How do you define being healthy?
What does it mean to you to be healthy? When so many are concerned with “being healthy,” perhaps it would be beneficial to take a look at what that actually is. Is it merely being free from any disease or ailments? Is it freedom from any physical suffering? Does it mean not having to take any vitamins, supplements or medications…ever? Does it mean you never have to go see a doctor? If we are not sure what the goal is, how will we ever get there?
The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
“Physical, mental and social well-being.” Physical well-being involves taking care of the body you have to live your life in: nutrition, fitness, medical care. Mental well-being involves a balance of self responsibility and self love, appropriate coping mechanisms to assist you in dealing with stress, freedom from worry, learning you can be happy no matter what circumstance you are in. And finally, social well-being involves having meaningful relationships with healthy communication. When it comes down to it, life is about relationship with yourself and others.
Physical, mental and social well-being are intertwined together. So what do you think, are you healthy? I’ve noticed that if you work on mental well-being first, the rest tends to fall into place.
Next post: how preventive medicine addresses physical, mental and social well-being.
Shortage of Primary Care Physicians in AL
It’s no surprise we are at a loss for primary care physicians in our nation. Primary care includes the specialties of Internal Medicine, Pediatrics and Family Medicine. Did you know that 98% of residents completing an internal medicine residency subspecialize to become cardiologists, gastroenterologists, pulmonologists, endocrinologists, etc? 85% of pediatric residents subspecialize. On the other hand, 98.9% of family medicine residents stay in family medicine.
This July 284 residents started their training in Alabama. Out of those 146 entered residencies in primary care. 74 in Internal Medicine,25 in Pediatrics, 42 in Family Medicine and 5 in a combined Medicine/Pediatrics program. Given the percentages above that means that in 3 years when these physicians are beginning their practices we’ll have 41.5 family medicine docs entering practice, 1.5 internal medicine docs and 3.75 pediatricians. The rest will be starting fellowships to further narrow their area of expertise.
So when I hear discussions from the powers that be about how to recruit more medical students into the field of primary care and specifically family medicine I am all for it. Not everyone needs a cardiologist or rheumatologist but everyone does need their own doctor that knows their medical problems and medications, can see them when they get sick and also treat their diabetes, congestive heart failure and other chronic diseases. Everyone needs a doctor that they see for routine check ups to order the tests and procedures needed to prevent further disease down the road, and knows when they need to tap into the expert opinion of the specialists. That’s what family medicine doctors provide, we call it a medical home for our patients.
Difference between Family Medicine and Internal Medicine
Have you ever wondered what type of doctor you need to have? I hear lots of people say, “I just need a regular doctor.” But even with “regular doctors” there are several different specialties and so which one should you see?
When I tell people I am a family medicine doctor, most people say “oh, so you’re a general practitioner.” Actually, general practitioner or GP refers to a doctor that has been to 4 years of medical school and 1 year of residency. They are licensed as a physician but not board certified in any specialty. There are very few physicians who are GP’s now as the vast majority of residents complete a minimum of 3 years of residency (after the same 4 years of medical school) in order to become board certified in a specialty. Primary care physicians include internal medicine, family medicine and pediatrics. OB/Gyn doctors are also under the umbrella of primary care for women’s health. So what’s the difference in these primary care doctors?
Pediatricians of course are trained specifically in children’s health. Most pediatricians see patients from birth to 18 years old. Internal medicine doctors are trained with an emphasis on inpatient medicine meaning they learn how to treat adult patients in the hospital. Many of these doctors train for 3 years in internal medicine then go on in their training to become a sub-specialist in a more specific area of medicine like cardiology. Some practice only inpatient medicine, some only outpatient medicine and probably the majority practice both. Family medicine doctors are trained to treat children and adults with more of an emphasis on outpatient treatment (like when you go to your doctor’s office to get a check up on your diabetes or find out if you have the flu).Although actually, most of our residency is training in the inpatient setting similar to internal medicine. We are also trained in OB/Gyn and are able to care for pregnant women and deliver their babies. Many doctors who practice in rural settings where there is no OB/Gyn will take care of the OB patients too. Like internal medicine, family medicine doctors can practice in an inpatient and/or outpatient setting but have more of a focus on preventative medicine. They also are able to literally see the whole family since they are trained in children and adults.
So if you are looking for a “regular doctor” you are most likely looking for an Internal Medicine or Family Medicine doctor. Their training is very similar in many respects it’s just that an internal medicine doctor has been trained with more of an emphasis on hospital patients and a family medicine doctor on clinic patients and preventative medicine.
