Differences Between Internal Medicine and Family Practice

With Brett Twente, M.D., Internal Medicine, Columbia St. Mary’s

Posted: Nov. 1, 2007

Internal medicine doctors, or internists, often are referred to as doctors for adults. In contrast, a family practitioner is trained to deal with the health care needs of men, women and children of all ages. Doctors who practice family medicine may provide a range of health services including preventative care, obstetrics, routine gynecological care and pediatric services.

Like family practitioners, internists may act as primary care physicians; however, their practice is solely concentrated on adult health care. Internists have special training in dealing with complex, chronic illnesses and treating several different illnesses at the same time.

The term internist often confuses people. Internists are not interns, who are doctors in their first year of residency, nor do doctors of internal medicine focus solely on treating people’s internal organs. Internists are specially trained to focus on the prevention and treatment of adult diseases. In fact, they spend at least three years of their post-graduate study learning how to prevent, diagnose and treat diseases that affect adults.

The term internal medicine also can be cause for confusion. The name was originally derived from the German term “Innere Medizin,” used to describe a medical discipline that emerged in Germany in the late 1800s that combined the science of the laboratory with the care of patients.

American doctors who studied in Germany in the early 20th century brought the medical field to the United States, roughly translating the German phrase to internal medicine. Today, the term internal medicine is nothing more than a historic relic that unfortunately doesn’t always fit the American definition of an internist’s scope of service.

Although the decision to see a family practitioner or an internist rests solely on a patient’s personal preference, doctors of internal medicine do have certain strengths when it comes to treating adult-related health problems.

While the training of family practitioners is divided between adult medicine and pediatrics, there is no shift in focus in the practice of internal medicine. The special training that internists receive enables them to diagnose and treat a host of chronic medical conditions experienced by adults that require frequent monitoring such as diabetes, asthma, emphysema, high blood pressure and heart disease. Internists take pride in the long-term relationships they develop with their patients and the continuity of care they can provide.

When not serving as primary care physicians for adults, internists often are called upon by other doctors to serve as consultants in diagnosing difficult medical problems in adult patients. This role has earned internists the nickname of the “doctor’s doctor.”

Internists practice in a variety of settings. These include private practice and health care clinics, hospitals and nursing homes, often coordinating their patients’ care with other medical specialists like surgeons and obstetricians.

In addition to practicing general internal medicine, there are 13 areas of internal medicine in which internists can choose to take training. Examples of these subspecialties include cardiology, oncology, geriatrics and rheumatology. Typically these specialties require one to three years of additional training (referred to as a fellowship) beyond the standard three-year general internal medicine residency.

As experts in adult health care, it’s not unusual for internists to treat their patients for life, from their teens through old age.

Brett Twente, M.D., Internal Medicine
Columbia St. Mary’s
414-326-1745

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