A primary care choice for Chicago patients: internist or family doctor?
Whether needing a physical or suffering a cold, Patricia Mackin of Chicago trusts her primary care to Dr. John Revis, a highly rated internist with Evanston-based NorthShore University HealthSystem.
When needed, Revis refers her to specialists like the endocrinologist she sees for diabetes, but all report to him so he can monitor her overall health. “He knows me ... and spends time answering all my questions,” Mackin says. She adds she prefers internists since they specialize in treating diseases that affect adults.
As the population ages and chronic conditions become more widespread, demand for primary care grows. The American Academy of Family Physicians and the Association of American Medical Colleges project the need to add 39,000 to 45,000 primary care doctors 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 completing medical school and a three-year internal medicine residency. “We’re focused on adult non-surgical care and also do complex, chronic disease management,” says Revis, who practices in Glenview, Ill.. Many pursue fellowship training in areas like cardiology and pulmonology. But about 100,000 like Revis currently practice in the U.S. as general internists, providing primary care for adolescents and adults.
Family physicians provide a hub for patient care, too. According to the AAFP, the 228 million annual visits to a family physician account for about one in four of all doctor visits in the U.S. — more than for any other specialty. They work mainly in office settings after completing a three-year residency that includes internal medicine training. But they also see obstetric and pediatric patients. “We’re creating caring relationships with the entire family,” says Chicago-based family physician Javette Orgain, who serves on the AAFP’s board.
General internists and family doctors share a focus on prevention and wellness. But internists say adult patients, especially those with complex health issues, benefit from their in-depth internal medicine training, while family doctors say their range of experience serves children and adults, including those with chronic conditions, equally well.
Prospect Heights, Ill., member Marsha Clesceri sees highly rated Dr. George Lagorio in Des Plaines, Ill., the same doctor her husband, Tony, saw as a child. She says his history with the family enhances the quality of their care. “It’s more comfortable for us to go to him and share issues,” says Clesceri, who consulted Lagorio about kidney stones and her late mother-in-law’s dementia.
Insurance nor price favor one specialty over another, says Susan Pisano of America’s Health Insurance Plans and Jeff Rice, CEO of Healthcare Blue Book. But demand for primary care means some doctors may not accept new patients and some rely on nurse practitioners and physician assistants.
Experts recommend finding a provider you trust, regardless of specialty. Based on insurer-negotiated rates, Healthcare Blue Book estimates the fair market price in Chicago for a new patient to see either doctor for a 30-minute visit at $198. The fair price represents what a health service provider typically accepts from insurance companies as full payment, which is less than the billed amount.