When you think you need to go to the doctor, do you know which doctor to go to? Maybe you are having heart palpitations off and on and are worried about that. Or you are having muscle spasms in your legs at night. Or a persistent cough that doesn’t seem to be connected with a cold. Do you see your family medicine practitioner or do you head straight to an internal medicine specialist?
Two doctors at the UCHealth Primary Clinic – Rockrimmon have some answers.
Dr. George Meyers practices family medicine at the clinic. But he’s not hung up on terminology.
“I think that we just practice primary care,” he said. Most people would define it as taking care of whole families, from newborns to geriatrics, “cradle to grave,” he added. “We deal with all diseases, all health issues.”
His background includes serving as an Army physician, remote medicine, emergency work and hospitalist work. He’s seen it all. Three years ago, he settled into outpatient family practice with the Rockrimmon group.
As a family physician, he experiences a lot of variety in his work. He gets simple to complicated cases at all age levels.
“The nice thing about family medicine is we get to change up our schedule a lot more. I might treat a diabetic adult with kidney disease, then a child with an ear infection. The nice thing for me is the variety. It keeps you challenged, but also maintains skills in lots of different areas.”
He knows where his skills lie. He doesn’t do deliveries anymore, but he does a variety of outpatient procedures including vasectomies.
“Mostly, we just do what has to be done,” he said, “using our best judgment and common sense.”
Though he doesn’t have a “typical” patient per se, he does have typical patients in each age category.
For example, in the ages 18 months to 4 years old, the typical toddler comes in for wellness checks, vaccinations and the occasional illness. “Sometimes a parent wants their child to see the same family physician, especially if there is a special need, like autism.”
School-age kids into teens are usually seen for school and sports physicals, routine care, and the occasional illness.
A typical young adult (ages 20-30) sometimes just wants a checkup or a look at specific medical concern.
Typical patients from 40 to 60 years of age often are looking at evolving health issues, and seeking preventative medical care.
By age 60 and older, some adults have developed chronic health issues that need more frequent attention, such as congestive heart failure, chronic lung disease or chronic kidney disease.
He also treats sports injuries and has quite a bit of experience with that. “Having been an Army doctor, it’s hard to avoid that,” he said.
“I think the biggest thing for some people is knowing your entire family is being treated by the same person,” he said. Sometimes, he finds himself treating four generations of the same family.
Doing so gives him a better picture of that family’s issues as well as health needs. He knows the caretakers and who’s dealing with mental health issues that may affect others. He knows which grandparents are caring for grandkids and may be under stress. He has a feel for family dynamics.
“It’s also rewarding, because you get to assist the whole family through situations,” he said.
Dr. Laura Longwell, a doctor of osteopathy specializing in geriatric care, practices in the same clinic with Dr. Meyers.
“We area clinic offering both internal medicine and family medicine – it did used to be all family medicine, but it changed a year ago when I joined the practice,” she said.
Patients ask all the time: “What’s the difference?”
So, she explains.
For one thing, she only treats adult patients, 18 and older, and in fact most of her patients are middle aged (40-50) and older.
”I’m not a geriatrician but I am interested in geriatrics,” she said. “And by the very nature of what I treat, many of my patients are older.” Her patient profile is mostly defined by the types of issues and illnesses she treats – persistent or chronic medical concerns, like diabetes, hypertension, high cholesterol, heart disease, congestive heart failure or chronic kidney disease.
These are illnesses that often affect patients the rest of their lives, “but I try to be positive. Instead of saying there’s no cure, I tell them, ‘We can manage this and you can have a good life, Mindset really makes a huge difference. You can have chronic diseases like COPD or heart disease, but that doesn’t mean you’re going to have a miserable life.”
Her biggest frustration, she said, is overcoming a previous thought process put into place by a different health care provider. She has had patients who rejected health care for too long because they were given discouraging news by another provider.
I think (we) should be mindful about what we are telling a patient,” she said. “We’re supposed to be kind and caring people. Being kind can go a long way toward being therapeutic.”
After finishing medical school she did three years post-doctoral training as a resident at a hospital, where she spent a lot of time caring for patients in intensive care. She worked with many specialists in cardiology, gastroenterology, nephrology, infectious diseases, hematology, auto-immune diseases, pulmonary and critical care.
“You get used to pretty sick people, and see the worst-case scenario of many diseases,” she said, “so I have a great deal of background in all those areas.”
An internist is “kind of like a health care coordinator. You can manage all those things, order some of the diagnostics and interpret some of them, but when you put the pieces together, you sometimes have to refer patients to specialists,” she said. “You need to have a healthy knowledge of your limitations, too.”
She also tries to be cognizant of health care costs.
“If I think I’m going to refer a patient, I don’t do a lot of workups,” she said. “They’ll just be repeated.”
The bottom line
So which doctor do you see?
“Honestly, I don’t think there’s a real discriminator,” Meyers said. “It just comes down to preference and fit. It’s really hard to say. A few years ago, internists mainly did hospitalist work. That’s no longer true.”
Longwell said: “Internal medicine has the benefit of focusing just on adult care, which allows us to go a little deeper into these medical problems.” And she adds: “I have to give family medicine physicians a whole out of credit as they take care of everybody and that is a vast amount of information to know.”
In other words, it’s really up to the patient to decide.