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Family Practice, Internal Medicine, and General Practice: What’s The Difference?

I get mail, this from a healthy 20-something reader who’s just moved to a new city:

What’s the difference between doctors listed as Family Practice, Internal Medicine, and General Practice?  Also, what are some things I should consider (that I might not already be considering) when finding a primary care physician?

That’s a bit of a loaded question, not because of any bias of mine (perish the thought!) but because each of those terms is used in different ways, by different people, at different times, for different purposes. So here’s the rundown on each of them in turn.

Family Practice

What it’s supposed to mean: Designates a physician who has completed a three-year postgraduate training program in Family Medicine, trained to provide primary care to patients of all ages, presenting with conditions of any organ system, including care of acute conditions and ongoing management of chronic diseases.

What doctors hope people think it means: Read more »

*This blog post was originally published at Musings of a Dinosaur*

Topical Medications And Bathing: A Source Of Water Pollution

I have written two posts in the past on proper disposal of unused medications, and I have always been mindful of the medicines as a source of environmental water pollution. This past week the American Chemical Society reminded (head-slapped me) that topical medications are a source of environmental water pollution from their active pharmaceutical ingredients (APIs). Yes, the simple act of bathing washes hormones, antibiotics, and other pharmaceuticals down the drain into the water supply.

Ilene Ruhoy, M.D., Ph.D. and colleague Christian Daughton, Ph.D. looked at potential alternative routes for the entry into the environment by way of bathing, showering, and laundering. These routes may be important for certain APIs found in medications that are applied topically to the skin — creams, lotions, ointments, gels, and skin patches. These APIs include steroids (such as cortisone and testosterone), acne medicine, antimicrobials, narcotics, and other substances. Read more »

*This blog post was originally published at Suture for a Living*

When 32 Million New Patients Look For A Doctor

With the passage of healthcare reform, an estimated thirty two million new patients will try to find primary care doctors. That’s not going to be so easy because we already face a shortage of primary care doctors and about 13,000 more will be needed to take care of those newly eligible for insurance.
According to the American Medical Association, there are about 312,000 primary care doctors practicing in the United States. That includes family medicine, general practice (GP), internal medicine, and pediatrics. (In addition, there are 43,000 ob-gyn’s who also may serve as primary care doctors.) The estimate that another 13,000 will be needed comes from a study done by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in partnership with the Agency for Healthcare Research and Quality.


Sixty five million Americans already live in areas that don’t have enough primary care doctors. And relief is not on the way anytime soon. It takes 5 to 8 years for a first year medical student to be trained as a primary care doctor. And the trend for budding doctors over the past decade has been away from primary care and towards more lucrative specialties. Read more »

Saved By Dance: One Doctor’s Story Of Burnout And Recovery

By Susan Biali, M.D.

Ten years ago, I was an emergency medicine resident and wanted to die. Today, I’m a general practitioner in part-time practice and in love with life. What made the difference? I signed up for a dance class.

Reports on physician burnout list the personality traits that set us up for trouble: we’re excessively conscientious, feel overly responsible, want to please everyone, and function on an extremely high level –- even if we’re overloaded, exhausted, or our personal life is falling apart. We burn out because we bend over backwards to help others, until something (like our minds or our health or our marriages) finally snaps. Now imagine this: what if we took some of that deep caring and hyper-responsibility, and turned it on ourselves?

When my depression hit bottom and I became a serious risk to myself and my patients, my chief resident asked me to take a stress leave. On impulse I went on a solo tropical vacation and one night at the resort, as I watched an exuberant group of salsa dancers burning up the stage, my eyes filled with tears. I suddenly remembered that when I was a little girl, I practiced incessantly in the basement to my ABBA records, preparing myself for the moment that I would live my dream and finally become a “Solid Gold Dancer.” That night, in that darkened tropical theater, I knew how I would save my life. Read more »

*This blog post was originally published at*

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