Is this normal???

HisChamaoleGirl · November 2012

I posted below (active duty mommys to be) and since then I have come up with a new question. i mentioned my first appt is on the 28. Well I found out it is with "family practice" which are the "jack of all trades" doctors (basically who we go to for sick call and who refer us to other clinics) and not an OB at all.

Should I be concerned? This is only a 8 week "go over my medical history" appointment, but I at least expected it to be with an OB.

My other concern is I was being seen at an REI clinic for infertility issues and have since been put on medication for my thyroid. Bc of the concerns the doctor mentioned at that clinic I feel as if I should see an OB.

HisChamaoleGirl · November 2012

Igoo0304:
If it works like the last base I was at, you'll go in and go over medical history, have blood work (if you haven't yet), fill out all the fun referral paperwork, and get scheduled for an actual OB appointment between 10-12 weeks pregnant. At our base, the OB clinic was always so busy they had family practice did the early appointments before u/s confirmation of the pregnancy.

Thank you!

Its just difficult when we're already having problems and friends with "normal" pregnancies are saying they had already been seen at this point during thier early months.

MiahT · November 2012

My base hospital does not have an L&D and only have five OBs on staff, so most pregnancies are handled by family practice. Only those considered high risk are sent upstairs to the OB department. I was high risk but my first appointment to go over my history was with a family practice nurse, and my second appointment for my dating ultrasound was with the head OB RN and then I was assigned my actual OB for the rest of my appointments (actually, our base encouraged seeing all the OBs because you never knew who would be on call at the delivering hospital when you went into labor).

amb04006 · November 2012

When I saw my PCP to get a referral to see an OB, he told me that "pregnancy up until 12 weeks, unless it's complicated, is a GYN problem, not OB". However, the majority of people I know, including myself with his referral, still had their first OB appointment between 8 and 12 weeks.

GreenFlamingo7 · November 2012

Family Practice docs are qualified to take care of OB patients and pediatric patients, so if you like your doc, you can probably keep the same one for your child. If you get assigned to a Resident, that will be the same doc that delivers you as opposed to going to see an OB and ending up with the doc on call. Given that the Family Practice docs can manage your thyroid and your pregnancy I think you were given a good assignment. See if you like the doc and go from there. Family Practice doesn't mean they are bad physicians, it just means that their specialty area is across all lifespans. Some of my absolute favorite Physicians have worked in Family Practice.

soontobemomma · November 2012

GreenFlamingo7:
Family Practice docs are qualified to take care of OB patients and pediatric patients, so if you like your doc, you can probably keep the same one for your child. If you get assigned to a Resident, that will be the same doc that delivers you as opposed to going to see an OB and ending up with the doc on call. Given that the Family Practice docs can manage your thyroid and your pregnancy I think you were given a good assignment. See if you like the doc and go from there. Family Practice doesn't mean they are bad physicians, it just means that their specialty area is across all lifespans. Some ofmy absolute favorite Physicians have worked in Family Practice.

Not disputing that family docs can be great, but some of the rest is inaccurate. A family doctor is a general doc that is not specialized in any certain area. They didn't receive extra training to specialize. A OB received the same training and then went on to specialize in OB. A ped received the general doc training and then went on to specialize in pediatrics.

If I had special issues in either area I would want the specialist, and I wouldn't want a Family Doc handling a pregnancy with thyroid issues.

GL to you.

NSL · November 2012

soontobemomma:
GreenFlamingo7:
Family Practice docs are qualified to take care of OB patients and pediatric patients, so if you like your doc, you can probably keep the same one for your child. If you get assigned to a Resident, that will be the same doc that delivers you as opposed to going to see an OB and ending up with the doc on call. Given that the Family Practice docs can manage your thyroid and your pregnancy I think you were given a good assignment. See if you like the doc and go from there. Family Practice doesn't mean they are bad physicians, it just means that their specialty area is across all lifespans. Some ofmy absolute favorite Physicians have worked in Family Practice.
Not disputing that family docs can be great, but some of the rest is inaccurate. A family doctor is a general doc that is not specialized in any certain area. They didn't receive extra training to specialize. A OB received the same training and then went on to specialize in OB. A ped received the general doc training and then went on to specialize in pediatrics.
If I had special issues in either area I would want the specialist, and I wouldn't want a Family Doc handling a pregnancy with thyroid issues.
GL to you.

Okay, Soontobemomma isn't even close to being accurate. There is no such thing as "general doc" training unless you're referring to medical school. All physicians complete an intern year where they rotate through multiple specialities but mostly focus on the one they matched with after graduating from medical school, and then spend 3-6 additional years (not including fellowships - your sub-specialists complete those) as residents completing training in their chosen area of practice. A Family Practice residency does include rotations involving OB and GYN care as well as pediatrics. Their speciality is general medical care for all ages, but they may not be equipped to handle complicated cases and would generally call in a consult at that point. A pediatrician completes a Pediatrics residency (not the same thing as Family Practice) and does not recieve additional OB/GYN training beyond one or two rotations their intern year when they have to rotate through every specialty. An OB/GYN also completes a residency specific to their specialty and does not train in Peds or Family Practice.

OP, see the Family Practice doctor and lay out all of your concerns. If you aren't satisfied with your experience or the depth of the doctor's knowledge about your case then move to be transferred elsewhere.

soontobemomma · November 2012

I wouldn't say I wasn't even close. I stand by my assertion that a pregnancy with issues should see a specialist. I don't think a family doc should handle a pregnancy with thyroid issues. In this world you have to take charge of your medical care.

I may have not been clear in explaining the training aspect- but an OB receives much more training in OB than a family doc, and a ped receives much more training in Peds than a family doc.

There are wonderful family doctors out there.

meganroselee · November 2012

Physicians have worked in Family Practice. 

Not disputing that family docs can be great, but some of the rest is inaccurate.  A family doctor is a general doc that is not specialized in any certain area.  They didn't receive extra training to specialize.  A OB received the same training and then went on to specialize in OB.  A ped received the general doc training and then went on to specialize in pediatrics.  

If I had special issues in either area I would want the specialist, and I wouldn't want a Family Doc handling a pregnancy with thyroid issues.

GL to you. 

This is horribly inaccurate. All physicians receive a generalist base in medical school. In residency, everyone specializes. Pedi docs get three years of mostly general peds outpatient and clinic mixed with speciality clinics like endo,nephrology, developmental peds. Family docs get three years of the same general adult care with rotations to include Ob, gun, endo,ortho etc Obs do what is called a rotational internship their first year that is supposed to be more general bit usually amounts to 68mth of Ob gyn rotations and four months of inpt internal med and surgery followed by three years of obgyn. Not even close to doing what fps learn then specializing as this would be a seven year not four year residency. For the average Ob pt, family med care prior to 20 wks is entirely appropriate. Having said that, op someone who just left RE and has hypothyroidism does need a higher level if care. Talk to your FP about this. A good FM doc will be comfortable referring you out GL!

meganroselee · November 2012

NSL:
soontobemomma:
GreenFlamingo7:
Family Practice docs are qualified to take care of OB patients and pediatric patients, so if you like your doc, you can probably keep the same one for your child. If you get assigned to a Resident, that will be the same doc that delivers you as opposed to going to see an OB and ending up with the doc on call. Given that the Family Practice docs can manage your thyroid and your pregnancy I think you were given a good assignment. See if you like the doc and go from there. Family Practice doesn't mean they are bad physicians, it just means that their specialty area is across all lifespans. Some ofmy absolute favorite Physicians have worked in Family Practice. 
Not disputing that family docs can be great, but some of the rest is inaccurate.  A family doctor is a general doc that is not specialized in any certain area.  They didn't receive extra training to specialize.  A OB received the same training and then went on to specialize in OB.  A ped received the general doc training and then went on to specialize in pediatrics.  
If I had special issues in either area I would want the specialist, and I wouldn't want a Family Doc handling a pregnancy with thyroid issues.
GL to you. 
 
Okay, Soontobemomma isn't even close to being accurate.  There is no such thing as "general doc" training unless you're referring to medical school.  All physicians complete an intern year where they rotate through multiple specialities but mostly focus on the one they matched with after graduating from medical school, and then spend 3-6 additional years (not including fellowships - your sub-specialists complete those) as residents completing training in their chosen area of practice.   A Family Practice residency does include rotations involving OB and GYN care as well as pediatrics.  Their speciality is general medical care for all ages, but they may not be equipped to handle complicated cases and would generally call in a consult at that point.  A pediatrician completes a Pediatrics residency (not the same thing as Family Practice) and does not recieve additional OB/GYN training beyond one or two rotations their intern year when they have to rotate through every specialty.  An OB/GYN also completes a residency specific to their specialty and does not train in Peds or Family Practice.
OP, see the Family Practice doctor and lay out all of your concerns. If you aren't satisfied with your experience or the depth of the doctor's knowledge about your case then move to be transferred elsewhere.  

just read this... Very well stated!

JMU_Bride09 · December 2012

In my experience, it varies from military hospital to military hospital. At the hospital where I delivered, you saw an OB in Family Practice unless you were high risk (then you went to the OB clinic). At the hospital where we are now, you can be seen by either one (no distinction). Regarding your infertility concerns, I don't know. That may make it more practical for you to be seen by the OB clinic. But I wouldn't be concerned about the family practice OBs otherwise. My Family Practice OB was the best doctor I've had my entire life.

GreenFlamingo7 · December 2012

soontobemomma:
GreenFlamingo7:
Family Practice docs are qualified to take care of OB patients and pediatric patients, so if you like your doc, you can probably keep the same one for your child. If you get assigned to a Resident, that will be the same doc that delivers you as opposed to going to see an OB and ending up with the doc on call. Given that the Family Practice docs can manage your thyroid and your pregnancy I think you were given a good assignment. See if you like the doc and go from there. Family Practice doesn't mean they are bad physicians, it just means that their specialty area is across all lifespans. Some ofmy absolute favorite Physicians have worked in Family Practice.
Not disputing that family docs can be great, but some of the rest is inaccurate. A family doctor is a general doc that is not specialized in any certain area. They didn't receive extra training to specialize. A OB received the same training and then went on to specialize in OB. A ped received the general doc training and then went on to specialize in pediatrics.
If I had special issues in either area I would want the specialist, and I wouldn't want a Family Doc handling a pregnancy with thyroid issues.
GL to you.

I was the Head Nurse in one of the Army's Family Practice Residency clinics and know exactly what additional training the docs go through for their FP specialization and certification. You have zero idea what you are talking about.

Is this normal???

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