What Exactly is "Internal Medicine"


So, what is "internal medicine"-- a strange term that has persisted for over a century despite periodic efforts to replace it with another designation. Simply stated, it is the specialty of assessment, diagnosis, and treatment of all illnesses in adults, often in collaboration with other specialists, including, of course, surgeons. It is historically the largest of the four broad foundation disciplines of allopathic (and osteopathic) medical science and pactice. (The other three are surgery, pediatrics, and obstetrics/gynecology.) Each of these is now divided into multiple subspecialties. Internal medicine currently has about a dozen subspecialties, including: cardiology, nephrology, gastroenterology, pulmonology, infectious disease, endocrinology, hematology, oncology, rheumatology, and allergy/immunology. Even the subspecialties have their own sub-sub specialties now, as medical science advances exponentially. The specialties of dermatology and neurology are also closely linked to internal medicine. Specialties such as radiology, psychiatry, and physiatry (physical rehabilitation) are independent offsprings, tangentially related to internal medicine. Adult patients frequently see sub-specialists, rather than or in addition to internal medicine specialists ("internists") or family practicioners. This may not always be such a good thing. Suffice it to say, excellent medical care is NOT necessarily proportional to the number of physicians, tests, procedures, or pills a person experiences. Actually it is often inversely so.

(The current specialty of "family practice" combines elements of internal medicine and pediatrics.)

But all of medicine is a “team game.” It's not an individual one. It's like football or baseball, not like bowling or golf. No physician, specialist, or sub specialist can function in isolation. (The concept of “hanging out one’s shingle” is long dead.) We are all dependent on each other— including to be dependent on our non-physician colleagues such as nurses (especially nurses), nurse practitioners, physician assistants, technicians, lab personnel, pharmacists, hospital workers, administrators, etc— to take proper care of our patients.

By definition, all physicians share the "common language” of medical science and medical practice, so that we can communicate with and understand each other. The purpose of medical school and lifelong continued medical education is to teach us this common language. Both we and our patients are in deep trouble if we do not learn it really well.

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