March 14, 2007

AMARILLO – Going to the "doctor" doesn't always mean a patient is seeing a doctor of medicine, a Texas Cooperative Extension specialist said.

Sorting out the ABCs of the medical profession can sometimes be daunting, said Andrew B. Crocker, Extension program specialist-gerontology in Amarillo.

Knowing the difference between an intern and an internist and knowing whether the physician is a osteopathic doctor or a medical doctor can help people choose or understand the level or care they are receiving, Crocker said.

For instance, medical students are interns and internists are doctors of internal medicine. There are many types of physicians, each with his or her area of expertise:

• General practitioners treat a wide variety of health problems – they do not specialize in one area of medicine.

• Family practitioners are doctors who provide care for all ages and are a popular choice if looking for one doctor for the entire family.

• Internists provide care for a wide spectrum of disorders. Many medical specialties require education as an internist before further specializing in a branch of medicine.

• Specialists are internists with additional training in a certain area. For example, a cardiologist is specially trained to treat heart problems.

General practitioners, family practitioners and internists provide what is called primary care, Crocker said.

"They treat diseases and conditions but also advise you on how to prevent health problems," he said. "While some specialists also provide primary care, many prefer not to practice general medicine."

A doctor of medicine (MD) and a doctor of osteopathic medicine (DO or osteopath) generally have the same educational background and length of study. Both are required to complete an undergraduate degree followed by four years of medical school and then a residency program, Crocker said.

A residency program is done in a specialty area such as surgery, gynecology or psychiatry, he said. All physicians must then pass state licensure requirements and examinations.

Osteopathic medicine is dedicated to treating and healing the entire patient as a whole, rather than focusing on one system or body part, Crocker said. An osteopath often uses a treatment method called manipulation – a hands-on approach to assure that the body is moving freely.

Osteopaths hold to the principle that a patient's history of illness and physical trauma are written into the body's structure, he said, and the osteopath's job is to "set" the body to heal itself.

Over the years, the gap between conventional medicine and osteopathic medicine has narrowed, Crocker said. Medical doctors have embraced some osteopathic premises, such as the impact of stress on the immune system or posture on various body systems. And osteopaths have incorporated the diagnostic and treatment techniques common to conventional medicine.

"In the end, it really becomes a matter of personal preference," Crocker said. "The determination about which doctor to see should depend more on skill, professionalism and individual personality rather than the initials behind his or her name."

Some patients will be treated by a nurse practitioner, who is a nurse with graduate training, he said. Nurse practitioners can serve as a primary care provider in family medicine, pediatrics, adult care or geriatrics, and women's health care and family planning.

Nurse practitioners are allowed to provide a broad range of health care services, he said. Some work in clinics without a doctor's supervision, while others work with doctors as part of a joint health care team. Their scope of practice and authority depends on state laws. In some states, they can prescribe medications.

A physician assistant can provide a wide range of services in collaboration with a doctor, Crocker said. Physician assistants practice in nearly every medical and surgical specialty area and allow the doctor to focus skills and knowledge on specific things.

When looking for a physician or care giver, talk to friends and family about health providers they recommend, he said.

"Perhaps your current health provider can even make some recommendations," Crocker said. "Nurses in your doctor's office or at your local hospital might be able to offer recommendations, since they often work with several health providers."

For more information, visit the "Choosing a Primary Care Provider" page on the National Library of Medicine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001939.htm .