry, and surgery, among others. This diverse training equips them with the skills and knowledge needed to provide comprehensive care to patients of all ages and with various medical conditions.
After completing their residency, family medicine doctors can obtain board certification through the American Board of Family Medicine (ABFM). Board certification demonstrates a physician's commitment to maintaining the highest standards of clinical care and staying current with the latest advancements in their field.
Internal Medicine: The Science of Adult Medicine
Internal medicine, also known as general medicine, is a medical specialty that focuses on the prevention, diagnosis, and treatment of diseases in adults. Internal medicine doctors, also known as internists, are experts in managing complex medical conditions, particularly chronic illnesses that affect multiple organ systems.
Scope of Practice - Internal medicine
The scope of practice for an internal medicine doctor primarily involves the diagnosis and treatment of diseases in adults, with an emphasis on internal organs and body systems. Internists often collaborate with specialists to manage patients with complex multisystem illnesses. They are skilled in diagnosing rare or unusual diseases and are frequently consulted by other physicians for their expertise in managing challenging cases. When a patient is hospitalized they will commonly have their medical care provided by an internal medicine physician. Most internists work only in hospital settings, however, there are some internists that also practice outpatient clinic medicine.
Some common medical conditions that internal medicine doctors may diagnose and manage include:
- Chronic conditions, such as diabetes, hypertension, and chronic kidney disease
- Infectious diseases, including pneumonia, urinary tract infections, and sexually transmitted infections
- Autoimmune and inflammatory diseases, like rheumatoid arthritis and lupus
- Neurological disorders, such as Parkinson's disease and Alzheimer's disease
- Hematological disorders, including anemia and clotting disorders
- Oncological diseases, such as lung, breast, or colon cancer
Patient Population of Internists
Internal medicine physicians, also known as Internists, primarily care for adult patients, although some may also see adolescent patients. They typically do not provide care for pregnant women, children, or infants, as these populations fall outside the scope of internal med. However, some internists may choose to focus on geriatric medicine, providing specialized care for older adults with complex medical health care needs or age-related health issues.
Internist Training and Certification
Like a family medicine physician, an internist completes an undergraduate and four-year medical degree, followed by a three-year residency program. However, their residency training focuses exclusively on adult medicine, with rotations in various internal medicine subspecialties, such as cardiology, endocrinology, infectious diseases, and nephrology. This specialized training equips an internist with a deep understanding of the complexities and nuances of adult medical conditions.
After completing their residency, internal medicine doctors can obtain board certification through the American Board of Internal Medicine (ABIM). Board certification demonstrates a physician's commitment to maintaining the highest standards of clinical care and staying current with the latest advancements in their field.
Subspecialties of Internal Medicine
One key difference between family medicine and internal med is the opportunity for internists to pursue further training in a wide variety of subspecialties. Internal medicine encompasses numerous subspecialties, each focusing on a specific area of adult medicine. Some examples include:
- Cardiology: The study and treatment of diseases and conditions affecting the heart and blood vessels, such as coronary artery disease, heart failure, and arrhythmias.
- Endocrinology: The diagnosis and treatment of hormonal disorders and diseases of the endocrine system, including diabetes, thyroid disorders, and adrenal gland abnormalities.
- Gastroenterology: The study and management of diseases and conditions affecting the gastrointestinal tract, including the esophagus, stomach, intestines, liver, gallbladder, and pancreas, such as inflammatory bowel disease, peptic ulcer disease, and liver cirrhosis.
- Infectious Diseases: The diagnosis and treatment of infections caused by bacteria, viruses, fungi, and parasites, as well as the prevention of such infections, particularly in high-risk populations.
- Nephrology: The study and management of kidney diseases and disorders, including chronic kidney disease, acute kidney injury, and glomerulonephritis, as well as the care of patients requiring dialysis or kidney transplantation.
- Pulmonology: The diagnosis and treatment of lung diseases and conditions, such as asthma, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis.
- Rheumatology: The study and treatment of rheumatic diseases and musculoskeletal disorders, including osteoarthritis, rheumatoid arthritis, lupus, and gout.
To become a subspecialist, internists must complete additional training, called a fellowship, which typically lasts 2-3 years. After completing their fellowship training, Doctors can obtain board certification in their chosen subspecialty through the American Board of Internal Medicine (ABIM) or other relevant certification boards. Board certification in a subspecialty demonstrates a physician's expertise and commitment to maintaining the highest standards of clinical care in their chosen field.
Choosing Between Family Medicine and Internal Medicine
When selecting a primary care physician, patients should consider the unique characteristics of family medicine and internal medicine to determine which specialty best meets their needs.
For patients seeking comprehensive care for the entire family, including children and the elderly, a family medicine physician may be the ideal choice. Family medicine physicians are trained to manage a wide range of health issues and can serve as consistent health care providers throughout a patient's life, fostering strong doctor-patient relationships.
On the other hand, adult patients with complex medical conditions or those who require specialized care for specific diseases may benefit from the expertise of an internal medicine doctor. Internists possess in-depth knowledge of adult medicine and can coordinate care with other specialists when necessary. Additionally, patients with a preference for a physician trained in a specific subspecialty can choose an internist with fellowship training in that area.
Ultimately, the choice between family medicine and internal medicine doctors will depend on a patient's individual needs, preferences, and health care goals. Communication is vital when selecting a primary care doctor, so patients should discuss their concerns and expectations with potential providers to ensure a good fit.
Family medicine and internal medicine are both crucial components of primary care, offering distinct approaches to patient care. While family medicine emphasizes comprehensive care for patients of all ages, internal medicine focuses on the prevention, diagnosis, and treatment of diseases in adults. By understanding the differences between these two specialties, patients can make informed decisions about their healthcare and choose the medical professional best suited to their needs. Regardless of the chosen specialty, a strong relationship with a primary care physician is essential for maintaining optimal health and well-being.
How to start a career as a Primary Care Physician?
The path to becoming a primary care physician, whether it be in Family medicine or Internal medicine, begins by getting your M.D. degree. Click here to find out more about the University of Medicine and Health Sciences' Doctor of Medicine program.
Callie Torres is a Captain in the United States Air Force and a resident at Wash U/Barnes Jewish Hospital in St Louis. She is a freelance writer with many published medical articles as well as multiple peer-reviewed medical publications