The United States is the only country in the Western world that has 3 separate tracts for generalist medicine: pediatrics, internal medicine, and family practice.
Is it time for some consolidation? Prominent physician bloggers debate the issue over at Medscape.
There are significant differences between family practice and internal medicine training, but it boils down to the fact that internal medicine residents spend more time in a hospital setting.
That said, I think the question should be rephrased, “Should general, outpatient, internal medicine be merged with family practice?”
And the answer is, perhaps. With the numbers of internal medicine residents choosing primary care declining at such an alarming rate, before long, the whole issue may be moot. The lack of applicants will lead to the eventual extinction of the primary care internist.
I predict that, with the hospitalist boom, general internists will soon be synonymous with an inpatient doctor, ceding outpatient medicine to family practice.
So, as long as hospital medicine is thriving, general internal medicine will continue to be strong, distinct specialty, albeit one solely associated with hospital-based care.
Related posts:
- Should you choose internal medicine or family practice?
- ACP: A practice model for increasing the appeal of General Internal Medicine
- Are family physicians better suited to practice primary care?
- Not happy with internal medicine’s direction
- Primary care is dying, may already be dead
- No respect for internal medicine
- Family physicians and extinction
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This is silly. To change our medical training simply because the follies of our government and insurance companies is ludicrous. Internists are heading towards hospitalist practice because they have been driven their by finances and bureacracy. This would be a myopic change. CMS is on the verge of imploding and insurance companies are pricing themselves into their natural role – catastrophic insurance. In the near future economics will swing back in favor of primary care as more patients are forced/electively shopping for their own care. Internists will begin to flee the collapsing hospital system and return to primary care.
No need for the debate.
Primary care is being taken over by nurse practitioners and physician assistants.
Physicians will be out of the picture except in states that require an MD or DO available for lawsuits.
This is the way the payers for healthcare want it. It’s the new Golden Rule: He who has the gold makes the rules.
-Steve
Only adding to What Dr. Parker said. Internal medicine residency programs are filling their positions with those willing to fill them Foreign and International medical grads. It is no different than our hispanic friends to the South willing to fill those positions citizens are not in the service industry (construction/maids/roofers/landscapers/cooks/etc). Citizens site the hard work/$/time. Whereas non-citizens/etc., whom have had less/see less, opt for the easiest pathway into a system which can reward them later.
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