Internist treating complicated conditions versus family practice doc advice...please help!?

my internist is treating my heart failure, Diabetes, hyptertension, and pulmonary fibrosis and HIV. I was told by my family practicioner that I need to be referred to other subspecialists. I told my internist and he said no referral. I am confident in his management. what should i do? listen to the family practice doc or listen to my internist? why did the family doc tell me to seek other subspecialists if my internist is competent?

The internist is an MD with a specialty in internal medicine. So he can still treat any medical condition if he so desires. Maybe your GP thinks you should see specialists that specialize in each condition you have. That is silly if one doctor can competently treat them all. I say if your happy with your internists treatment than stick with what works.

not sure about your med system, but if i am right and your internist can treat them all then let him if you like him and feel confident than this is good. gp's are specialists in general medicine. our gp's here do the general easy stuff and if they feel overwhelmed or unsure then the send to a physician who recommends tests and then on to a specialist. a gp can go strait to a specialist and a physician can treat most things. otherwise you need a respiritory physician, an endocrinologist an immunologist and a cardiologist. it is what u feel comfortable with. you have some pretty major health probs. and alot of them you go for symptom control not cure, as in heart failure. if you feel that you are getting good symptom control then stay as you r.

Physicians aren't gods so they are very capable of making mistakes. From what I've learned so far in med school, I know it would be impossible for any one person to know everything there is to medicine so your family physician's recommendation for referrals to subspecialists is sound. On the other hand, a doctor's diagnoses are often influenced by the information they're most comfortable with so you may get 5 different treatment plans from 5 different subspecialists. I think the criteria you should use to determine if you should seek subspecialists lies in how well the internist is managing your symptoms and keeping your body functioning. If you're doing fine as you mentioned and he's the meticulous type that doesn't cut you off when you talk to him about your condition, you should probably be okay until you develop some serious complication that you'll want to see a subspecialist for. Heart failure, diabetes, and hypertension are all common enough for an average internist to see enough and be competent in. I'd be on the lookout for any problems that come out of your pulmonary fibrosis or HIV though, because they're far less common so your internist may not be as aware of the most recent advances in therapies.