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Internal Medicine Experts

Background & Scope

Internal medicine is a branch of medicine that deals with the diagnosis and treatment of adult illnesses. It encompasses a wide range of acute and chronic illnesses and conditions that affect the internal organs of the body such as the heart, lungs, kidneys, and digestive system.

The scope of internal medicine includes the prevention, diagnosis, and treatment. The scope runs from the simple, like flu, to more complex like pneumonia, diabetes, and heart disease. This branch of medicine also includes subspecialties such as cardiology (heart and blood vessel diseases), pulmonology (lung diseases), nephrology (kidney diseases), endocrinology, hematology, oncology, rheumatology, hospitalist medicine, critical care medicine, and gastroenterology (digestive diseases).

Internal medicine physicians, also known as internists, are specialists in adult medicine and have completed additional training beyond medical school to become experts in the diagnosis and treatment of adult illnesses. They often serve as primary care physicians, providing ongoing care to adult patients and coordinating care with other specialists as needed.

One of the key aspects of internal medicine is the focus on the whole person, rather than just their illness. Internists take into account a patient's overall health and well-being, including physical, emotional, and social factors, when making a diagnosis and developing a treatment plan.

Internal medicine also has a strong focus on preventive care, including screenings and immunizations, to help prevent the onset of illnesses and conditions. This includes the management of chronic conditions such as high blood pressure, diabetes, and heart disease to help prevent the progression of these conditions and reduce the risk of complications.

Qualifications, Training, and Certifications

Internal medicine is a highly specialized field of medicine that requires a significant amount of education and training. 

After completing medical school, prospective internists then do postgraduate training, known as residency for three years in internal medicine. This includes rotations through various subspecialties, such as cardiology, pulmonology, nephrology, and gastroenterology.

After completing residency training, internists are then eligible to sit for board certification in internal medicine. Board certification is a process that ensures that a physician has met certain standards of education, training, and knowledge in their field of expertise. In addition to board certification in internal medicine, many internists choose to pursue additional training (called fellowship) and certification in a fellowship field.

Conditions, Diseases, Treatments, and Procedures

Conditions:

Internists diagnose, treat, and provide a wide variety of medical illnesses and conditions, from diabetes to cancer to infections to minor musculoskeletal injuries; the field is very broad. Internists treat conditions affecting the heart, blood, kidneys, joints, and the digestive, respiratory, and vascular systems. Examples of conditions treated by internists include:

  • hepatitis

  • cirrhosis

  • gastroesophogeal reflux disease (GERD)

  • thrombotic thrombocytopenic purpura (TTP)

  • aortic regurgitation

  • bacterial meningitis

  • bronchitis

  • cholecystitis

  • cholangitis

  • diverticulitis

  • heart failure

  • asthma

  • migraine

  • myocardial infarction

  • pancreatitis

  • pericarditis

  • pharyngitis

  • pulmonary embolism

  • respiratory distress syndrome

  • sinusitis

  • variceal hemorrhage

  • gastroenteritis

  • adrenal insufficiency

  • (COPD)

  • hyponatremia

  • otitis media

  • thrombolysis

  • gastrointestinal infections

  • cardiogenic shock

  • myocardial infarction

  • cellulitis

  • skin abscess

  • hemophilia

  • gangrene

  • cognitive impairment

  • dementia

  • peripheral ischemia

  • gout

  • HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets)

  • hyperkalemia

  • hyponatremia

  • intestinal ischemia

  • streptococcal infections

  • toxic shock syndrome

  • rhinitis

  • anal fissure

  • angioedema

  • meningitis

  • pneumonia

  • atrial fibrillation

  • peptic ulcers

  • cardiac arrest

  • pericarditis

  • epilepsy

  • metabolic alkalosis

  • mitral valve prolapse

  • hypertensive encephalopathy

  • QRS-complex tachycardias

  • neuropathies

  • atrial fibrillation

  • ventricular tachycardia

  • mesenteric ischemia

  • osteonecrosis (avascular necrosis of bone)

  • pelvic inflammatory disease

  • perianal and perirectal abscess

  • peripheral nerve disease

  • acute tubular necrosis

  • pulmonary infections

  • retinal detachment

  • pneumothorax

  • diverticulosis

  • Crohn's disease

  • hypovolemia or hypovolemic shock

  • ulcerative colitis

  • sickle cell disease

  • Stevens-Johnson syndrome and toxic epidermal necrolysis

  • Streptococcal pharyngitis

  • supraventricular arrhythmias

  • acute coronary syndrome

  • kidney stones

  • gall stones

  • unstable angina

  • non-ST elevation (non-STEMI) myocardial infarction

  • ST elevation (STEMI) myocardial infarction

  • upper gastrointestinal bleeding

  • urinary tract obstruction

  • rhabdomyolysis

  • Lyme disease

  • hemoptysis

  • small-bowel obstruction

  • mesenteric venous thrombosis

  • endocarditis

  • atrioventricular blocks

  • pregnancy complications

  • sinus bradycardia

  • syncope

  • thoracic aortic aneurysm

  • thyroiditis

  • Transient ischemic attack (TIA)

  • thrombocytopenia

  • hydronephrosis

  • ventricular arrhythmias

  • vertigo

  • viral encephalitis

  • tachycardia

  • corneal abrasions

  • Cushing's syndrome

  • diabetic ketoacidosis

  • hyperosmolar hyperglycemia

  • dysphagia

  • chronic obstructive pulmonary disease

  • spinal epidural abscess

  • bacterial peritonitis

  • toxic shock syndrome

  • osteomyelitis

  • aortic stenosis

  • lactic acidosis

  • lower gastrointestinal bleeding

  • metabolic acidosis

  • pneumothorax

Diagnoses:

Internists are responsible for making diagnoses of a wide range of illnesses and conditions, including:

  • Cardiovascular diseases such as heart disease, hypertension, and stroke

  • Respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), and lung cancer

  • Gastrointestinal diseases such as acid reflux, inflammatory bowel disease (IBD), and liver disease

  • Kidney and urinary tract diseases such as kidney stones and chronic kidney disease

  • Endocrine and metabolic diseases such as diabetes and thyroid disorders

  • Infectious diseases such as HIV and hepatitis

  • Blood disorders such as anemia and leukemia

  • Neurological disorders such as Alzheimer's disease, multiple sclerosis, and Parkinson's disease

  • Rheumatologic disorders such as rheumatoid arthritis and lupus

Treatments:

Internists use a variety of treatments to manage and treat illnesses and conditions, including:

  • Medications to manage symptoms and slow the progression of diseases

  • Lifestyle changes such as diet and exercise to prevent and manage chronic conditions

  • Procedures such as diagnostic tests (e.g.,electrocardiograms), laboratory tests (e.g., blood tests, urinalysis), and imaging studies (e.g., xrays) to help make a diagnosis

  • Referral to specialists as needed

  • Preventive care including screenings and immunizations to help prevent the onset of illnesses and conditions

  • Ongoing management of chronic conditions such as high blood pressure, diabetes, and heart disease to help prevent the progression of these conditions and reduce the risk of complications

Procedures:

Internists and/or subspecialist within internal medicine may be trained to perform a variety of procedures, including:

  • Physical exams

  • Diagnostic tests such as blood tests and imaging studies

  • Procedures such as skin biopsies, joint injections, and lumbar punctures

  • Procedures for the diagnosis and treatment of heart and blood vessel diseases, such as stress tests and electrocardiograms (ECGs)

  • Procedures for the diagnosis and treatment of lung diseases, such as bronchoscopies and lung biopsies

  • Procedures for the diagnosis and treatment of digestive diseases, such as colonoscopies and endoscopies

  • Procedures for the diagnosis and treatment of kidney diseases, such as kidney biopsies

Related Medical Specialties

Internal medicine is a broad field of medicine that encompasses a wide range of illnesses and conditions that affect the internal organs of the body. As a result, it is closely related to several other medical specialties that also focus on specific organs and systems within the body.

One of the most closely related specialties to internal medicine is family medicine. Family medicine physicians, also known as family practitioners, are primary care physicians who provide comprehensive care to patients of all ages, including adults and also includes the core of what is obstetrics and gynecology. Like internists, family medicine physicians focus on the whole person and take into account a patient's overall health and well-being when making a diagnosis and developing a treatment plan.

Another closely related specialty is pediatrics, which deals with the diagnosis and treatment of illnesses and conditions in children. While pediatrics is focused on the care of children, internists and pediatricians often work together to provide continuity of care as children transition into adulthood.

Other specialties that are related to internal medicine include:

  • Cardiology, which deals with the diagnosis and treatment of heart and blood vessel diseases

  • Pulmonology, which deals with the diagnosis and treatment of lung diseases

  • Gastroenterology, which deals with the diagnosis and treatment of digestive diseases

  • Nephrology, which deals with the diagnosis and treatment of kidney diseases

  • Endocrinology, which deals with the diagnosis and treatment of endocrine and metabolic diseases

  • Rheumatology, which deals with the diagnosis and treatment of rheumatologic disorders

  • Geriatrics, which deals with the diagnosis and treatment of illnesses and conditions in older adults

  • Infectious disease, which deals with the diagnosis and treatment of infectious diseases

  • Hematology, which deals with the diagnosis and treatment of blood disorders

  • Oncology, which deals with the diagnosis and treatment of cancers

These specialties are considered subspecialties of internal medicine, and internists who choose to pursue additional training and certification in these areas are referred to as "subspecialists."

Internists typically are the first physician to see a patient with a condition outside their field or that need treatment by another physician: a broken bone, a dog bite, a nail in a foot, an unusual neurologic syptom, and much more, so their scope of knowledge is very broad.

In addition to these medical specialties, internists also often work closely with other healthcare professionals such as pharmacists and radiologists provide comprehensive care to their patients.

Medical-Legal Cases Involving Internal Medicine

Medical malpractice is the most common type of medical-legal case involving internists. One example involving an internist is a failure to diagnose, for example, a cardiac condition leading to a heart attack and the patient suffering additional heart damage as a result.

Another example is misdiagnosis--diagnosing the wrong illness or condition leading to delayed or inadequate treatment.

Another example is a failure to treat, for example, failing to prescribe medication, perform a necessary procedure, or refer the patient to a specialist.

IF YOU NEED An Internal Medicine MEDICAL EXPERT, CALL MEDILEX AT (212) 234-1999.