General Medicine

General Medicine


General medicine or internal medicine deals with the diagnosis, prevention and treatment of undifferentiated or multi-system disease processes. Internal medicine is mostly considered for adults. The internal medicine patients are often seriously ill and complex investigations might be required. That is why most of the internists offer their services in hospitals. The internists, i.e. the doctors involved in general medicine mostly have subspecialty interests in diseases that affect certain organs or organ systems.

The doctors are skilled in managing patients who are suffering from acute and chronic symptoms and medical conditions.

What is involved in general medicine?

The doctors who are experts in general internal medicine or GIM are involved in managing uncertainty, diagnostic reasoning and deal with co-morbidities (the complex medical problems that involve multiple conditions and symptoms) and recognise when care or speciality opinion is required. The work also includes:

  • Treatment and diagnosis of a wide spectrum of acute medical disorders and function in the emergency departments of hospitals or acute medical units. They offer specialist opinion and offer appropriate care.
  • Treatment and diagnosis of medical conditions in outpatient clinics.
  • Providing care and advice to patients who are admitted to the clinic under other specialities, e.g. obstetrics, surgery and gynaecology, developing other medical problems.
  • Managing outpatients and inpatients with co-morbidities. This includes elderly patients suffering from dementia and frailty.

The doctors who expertise in General Internal Medicine forms a part of the acute medical team. This includes those who are practising geriatrics, acute medicine and other specialities like endocrinology and diabetes, gastroenterology, cardiology, respiratory medicine, rheumatology and renal medicine. Most of the doctors in this field have a sub-speciality or another physician speciality. The others combine GIM with a non-clinical role or academic research.

What is the role of the internists?

The internists or internal medicine specialists are trained in  managing a multisystem disease or complex disease conditions. The single organ disease specialists might not be equipped to deal with such problems. They can deal with undifferentiated presentations that do not fit in the expertise of single organ speciality, like fatigue, dyspnoea, chest pain, weight loss, change in conscious state and confusion. The doctors manage the serious cases of acute illnesses that might be causing problems in multiple organ systems at the same time. They might even help to combat multiple chronic diseases in a person.

It is not true that general internal medicine specialists offer less expertise than single-organ specialists. They are trained in caring for patients with simultaneous problems.

Treatment of a disease that is not localised to a single organ can be quite complex. Often the internists act as the primary care physicians. However, they should not be confused with general practitioners or family practitioners. The training of such physicians might be solely restricted to adults and might include obstetrics, surgery and paediatrics. The internists are defined as those physicians who are specialised in the detection, prevention and treatment of the illnesses in adults. These specialised doctors practise both in clinics and hospitals and cater to the requirements of the patients.

Authored By Dr.V.Sivakumar (M.B.B.S., M.D., FIPM)

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