Internal Medicine is a specialty of medicine that deals with the overall view of the health of the adult person. It encompasses both acute and chronic diseases, as well as predisposing factors to the development of these diseases in the future. Internal Medicine takes care of the patient as a whole person, focusing on the diagnosis and non-surgical treatment, without focusing only on a single anatomical part of the body, organ or system.
For ease of understanding, a definition is proposed based on data compiled by Drs. William B. Bean, 1982, and Paul B. Beeson, 1986. Beeson, in 1986: “Internal Medicine is a medical specialty dedicated to the comprehensive care of the sick adult, focusing on the diagnosis and non-surgical treatment of diseases affecting their internal organs and systems, and their prevention”.
What exactly does an internist do? What are his or her functions?
Broadly speaking, we can identify 5 functions of an internist:
- Evaluation of symptoms and signs of a patient with a given condition to reach an accurate diagnosis through a differential diagnosis (set of possible diagnoses more or less likely).
- Evaluates the causes and predisposing factors that have led the patient to present a disease.
- It provides a treatment oriented to treat the symptoms and/or causes according to the diagnosis.
- It follows up the patient over time in order to cure or control the disease.
- In addition, what is crucial and differentiates the internist from other specialties is primary prevention (avoiding the acquisition of the disease), secondary prevention (avoiding its progression) and tertiary prevention (avoiding complications and improving the quality of life).
If the diagnosis or treatment of a condition exceeds the internist’s competence and requires study, assessment, technology or surgical intervention by another specialty, the internist will refer the patient to the appropriate specialist for further care.
An internist may work in Emergency Departments, Home Hospitalization, Palliative Care Units and Infectious Disease Departments, among others. They usually work in hospitals with admitted patients, but also on an outpatient basis through outpatient consultations and Telemedicine.
In general, an internist sees chronic, multi-pathological and polymedicated patients, i.e., with multiple medical conditions and simultaneous treatments, thus being a link between different specialists.
What are some incorrect topics about Internal Medicine?
- Internal Medicine is not a surgical specialty, i.e., an internist does not operate.
- Internal Medicine is not a family physician working in a hospital.
- Internal Medicine is not disappearing or destined to disappear because of specialties. In fact, in many countries, in order to become a specialist in a medical specialty (non-surgical), it is mandatory to have two or three years of Internal Medicine beforehand.
What are the differences between Internal Medicine and General or Family Medicine?
Internal Medicine is dedicated only to adult patients, usually from 14 years of age. Family Medicine can take care of patients of all ages.
Internal Medicine is a specialty that treats outpatients and patients admitted to a hospital. Family Medicine does not see hospitalized patients, only in Health Centers.
The family physician will refer to the Internal Medicine specialist any patient who requires a more in-depth, thorough and sometimes urgent approach to a pathology.
Sometimes a study or treatment must be comprehensive, encompassing all the patient’s conditions, in order to unify criteria, complementary tests and optimize treatments. Internal Medicine is the reference specialty.