IM Specialties

[Dawg_MD]

Is it possible to just do an IM residency and then do a specialty of it without doing a fellowship? The reason I am asking is that my wife saw a gastroenterologist who performed a colonoscopy, but he was only an internist.

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[hamburgler]

internists and family practice ppl can do sigmoidoscopies (i'm not sure about colonoscopies). you don't have to be a GI doctor to do them.

 

[mandownunder]

General Internists in private practice can do colonoscopies, bronchoscopies, echocardiographies, stress tests or anything that they are comfortable with.

 

[AJM]

Originally posted by mandownunder
General Internists in private practice can do colonoscopies, bronchoscopies, echocardiographies, stress tests or anything that they are comfortable with.

Good luck getting Medicare or other insurance companies to compensate you for these procedures if you're not board certified in those specialties (let alone getting hospital privileges to use their facilities for those procedures). You're also putting yourself at risk for huge liabilities if you are doing them without board certification, especially for colos and bronchs, which have their own sets of potential complications. Some general practitioners might do some of those types of procedures, but they are generally in a very rural area. (a stress test might be an exception -- I know one GP who does those once in a while.)

General practitioners do sigmoidoscopies, however. (Actually, NP's do them too). But even after working with physicians in private practice, I've never heard of a GP or FP doing a full colo or bronch.

 

[southerndoc]

An internist who is my rural medicine preceptor does about 7-10 bronchs per month, does echoes and stress echoes, and also does stress tests.

Keep in mind that there is no pulmonologist or cardiologist practicing where this physician does.

Medicare reimburses him for all procedures. Blue Cross/Blue Shield was giving him some trouble with reimbursements for the stress echoes. I haven't heard if he got that resolved or not.

Oh yea, he also interprets sleep studies.

 

[smackdaddy]

Originally posted by Dawg_MD
Is it possible to just do an IM residency and then do a specialty of it without doing a fellowship? The reason I am asking is that my wife saw a gastroenterologist who performed a colonoscopy, but he was only an internist.

i am not sure if 'only' is appropriate, but if he was 'only' an internist then he wasn't a gastroenterologist.

the answer to your question you already know, since your wife has already been through the procedure done by an internist. several people were grandfathered in. it is possible to do them without fellowship, all you need is certification. no one will certify you without gi training these days, unless you are really in the sticks.
but if you quit fellowship after one year, you probably have done enough to get certified and then could do them, if you could find a hospital to give you privileges. getting reimbursed is another discussion.

 

[Behcet]

anybody can do any procedure if you find somewhere to let you do it and an insurance company to pay you for it. it's not unusual for internists to do things like echos. actually, some FP programs train their residents to do colonoscopy (for rural med where there are no GIs). i've interviewed at one program where they mentioned that their outpatient curriculum includes teaching their IM residents how to do things like sigmoidoscopy, treadmill tests, and ultrasound, but i don't know of any others that specifically teach those skills.