Sick adults often see an internal medicine physician.
An internal medicine physician, or internist, specializes in the medical treatment of adults. The name internal medicine suggests physicians who specialize in treating disease of the internal organs, but internists may also treat diseases of the extremities, muscles or bones. While many internists practice a kind of general medicine, most sub-specialize in the treatment of diseases of a particular organ or organ system.
Definition
The American College of Physicians, a national association of internal medicine doctors, describes internal medicine as specialization in the prevention, detection and treatment of illnesses in adults. The specialization excludes any particular expertise in treating injuries, performing surgeries, providing obstetric care or caring for children. Internists often have the knowledge to treat more serious, rare or complex adult diseases that may exceed the expertise of general practice physicians, who then consult with internists.
Sub-specialities
Internists may sub-specialize in any of several medical areas, including diseases of the heart (cardiology), hormonal systems (endocrinology), blood (hematology), digestive system (gastroenterology), kidneys (nephrology or immune system (immunology, which often includes allergies). Some internists do not sub-specialize and instead practice a kind of general or primary care medicine, being the first to see a particular patient who might have any disease. Others serve in a consultant role for the complex or difficult cases beyond the scope of primary care or general practice physicians.
History
The discipline of internal medicine has its roots in 19th-century Germany, where such physicians strived to combine laboratory science with patient care. It then established itself in the United States as German-trained American physicians returned home to practice. The American internists soon began collaborating and communicating, establishing professional associations and then certifying medical students who choose to specialize in internal medicine.
Training
Like all physicians, internists must attend medical school for four years and then do a residency for three years. Some academic internists who train residents recently began pushing for shorter residency programs in internal medicine so that new internists can begin their sub-specialization training sooner. The authors of an article on the subject, published in December 2008 in Academic Medicine, reflect on the arguments in favor of such changes, but in the end defend the traditional practice of a long and extensive residency in general internal medicine.
Internal Medicine as Family Medicine
An opposite trend emphasizing general medicine over sub-specialization may also threaten the traditional approach to internal medicine. Many internists treat various members of a single family (teenage children, parents, grandparents), offering a kind of general family practice. Meanwhile, many pediatricians treat children well into post-adolescence, and many family practice physicians treat the whole family from newborns to the elderly. An article published online for Medscape Family Medicine in March 2009 examines the merging internal medicine, family medicine and pediatrics into a single, new specialty.
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