Did you know that the practice of internal medicine can be traced back to ancient India and China? In fact, the term Internal Medicine originates from the German term Innere Medizin. This term was popular in the 19th century and was brought to the United States from American physicians who trained in Germany in the early 20th century. The term Innere Medizin was used to describe physicians who combined the science of laboratory to patient care.
Internal Medicine physicians specialize in adult and geriatric medicine. So what defines "adult?" Well, nowadays that can be as young as 14 years old as kids are reaching adult weight of 50-70kg. In the past when I was in training we used to say anyone older than 16 or 18 years old. But, given the size of the average American, this definition has changed. I am comfortable seeing anyone who is "adult" weight. Therefore, I picked 14 years old as my starting age. You can twist my arm to see 13 year old folks...
The American College of Physicians defines Internal Medicine as the following:
"Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness."
So our favorite question is "why?" This used to drive my parents crazy when I was young. I was that annoying little one that always popped his head up and asked "why?"
It is a lot of detective work and we love looking at data and forming hypotheses. We do not zone in on one diagnosis, but have a list of possibilities and eliminate each one as more clinical information becomes available. I feel like this is being lost in today's "hamster wheel" medicine where everyone is rushed and the average exam time is 7 minutes.
We treat ear infections, eye infections, headaches, post stroke care, post heart attack, high cholesterol, diabetes, adrenal issues, thyroid issues, copd, asthma, pneumonia, skin infections, depression, anxiety, any mental disorder, arthritis, urinary tract infection, prostate issues, trouble urinating, impotence, diarrhea, constipation, any gasterointestinal diseases, arrythmia, heart failure....I think you get the idea.
If the illness is beyond the scope of internal medicine or a special procedure is needed, a referral is made to a specialist.
We are skilled in suturing, skin biopsy, skin tag removal, cautery, joint injections, some do botox injections and liposuction, and various other small office procedures.
In addition, the major skill is prevention and early recognition of disease or pathology. So, coaching clients through current guidelines for screening for breast cancer, colon cancer, heart disease, high cholesterol, and much more is critical in the care of our community.
This is what excites me about my new practice! As a hospital physician I treated post stroke care, acute heart attacks, head bleeds, severe infections with multi-organ failure and all that was gratifying. But, there were some cases where I would sit with my head in the palms of my hands thinking, "if only she had an internist or the internist had more time in taking care of her, or her medications would be affordable...if only..."
I'll be honest, I did cry at times for my patients because many times it is not their fault. The system has failed them and they suffered such a catastrophic event that will only cost the system and more importantly the individual significant dollars.
Thus, prevention, wellness, and being a coach is as, if not more important, than treating an acute illness. So when people ask, "why do I need an internist?" I usually tell them, "well you can get one when you get terribly sick in the hospital with a large bill or you can get one now and prevent a catastrophic event if possible." More importantly, life is about building relationships. The sooner you find an internist you like and can partner with, the better you will feel and likely live healthier. Statistics show that people do better with a good support system regardless of what the issues they are dealing with - medications are not always the answer.
Sometimes people just need to talk. In my model, I will have time to listen. Maybe the anxiety or panic attacks you are experiencing is because of an acute issue you are dealing with. Does it make sense to prescribe an anti-anxiety medication in 7 minutes of hearing your story or does it make more sense to listen and see if we can work out a solution together and only prescribe if needed? I argue that these quick visits are leading to unnecessary prescribing, imaging, and laboratory - this all drives rising costs for everyone.
I have passion for science and am amazed at our progress. But I also understand that there are things in this world that we still do not understand. Sure, not everything is in our control. But, I believe with the knowledge and technology that we have today, prevention of disease and the management of disease is not only our responsibility but it will allow us to take care of each other. As I tell all care-takers, you have to take care of yourself before you take care of others. We have to be there for each other and more importantly be healthy when we stand together; or else we both fall.
Living healthy does not have to cost so much nor should it be a burden.
So, join my practice and let's do this together! Let's live life to it's fullest and I will be honored if I can be your internist in this journey we like to call life!
"He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all."