On the lesser importance of internal medicine: is it right to forget about it?

Abstract

FORUM FOR INTERNAL MEDICINE On the lesser importance of internal medicine Introduction Internal medicine constitutes a unique medical specialty. Not only does it include both outand in patient care, but also involves acute cases and life -threatening conditions. Subjectively, in my view, internal medicine is the essence of medicine, and all the attempts at the reduction of the physician’s role in the health care system result in the system instability. The physician’s scope of activity is extremely wide and is deeply rooted in pathophysiology. When I started my professional journey, the most important educational element was a specialty in internal medicine—extremely difficult and demanding. At that time, the 2-step system required constant education and practical verification of skills. Furthermore, a natural consequence of choosing internal medicine was the necessity of active participation in on-call shifts, especially at the Accident and Emergency Department. Nevertheless, this extremely hard and difficult path gave my friends and me much professional satisfaction, as well as a feeling of being the elite—the chosen ones who can establish a good diagnosis on the basis of an interview, a physical examination, and additional tests. What is more, other hospital departments were unable to function properly without the internal medicine specialist. However, nowadays, there are many of those who would gladly pronounce this specialty dead, and treat it as an unnecessary relic of the past. Some even claim that physicians used to be the opponents of progress. The abovementioned preposterous theses do not reflect the reality and are unfair towards the doctors whose knowledge is frequently underestimated. All in all, it might give the impression that knowledge and clinical practice have become less vital in face of modern imaging, equipment, and laboratory possibilities. In my view, neither the equipment present in our profession, nor any of the biochemical test possibilities, will ever substitute the physician. On the other hand, these novelty methods are extremely expensive, FORUM FOR INTERNAL MEDICINE