Open enrollment time arrives and you stare at the list of primary care physician options, wondering which is the best choice.
Family medicine or internal medicine? Is your child too old for a pediatrician? Are you too young for a geriatrician?
Primary care physicians fall into four basic categories: internal medicine, family medicine, pediatrics and geriatrics. Each has its own emphasis and category of patient that it serves. The doctor best for your needs will depend on your age and health status, plus the age and health needs of any of your dependents.
Before you select the one with the closest office, you may want to consider a few key factors to get the most value for your health care investment.
“An ideal primary care provider is someone you feel comfortable with and who is available when you need to be seen. You should feel secure in their abilities, because they are ultimately responsible for coordinating your care. That includes ensuring you stay healthy and, when you are sick or injured, making sure you get the care and medicine you need,” says Dr. Sajee Lekawa, medical director for the UC Irvine Health Medical Group in Tustin.
Our “primary care primer” will help you navigate the differences among the four physician categories to help you confidently decide which will best serve you and your loved ones.
Download this chart: 'Which primary care doctor should I choose?' (PDF) ›
Doctors in internal medicine, or internists, specialize in the diagnosis, treatment and care of adult patients. Their practice includes disease prevention, treatment of chronic conditions such as diabetes, and complex conditions involving multiple diseases or disorders. Many also have special areas of interest or training.
“If you have a specific health concern, look at the internist’s online bio to see if they have an interest in that area. If they do, they can manage more of your care without you having to see a specialist,” says Lekawa, who practices internal medicine.
An internist’s bio can also provide clues as to whether a doctor is a good match for your age and health focus. “If a physician’s bio states that he specializes in geriatrics, that may be fine for an older patient, but may not be necessary for a 35-year-old healthy patient," says Lekawa.
Family medicine physicians have broad education and training in pediatrics, internal medicine, women’s health and mental health as well as many subspecialty areas, explains Dr. David Kilgore, vice chair of the UC Irvine Health Department of Family Medicine. These doctors are dedicated to providing ongoing, personalized care for all members of the family, from newborns to elders, and are trained to care for a wide variety of common primary care conditions.
Many will perform a variety of simple, in-office procedures such as suturing lacerations and doing pap smears and joint injections. They also will give referrals to medicine and surgical specialties when needed.
Family medicine physicians place special emphasis on prevention and whole-person care by helping to educate you and your family about the many things you can do to improve your own health and wellness, Kilgore says.
“Think of them as your family’s primary medical home — a one-stop-shop for high quality, broad-spectrum care for whole family.”
Pediatricians care for children from birth through 17. Along with diagnosing and treating illness and disease, they offer services for a growing child that include vaccinations, monitoring growth, and offering information about child safety and nutrition.
If you have a baby or very young children, a pediatrician can be a great primary care choice for your kids. If your middle-school child or high-schooler feels uncomfortable seeing a pediatrician, however, it may be time to switch to a family practitioner.
“A lot of times girls don’t want to see a pediatrician once they start getting their period. Or, if your child is 14 or older and doesn’t want to see a pediatrician anymore, then a family practitioner is a nice transitional person who has knowledge of children and also knows what to do with an adult patient,” Lekawa says.
Geriatricians coordinate care for older adults, primarily age 65 to 100. Most are internists or family practitioners credentialed in geriatrics, experienced in treating age-related health issues. They collaborate with other health professionals, such as neurologists, psychiatrists, psychologists, and physical and speech therapists, to help patients retain function and quality of life.
“We specialize in disorders such as dementia, gait disorders and falls, osteoporosis, urinary incontinence, failure to thrive and psychiatric problems in older adults,” says UC Irvine Health geriatrician Dr. Herbert Sier. “If we can cure something, great, but many chronic diseases can’t be cured. So we look at how to help a person function independently and, if they need assistance, help determine what kind of assistance they need.”
A geriatrician usually serves as a primary care provider for older adults with multiple chronic illnesses and individuals with cognitive or functional — mental or physical — deficits. However, a younger senior may wish to choose a geriatrician as a primary care doctor for preventive healthcare.
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