Family physicians and internists: differences in practice styles and proposed reasons

This is a review of published reports comparing family physicians with internists. The results show that family physicians are more likely to stay in their field of training; to locate more frequently in rural and underserved areas; to see fewer referred patients; to have similar case severity; and to engage in more obstetrics and gynecology, surgery, trauma, acute illness, and pediatrics. Family physicians spend less time per patient, ask fewer history questions, obtain fewer physical examination items, order fewer diagnostic studies, make referrals less often, and hospitalize patients less often. The reasons for the practice style differences between family physicians and internists are likely to be multiple, but they probably include such factors as: training, decision-making expertise, patient demands, types of visits, office staff, economics, and attitude. The implications of the proposed reasons for the differences are discussed.