To the Editor:

Not only do many patients misunderstand the difference between internists and family physicians, but as the years pass, so do I. I didn’t find the answer in “Recommendations for the Future of Family Medicine” [April 2004, page 34]. Even internists should be following the recommendations set forth in the article.

Perhaps the only distinction between the two specialties is our ability to practice obstetrics and pediatrics. However, given current malpractice premiums, I doubt most family physicians deliver enough babies to make it worth their while to continue. And obstetricians are more likely to recommend a pediatrician to provide the immediate postpartum care. This is most likely because family physicians spend approximately one year of their residency practicing pediatrics (most of that in outpatient settings), whereas pediatric residents spend three to four years practicing nothing but pediatrics and spend a good deal of time in the delivery suite.

The differentiation between internists and family physicians becomes even more daunting when confronting reviewers from the Joint Commission on Accreditation of Healthcare Organizations. I would like to have some answers in the future when confronted with this question.