Important topics in internal Medicine
What Is Internal Medicine?Internal medicine is a medical specialty in which physicians apply scientific knowledge and clinical expertise to diagnose and treat adults with a very broad range of health concerns and diseases. Physicians who specialize in internal medicine are called internists or general internists.By Sridhar Nadamuni, Debra Fulghum Bruce, PhD (Editor) Medically Reviewed by Robert Jasmer, MD Last Updated: May. 25, 2021
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iStock Differences Between Internal Medicine and General/Family PracticeWhile they are both primary care doctors and the terms are often used interchangeably internists are not the same as general practitioners and family physicians. One of the key differences is that internists see only adults, and family practitioners see both children and adults. Show
General InternistsGeneral internists are uniquely qualified to practice primary care and follow patients through their adult lives. Some internists work as hospitalists, delivering primary care in hospital settings; others provide only out-patient care. General internists may also practice in rehabilitation centers and long-term care facilities. Internal medicine doctors are trained to provide:
General Family PractitionersUnlike internists, general family practitioners do not solely concentrate on adults and may practice pediatrics, obstetrics, and do minor surgery. Family physicians can treat a full range of medical issues and provide acute, chronic, and wellness services for patients. Family physician training involves:
Family medicine training also includes behavioral health, common skin diseases, population health, and health system management, wellness, and disease prevention. Specialized TrainingInternists are medical doctors who specialize in preventing, diagnosing, and treating a wide variety of diseases and other health issues that affect adults. They are experts in health promotion, disease prevention, and the care of problems both simple and complex, acute and chronic. Internal medicine training includes general medical education, as well as time spent rotating among a variety of subspecialty clinics, both in-patient and out-patient. Internal Medicine SubspecialtiesInternal medicine trainees gain experience working in areas that include:
Internal medicine trainees spend at least one year caring for hospitalized patients, with at least three months in intensive/critical care settings. They undergo hospital-based training for at least one year, with additional exposure to in-patient subspecialties such as cardiology, hematology-oncology, or gastroenterology. Recognized internal medicine subspecialties include:
Internal Medicine/Body ConnectionInternal medicine is the study, diagnosis, and treatment of conditions that affect the internal organs conditions such as heart disease, hypertension, diabetes, obesity, and lung disease. Internal medicine specialists often care for people with complex, chronic, and multisystem disorders. Based on their subspecialties, internists may work with doctors in other medical specialties or consult on patients referred by another specialist. Treating a Broad Range of Internal Medicine ConditionsInternal medicine doctors diagnose, manage, and treat a wide range of conditions. These include cancer, infections, and conditions affecting the heart, blood, kidneys, joints, and the digestive, respiratory, and vascular systems. Examples of conditions treated by internists include:
Internal Medicine Tests, Procedures, and SurgeriesInternal medicine specialists perform or order tests, procedures, and surgeries based on patients condition, overall health, and wellness goals. I believe that to a degree we have become too reliant on diagnostic testing, says Aldo Arpaia, MD, a Castle Connolly Top Doctor in Staten Island, New York. An internist with a subspecialty in emergency medicine, Dr. Arpaia is affiliated with Staten Island University Hospital. Thats not to say there arent prudent and timely diagnostic tools at the internists disposal that have value and can improve the quality of care. These include the OralID® cancer-screening device and non-invasive coronary artery calcium scanning. Coronary artery calcium score testing helps us determine the atherosclerotic load in asymptomatic patients at increased risk for heart disease, says Dr. Arpaia. Calcium scoring can help us to identify and treat at-risk patients more aggressively. According to Dr. Arpaia, in training his house staff the basic tenet has become known as the Arpaia rule of nines: 90% of your answer comes from a detailed history, 9% from the physical exam and 0.9% from testing. And with the rise in the incidence of head and neck cancers, internists are on the front lines of oropharyngeal cancer screening. The Centers for Disease Control Prevention (CDC) recommends that all adults 18 and older get screened annually. Internists as well as nurses and other providers are trained to perform many types of medical procedures, the use of which can vary greatly by specialty, diagnosis, and treatment. Providers need experience and skill and in many cases, additional training and medical credentials to perform these procedures, as well as to minimize patient discomfort, optimize outcomes, and reduce side effects. Internal medicine specialists commonly perform procedures that include:
Some internists have been trained in more complex and/or invasive diagnostic and therapeutic procedures, such as thoracentesis, lumbar puncture, and paracentesis. Categories and other types of tests and procedures an internist might perform include:
Internal medicine and many other medical specialties use ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) to guide invasive procedures. Flexible fiberoptic instruments may be used to access hard-to-reach areas of the body. Major Professional Societies for Internal MedicineMajor professional societies for internists include:
Breaking News and Information on Internal MedicineThere are new advances in internal medicine all of the time. This includes new medications and types of surgery that improve how internists can help their patients. Because of this, its important to stay up to date on the latest news. Here are a few reliable websites where you can stay current on the latest news and information within internal medicine:
Q&A with Aldo Arpaia, MDAldo Arpaia, MD, is a Castle Connolly Top Doctor in Staten Island, New York. An internal medicine doctor who subspecializes in emergency medicine, Dr. Arpaia is affiliated with Staten Island University Hospital. Nice to meet you Dr. Aldo A. Arpaia Staten Island, NY Internal Medicine View Profile Q: How do you encourage people to make lifestyle adjustments that will improve their present and future health? As for things people can do to improve their present and future health, diet, exercise, and statin therapy where indicated can help slow the progression of coronary artery disease. An active lifestyle does indeed improve outcomes, as does refraining from tobacco and excessive alcohol use. Patients under 45 should consider being vaccinated against human papillomavirus (HPV). Q: Who should be on a persons health team besides an internist? |