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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*

Should Med Students Be Taught How To Maintain A Healthy Lifestyle?

Last week I wrote a simple post on eating yogurt with fresh fruit for lunch. It wasn’t until later that I realized why it’s a medical lesson.

It happens that yesterday morning I was up and out early. I saw a former colleague walking along the street. He’d gained weight, and walked slowly. I thought about how hard he works, and what a good doctor I know him to be. And yet any citizen or patient might size him up as heavy, maybe even unhealthy.

The problem is not that he’s uneducated or can’t afford nutritious foods. He knows fully about the health benefits of losing weight and exercise. The problem is the stress and long hours of a busy, conscientious physician’s lifestyle.

When I worked as a practicing doctor and researcher at the hospital, I rarely ate a nutritious breakfast or lunch. My morning meal, too often, consisted of Read more »

*This blog post was originally published at Medical Lessons*

How Much Are Med School Students Paying For Licensure?

You could see the frustration in his eyes as he spoke to his fellow resident.

“I had to fork over eight hundred and thirty five dollars,” he said slowly in a disgusted tone, “… and that doesn’t even include the $300 state license fee we have to pay later….”

So much for starting our EKG conference on time.

The comments continued. No one could understand why medical school licensure has become so expensive in the US. I thought I’d look into what medical students can expect to pay these days for licensure since it had been a while since I had gone through the gauntlet. Here’s what I found out: Read more »

*This blog post was originally published at Dr. Wes*

Being A Doctor Is A Lot Like Being A Parent: You Can’t Tap Out

The American College of Graduate Medical Education has enacted further restrictions on resident work hours.  No more than 80 hours per week of work for resident physicians, averaged over one month.  And no more than 16 hours of continuous work for first year residents (24 after that), which includes patient care, academic lectures, etc.

Whenever they do this sort of thing, everyone seems excited that it will make everyone safer.  After all, residents won’t be working as much, so they’ll be more rested and make much better decisions.  It’s all ‘win-win,’ as physicians in training and patients alike are safer.

I guess.  The problem of course is that after training, work hours aren’t restricted.  There is no set limit on the amount of work a physician can be expected to do, especially in small solo practices, or practices in busy community hospitals.

I understand the imperative to let them rest.  I understand that fatigue leads to mistakes.  I get it!  But does the ACGME get it? Read more »

*This blog post was originally published at*

Will The Next Generation Of Physicians Save Healthcare Or Abandon It?

The old joke in medicine goes, ‘don’t get sick on July 1st.’ That’s because it’s the day when new resident physicians, freshly graduated from medical schools across the land, begin their training programs. Although they have spent four years in undergraduate school and four years in medical school, it’s residency where physicians are made from the raw material of knowledge-rich, experience poor high achievers.

However, even in residency physicians are seldom told the entire story of how the practice of medicine, and their lives, will look and feel as their careers evolve and they enter the medical work-force.

Since our profession changes from year to year and administration to administration, it seems a good time to mention some of the things upcoming young physicians will face. Sadly, these are things seldom mentioned by pre-med advisors or academic medical educators.

You see, physicians are struggling. Due to falling reimbursements and the ongoing federal mandate to see non-paying patients on call, it is increasingly difficult for physicians to cover costs like malpractice insurance, licensure, professional memberships and office overhead. (Well, if they want to have a house, family and food, that is.)

Many physicians are Read more »

*This blog post was originally published at*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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