Talk:Internal medicine

This

This page is really quite messy. It simply provides some loose change on every specialism, without even going into the diagnostic process Technically, radiation oncologists are not Internal Medicine subspecialists. In the US, they are distinct from medical oncologists. DocJohnny 08:46, 21 November 2005 (UTC)

In the UK, clinical oncologists are internists by training. JFW | T@lk 00:25, 22 November 2005 (UTC)

Here in the US, we distinguish between Medical Oncologists, which are IM subspecialists, and radiation oncologists, who are trained in a completely separate track.DocJohnny 06:54, 22 November 2005 (UTC)

The situation in The Netherlands is quite similar to the US one (as it was introduced by Andries Querido). JFW | T@lk 08:20, 22 November 2005 (UTC)

Allergy/Immunology This article leaves out Allergy/Immmunology and Nuclear Medicine as sub-specialties of IM. Just because the ABIM doesnt cover Allergy, that doesnt detract from its connection to IM. Wikipedia doesnt even have an article for Allergy as a medical specialty.

UK General medicine

From what I have read, the UK general medicine docs are more like our family practice docs in that they have training in ob/gyn and pediatrics, is that true?

Not true, at least not anymore. In the past UK general physicians were examined on paeds, but not anymore. JFW | T@lk 08:20, 22 November 2005 (UTC)

A bit of a late reply, but the questioner may be confusing UK general physicians, who are hospital doctors who deal with adult medical (as opposed to surgical, problems) with general practicioners, (often known informally as "family doctors") who work in the community and are the first port of call for the majority of patients, including obs and gynae and paediatrics.

Nice catch on that error 200.75.217.179

I looked past that error numerous times. Good Grief. --DocJohnny 04:40, 27 December 2005 (UTC)

Classification as start

I have classified this article as a start. It needs to be sourced. Capitalistroadster 08:52, 25 June 2007 (UTC)

BrEng

Am I right in thinking that the medical specialty is spelt like that even in British English, where the general word is spelt "speciality"? I'm sure I've seen it used in the UK. 81.153.110.216 03:10, 16 July 2007 (UTC)

IM as the "Doctor's Doctor"

Does anybody know who calls IM Docs "Doctor's Doctor"? I think that this is backwards. IM Docs consult specialties like radiology and pathology to make their diagnoses and then they (IM) treat the patient. radiologists and pathologists are called "Doctor's Doctors" because their job is to advise other doctors and not to treat patients. I think we should delete that section of the article 208.63.240.59 21:23, 28 July 2007 (UTC)

I think you've hit on a major historical point of which the article needs further development - the history of internal medicine as a specialty and the derivation of the term "internal medicine." As it was conceived, practitioners of "internal medicine" were consultants, having taken rigorous training beyond their undergraduate medical education in histology, gross pathology, and medical chemistry. General Practitioners, were the 'doctors' to who internists were "doctor's doctors." The term still applies today, however, to the modern consultants of Internal Medicine, the subspecialists. 132.192.82.245 03:41, 6 October 2007 (UTC)

Internists without MD or DO, "Biomedical Doctors"

If this section means to say that you can be an internist without being a physician then it's wrong... at least in the US, but probably by definition. Whatever a "Biomedical Doctor" is, if they aren't licensed to practice medicine then they can in no way be specialized in internal medicine. 208.63.240.59 21:29, 28 July 2007 (UTC)

I strongly agree with you; I was infuriated to see the inclusion of osteopaths as a branch of medicine. It must be emphasised in this page, (if discussion of this psuedoscience is included at all, which it probably shouldn't) that nobody in their right mind would consider and osteopath a practioner of internal medicine. —Preceding unsigned comment added by 58.166.118.221 (talk) 09:05, 15 January 2008 (UTC)

Three years later, for the record: It depends on where you are. In the United States, for instance, osteopathic physicians' training and scope of practice is equivalent to that of "allopathic" (i.e., regular) physicians. In other words, there are osteopathic internists, and they're just as entitled to call themselves internists as internists who attended non-osteopathic medical schools. This is not true worldwide. As of today, the only mentions of osteopathic medicine in the article are unambiguously region-specific, so all is cool. Rivertorch (talk) 18:33, 12 December 2010 (UTC)

(following the passage of yet another couple years) I think Rivertorch is right...usage of the term "osteopathy" in the US is different from in Europe (and probably everywhere else too). AFAIK most modern DOs don't actually use "manipulative treatment" (which is indeed cheesy...it might help with low back pain, but so can massage, which has the additional advantage of being quite a bit sexier). This point of understandable confusion is discussed in the article Osteopathic medicine in the United States.

208.63.240.59: I'd guess that a "biomedical doctor" is a scientist who does biomedical research. It sounds like it might particularly refer to biomedical researchers who are MDs or MD/PhDs, and who therefore could (at least in theory) be licensed to practise internal medicine (or some other specialty), but have pursued a career in research instead (or perhaps switched to research after practising clinical medicine for a while). (Let me stress just once more that I'm totally speculating here.) Mia229 (talk) 07:32, 23 February 2013 (UTC)

Or DOs or DO/PhDs Mia. I also fail to see what is "cheesy" about osteopathic manipulative medicine. It's not meant to be "sexy" as you put it, but meant to be an adjunct form of treatment (i.e., for low back pain as you say) and is being actively researched. Your comments sound quite POV in my estimation. Regarding the matter of a biomedical doctor, the Biomedical scientist article seems appears to say that biomedical doctor is synonymous with medical scientist, clinical scientist, biomedical scientist, etc. Sounds like they can be a Ph.D., DO, MD, MBBS, or some combination of these degrees (again, this is according to the main article for this title). TylerDurden8823 (talk) 07:36, 23 February 2013 (UTC)

References Section

Since the references section has no actual references, I've taken it out. Until and unless someone goes through and starts listing citations in the text, there's really no need for it.--Aervanath (talk) 17:22, 3 March 2008 (UTC)

Fake information?

The intro mentions "Doctors of Internal Medicine". This is a made up wikipedia term.

It is so misleading that I must put a POV label on it.

Let's not make up information or at least put a citation. JerryVanF (talk) 05:16, 11 May 2008 (UTC)

More opinions.... "Internists are sometimes referred to as the "doctor's doctor," because they are often called upon to act as consultants to other physicians to help solve puzzling diagnostic problems"

Don't internist refer patients to dermatologists, surgeons, and others. So they ask for consultants and are not always consultants themselves. Aren't some of them rarely consultants but just general doctors?

So either find a citation or just eliminate this personal opinion that really isn't true.

This is not to suggests that internists are dumb. They are probably very smart. JerryVanF (talk) 05:19, 11 May 2008 (UTC)

I agree that the article was worthy of a POV alert, which I have removed. I have made a big edit on the introduction, and also added a new section on education and training (this came largely from the entry on physician, on which I have previously made a lot of edits). The next section, on definition of an internist, also need a lot of work and has POV issues, as does the list of subspecialities of internal medicine.

--DavidB 14:51, 30 May 2008 (UTC)

Current Linkage

I recently attempted to add Dallas Nephrology Associates to Internal Medicine page only to find it was deleted as 'advertising'. I believe my link to be more plausible since:

1) This link, http://www.soundphysicians.com/physician-careers/employment-openings.aspx/, which is a 404 page (yet currently linked inside the Internal Medicine page) is listed on the site yet has no value.

2) http://www.henryfordinternalmedicine.com/ , another link on this page, is 100% self-promotional as the landing page depicts.

The link I added was an actual Internal Medicine facility which has nothing for sale. It's a Dallas-based internal medicine facility which is heavily accredited. Therefore, since it's plausible and not selling anything, it should be added and left unaltered.

98.212.117.91 (talk) 12:03, 7 November 2012 (UTC)Dave G.

If there are inappropriate links on the article, that is a reason to remove those links, not to add more inappropriate links. - MrOllie (talk) 14:42, 7 November 2012 (UTC)

How can you call an actual facility 'inappropriate'? That would make every link in that section 'inappropriate' as this would equivocally construed each facility as 'sale-like'. If there was some landing page on the site which begged for money, I could see your deletion as merited; however, since the facility is extremely 'internal medicine' concentrated (unlike the other link on that page: http://www.acoi.org/ ) and doesn't 'collect', 'openly sell' or 'attempt to propagate sales', I cannot see your deletion as having much merit at all. 98.212.117.91 (talk) 15:22, 7 November 2012 (UTC)Dave G.

MrOllie is correct. (Please read the relevant guideline.) I have removed the two links you mentioned above. Rivertorch (talk) 19:02, 7 November 2012 (UTC)

For anyone desiring more information on wikipedia policy regarding advertising, please refer to WP:SPAM. The external link policy provided above, by Rivertorch, may also be helpful. Rytyho usa (talk) 05:08, 9 November 2013 (UTC)

Adding Canada

This would be a step in the right direction for expanding the worldview on this page Tylerdore (talk) 21:23, 4 December 2020 (UTC)

Requesting lead clarifications:

Some issues in the lead are confusing for naive general readers like me:

1. Internist vs Medical intern: It's obvious to medical professionals, but the distinction is important enough to emphasize early in the article, in order to orient general readers. Note that readers seeking to know what an internist is are redirected to this article. The difference is explained very well in a later section, too late for readers trying to select which article to read. The hatnote helps ("For the medical intern, see Internship (medicine)"), but it does not clearly communicate that internist is a completely different designation than medical intern. Perhaps a parenthetical phrase such as "...are called internists (not to be confused with medical intern)..." would be beneficial, even though it breaks the flow.
2. Meaning of the internal medicine as a "specialty": It's very well explained progressively throughout the article, but it is quite confusing at first — what's not equally "internal" for most of the other specialties? The lead explains it with "Internists are skilled in ..." but doesn't make clear that this informally defines the specialty. Part of my confusion arises because it is an extremely broad "specialty", and "subspecialties" exist to cover specific organs and systems. The lead says that "Internists often have subspecialty interests...", but this sounds like they have curiosity or emphasis, rather than the intense training, certification, and focus on a subspeciality, such as cardiology.
3. "Internists care for hospitalized and ambulatory patients ": does ambulatory mean not hospitalized or does it mean outpatient (not hospitalized overnight)? For general readers, the word means capable of walking, which I presume is not relevant in either case.
4. "...may play a major role in teaching and research" is a weak statement that applies to any professional in any field; if they usually play a role please say so. Also, teaching and research do not appear anywhere else in the article. If they are important enough for the lead, shouldn't they be covered in the body?

I'd be grateful to have experts clarify these points for this heavily visited article. –MadeOfAtoms (talk) 23:20, 26 November 2021 (UTC)

Thank you MedKnightSB for thoroughly answering these. –MadeOfAtoms (talk) 03:41, 1 December 2022 (UTC)

Wiki Education assignment: WikiProject Medicine Fall 2022 UCF COM

This article was the subject of a Wiki Education Foundation-supported course assignment, between 24 October 2022 and 18 November 2022. Further details are available on the course page. Student editor(s): MedKnightSB (article contribs). Peer reviewers: As827245.

— Assignment last updated by DrDexterN (talk) 20:28, 14 November 2022 (UTC)

Hi everyone! I am a 4th year medical student with the University of Central Florida College of Medicine. My draft workplan for this article is listed below. Any suggestions are welcome!

Overall, this article needs to be re-written to follow the format provided by Wikipedia for medical specialties, including the following sections (in addition to the Lead): Scope, History, Investigations, Treatments, Training, Ethical and Medicolegal Issues. I will review other higher-rated medical specialty pages including Surgery, Psychiatry, and Radiology for examples and ideas.

Lead: Several clarifications are needed here and were requested by another Wikipedian in the Talk page.  Specifically –

1)     Statement distinguishing “Internist” versus “Medical Intern” and why this is needed. This is important as this is often confused by the layperson as evidenced by the redirection/links to the Internal Medicine article.

2)     Providing more clarification on the Internal Medicine field overall and ensuring that it supports and sets up the rest of the article well.

3)     Providing clarification on terminology, including the term “ambulatory” and ensuring the layperson understands the Lead section fully.  I will have the drafts reviewed by non-medical people to ensure this goal is met.

4)     Expanding on the teaching / research aspect of the specialty.

I will address the following existing and new sections (note: titles are subject to change):

Scope: This is loosely referenced throughout the article, but there is no coherent section addressing the scope of the profession.  I plan to add one.  This will also include reference to inpatient versus outpatient, sub-specialties (which will be listed in another section), and distinction from the often-confused Family Medicine profession.

History: There is a good start to this section including etymology and brief reference to key historical figures and other countries.  I plan to review and expand this section.

Investigations: Since diagnosis and the diagnostic process is foundational to this profession, I plan to add information (with references) on diagnostic approaches used by Internists.  This section is currently sparse and listed under “Medical diagnosis and treatment.”

Treatment: This section is also included under “Medical diagnosis and treatment.”  There are currently a few items listed / linked by sub-specialty.  This is confusing to the reader.  Clarification is needed to address the treatment options used by Internists – general versus sub-specialty – with instructions to visit specialty pages for specific treatment modalities.

Professional Training: This section has US and UK perspectives.  I will add EU and Canada.  I will add others if time and references permit.  Sub-specialties with links (if available) will be included here. There is currently a list of sub-specialties for US and UK, but they need to be updated.

Ethics: I will create this section and plan to include fundamental and emerging issues in medical ethics and professionalism as addressed in the most current (7^th) edition of the American College of Physicians Ethics Manual as published in the 2019 Annals of Internal Medicine.  I will add links to other Wikipedia articles as appropriate.  

MedKnightSB (talk) 19:27, 3 November 2022 (UTC)

To date I have completed the ethics section. I have expanded the diagnosis and treatment section and may leave it under that heading instead of breaking up into investigations and treatment. I may simply retitle it "Investigations and treatment" instead and call it a day.

I am working to expand the professional training section to include more of a global perspective. I added the EU. I plan to add Canada and Australia. I'm still a bit unhappy with the headers of the professional training sections - any suggestions are appreciated. Specifically, there was a header entitled specialty certification that only mentions the US and then a separate header for subspecialities that included US and other countries.

History seems decent.

I have yet to edit scope (there's currently a section that may suffice with some edits) and I'm saving the lead section for last to ensure that all the newly incorporated and reformatted important information is included (and concise).

Any suggestions, comments, edits, etc. are appreciated!! Thank you! MedKnightSB (talk) 11:30, 10 November 2022 (UTC)

Edits completed to date:

Lead: added clarifications requested above - please let me know if further clarification is needed.

Scope: I believe the "Role..." section addresses this adequately. I added information to this section.

History: as edited above.

Investigations / Treatment: Addressed under "Medical diagnosis and treatment" section - I decided to leave the header as is for now. Changes as noted above.

Professional Training: I added additional information to Australia and Canada and provided more to the general certification intro paragraph. I feel that this section may benefit from additional information on other countries including Japan, China, and specific EU member countries.

Ethics: changes as noted above.

Please let me know if anyone in has suggestions / comments. I hope I have added to the overall quality of the article.

MedKnightSB (talk) 18:54, 14 November 2022 (UTC)

Peer review- UCF WIKIMED Project November 2022

Overall:

You did a great job covering the breadth of internal medicine. I liked your inclusion of the various medical boards and the delineation of the process of becoming a board-certified physician. I enjoyed reading the history section and ethics section. It is clear that you put a ton of effort into this article. You were able to accomplish most of your workplan and I commend you for that. For future direction, I suggest adding information on the eastern influences of internal medicine, a graphic depicting the timeline of medical school and residency, expanding on the telehealth section, expanding on the EMR section, clarifying jargon from different countries, and in general adding more information to the subsection for completeness. Listed below are specific recommendations for the article:

1. The initial definition section and the Role of Internal medicine physicians section overlap in contact. I would be more concise to reduce redundancy.

2. History section:

The information outlines western influences on internal medicine. It would be interesting and beneficial to learn some of the more eastern influences. This would increase a global perspective on the article. Could be a future project!

3. Professional education training section clearly delineated the process in the United States. However, the process in the commonwealth countries could be expanded. Also, it would be nice to see a graphic representation of the training because there is a lot of jargon that can be unfamiliar to the general public.

4. In the certification section, I would simplify the jargon under the United Kingdom SubHeading. The core and medical training concepts can get confusing.

5. Charting in the EMR is a big component of an internist’s job. Adding information on this topic will make the article more complete. As827245 (talk) 14:35, 17 November 2022 (UTC)

Thank you so much for your review! You clearly read every section in great detail - I appreciate all of your feedback. I'm glad you liked the ethics section in particular - I put a lot of thought into that. I agree there is still work that can be done to improve the article. I hope that future Wikipedians are able to take your suggestions and incorporate them, even if I do not have time to do all of them! I'm glad you agree that inclusion of more of the eastern perspective would add value to the article. I found some information on Internal Medicine in Japan and China that would be a great start. I will try to add a few sentences on charting in the EMR before the class concludes - that's a great suggestion! It has been a pleasure working on this article. MedKnightSB (talk) 23:27, 17 November 2022 (UTC)