We see a paediatrician but he only does specialist stuff like refer the kids for psych evaluation and medications. He doesn’t do any routine healthcare at all, we see the GP for that.
I’ve always seen a Family Practice doctor. After we moved I searched for a Family Practitioner specifically. We all see the same doctor. I have all my routine gyn stuff handled by him.
When I was pregnant I went to an OB but I had two very high risk pregnancies and my OB was the director of the high risk program at Beth Israel in Boston - I cannot recommend him highly enough.
I like that we all see the same doctor. I can schedule our appointments back to back and take both kids at the same time. We get to know our doctor as a family. He’s aware of much more of our lives this way. He asks me how everyone is when I am in to see him.
I manage my own care too. I see a Nephrologist regularly and make sure he and my PCP communicate often. I have all my meds prescribed through my PCP to make sure there are no problems. We discuss side effects and alternative medicines and interactions. I want to know what is happening with my and my kids’ care. I take notes and leave the office with written instructions for me. Sometimes the pharmacy makes mistakes and I’ve caught them by comparing my notes to the finished prescription.
I take my kids to him and am confident he’s able to handle their care. He found my daughter’s pneumonia right away! He’s good with my kids - he gave them their own nicknames. He also maintains that he is here to give us information and support whatever decision we make. I think he was the only person who did not balk when I said we weren’t circumcising our son!
If he could, he’s remembering it from medical school. I’m an internist, and our training explicitly excludes kids. As I’ve explained to my family a million times, an internist is to adults what a pediatrician is to children. (It’s hard to explain what internal medicine is to people who have never known anything but family doctors, like most people in my family.)
There are two kinds of primary care doctors–those who like to refer to specialists, and those who don’t. I’m definitely in the former category, as long as I’m able to maintain communication with and among the specialists. I have this deep conviction that, if possible, a job should be done by the best person available to do it. I think of primary care as a specialty in and of itself, focused on preventive care, coordination of care, and treatment of basic systemic diseases like hypertension or hyperlipidemia.
That doesn’t mean I want every diabetic to see an endocrinologist, or that I mind providing basic regular gyn care when the patient wants me to. All things considered, however, I’d prefer it if the patient went to a gynecologist for her annual exam. I can do a Pap smear just as well as anybody, but I can never trust my ability to be up on the literature or to pick up on abnormalities the way a gynecologist could.
Of course, after I’m a more seasoned doctor, I may feel differently, especially since I’m going into rural practice. I’ve been thinking about this because I’m trying to decide whether or not to put the time into learning to do flexible sigmoidoscopies. It might be useful, especially in a rural practice, but I’d ultimately feel more comfortable referring patients to a gastroenterologist for a full colonoscopy, which is a better screening test and is done by more capable hands than mine.
I’m not sure I accept the premise that a specialist is “better” for your average person.
We see a FP doctor for everything. For my pap smears, for my obstetrics care, for my general checkups and illnesses, for all of my son’s care (from wombhood through childhood, sick and well-child appointments), for my husband’s flu and skin rashes, etc. We all go to the same guy. Like Qadgop, he has seen hundreds of women through normal, healthy pregnancies and deliveries, and provided medical care for thousands of kids.
I have found him to be up on the latest developments. I can bring up something I’ve read or heard, and he usually has something to add. Now, admittedly, perhaps it helps that he is also on the faculty of the med school and helps train medical students. I was the first patient to whom he prescribed the Nuvaring but he had read up on it exhaustively. He and his practice said “no” to rotovirus when many pediatricians were giving it out–it was later yanked from the market.
When I was pregnant, one of the arguments I heard for seeing an FP doctor is that he or she has a unique perspective because s/he sees the pregnancy through to way beyond delivery. What comes out at the end will ALSO be his or her patient. As will the mother, not just for the postpartum checkup. Of course there are special advantages to seeing someone who has specialized in pregnancy, but an FP is not a “lesser” choice.
Frankly, I find it helpful that when we go in, no matter who among my family he is seeing, my doctor knows significant history and family context, something that I happen to believe makes a difference in evaluating us and knowing what guidance and medical advice to provide.
Of course, it’s important that if we had a special problem, something beyond the scope of his expertise, he would not hesitate to refer us. But we haven’t needed much by way of specialists.
Say, interestingly, my doctor feels the same way in my case–BUT I have had cervical dysplasia and had surgery for it, and at one time was considered high enough risk that I was going every six months for a colposcopy. After ten years of nothing, he has put me in the same camp–he’s okay with me NOT getting yearly gyn checkups. Probably helps that I’m married and am not having any fertility concerns. So what you’re reporting doesn’t seem all that unusual.
The big difference between the US and Australasia is that even if a parent wanted to see a paed for routine care, we couldn’t and claim it on medicare. GPs do referrals which last for a year and there has to be a reason for the referral. I suppose in some rare cases, some parents choose to see a paed for routine care and pay out of pocket but I don’t know why you would. I’ve never come across a paed who does immunisations or diagnoses chickenpox or the like.
Now if my paed would just kindly return my call or answer my email or let me know if I need to get to his office for an emergency visit my day would improve considerably 