General medicine vs Internist - Page 2

orthodoc · 06-19-2014, 07:59 PM

In the US, internists are primary care physicians who only see adults. Family practitioners see all ages, from infants to geriatrics. Both are primary care physicians.

For what you want, Lola, I would look for someone who sees women in your age range, someone who will address your concerns and who you feel comfortable with. It could be an internist or a FP.

DOs are Doctors of Osteopathy; they learn techniques of musculoskeletal manipulation in addition to medical information. They are a sort of hybrid between chiropractors and doctors and are unique to the US; there are none in Canada. MDs come from the allopathic, or traditional, medical school model.

In the US there's a great deal of variation in quality between schools of osteopathy (and to a lesser extent, between schools of medicine). Schools of osteopathy can be started on an independent, for-profit basis, and that has led to some very inadequate educational situations. There are also some respectable DO schools. In terms of traditional MD schools, there's also a variation in the US, but less than for DO schools. There's more variation in residencies (graduate training). The US spans a huge spectrum in terms of quality, from literally the best on the planet to minimally-adequate single-hospital programs.

monster · 06-19-2014, 08:01 PM

Quote:

Originally Posted by Lola Bunny

Oh yeah, I want a woman doctor. Few people I've asked go to a prescription happy doctor. Hmmm....I don't really like that.

In my experience, some prescription-happy doctors are only so because that's what the majority of their patients expect. They quite enjoy the challenge of a patient who wants to fix things without drugs if at all possible.

If you can't get a decent recommendation from a friend with similar feelings about doctors, pick a group practice relatively nearby that has several female doctors. then choose whichever one can see you soonest. If you don't like her, it's usually fairly easy to switch to another one in the same group -far less hassle than starting the hunt all over again.

Remember, if you hate them you don't have to go back, but you really should get your current issue checked out asap, and maybe get a pap smear and boob exam done too just to get it out of the way, seeing as it sound like you haven't had a physical in a while. It's going to be unpleasant whoever the doc is, so it might as well be one you may not want to see again

sexobon · 06-19-2014, 10:06 PM

I go to a group practice affiliated with a teaching hospital and let the internal medicine residents practice on me. They tell me what they think is causing my issue and I ask them what atypical causes there are for my presentation. Sometimes they politely leave and come back with their attending who usually comes up with something the resident hadn't considered and asks the right questions to rule it out. The residents' diagnoses stand so they feel good about themselves while they learned something. They seem to like this old military instructor who remembers how it was competing for patients to practice on (during core rotations).

Lola Bunny · 06-20-2014, 02:58 PM

Quote:

Originally Posted by monster

If you can't get a decent recommendation from a friend with similar feelings about doctors, pick a group practice relatively nearby that has several female doctors. then choose whichever one can see you soonest. If you don't like her, it's usually fairly easy to switch to another one in the same group -far less hassle than starting the hunt all over again.

Remember, if you hate them you don't have to go back, but you really should get your current issue checked out asap, and maybe get a pap smear and boob exam done too just to get it out of the way, seeing as it sound like you haven't had a physical in a while. It's going to be unpleasant whoever the doc is, so it might as well be one you may not want to see again

Yeah, I found a group practice and trying to decide which of their female docs I want to choose. I am going to get a full check-up and get everything done. It's been over 10 years since I got a check-up.

Actually, I would really like to get my heart checked too, but I'm sure it's not really necessary. My heart rate occasionally would spike, but I'm sure it's due to stress.

Lola Bunny · 06-20-2014, 03:05 PM

Orthodoc: Thanks! You say DOs learn techniques of musculoskeletal manipulation. Do you know how that affects how they treat you or how it could help treat the patients?

infinite monkey · 06-20-2014, 05:47 PM

My doctor is a DO. He is in a practice started when I was a teenager, by two other DOs. There are also a couple of MDs and PAs and NPs, and women and men so I have a choice, depending on what I'm being seen for.

In my view, I like the DOs because they look at the whole person, not just current individual symptoms. My medical history matters, and they ask a lot of questions about my life in general too. Also, I was there once for something else and my doc saw that my hips weren't exactly lined up so he cracked me in half and I felt all around better. (Really, the back cracking was awesome.)

Lola Bunny · 06-20-2014, 08:26 PM

Thanks, Infinite!

Big Sarge · 06-21-2014, 10:11 AM

Pam - I hope you find some way to get your meds. I know how rough things can be.

Lola B - Sounds like you got your answers. I wish I was close enough to have Ortho as my doc. She is someone I have complete faith in

Lola Bunny · 06-21-2014, 03:51 PM

Thanks everyone for your inputs. I just made an appointment for Wednesday.

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sexobon · 06-21-2014, 04:56 PM

Gettin' it over with on hump day, that's A-OK.

orthodoc · 06-21-2014, 09:37 PM

Um ... DOs don't have the corner on looking at the whole person. What they have is some aspects of chiropractic theory, which has no evidence-based support, and an EXTREMELY variable education in some of the aspects of allopathic medicine. Some DOs are very good, in spite of their training. Many are significantly lacking.

As an example - I attended a national convention two months ago, and signed up for a small group session on low back pain that was conducted by a DO. He told us that most low back pain is due to pelvic infirmity. He wouldn't elaborate on what he meant. He had a volunteer lie down on a table and, after palpating, triumphantly declared that the volunteer's symphysis pubis was at least 1 cm displaced. I commented that a 1 cm displacement would be easily visible on plain x-ray, correct? He replied that x-rays are always normal in spite of the 1 cm displacement. This is impossible.

He can't have it both ways; either there are measurable displacements or there are not. He admitted that no displacement that he assures his patients is present is ever provable on x-ray.

To conclude a horribly long story, Lola, I have talked with DOs, I have watched them do their manipulations, and I have done manipulations under their supervision, and not a single patient has ever felt better afterward. I don't agree that their medical training is equal to MD training. And they certainly don't have any basis for a claim to 'look at the whole person' more than an MD. My opinion is that they spend precious training time learning 'crack the back' techniques that help for a few minutes, if that, but don't do anything long-term, except get the patient to come back for more 'crack the back' stuff; and the time they spend doing this is time lost from learning more evidence-based material.

Lola Bunny · 06-21-2014, 10:12 PM

Ugh...I made the appt with the DO doc because she has the highest rating among other MDs and internists in that particular clinic. Go figure. Btw, the DO that you just described sounds like a quack. :p

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infinite monkey · 06-21-2014, 11:30 PM

Shut up fake doc. You lie so much you don't even know when you're doing it.

xoxoxoBruce · 06-22-2014, 03:20 AM

I've had two DOs I was happy with, but then I didn't see them for anything serious.
Chiropractors? The first one performed miracles, then I shuffled through four who were complete charlatans, before I found another good one close to me. Both good ones were Palmer School grads, which may be significant.

orthodoc · 06-22-2014, 09:07 AM

Quote:

Originally Posted by infinite monkey

Shut up fake doc. You lie so much you don't even know when you're doing it.

I don't even ...
Have a good day, IM.

Rereading my post from last night, my statement early on that there are very good DOs gets lost in the story about the charlatan. Story notwithstanding, there ARE very good DOs. If you made an appointment with one who is highly recommended and meets your other criteria, Lola, I'd keep it.

06-19-2014, 07:59 PM	#16
orthodoc Not Suspicious, Merely Canadian Join Date: Oct 2006 Posts: 3,774	In the US, internists are primary care physicians who only see adults. Family practitioners see all ages, from infants to geriatrics. Both are primary care physicians. For what you want, Lola, I would look for someone who sees women in your age range, someone who will address your concerns and who you feel comfortable with. It could be an internist or a FP. DOs are Doctors of Osteopathy; they learn techniques of musculoskeletal manipulation in addition to medical information. They are a sort of hybrid between chiropractors and doctors and are unique to the US; there are none in Canada. MDs come from the allopathic, or traditional, medical school model. In the US there's a great deal of variation in quality between schools of osteopathy (and to a lesser extent, between schools of medicine). Schools of osteopathy can be started on an independent, for-profit basis, and that has led to some very inadequate educational situations. There are also some respectable DO schools. In terms of traditional MD schools, there's also a variation in the US, but less than for DO schools. There's more variation in residencies (graduate training). The US spans a huge spectrum in terms of quality, from literally the best on the planet to minimally-adequate single-hospital programs. __________________ The greatness of a nation and its moral progress can be judged by the way its animals are treated. - Ghandi

06-21-2014, 10:11 AM	#23
Big Sarge Werepandas - lurking in your shadows Join Date: Jun 2008 Location: In the Deep South Posts: 3,408	Pam - I hope you find some way to get your meds. I know how rough things can be. Lola B - Sounds like you got your answers. I wish I was close enough to have Ortho as my doc. She is someone I have complete faith in __________________ Give a man a match, & he'll be warm for 20 seconds. But toss that man a white phosphorus grenade and he'll be warm for the rest of his life.

06-21-2014, 09:37 PM	#26
orthodoc Not Suspicious, Merely Canadian Join Date: Oct 2006 Posts: 3,774	Um ... DOs don't have the corner on looking at the whole person. What they have is some aspects of chiropractic theory, which has no evidence-based support, and an EXTREMELY variable education in some of the aspects of allopathic medicine. Some DOs are very good, in spite of their training. Many are significantly lacking. As an example - I attended a national convention two months ago, and signed up for a small group session on low back pain that was conducted by a DO. He told us that most low back pain is due to pelvic infirmity. He wouldn't elaborate on what he meant. He had a volunteer lie down on a table and, after palpating, triumphantly declared that the volunteer's symphysis pubis was at least 1 cm displaced. I commented that a 1 cm displacement would be easily visible on plain x-ray, correct? He replied that x-rays are always normal in spite of the 1 cm displacement. This is impossible. He can't have it both ways; either there are measurable displacements or there are not. He admitted that no displacement that he assures his patients is present is ever provable on x-ray. To conclude a horribly long story, Lola, I have talked with DOs, I have watched them do their manipulations, and I have done manipulations under their supervision, and not a single patient has ever felt better afterward. I don't agree that their medical training is equal to MD training. And they certainly don't have any basis for a claim to 'look at the whole person' more than an MD. My opinion is that they spend precious training time learning 'crack the back' techniques that help for a few minutes, if that, but don't do anything long-term, except get the patient to come back for more 'crack the back' stuff; and the time they spend doing this is time lost from learning more evidence-based material. __________________ The greatness of a nation and its moral progress can be judged by the way its animals are treated. - Ghandi

06-22-2014, 03:20 AM	#29
xoxoxoBruce The future is unwritten Join Date: Oct 2002 Posts: 71,105	I've had two DOs I was happy with, but then I didn't see them for anything serious. Chiropractors? The first one performed miracles, then I shuffled through four who were complete charlatans, before I found another good one close to me. Both good ones were Palmer School grads, which may be significant. __________________ The descent of man ~ Nixon, Friedman, Reagan, Trump.

06-19-2014, 10:06 PM	#18
sexobon I love it when a plan comes together. Join Date: Oct 2009 Posts: 9,793	I go to a group practice affiliated with a teaching hospital and let the internal medicine residents practice on me. They tell me what they think is causing my issue and I ask them what atypical causes there are for my presentation. Sometimes they politely leave and come back with their attending who usually comes up with something the resident hadn't considered and asks the right questions to rule it out. The residents' diagnoses stand so they feel good about themselves while they learned something. They seem to like this old military instructor who remembers how it was competing for patients to practice on (during core rotations).

06-20-2014, 03:05 PM	#20
Lola Bunny Junior Master Dwellar Join Date: May 2011 Posts: 2,728	Orthodoc: Thanks! You say DOs learn techniques of musculoskeletal manipulation. Do you know how that affects how they treat you or how it could help treat the patients?

06-20-2014, 05:47 PM	#21
infinite monkey Person who doesn't update the user title Join Date: Mar 2011 Posts: 13,002	My doctor is a DO. He is in a practice started when I was a teenager, by two other DOs. There are also a couple of MDs and PAs and NPs, and women and men so I have a choice, depending on what I'm being seen for. In my view, I like the DOs because they look at the whole person, not just current individual symptoms. My medical history matters, and they ask a lot of questions about my life in general too. Also, I was there once for something else and my doc saw that my hips weren't exactly lined up so he cracked me in half and I felt all around better. (Really, the back cracking was awesome.)

06-20-2014, 08:26 PM	#22
Lola Bunny Junior Master Dwellar Join Date: May 2011 Posts: 2,728	Thanks, Infinite!

06-21-2014, 03:51 PM	#24
Lola Bunny Junior Master Dwellar Join Date: May 2011 Posts: 2,728	Thanks everyone for your inputs. I just made an appointment for Wednesday. Sent from my SAMSUNG-SGH-I747 using Tapatalk

06-21-2014, 04:56 PM	#25
sexobon I love it when a plan comes together. Join Date: Oct 2009 Posts: 9,793	Gettin' it over with on hump day, that's A-OK.

06-21-2014, 10:12 PM	#27
Lola Bunny Junior Master Dwellar Join Date: May 2011 Posts: 2,728	Ugh...I made the appt with the DO doc because she has the highest rating among other MDs and internists in that particular clinic. Go figure. Btw, the DO that you just described sounds like a quack. :p Sent from my SAMSUNG-SGH-I747 using Tapatalk

06-21-2014, 11:30 PM	#28
infinite monkey Person who doesn't update the user title Join Date: Mar 2011 Posts: 13,002	Shut up fake doc. You lie so much you don't even know when you're doing it.

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