Internal
Medicine, nonsurgical medical specialty concerned with diseases
of internal organs in adults. Physicians who specialize in
the field, known as internists, are skilled in disease prevention
and in managing complex disorders of the body. Internists
may be either generalists or specialists.
General
internists typically act as personal physicians, developing
long-term relationships with patients. Internists give patients
regular physical examinations, offer preventive care, diagnose
and treat most nonsurgical illnesses, and refer serious
or unusual cases to an appropriate specialist. If a patient
complains of persistent stomach problems, for example, a
general internist might refer the patient to a gastroenterologist,
an internist who specializes in disorders of the digestive
system.
Within
the field of internal medicine, nine subspecialties are
recognized: cardiology, the treatment of diseases of the
heart and blood vessels; endocrinology, the study of glands
and other structures that secrete hormones; gastroenterology,
the care of conditions of the digestive tract, liver, and
pancreas; hematology, the study of blood and blood-forming
tissues; infectious disease, the study of severe or unusual
infections; nephrology, the diagnosis and treatment of kidney
diseases; oncology, the study and treatment of cancerous
tumors; pulmonary disease, concerned with disorders of the
lungs and other components of the respiratory system; and
rheumatology, the treatment of disorders involving joints
and other connective tissues. An additional subspecialty
gaining prominence is geriatrics, the study of diseases
affecting older adults.
The
development and widespread use of many technologies have
enabled internists to perform procedures that formerly were
considered the responsibility of surgeons. For example,
a procedure called endoscopy, performed using an illuminated
tubular instrument called an endoscope, permits doctors
to examine and photograph internal organs and manipulate
tools inside the body without invasive surgery. Another
tool, a narrow tubular device called a cardiac catheter,
permits physicians to inject drugs or fluids directly into
the heart.
The
origins of internal medicine date back to the late 19th
century, when the practices of general medicine and surgery
began to split into separate disciplines. Over time, internists
became hospital-based generalists who played a role somewhere
between those played today by family physicians and surgical
specialists. Since the mid-1990s internal medicine in the
United States has shifted from a primarily generalist field
to a discipline in which roughly 65% of all internists are
certified as sub specialists.
Those
seeking a career in internal medicine must obtain a medical
degree and complete a three-year in-hospital internal medicine
training program. Internists interested in a subspecialty
must spend one or two additional years studying that discipline
and must pass a certification test. The specialty board
for internal medicine, the American Board of Internal Medicine,
was established in 1936.
