Charlotte primary care: internist or family doctor?
To treat a persistent cough caused mainly by acid reflux disease and other complex problems, Elizabeth Anderson of Charlotte sees specialists.
But to get the broader view of her health, she always returns to her primary care doctor. “He just kind of speaks my language,” says Anderson of highly rated Dr. Edwin Shoaf, a Charlotte-based internist. “He’s able to see this larger picture.”
As the population ages and chronic diseases like diabetes become more widespread, demand for primary care grows. The American Academy of Family Physicians and the Association of American Medical Colleges project the need for an additional 39,000 to 45,000 primary care physicians by 2025. Many people see an internist or family physician, but most remain unclear on the differences between the two.
Internists often practice in a hospital after graduating medical school and undergoing a residency that focuses on problems affecting adolescents and adults. Many pursue training in areas like cardiology, but about 100,000 currently practice in the U.S. as general internists that provide primary care.
“Part of the role of center of the wheel,” says highly rated Dr. Thomas Parker of Parker Internal Medicine in Charlotte. Internists guide care, and often weigh in on specialists’ recommendations.
Family physicians also provide a hub for patient care. According to the Family Physicians group, the 228 million annual visits to a family doctor account for about one in four of all doctor visits in the U.S. — more than for any other specialty. Family doctors typically complete a residency that includes internal medicine training. But they also see obstetric and pediatric patients.
“‘Birth to earth’ we sometimes call it,” says highly rated Dr. Rhett Brown of Presbyterian Family Medicine Midtown in Charlotte. Some go on to specialize in areas like geriatrics, but primary care remains the central focus.
Internists like Fred Ralston Jr., immediate past president of the American College of Physicians, say adult patients, especially those with complex health issues, benefit from their in-depth internal medicine training. Family doctors say their range of experience serves children and adults equally well.
“I can’t help but see that’s a good thing,” says Charlotte member Alice Cauble of the age ranges seen by her highly rated family doctor, Larry Maugel of Matthews Family Physicians. Maugel teams with specialists to help Cauble manage issues from sleep apnea to followup from spine surgery.
Neither insurance nor price favor one specialty over another, according to Susan Pisano of America’s Health Insurance Plans and Jeff Rice, CEO of Healthcare Blue Book. But growing demand for primary care means some doctors may not accept new patients and some rely more heavily on nurse practitioners and physician assistants, so be persistent in finding the right provider for you.
Healthcare Blue Book estimates the fair market price in Charlotte for a new patient to see either doctor for a 30-minute visit at $165. The fair price represents what a health service provider typically accepts from insurance companies as full payment, which is less than the billed amount.
Above all, experts say, choose a primary care provider you trust. “Specialty is an important consideration, but not the only consideration,” Ralston says.