Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What’s the difference between family practice and med-peds?

Lucy Hornstein, MD
Physician
September 26, 2010
Share
Tweet
Share

I like Dr. Rob, the one with the distractible mind. And although I thoroughly agree with the stance he takes in his recent post against cholesterol screening in kids, I must take issue with his opening statement:

I have a unique vantage point when it comes to the issue universal cholesterol screening in children, when compared to most pediatricians.  My unique view stems from the fact that I am also an internist who deals with those children after they grow up on KFC Double Downs.

From Dictionary.com:

“Unique”: existing as the only one or as the sole example; single; solitary in type or characteristics

Your med-peds training allows you to follow patients from birth to death (but no obstetrics or gynecology). You can care for all organ systems and all stages of disease (but without as much training in psychiatry). Congratulations! You’ve just (re)invented family practice (except for the above shortcomings). Oh, wait: that’s already a recognized specialty with its own residency programs, boards and everything for, like, forty years now.

This misuse of the word “unique” is one of my pet peeves.

“Unique?” I do not think that word means what you think it means.

After twenty years in practice, I agree that there probably isn’t much difference between what Dr. Rob does and what I do. After twenty years, I’m not even sure how much relevance remains from our “training”. Still, there remains a great deal of confusion about the very real differences between FP and med-peds residencies.

For starters, med-peds doesn’t provide much in the way of psychiatry or gynecology. I suppose Dr. Rob is either comfortable referring out half his patients for the bulk of their primary care needs, or he has gleaned sufficient on-the-job training to provide office gynecology care. (I’m sure he’s perfectly competent at it by now, though I wouldn’t have wanted to be one of his early patients as he figured out how to use the speculum on his own.) As for psychiatry, I’m sure he will agree that it makes up a hefty chunk of primary care medicine. Hopefully he’s picked up enough of it over the years so that he is comfortable dealing with his patients’ psychiatric issues. So I think we can agree that the farther you get from training, the more our skill sets converge.

The main difference in the training programs is this: med-peds residents mainly see hospital patients. Their outpatient experience is limited to one “continuity clinic” a week throughout their four years of training. First year family practice residents are also in the office (we offer continuous care by definition, so we don’t need the “continuity” modifier) one half-day per week, but this increases over the next two years so that by the third year, we spend 3-4 half-days a week in the office. Family practice provides specific training in outpatient medicine: how to work up problems without a hospital admission; prescribing with an eye towards compliance (and cost); basic office management; the works. My program even required that we do house calls, which I continue to do in my own practice today.

If you’re looking for a doctor to care for your entire family and you come across someone who’s been practicing a decade or two, it probably doesn’t matter whether you find someone who calls herself a family doctor or an “internist and pediatrician,” as you’re likely to get very similar care. But if you’re looking to hire someone fresh out of training, bear in mind that the FP-trained doc is more likely to be able to hit the ground running in an office setting. That’s the real difference between med-peds and family practice.

Lucy Hornstein is a family physician who blogs at Musings of a Dinosaur, and is the author of Declarations of a Dinosaur: 10 Laws I’ve Learned as a Family Doctor.

Prev

Doctor appointment tips every patient can use

September 26, 2010 Kevin 6
…
Next

Why unnecessary cesareans is a misnomer

September 26, 2010 Kevin 26
…

Tagged as: Primary Care

Post navigation

< Previous Post
Doctor appointment tips every patient can use
Next Post >
Why unnecessary cesareans is a misnomer

ADVERTISEMENT

More by Lucy Hornstein, MD

  • After #MeToo, have the rules changed?

    Lucy Hornstein, MD
  • A patient’s view on cancer surprises this physician

    Lucy Hornstein, MD
  • Never underestimate the power of pus

    Lucy Hornstein, MD

More in Physician

  • Why the heart of medicine is more than science

    Ryan Nadelson, MD
  • How Ukrainian doctors kept diabetes care alive during the war

    Dr. Daryna Bahriy
  • How women physicians can go from burnout to thriving

    Diane W. Shannon, MD, MPH
  • Why more doctors are choosing direct care over traditional health care

    Grace Torres-Hodges, DPM, MBA
  • How to handle chronically late patients in your medical practice

    Neil Baum, MD
  • How early meetings and after-hours events penalize physician-mothers

    Samira Jeimy, MD, PhD and Menaka Pai, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why the heart of medicine is more than science

      Ryan Nadelson, MD | Physician
    • How Ukrainian doctors kept diabetes care alive during the war

      Dr. Daryna Bahriy | Physician
    • Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

      Harvey Castro, MD, MBA | Tech
    • How women physicians can go from burnout to thriving

      Diane W. Shannon, MD, MPH | Physician
    • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

      William J. Bannon IV | Conditions
    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 9 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why the heart of medicine is more than science

      Ryan Nadelson, MD | Physician
    • How Ukrainian doctors kept diabetes care alive during the war

      Dr. Daryna Bahriy | Physician
    • Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

      Harvey Castro, MD, MBA | Tech
    • How women physicians can go from burnout to thriving

      Diane W. Shannon, MD, MPH | Physician
    • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

      William J. Bannon IV | Conditions
    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What’s the difference between family practice and med-peds?
9 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...