More than a few patients wonder what Internal Medicine is, or those who assume that these professionals are in charge of operating. This is not something that happens to cardiologists or neurologists, for example, since, in principle, everyone has an idea of what they do.
Internal medicine is a specialty that tries to approach the patient as a whole. The adult patient, over the years, is likely to accumulate various health problems. It may not make sense for each of these problems to have to consult different specialists if the internist is able to manage them well. It is also possible that, if you go to a specialist for each problem, a small conflict may arise, because each specialist may be more concerned about his or her own. I believe that the role of the internist gives balance to the treatment of the complex patient.
Pathologies treated by internal medicine
As I just mentioned, one type of patient would be one with more than one medical problem. For example, a patient who is diabetic, but who has also had a heart problem, and because of the diabetes or because he has had poorly controlled blood pressure, his kidney is not working properly either.
Another type of patient is one who has symptoms of disease that are not well defined. For example, a patient who has been having episodes of fever for two months without any other manifestation. Or a patient who is fatigued. Or a patient who has lost weight involuntarily and perhaps has less appetite. Who should you consult? An internist would probably be the most appropriate specialist to investigate why this happens to these patients and, once the problem has been discovered, find a solution or refer the patient to another specialist, if that is what the patient needs.
Collaboration of internal medicine with other specialties
Finally, at the hospital level, the internist is required by other specialists to ensure that the patient’s evolution is correct. This would be the case, for example, of an elderly patient undergoing hip replacement surgery. For a successful outcome of the operation, it is essential not to forget that this patient has other medical problems (diabetes, heart disease, for example) and that they may decompensate during the operation. The orthopedic surgeon will certainly consult with the internist to ensure a smooth evolution.
The process that every specialist in Internal Medicine must follow is:
The main thing in the diagnostic process is the visit with the patient to question him about his symptoms: if he has had them for a long time or a short time, if they have become more frequent, if they appear at some specific moment of his daily activity, to be able to ask him about other symptoms that he does not refer to because perhaps they did not seem important to him. After this, it is important to examine the patient to auscultate him, explore his abdomen and, in some way, look for clues that have to do with what the patient has just explained.
Finally, probably already with some idea of what is wrong with the patient, help is sought in laboratory tests or imaging tests that can confirm the diagnostic suspicions.
The internist has an exhaustive general knowledge of the different areas of medicine (pneumology, endocrinology, cardiology, etc.) and this global vision is an advantage for the patient. But, logically, he does not pretend to know more than each specialist in his specific specialty. Sometimes the internist will encounter problems that, because of their complexity, exceed his knowledge in a given area and he will have to consult with the other specialists or refer the patient.