Which medical specialty is best for you?

Created date

March 2nd, 2018
A geriatrics specialist meeting with a patient.

A geriatrics specialist meeting with a patient.

When the practice of medicine began in ancient times, doctors were, for the most part, generalists. Since then, specialization has become a common trend, but one thing that hasn’t changed is the role of the primary care doctor.

Primary care 

According to the American Academy of Family Physicians, primary care involves promoting and maintaining health, preventing disease, educating patients, and of course, diagnosing and treating acute and ongoing health conditions. 

Most primary care providers are family medicine doctors or internal medicine doctors. (Increasingly, nurse practitioners and physician’s assistants are also seeing patients who need comprehensive primary care.) When you are choosing a primary care provider, however, you may be confused about which specialty is best for acting as a primary care provider. 

Family medicine 

The specialty of family medicine became popular in the 1960s and developed from the general practitioner role. “Instead of being focused on a specific patient population, such as men, women, older adults, or children, family medicine doctors are generalists,” says Teri Dreher, R.N., C.C.R.N., owner and CEO of NShore Patient Advocates in Chicago, Ill. 

Along with disease management, a family doctor has a broad skill set. They emphasize preventive care, health maintenance, and care continuity. They are adept at identifying resources and coordinating services among numerous providers. “If a patient requires complex case management or services, a family doctor can consult with a specialist and still remain as a primary care provider.”

Family medicine providers can be especially valuable in geographical regions where specialists are not available, such as in rural areas. Their breadth of knowledge and ties to the community make them indispensable to patients in remote regions. They get to know their patients very well and can detect subtle changes that may signal a health problem.

Internal medicine 

According to the American College of Physicians (ACP), internal medicine as a specialty came about beginning in the late 1800s because of the scientific knowledge that was increasingly being applied to the management of disease. In addition, internal medicine doctors began to focus more on adult patients when pediatrics emerged as a separate area of medical practice in the 1900s. Training for internal medicine providers usually includes significant experience in medical subspecialties, including cardiology, endocrinology, infectious diseases, and neurology. To care for adults, however, internal medicine providers must also gain experience in psychiatry, rehabilitation medicine, palliative care, and dermatology, among other specialties. 

“Internal medicine providers are experts at management of common chronic diseases such as diabetes, hypertension, and certain respiratory ailments,” Dreher says.


When it comes to geriatrics, a doctor born in Austria who became a U.S. citizen coined the term in 1909, but the specialty as we know it today was developed in England beginning in the 1930s.

According to the American Geriatrics Society (AGS), most geriatricians have an internal medicine or family medicine background. They receive special training and certification in providing primary care to seniors with complicated medical problems or difficult social circumstances. 

“Geriatricians treat the same chronic medical conditions as other physicians, but they understand the special care needed for seniors,” Dreher says.

Geriatricians understand the practical needs of seniors and understand the individuality of each person’s aging process. They believe strongly in partnerships and sharing decisions with patients and families. They take the lead in coordinating care with medical specialists as well as social workers, therapists, dietitians, and pharmacists. 

The best primary care provider for you

“If you are in fairly good health, it’s not imperative for you to see a geriatrician just because you are over age 65,” says Jennifer Tam, M.D., medical director at Linden Ponds, an Erickson Living community in Hingham, Mass. “Seniors who are happy with their current provider should stay put unless their care becomes too complicated.”

Some seniors rely on a specialist for primary care services. “For example, a cardiologist may be the best person to provide primary care for a long-term patient with a long history of heart disease,” Tam adds.

According to the AGS, a geriatrician should be considered to provide primary care when significant functional impairment has set in because of numerous medical conditions, or when caregivers begin to feel overwhelmed trying to safely care for their loved one.

“When a senior begins to develop age-related syndromes such as dementia, falls, malnutrition, and incontinence, then a geriatrician may be the best choice,” Tam says. “Ultimately, however, it is up to you to choose.”

Did you know?

A doctor of osteopathic medicine (D.O.) can also be your primary care provider. He or she receives the same training as M.D.s, with additional experience in the nervous system, musculoskeletal system, and chiropractic care. D.O.s also practice a holistic approach to patient care.

Source: American Osteopathic Association