General Practice, Family Practice, and Internal Medicine: What's the Difference?

Primary care providers, family physicians, generalists, and internists can be tricky designations to understand because these healthcare providers similarly cover a number of areas when diagnosing and treating people. However, knowing their differences can be helpful when it comes to finding the right physician for you and your family. 

What is primary care?

Primary care is provided by physicians, who are specifically trained for the first contact or continuing health care for people with undiagnosed health conditions. Primary care is managed and performed by a physician who often works with other healthcare professionals. It also involves consultation, referral, and transfer of care. Primary care also involves the following:

• Promotion and maintenance of health
• Prevention of diseases
• Patient counseling and education
• Diagnosis and treatment of both acute and chronic diseases

Primary care providers (PCPs) are usually the first point of contact between the patient and the medical system to provide patients the access to information and resources they would need to have optimum health. PCPs can provide an evaluation and management of many complex medical conditions including specialist referral if patients need it. 

One of the main roles of a primary care provider is to look into the improvement of public health. This is done by providing an easy access to medical care, which includes the prevention, early diagnosis, treatment, and management of both acute and chronic diseases. 

However, doctors are not all the same. There are numerous healthcare providers with different types of education and specialties. For example, infants and children could see a pediatrician, the whole family could see a family practitioner, adults could go to an internist, and older adults could see a geriatrician.

General Practice

A generalist, also called a general practitioner or GP, is a doctor who provides routine health care to patients, such as physical examinations, screenings, immunizations, diagnosis and treatment of different health problems, including injuries and illnesses. General practitioners usually do not specialize in a specific area in medicine, but provide regular health care to patients at any age. 

People who seek medical care often initially see a GP first. When GPs suspect a serious medical condition in their patients, they may refer them to specialists, who are also physicians but with more training and expertise in specific areas of medicine, such as neurology, cardiology, oncology, urology, and gastroenterology, among others. General practitioners usually work in clinics or private offices. Most of the time, GPs are assisted by staff nurses and administrators. They may also be part of a health maintenance organization (HMO) or a group practice.

Education and Training

It takes four years of an undergraduate program, another four years of medical school, and a 2-3 year residency training program to become a general practitioner. After graduating from medical school, graduates receive a degree in Doctor of Medicine (MD) or Doctor of Osteopathy (DO). Their residency training usually involves working in a clinic or hospital as a resident. General practitioners may complete their residency training in family medicine or internal medicine. 

Family Practice 

Family practice is now called family medicine, which is a medical specialty that is completely devoted to the healthcare of all age groups. The specialist, in this case, is called a family doctor or a family physician. It is a division of primary care that provides a comprehensive personal touch and continuing health care for the individual and their family members and to the community as a whole.

When we talk about the scope of family practice, it usually covers a wide spectrum. Unlike other specific specialties that focus on particular diseases or organs, family physicians see patients of every gender and age (newborns to the elderly) as well as support them in complex healthcare systems. 

Education and Training

After graduating from medical school, family physicians complete their residency training for three years, like other medical specialists. Their residency program includes integrated inpatient and outpatient education as well as training in the following major areas:

• Internal medicine
• Obstetrics and gynecology
• Pediatrics
• Community medicine
• Psychiatry and neurology
• Surgery

They also train in the following medical areas:

• Emergency medicine
• Urology
• Geriatrics
• Otolaryngology
• Ophthalmology
• Orthopedics
• Radiology

Family physicians also provide and manage the following:

• Preventive care (regular checkups, health risk assessments, screening tests, and immunizations)
• Counseling on how to live and maintain a healthy lifestyle.
• Coordinating with other subspecialists when it comes to patients with chronic illnesses.
• Personal and ongoing health care to patients with serious medical conditions from asthma, heart disease, diabetes, stroke and hypertension, and cancer.

A family practitioner is a combined internist and pediatrician, who sees children and adults. The following are subspecialties in family medicine:

• Adolescent medicine
• Sleep medicine
• Sports medicine
• Geriatric medicine
• Hospice and palliative medicine

Internal Medicine

Internal medicine doctors are also called internists, who specialize in adult care. Internists provide comprehensive and long-term adult health care as well as manage diseases from the most common to complex ones. An internist can be a consultant to other specialists or a primary care provider. There are also many internal medicine physicians who teach and are involved in research studies. 

When patients need surgery for treatment, internists usually coordinate with other specialists, such as obstetricians and surgeons, since they do not perform surgery. Internists often have a private practice in clinics or offices. However, they also provide medical care for those who are in hospitals and nursing homes. In general, internists usually develop doctor-patient relationships and act as personal physicians. They perform physical examinations, diagnose and treat both acute and chronic diseases, promote the prevention of illnesses and mental health, as well as substance abuse. Internists also prescribe or give medications, specific treatments, and immunizations. 

Education and Training

After completing a degree in Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO), graduates undergo a general internal medicine residency program for at least three years. Their training includes at least two years of the following:

• Patient contact
• Prevention of diseases
• Diagnosis
• Nonsurgical treatment of adult diseases

With their two-year training, they also spend 20 months in the following settings:

• Inpatient and outpatient services
• Dermatology
• Neurology

They may also spend four months outside of these areas as part of their training. An additional 1-3 years of training may be completed by internists to subspecialize in any of the following areas:

• Infectious disease
• Allergy and immunology 
• Pulmonology
• Rheumatology 
• Gastroenterology
• Endocrinology
• Cardiology 
• Nephrology 
• Hematology
• Medical Oncology

Additional training is usually required to qualify in the following areas:

• Sports medicine
• Geriatric medicine
• Adolescent medicine

Both family physicians and internists undergo additional training as well as pass their licensure examination and certifications to subspecialize. General practitioners, family physicians, and internists are all primary care providers. However, internists specialize in treating adults.