Currently in medical care in the United States, there are four main primary care specialties: family medicine, internal medicine, pediatrics, and geriatrics. Internal medicine is primary care for adults, pediatrics is primary care for children and infants, and geriatrics is primary care for seniors. Family medicine, the broadest specialty, is primary care for all ages.
A family medicine physician is a medical ‘home base’ for patients. They treat all ages, all sexes, all organs, and all diseases. They can see every member of the family, from birth through old age. This allows family medicine doctors to develop long-term relationships with their patients and to understand how their patients’ role in the family affects their health. They can provide check-ups, immunizations, screening services, gynecological exams and obstetric care, routine health care, and health counseling. When more specialized care is needed, a family medicine doctor can refer their patients to appropriate specialists. They can become educators and advocates for their patients in the sometimes overwhelming health care system.
As health care changes in this country, family medicine is a growing specialty for families and individuals who are seeking more personalized health care and a more personal relationship with their physician.
What is Sleep Medicine?
Sleep medicine is the medical field that deals with the diagnosis and treatment of conditions related to sleep and rest. This can include difficulty sleeping well at night or problems with daytime sleepiness. Sleep medicine specialists treat patients of all ages who need better rest.
When people think of sleep disorders, they often think of insomnia. That’s one kind of sleep disorder, but there are several others. In addition to insomnia, a sleep medicine specialist may treat conditions such as:
Shift work disorder
Circadian rhythm disorder
Severe or recurrent jet lag
Treatments may include medication, light therapy, cognitive behavioral therapy, or CPAP therapy. CPAP, which stands for continuous positive airway pressure, is one of the most commonly prescribed treatments. These tiny machines have a tube and mask and blow a stream of air over the face at night, helping patients with snoring or sleep apnea to breathe easily and sleep more soundly.
One important tool often used in sleep medicine is the sleep study or polysomnogram, where patients sleep either in a lab or at home with a monitoring device. The sleep study allows doctors to measure the quality of sleep over an entire night, check for various sleep problems, and identify breathing disorders such as sleep apnea. If performed in a lab, you will arrive and spend the night sleeping in a bed similar to one in a hotel room. You may have electrodes attached to your head and chest to monitor your breathing, oxygen levels, brain waves, and heart rate. Technicians collect the information, which your physician can use to identify and diagnose disorders that have been interrupting your sleep.
Not getting enough rest at night makes you feel terrible, can make it difficult to do the things you need to do, and can even put you at higher risk for physical and mental health problems. Feeling tired all the time can be a huge quality of life issue. If a sleep disorder is preventing you from getting enough rest, a sleep medicine specialist can help you manage the problem so that you have the energy to enjoy your life.
Geriatrics is the subspecialty of internal medicine that provides primary care to older adults. Physical health tends to decline with age, and geriatricians work to manage such age-related concerns as chronic illness, frailty, multiple medications, and declining mental health to keep seniors as active and independent as possible.
Some of the most common concerns seen by a geriatrician include:
Mobility issues, including the need for canes and walkers, as well as preventing falls
Osteoporosis, a weakening of the bones, which affects as many as a quarter of all men and half of all women over fifty
Loss of hearing or vision
Incontinence, or the inability to control one’s bladder
Memory loss, including dementia and Alzheimer’s disease
A geriatrician may also provide their patients with comprehensive care that includes checking on their social health. Seniors are at increased risk for poverty, loneliness, abuse, and injuries in the home. As part of their health care, a geriatrician may inquire about family support, living conditions, or the ability of a patient to perform daily self-care tasks.
In some cases, a geriatrician may serve as an advisor to other physicians on a specific case or condition. However, most of the time geriatrics is a primary care specialty, and geriatricians provide routine health care to the older patients they work with.