Dr. RW says that there’s nothing to differentiate general internal medicine from FPs:
Worse yet, the proposals are another failure of the ACP to reclaim the identity of internal medicine. In defining the way internists fill the primary care role the proposals make no distinction from family practice. Is it any wonder there is a growing perception that the only way to be an internist is to be a hospitalist?
Related posts:
- Should general internal medicine merge with family practice?
- Should you choose internal medicine or family practice?
- Hospitalists: The last true internal medicine physicians?
- ACP: A practice model for increasing the appeal of General Internal Medicine
- Procedures becoming obsolete for internal medicine?
- Primary care shortage and physician recruiters
- No respect for internal medicine
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{ 3 comments }
When I was plotting my future career in med school in 1990 internists were still the big men on the ward. The senior teaching staff was a group of which we all stood in awe. Most of the great ones had areas of clinical expertise carved out by years of academic practice, but it was rare that they were specialty trained and boarded. They were masters of medicine first and subspecialists second. But, even then the writing was on the wall. Even then it was common for new grads to seek a fellowship, develop a niche and never become a great well rounded internist. The specialty then needed to more training than three years to become a well rounded general internist. They met this challenge by turning medicine instead into a preliminary position to use as a stepping stone toward fellowship application.
You mean you can stop training after 3 years of medicine residency?
What does that make me?
I know. A quiter.
Internal Medicine IS taking the wrong direction and the ACP is not helping by cedeing hospital medicine to the hospitalists movement and promoting primarycare as the central care model for the internist. I do truly believe that hospital medicine requiring distinct, unique skills different from primary care. But this is where the internist’s excel. This is what give’s Internal Medicine its unique dual role identity. Most FPs don’t get trained in inpatient medicine and hence don’t practice it. Internal Medicine training at it’s core is hospital based training. By practicing optimal inpatient medicine and primary care, the internist is, correction was, at the top of the interlectual medical pyramid. I understand the evolution of the field, both from a financial standpoint (why we can’t afford to keep running around providing both inpatient and outpatient care) and increased complexity of chronic outpatient care coupled with the agewave. If we can restore the financial model, build a team based chronic care disease model, internal medicine can once again reclaim it’s identity. But until then, it will continue to be only a path towards fellowship.
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