“Internal medicine.” I confess that when I first began looking for a doctor as an adult, this term confused me. I wondered if “internal” medicine meant the doctor just handled inner organs, not skin or bones? Where were the external medicine doctors?
Later, when I had my children, I wondered about family medicine. My kids went to a pediatrician. Was that the right choice?
Internal Medicine vs. Family Medicine
When it comes to internal versus family medicine, the distinctions seem less obvious:
- Family medicine — primary care for the whole family
- Internal medicine — primary care for adults
As an adult with children, I could see either an internal or family medicine provider. So what’s the difference?
I asked two doctors, an internal medicine doctor and a family medicine doctor, to provide their input and clear the confusion.
Best for: If you have “significant medical issues and need someone to coordinate care among your specialists,” advises Ira Helenius, MD.
Internal medicine providers treat adults only, usually 18 years of age and over (but no pregnancy or birthing care). They “offer office procedures such as pap smears, joint injections, minor skin procedures,” and treat general medical issues, like:
- Thyroid problems
- High cholesterol
Doctors in internal medicine also focus on wellness and preventive medicine, such as weight-loss or smoking-cessation counseling. And they often oversee the care of patients who have multiple complex, chronic illnesses.
Ira Helenius, MD: Why I Became an Internal Medicine Doctor
“I chose internal medicine because I felt like I wanted to spend my training focusing on the adult only. My understanding the organ systems could be deeper if I spent three years of residency working with adult patients. I really enjoyed the intellectual challenge of working up a patient with a complex medical issue, but I also enjoyed meeting a relatively healthy patient and getting to know them and helping them tweak their lifestyle to be more healthy.”
Family medicine, according to Heim, focuses on “you, the whole person, the doctor-patient relationship and the continuity of care.” All family members can be seen at the same office for the entire spectrum of medical issues they could face
This all-in-one care doesn’t just provide you and your family convenience. Heim notes the added advantage that “seeing the entire family gives me a unique perspective on both the individual’s health and the overall family’s health.”
Heim finds that treating the whole family gives him the “ability to counsel family members on how to stay healthy and what preventive medical testing to get.” When treating families with genetic conditions, that knowledge helps his ability to care for an individual.
Family medicine providers offer:
- Prenatal care
- Delivering babies
- Gynecologic care
- Office procedures, including joint injections
- Skin lesion excisions
- Contraception services (IUD placement)
“A family medicine physician serves as an advocate for the patient in an increasingly complex health care system,” Heim adds.
Steven Heim, MD: Why I Chose Family Medicine
“Practicing family medicine means I get to enjoy taking care of entire families and developing long-term relationships with my patients. Some of the babies I have delivered are now my teenage patients. Seeing patients in the office is the most rewarding part of being a physician.”
Primary Care 101
Internal and family medicine aren’t your only choices. There are other primary care types to consider.
Primary Care Provider or PCP
First, a word about the term “primary care provider.” Why not just “doctor”? The label only makes sense if you consider the term in context:
- Primary – in this case, “primary” refers means “first.” Primary care contrasts with specialists, who provide services for specific body parts and conditions, like infectious disease, cancer, diabetes, kidney, liver, etc. Your primary care provider, or PCP, serves as the main person caring for you. This is why you want to form a good relationship with your PCP. Even if you end up seeing specialists, your PCP is your home base, your quarterback.
- Provider – the medical profession uses this term because not everyone with the capability and authority to serve as your main medical squeeze has a “medical doctor” degree. Nurse practitioners, for instance, also provide primary care.
Primary Care Types Explained
Most primary care types treat specific populations. These providers have in-depth knowledge and experience in treating people at specific life stages:
- Pediatricians: Primary care for children. Babies and growing kids benefit from a child-friendly environment of care.
- Teen health: Primary care for adolescents. Specific emotional and behavioral support supplements medical and physical care for this group.
- OB-GYN: Primary care for women. A good choice if you’re a healthy young woman of child-bearing age with no medical conditions.
- Midlife health: Primary care focusing on the challenges faced by menopausal and post-menopausal women.
- Geriatricians: Primary care for people in their 70s and older. Perfect for a frail, elderly parent.
At UVA, we have integrative healthcare providers. These doctors, nurse practitioners, and nurse practitioners combine Western medicine with alternative therapies and complementary medicine, such as:
- Herbal medicine
- Homeopathic medicines
This holistic approach may be a perfect fit for you if you prefer health strategies that don’t exclusively focus on medicine and surgery for treatment.
Find Your Doctor
Explore more about primary care services we offer at UVA.
Helenius cautions that when choosing this kind of provider, ”Look for someone who has real qualifications, such as a certification in integrative medicine.”
Which Primary Care Type is Right for You?
At the end of the day, “the most important thing is that you connect with your doctor and the doctor’s practice is working for you. I know it is corny, but so true,” chuckles Helenius.
Heim agrees. “Patients are best served by finding a doctor with who they can develop a trusting relationship.”