Doctors, General Practitioners, Family Practitioners and Internists
Everyone should have a good, reliable doctor of the ordinary medical problems that come up from time to time. Using a specialist such as a gynecologist or a cardiologist for basic medical care is a mistake - and can be costly. Going to an emergency room is also a mistake, since emergency rooms will not have access to your medical records and are, in any case, oriented to handle emergencies, not ordinary medical problems. A primary care physician ought to be competent to recognize and handle the full range of problems that individuals usually encounter, know your medical history, and keep your records on file. For adults, there are three basic types of such physicians to choose from:
At the turn of the century, most doctors were general practitioners - able to deliver a baby, set a broken bone, and even perform surgery. Then the age of specialization hit, and the number of general practitioners (GP's) fell from 112,000 in 1920 to just over 24,000 in 1988. Yet, there are sill some general practitioners in business - usually older men who went into practice after only a year of postgraduate training, and who often make up in clinical experience what they lack in formal education. General practitioners still treat the full range of medical problems, though they usually refer patients to specialists for consultation and sometimes ongoing care for such conditions as heart disease, diabetes, arthritis, asthma, cancer, and most surgical procedures. They are usually associated with community hospitals.
Because of the decline in the number of general practitioners, the American Medical Association in 1969 recognized family practice as a specialty. To qualify, a physician must complete a three-year residency that covers certain aspects of internal medicine, pediatrics, obstetrics, and orthopedics, and then pass a comprehensive examination. Family practitioners handle a wide range of problems for people of all ages, treating most acute and chronic illness, and even offering psychological counseling for such family problems as alcoholism. For complicated ailments and diseases, they refer individuals to appropriate specialists.
These doctors specialize in adult medical problems.Internists must take a three-year residency after medical school and pass a rigorous examination to receive specialty certification. They have more advanced training in the diagnosis and management of such common medical problems such as heart disease, diabetes, arthritis, and cancer. Some internists will take further training in one of these of other subspecialties. A general internist may refer a patient to a subspecialist for evaluation, but will usually continue to see the patient for supervision of treatment.