Which type of Primary Care Physician?

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dm200
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Which type of Primary Care Physician?

Post by dm200 » Tue Sep 25, 2018 5:00 pm

I think I will be soon faced with selecting a new Primary Care Physician with Kaiser. For adults (I am in my early 70's), we can choose Physicians who are Board Certified in Internal Medicine or Family Medicine/Practice. In recent decades, I have chosen Internal Medicine.

Other factors being more or less equal, opinions on which to choose? Or, perhaps, it does not matter much?

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Re: Which type of Primary Care Physician?

Post by dm200 » Tue Sep 25, 2018 5:07 pm

Let me add that if I chose Family medicine/practice - it would be with a Physician who only saw adults.

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Re: Which type of Primary Care Physician?

Post by mrc » Tue Sep 25, 2018 5:15 pm

A geriatrician would not be out of line for a primary, otherwise I'd go with an internist.
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Re: Which type of Primary Care Physician?

Post by lthenderson » Tue Sep 25, 2018 5:20 pm

The scope of what an internal medicine doctor is less than that of a family doctor so they tend to be more focused on middle age ailments. Likewise, a geriatrician has even a more specific scope so that would be my recommendation at your age.

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Re: Which type of Primary Care Physician?

Post by dm200 » Tue Sep 25, 2018 5:21 pm

mrc wrote:
Tue Sep 25, 2018 5:15 pm
A geriatrician would not be out of line for a primary, otherwise I'd go with an internist.
As far as I can tell, "geriatrics" is not an identified Kaiser category for Physicians.

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Re: Which type of Primary Care Physician?

Post by mrc » Tue Sep 25, 2018 5:22 pm

dm200 wrote:
Tue Sep 25, 2018 5:21 pm
mrc wrote:
Tue Sep 25, 2018 5:15 pm
A geriatrician would not be out of line for a primary, otherwise I'd go with an internist.
As far as I can tell, "geriatrics" is not an identified Kaiser category for Physicians.
Please don't me mad at me, but that's one reason I don't care for Kaiser's HMO model.
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Re: Which type of Primary Care Physician?

Post by jebmke » Tue Sep 25, 2018 5:24 pm

dm200 wrote:
Tue Sep 25, 2018 5:00 pm
I think I will be soon faced with selecting a new Primary Care Physician with Kaiser. For adults (I am in my early 70's), we can choose Physicians who are Board Certified in Internal Medicine or Family Medicine/Practice. In recent decades, I have chosen Internal Medicine.

Other factors being more or less equal, opinions on which to choose? Or, perhaps, it does not matter much?
As long as it isn't a pathologist I think you will be ok with either one.
When you discover that you are riding a dead horse, the best strategy is to dismount.

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Re: Which type of Primary Care Physician?

Post by dm200 » Tue Sep 25, 2018 5:25 pm

mrc wrote:
Tue Sep 25, 2018 5:22 pm
dm200 wrote:
Tue Sep 25, 2018 5:21 pm
mrc wrote:
Tue Sep 25, 2018 5:15 pm
A geriatrician would not be out of line for a primary, otherwise I'd go with an internist.
As far as I can tell, "geriatrics" is not an identified Kaiser category for Physicians.
Please don't me mad at me, but that's one reason I don't care for Kaiser's HMO model.
No ;)

I do want a Physician that has a significant number of patients "like me". However, my opinion is that we (just about whatever age) deal with diseases and conditions and that "old age" is not such.

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Re: Which type of Primary Care Physician?

Post by dm200 » Tue Sep 25, 2018 5:27 pm

When I was a child, our family doctors were my grandparents' age.

Then, my parents ages

Then my age

Then my child's age.

Now, if I had any - grandchildren's age. :happy

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Re: Which type of Primary Care Physician?

Post by ResearchMed » Tue Sep 25, 2018 6:13 pm

dm200 wrote:
Tue Sep 25, 2018 5:27 pm
When I was a child, our family doctors were my grandparents' age.

Then, my parents ages

Then my age

Then my child's age.

Now, if I had any - grandchildren's age. :happy
Ouch.
How true!

RM
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Re: Which type of Primary Care Physician?

Post by dm200 » Tue Sep 25, 2018 6:15 pm

ResearchMed wrote:
Tue Sep 25, 2018 6:13 pm
dm200 wrote:
Tue Sep 25, 2018 5:27 pm
When I was a child, our family doctors were my grandparents' age.
Then, my parents ages
Then my age
Then my child's age.
Now, if I had any - grandchildren's age. :happy
Ouch.
How true!
RM
And I hope to live long enough to be great-grandchildren's ages (I I have any) :)

Let's see - if I am 100 and he/she is 25 ...
Last edited by dm200 on Tue Sep 25, 2018 6:33 pm, edited 1 time in total.

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Re: Which type of Primary Care Physician?

Post by mighty72 » Tue Sep 25, 2018 6:32 pm

dm200 wrote:
Tue Sep 25, 2018 5:00 pm
I think I will be soon faced with selecting a new Primary Care Physician with Kaiser. For adults (I am in my early 70's), we can choose Physicians who are Board Certified in Internal Medicine or Family Medicine/Practice. In recent decades, I have chosen Internal Medicine.

Other factors being more or less equal, opinions on which to choose? Or, perhaps, it does not matter much?
At Kaiser, both have the same scope as long as they are PCP. AFAIK, in terms of training, family medicine are trained also to see kids and OB issues. Internist are not. Internal Medicine has much broader choice for fellowships. Primary Medicine, not so much.

At Kaiser, I would choose a person whom you feel comfortable with regardless of which BC they have.

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Re: Which type of Primary Care Physician?

Post by livesoft » Tue Sep 25, 2018 6:33 pm

My experience is that internal medicine doctors really like to deal with arteries, blood pressure, and things like that. They will phone in prescriptions for sore throats and pretty much refer you to another doctor for anything else. Basically, you won't need to see your internal medicine physician except for physicals and checking over your regimen of drugs that you take.

Family practice physicians will not mind looking at your skin, your feet and toes, down your throat and nose, allergies, medicines, and your blood pressure. I've even had one that read X-rays incorrectly, but later got an expert opinion and did a good job with the required cast.

Of course, all the above is just my experience and may not be anyone else's.
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Re: Which type of Primary Care Physician?

Post by dm200 » Tue Sep 25, 2018 6:35 pm

livesoft wrote:
Tue Sep 25, 2018 6:33 pm
My experience is that internal medicine doctors really like to deal with arteries, blood pressure, and things like that. They will phone in prescriptions for sore throats and pretty much refer you to another doctor for anything else. Basically, you won't need to see your internal medicine physician except for physicals and checking over your regimen of drugs that you take.

Family practice physicians will not mind looking at your skin, your feet and toes, down your throat and nose, allergies, medicines, and your blood pressure. I've even had one that read X-rays incorrectly, but later got an expert opinion and did a good job with the required cast.

Of course, all the above is just my experience and may not be anyone else's.
Thanks. My internal medicine PCPs have looked at all these things.

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Re: Which type of Primary Care Physician?

Post by livesoft » Tue Sep 25, 2018 6:46 pm

I want to add that my insurance does not force me to get a referral from my PCP for anything. When I break a bone, my PCP will only learn about it after it is all healed because I went to my orthopedist. If I had lithotripsy, my PCP won't know about it until months later because I just went to my urologist. The PCP is not going to do a colonoscopy and just says, "All these doctors are good, pick one and make an appointment."

I'm not even sure what a PCP does for me anymore.
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Re: Which type of Primary Care Physician?

Post by staythecourse » Tue Sep 25, 2018 7:01 pm

I would go with internal medicine. No offense to the FP out there, but on average I have seen stronger IM docs then FP in my career.

Find someone who is about 5-7 years out of training. Who has hours that jive with yours. Who trained at a well known place. Who is board certified. Best if you can find one that was chief resident during training.

Most IMPORTANT is after meeting him/ her see if your personalities jive. As I tell my own patients the doctor/ patient relationship is no different then dating. You meet and if you are interested in each other you keep seeing each other. This goes on and on, but if there is a point you or they don't see eye to eye on your care it is time to break up and go your different ways.

Good luck.
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Re: Which type of Primary Care Physician?

Post by dm200 » Tue Sep 25, 2018 7:04 pm

staythecourse wrote:
Tue Sep 25, 2018 7:01 pm
I would go with internal medicine. No offense to the FP out there, but on average I have seen stronger IM docs then FP in my career.
Find someone who is about 5-7 years out of training. Who has hours that jive with yours. Who trained at a well known place. Who is board certified. Best if you can find one that was chief resident during training.
Good luck.
Hope that I do not need to change and can keep my current IM PCP. Have had her for almost 8 years and we get along very well. All Kaiser PCPs are Board certified.

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Re: Which type of Primary Care Physician?

Post by calmaniac » Tue Sep 25, 2018 7:24 pm

livesoft wrote:
Tue Sep 25, 2018 6:33 pm
My experience is that internal medicine doctors really like to deal with arteries, blood pressure, and things like that. They will phone in prescriptions for sore throats and pretty much refer you to another doctor for anything else. Basically, you won't need to see your internal medicine physician except for physicals and checking over your regimen of drugs that you take.
At Kaiser, internists have to be more holistic and cannot simply focus on "arteries and blood pressure". If you have any chronic medical issues, I would go with the internist. Internists have much more experience dealing with chronic disease, such as hypertension, diabetes, kidney disease, COPD.

Not medical advice, just a U.S. Centers for Disease Control information page on the shingles vaccine
https://www.cdc.gov/vaccines/vpd/shingl ... index.html

Full disclosure: I am a board certified internist

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Re: Which type of Primary Care Physician?

Post by Sheepdog » Tue Sep 25, 2018 8:02 pm

If you find your PCP and he/she can diagnose your problem and knows good specialists to refer you to, you are very fortunate.
I found mine. For example I ran a half marathon 10 years ago at 77.. My legs turned technicolor. He saw me immediately when I reported in and he referred me to a specialist for vein problems within just a few days.'

I was several hundred miles away 4 years ago when I found blood in my urine. I called his office and he said to get home fast. He saw me the next morning, ordered xrays or c scans or whatever. The result was not good. I saw his referred urologist who removed bladder cancers.

A couple months ago I had some major vision, dizziness and face numbness while driving the interstate after attending a Colts game in Indy. I called him the next morning, I told him what I experienced (kinda scary). He saw me as soon as I could get there. He ordered numerous tests and referred me within days.

Old age can be life altering,. but a good PCP can be life lengthening. It is wonderful to have found one who is a good listener and diagnostician. He is an Internal medicine physician, by the way.

Try to get to know your doc, whomever it is. They may like that and watch out for you.
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Re: Which type of Primary Care Physician?

Post by FrugalInvestor » Tue Sep 25, 2018 8:10 pm

I choose an internist. However, I also know that my PCP deals with a lot of elderly patients which I will inevitably become.
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Re: Which type of Primary Care Physician?

Post by TheNightsToCome » Tue Sep 25, 2018 8:45 pm

I recommend an internist rather than a FP.

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Re: Which type of Primary Care Physician?

Post by Yooper16 » Tue Sep 25, 2018 10:05 pm

livesoft wrote:
Tue Sep 25, 2018 6:46 pm
I want to add that my insurance does not force me to get a referral from my PCP for anything. When I break a bone, my PCP will only learn about it after it is all healed because I went to my orthopedist. If I had lithotripsy, my PCP won't know about it until months later because I just went to my urologist. The PCP is not going to do a colonoscopy and just says, "All these doctors are good, pick one and make an appointment."

I'm not even sure what a PCP does for me anymore.

Where we moved from, what you stated was pretty much the case. Where we moved to, the PCP, actually performs many of the tasks.

My PCP did my colonoscopy and has delivered babies. My PCP, was from this area, went to medical school at U.of MI and ended up in a practice outside of Atlanta GA and moved back maybe a decade ago. Many of the specialties have only 1 physician in the area, with maybe another that splits time between 2 areas. And there are a couple of specialties that there are none. The couple of surgeons in the area, do pretty much everyting from lithotripsy to heart surgery.

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Re: Which type of Primary Care Physician?

Post by toofache32 » Tue Sep 25, 2018 10:30 pm

I would choose internal medicine. Family practice docs are quickly being replaced by nurses and you will suddenly find yourself without a doctor.

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Re: Which type of Primary Care Physician?

Post by hmw » Tue Sep 25, 2018 10:43 pm

I would go with an internist. I am a MD, but not a primary care physician.

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Re: Which type of Primary Care Physician?

Post by HIinvestor » Tue Sep 25, 2018 11:01 pm

I’m BCBS and recently faced this issue as my internist is 68 and having increasing personal health issues of his own. I asked my lung doctor for a referral of an internist he worked well with, since I figure he and this MD will provide most of my care. He referred me to his internist who is in her early 40s. We get along very well and she has an excellent working relationship with him and they share the same electronic records system.

She’s agreed to take H in when he decides to switch from
His 68 year old internist as well. I have never seen a family practice MD—went from pediatrician to internist. We do have a family practice APRN on our board. She practices in the lung clinic and works with the lung specialists.

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Re: Which type of Primary Care Physician?

Post by carolinaman » Wed Sep 26, 2018 7:28 am

I would go with internist. I had a wonderful internist for over 20 years. He was very thorough in physicals and treating general issues. I always went to him first whenever I had a medical issue. Whenever there was a need for a specialist, he always recommended very good doctors for me. Unfortunately for me, he became certified in cardiology and quit practicing as an internist. I now have another internist as my PCP.

My mother had a geriatrician and based upon a very small sample size of one, I would not recommend this type of doctor.

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Re: Which type of Primary Care Physician?

Post by lthenderson » Wed Sep 26, 2018 8:00 am

livesoft wrote:
Tue Sep 25, 2018 6:33 pm
My experience is that internal medicine doctors really like to deal with arteries, blood pressure, and things like that. They will phone in prescriptions for sore throats and pretty much refer you to another doctor for anything else. Basically, you won't need to see your internal medicine physician except for physicals and checking over your regimen of drugs that you take.

Family practice physicians will not mind looking at your skin, your feet and toes, down your throat and nose, allergies, medicines, and your blood pressure. I've even had one that read X-rays incorrectly, but later got an expert opinion and did a good job with the required cast.

Of course, all the above is just my experience and may not be anyone else's.
For what it is worth, my wife is an internal medicine physician and sees all the complicated patients that the family practice physicians in her practice don't want to look at.

I always recommend asking others who have lived in your area for advice on whom they have as a doctor and recommend. Like any other profession, the quality of their knowledge and beside manners can vary widely.

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Re: Which type of Primary Care Physician?

Post by livesoft » Wed Sep 26, 2018 8:06 am

Perhaps the physician's staff and colleagues are more important than the physician.

When you call on the weekend, will the Service get the doc to call you back within 15 minutes? Do you get the annoying "If this is an emergency, hang up and dial 911"? During regular hours, will you get voice mail or the real live triage nurse? If voice mail, how quickly do they call back? Does the receptionist ask annoyingly "Are you a patient of Dr. G?"

Health care is complicated and there are many paths to healing and to staying healthy.
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Re: Which type of Primary Care Physician?

Post by jhwkr542 » Wed Sep 26, 2018 8:11 am

As a fellow MD, I think either will be fine as a primary care physician. You'll want to find the physician you trust and get along with best, regardless of board certification. There will be good internists and bad internists, and good family docs and bad family docs. For the typical patient, most ailments/screening will be bread-and-butter issues both see commonly, so focus more on finding the right person.

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Re: Which type of Primary Care Physician?

Post by dm200 » Wed Sep 26, 2018 11:41 am

jhwkr542 wrote:
Wed Sep 26, 2018 8:11 am
As a fellow MD, I think either will be fine as a primary care physician. You'll want to find the physician you trust and get along with best, regardless of board certification. There will be good internists and bad internists, and good family docs and bad family docs. For the typical patient, most ailments/screening will be bread-and-butter issues both see commonly, so focus more on finding the right person.
Yes - "communication" (both ways) is vital for me and my satisfaction. There are differences, as well, between my Kaiser system and regular practice PCPs.

About 2/3 of Kaiser PCPs (for adults) are female as well - which is a different mix with overall Physicians. Although there are exceptions (both directions) - I lean very slightly to female PCPs because they tend to communicate better. For specialists, I don't care one way or the other about male or female. I have noticed that, over time, Kaiser does seem to be hiring more Family Medicine/Practice PCPs for adult primary care.

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Re: Which type of Primary Care Physician?

Post by dm200 » Wed Sep 26, 2018 11:43 am

livesoft wrote:
Wed Sep 26, 2018 8:06 am
Perhaps the physician's staff and colleagues are more important than the physician.
When you call on the weekend, will the Service get the doc to call you back within 15 minutes? Do you get the annoying "If this is an emergency, hang up and dial 911"? During regular hours, will you get voice mail or the real live triage nurse? If voice mail, how quickly do they call back? Does the receptionist ask annoyingly "Are you a patient of Dr. G?"
Health care is complicated and there are many paths to healing and to staying healthy.
Not dependent on PCP (at Kaiser) for this. Have urgent care 24x7 and 24x7 telephone nurse advice line.

I do a lot with a PCP by email for things that are not urgent (up to 72 hours to reply), BUT some Kaiser physicians are much more responsive to email. Some almost always respond themselves, while others seem to delegate to others on the "team". I like the fact that I can see whether it is the Physician him/herself or an assistant.

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Re: Which type of Primary Care Physician?

Post by dm200 » Thu Sep 27, 2018 2:55 pm

Another odd (to me) thing Kaiser seems to be doing (when I look at PCPs online) is categorizing some Physicians as "Internal Medicine" when these Physicians are Board Certified in Family Medicine/Practice. This seems to be a fairly recent trend.

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Re: Which type of Primary Care Physician?

Post by Munir » Thu Sep 27, 2018 3:29 pm

livesoft wrote:
Tue Sep 25, 2018 6:33 pm
My experience is that internal medicine doctors really like to deal with arteries, blood pressure, and things like that. They will phone in prescriptions for sore throats and pretty much refer you to another doctor for anything else. Basically, you won't need to see your internal medicine physician except for physicals and checking over your regimen of drugs that you take.

Family practice physicians will not mind looking at your skin, your feet and toes, down your throat and nose, allergies, medicines, and your blood pressure. I've even had one that read X-rays incorrectly, but later got an expert opinion and did a good job with the required cast.

Of course, all the above is just my experience and may not be anyone else's.
You are correct. Your description of internists is your own personal experience and not what the general description of internists is among other physicians since they do cover all these areas that you think they do not cover.

To OP, I suggest an internist or geriatrician whom you trust and who is responsive to your needs.

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Re: Which type of Primary Care Physician?

Post by dm200 » Thu Sep 27, 2018 5:02 pm

To OP, I suggest an internist or geriatrician whom you trust and who is responsive to your needs.

Yes - thanks to all..

One BIG priority of mine, with just about any Physician, is that he or she is comfortable with my asking a lot of relevant questions, being fully informed and following the details of every test and every medication. I also disclose all information about myself and almost always follow physician recommendations and instructions.

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Re: Which type of Primary Care Physician?

Post by 2015 » Thu Sep 27, 2018 10:26 pm

This is exactly why I keep my own excel spreadsheet documenting all health conditions, tests, labs, procedures going back 20 years. To me, it doesn't matter who the PCP is, I own my health. Yes, I know some people want "the best care out there" but I believe no one is going to be more of an advocate for you than yourself.

Case in point, as a result of decades of experience owning my own care, I was very much at ease interacting with each and every specialist, physician, health care provider, along with a plethora of other health care professionals I interacted with while overseeing my mother's health care up until her passing. There wasn't an individual I interacted with that I didn't pepper with checklists of questions on an ongoing basis, keeping copious notes all the while. I didn't need someone I was "comfortable with", as I wasn't there to shake hands and kiss babies. Once each professional understood that I understood, each and every one of them were extremely easy to "get along with", extremely responsive to me, and provided the best care. My mother had an exceptional end of life, and it was because I owned each and every aspect of it.

I don't need to "date" any health care professional. In my long experience, health care professionals are like any other professional. Once they see you know what you're doing, and what you're talking about, and most importantly you accord them with the respect they deserve, you automatically get "the best care." At least I have. YMMV.

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Re: Which type of Primary Care Physician?

Post by Dottie57 » Fri Sep 28, 2018 6:42 pm

I am at a family care medical group. The physicians there actually take time to talk with you. Not as packed in with 15 min appointments.

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Re: Which type of Primary Care Physician?

Post by Dottie57 » Fri Sep 28, 2018 6:42 pm

I am at a family care medical group. The physicians there actually take time to talk with you. Not as packed in with 15 min appointments.

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Re: Which type of Primary Care Physician?

Post by Rwsawbones » Fri Sep 28, 2018 7:56 pm

You can receive excellent care from either a well trained concerned Family Practitioner or Internist. (Discloser I am an Internist certified in both Internal Medicine an Geriatrics) zIt is key that your PCP (primary care provider) be as much as possible always in the loop. If not your care will become episodic and fragmented. No one will be responsible for you. Your PCP can expeditiously open doors for you when needed by s/he requesting same. Patients left to their own devices chose celebrity type but not very competent consultants. Docs chose consultants for their patients based on the fewest unforced errors and those who other docs in the same field send their most difficult patients. Patients are often surprised to see their own docs or own doc’s family in the reception room of a consultant , but of course this is logical. Docs themselves also go to the best docs. These best docs are not likely to be recommended by a friend of a relative. Beware of docs and medical institutions who need to advertise for patients. You may not have heard of the best but your PCP knows who they are

There is one situation where all bets are off. If your PCP is employed by an institution s/he has to refer within that institution or organization even when the work would be more safely done elsewhere. But you know this. If there is any doubt ask your doc who signs his or her paycheck. Don’t be shy about asking this or any question. Docs prefer that patients understand the situation and that all concerns be answered. Never regard a question or concern of yours not worthy of enough discussion to make one fully informed and comfortable. M

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Re: Which type of Primary Care Physician?

Post by dm200 » Sat Sep 29, 2018 9:51 am

Dottie57 wrote:
Fri Sep 28, 2018 6:42 pm
I am at a family care medical group. The physicians there actually take time to talk with you. Not as packed in with 15 min appointments.
Kaiser PCPs are booked at 3 patients per hour [the assistant left the computer on one time when she left the room]. Some appointments take longer and some shorter. While, obviously, there is a time "pressure" on Physicians, I have never felt that the Physician was not willing/able to adequately address my needs.

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Re: Which type of Primary Care Physician?

Post by dm200 » Sat Sep 29, 2018 9:59 am

Rwsawbones wrote:
Fri Sep 28, 2018 7:56 pm
You can receive excellent care from either a well trained concerned Family Practitioner or Internist. (Discloser I am an Internist certified in both Internal Medicine an Geriatrics) zIt is key that your PCP (primary care provider) be as much as possible always in the loop. If not your care will become episodic and fragmented. No one will be responsible for you. Your PCP can expeditiously open doors for you when needed by s/he requesting same. Patients left to their own devices chose celebrity type but not very competent consultants. Docs chose consultants for their patients based on the fewest unforced errors and those who other docs in the same field send their most difficult patients. Patients are often surprised to see their own docs or own doc’s family in the reception room of a consultant , but of course this is logical. Docs themselves also go to the best docs. These best docs are not likely to be recommended by a friend of a relative. Beware of docs and medical institutions who need to advertise for patients. You may not have heard of the best but your PCP knows who they are

There is one situation where all bets are off. If your PCP is employed by an institution s/he has to refer within that institution or organization even when the work would be more safely done elsewhere. But you know this. If there is any doubt ask your doc who signs his or her paycheck. Don’t be shy about asking this or any question. Docs prefer that patients understand the situation and that all concerns be answered. Never regard a question or concern of yours not worthy of enough discussion to make one fully informed and comfortable. M
Thanks. I sure hope I do not need to change - will know soon. I place almost zero reliance on what other patients tell me about Physicians. I personally know two folks who cannot stand my PCP and they each switched away. There must be a lot of others as well. Searching online, she has some bad "reviews" by patients. Very puzzling.. In my almost eight years with her, however, I cannot recall anything where I have been dissatisfied. Her responsiveness is outstanding. I also learned that my Dermatologist (at Kaiser) is her very satisfied patient.

staythecourse
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Re: Which type of Primary Care Physician?

Post by staythecourse » Sat Sep 29, 2018 10:10 am

Rwsawbones wrote:
Fri Sep 28, 2018 7:56 pm
There is one situation where all bets are off. If your PCP is employed by an institution s/he has to refer within that institution or organization even when the work would be more safely done elsewhere.
Just wanted to highlight this as maybe the MOST important aspect for patients to understand. Folks are way to focused on financial ties between docs and companies, i.e. He had a free lunch from company x so he must write the drug because of that.

The focus should be on if your PCP has your best interest at heart and refers to who he/ she thinks is the best. I worked at a hospital then went solo outside the hospital. Some of those same PCP no longer refer to me, but without fail I still see referrals from them for their own family members and friends.

The best is if you can find a PCP whose financial incentive is taking care of you and by doing that getting word of mouth. That usually means they own their own practice.

Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” | -Jack Bogle

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Re: Which type of Primary Care Physician?

Post by rjbraun » Sat Sep 29, 2018 11:11 am

I like my PCP a lot. He probably finished his medical residency in FP about a decade ago. He mostly sees adults, I assume, based on the other patients I've seen in the waiting room, and that the waiting room is not particularly child-friendly.

I agree with other posters that fit is key as are overall credentials. My doctor is part of a "sports medicine" practice, so he treats me and others for sports-related injuries as well. His office has a section staffed with physical therapists, which I find convenient when he prescribes PT treatment. This is the first time my PCP had an arrangement like this that I made use of, but all else equal it is something I think I would probably aim for in the event I were to look for another PCP.

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Re: Which type of Primary Care Physician?

Post by squirm » Sat Sep 29, 2018 11:17 am

I like my PCP, I just hate the three minute appointments. I guess they have their schedule packed with managed care.

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dm200
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Re: Which type of Primary Care Physician?

Post by dm200 » Sat Sep 29, 2018 11:19 am

squirm wrote:
Sat Sep 29, 2018 11:17 am
I like my PCP, I just hate the three minute appointments. I guess they have their schedule packed with managed care.
Wow! That sure is "tight" scheduling!!

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Re: Which type of Primary Care Physician?

Post by mouses » Sat Sep 29, 2018 11:28 am

livesoft wrote:
Tue Sep 25, 2018 6:33 pm
My experience is that internal medicine doctors really like to deal with arteries, blood pressure, and things like that. They will phone in prescriptions for sore throats and pretty much refer you to another doctor for anything else. Basically, you won't need to see your internal medicine physician except for physicals and checking over your regimen of drugs that you take.

Family practice physicians will not mind looking at your skin, your feet and toes, down your throat and nose, allergies, medicines, and your blood pressure. I've even had one that read X-rays incorrectly, but later got an expert opinion and did a good job with the required cast.

Of course, all the above is just my experience and may not be anyone else's.
This is exactly the opposite of my experience. My internists have seemed to know a lot more in detail than "family physicians" and have dealt with pretty much anything. I have been referred to specialists like cardiologists, etc. when something out of the ordinary happens but the internist has coordinated everything. Especially as I have aged, I like having a knowledgeable doctor keeping track of what the specialists are doing.

I can't imagine having a generalist doctor read imaging except for something like a broken bone.

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Re: Which type of Primary Care Physician?

Post by mouses » Sat Sep 29, 2018 11:33 am

dm200 wrote:
Thu Sep 27, 2018 2:55 pm
Another odd (to me) thing Kaiser seems to be doing (when I look at PCPs online) is categorizing some Physicians as "Internal Medicine" when these Physicians are Board Certified in Family Medicine/Practice. This seems to be a fairly recent trend.
Wow that seems deceptive. Like PAs introducing themselves as Dr. SoandSo. Even if the latter have a doctorate in something, if it is not in medicine they are just plain deceptive.

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Re: Which type of Primary Care Physician?

Post by staythecourse » Sat Sep 29, 2018 11:45 am

mouses wrote:
Sat Sep 29, 2018 11:33 am
dm200 wrote:
Thu Sep 27, 2018 2:55 pm
Another odd (to me) thing Kaiser seems to be doing (when I look at PCPs online) is categorizing some Physicians as "Internal Medicine" when these Physicians are Board Certified in Family Medicine/Practice. This seems to be a fairly recent trend.
Wow that seems deceptive. Like PAs introducing themselves as Dr. SoandSo. Even if the latter have a doctorate in something, if it is not in medicine they are just plain deceptive.
A lot of that is likely more the attempt to make it more clear the scope of practice of the doctor in the Kaiser model for the public. If a FP is NOT doing OB (most don't as malpractice is too high for a FP) and peds (likely Kaiser has peds done by boarded prediatricians) then they are just doing adult medicine. In a large corporate medicine model FP are likely NOT allowed to do much of the extensive breadth that they are trained. Can only imagine the ENT guys flipping out over a FP getting OR privileges to do tonsillectomies.

FP have a great role, but they seem to get minimized or restricted in a corporate medicine model. The purpose of those models is to get as many PCP to see as many patients to funnel the higher revenue "stuff" to the employed specialists.

Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” | -Jack Bogle

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dm200
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Re: Which type of Primary Care Physician?

Post by dm200 » Sat Sep 29, 2018 1:01 pm

mouses wrote:
Sat Sep 29, 2018 11:33 am
dm200 wrote:
Thu Sep 27, 2018 2:55 pm
Another odd (to me) thing Kaiser seems to be doing (when I look at PCPs online) is categorizing some Physicians as "Internal Medicine" when these Physicians are Board Certified in Family Medicine/Practice. This seems to be a fairly recent trend.
Wow that seems deceptive. Like PAs introducing themselves as Dr. SoandSo. Even if the latter have a doctorate in something, if it is not in medicine they are just plain deceptive.
Very curious - not that bad, IMO :)

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dm200
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Re: Which type of Primary Care Physician?

Post by dm200 » Sat Sep 29, 2018 1:04 pm

staythecourse wrote:
Sat Sep 29, 2018 11:45 am
mouses wrote:
Sat Sep 29, 2018 11:33 am
dm200 wrote:
Thu Sep 27, 2018 2:55 pm
Another odd (to me) thing Kaiser seems to be doing (when I look at PCPs online) is categorizing some Physicians as "Internal Medicine" when these Physicians are Board Certified in Family Medicine/Practice. This seems to be a fairly recent trend.
Wow that seems deceptive. Like PAs introducing themselves as Dr. SoandSo. Even if the latter have a doctorate in something, if it is not in medicine they are just plain deceptive.
A lot of that is likely more the attempt to make it more clear the scope of practice of the doctor in the Kaiser model for the public. If a FP is NOT doing OB (most don't as malpractice is too high for a FP) and peds (likely Kaiser has peds done by boarded prediatricians) then they are just doing adult medicine. In a large corporate medicine model FP are likely NOT allowed to do much of the extensive breadth that they are trained. Can only imagine the ENT guys flipping out over a FP getting OR privileges to do tonsillectomies.

FP have a great role, but they seem to get minimized or restricted in a corporate medicine model. The purpose of those models is to get as many PCP to see as many patients to funnel the higher revenue "stuff" to the employed specialists.

Good luck.
Been a long time since we needed a "Pediatrician" :)

At Kaiser here, some of the FPs seem to do both adult and pediatrics. Then there are also Board certified pediatricians. Folks have a choice.

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Re: Which type of Primary Care Physician?

Post by mickeyd » Sat Sep 29, 2018 1:08 pm

My medical care is a triangular affair. Between the doctor, the computer and me we generally arrive on the best care for what ales me. I think my current doctor is an internist, but it really does not matter as I receive excellent care from a guy that is obviously interested in me remaining in good health for a long time.
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