It’s time to replace the internist with an internal medicine doctor

OWhen my kids were young, they repeatedly asked, “Dad, what does ‘internal medicine’ mean? The term “internal medicine” is not intuitive to what we do as internal medicine physicians and continues to be confusing to many.

Defining the role of internal medicine within the health care system has been a challenge since the field began in the late 1800s in Germany. It was then that a group of “internal medicine” doctors began to apply scientific knowledge related to medicine to treat their patients, which differed significantly from the way medicine was practiced at the time. Sir William Osler brought this approach to patient care to America, and with it came the name “internal medicine.” It’s a confusing name that contributes to a popular lack of understanding of the range of clinical activities, types of practice settings, and job responsibilities that the specialty of internal medicine encompasses.

Adding to this confusion is the fact that those who specialize in internal medicine are often referred to as “internists.” It is a confusing and dated term, which has persisted over time by tradition and practical concern as a shorthand reference to the field of “internal medicine”. A clear problem with being called “internists” is that people often mistakenly confuse us with medical interns – doctors in training who have completed medical school but do not yet have a license to practice. medicine without supervision. This means that patients do not always understand why or when they see an internal medicine doctor or how the role of one of these doctors is different from that of a medical intern.

The confusion is further compounded by the fact that some subspecialists have titles clearly based on the organ or system they care for (e.g., cardiology, pulmonology, gastroenterology, nephrology), while others have easier-to-understand titles, such as a pediatrician’s role in caring for children, or a surgeon in the operating room. Some people wonder if we internal doctors deal exclusively with internal organs. (We don’t.)

It’s time for us to stop calling ourselves “internists” and officially claim the title “internal medicine physician”, which more clearly denotes our training, knowledge and clinical expertise. This change would help unite us as critical thinkers specially trained to understand a multitude of diseases, the connections in the body and the social environment of patients.

Confusion and ambiguity about our name and our role is detrimental, preventing people from understanding the depth and breadth of our specialty and the range of activities, types of practices and professional roles it encompasses. Without a clearer sense of identity and understanding of our collective professional impact, we risk an erosion of credibility and influence, and a lack of appreciation or understanding of the role and value of physicians in internal medicine in today’s healthcare environment.

Grouping people trained in internal medicine under the aegis of “internal medicine physicians” clarifies our training and our professional status. It also allows us to harness the power of our collective contributions across the health system and across the world, influencing better health outcomes and healthier communities.

As a specialty, internal medicine is broad and includes both generalist internal physicians and internal medicine subspecialists, making it difficult to succinctly articulate the breadth and depth of knowledge internal physicians have. The diversity within the specialty of internal medicine provides us with the opportunity and ability to practice in the variety of clinical settings we practice and types of patient care we provide.

Despite the ambiguity of the term, internal medicine is the cornerstone of comprehensive healthcare, vital for patients and other healthcare professionals. Our diverse roles within healthcare and our ability to thrive as critical thinkers make our specialty an essential component of healthcare. So, it’s good news to see the record number of medical students who have been matched into internal medicine residency programs this year.

I was drawn to this field because I was intrigued by the complex diagnostic challenges, which not only required a great depth of knowledge, but also a unique and engaging opportunity to connect and support patients throughout their journey. adult life. I have also been inspired by the relationships and perspective that internal medicine offers with internal medicine colleagues, trainees and leaders across medicine, working to evolve and align healthcare to improve the well-being of the patients I serve. Finally, I loved the prospect of being part of a community of internal medicine physicians working in many healthcare roles and settings who could provide me with invaluable feedback, support, guidance, and collaboration.

The value and impact physician interns bring to patients and healthcare systems is beyond doubt. Internal medicine is an incredibly diverse community of professionals. Our comprehensive training provides a solid foundation that creates opportunities for a variety of career paths as specialists and subspecialists, in clinical care settings and far beyond.

So, to my fellow internal medicine physicians across the country and around the world, join me in celebrating our profession, embracing our common roots, and proudly claiming the title of “internal medicine physicians” to help bring light this specialty. Let’s embrace a real retreat from the term “internist”. Together, we improve the lives and experiences of patients, create healthier communities, and help shape effective and innovative healthcare for the future.

Ryan D. Mire, MD, MACP, is president of the American College of Physicians.