Who is an internist?
Internal medicine is a discipline that primarily focuses on adult medical conditions using advanced medical science and procedures. An internal medicine specialist, commonly known as an internist, treats conditions in the body's internal organs and systems and is an expert in treating a broad spectrum of health issues. Internists use a combination of medication, doctor-patient relationships, and preventive care to provide complete adult care. Apart from internal problems, they can also treat ear infections, skin rashes, diabetes, and hypertension.
Internists possess the scientific knowledge to provide diagnoses and treatment plans and develop a good relationship with their patients, helping them devise holistic medical interventions and treat conditions with complex comorbidity.
To become an internist, one must complete at least seven or more years of medical school. During their postgraduate training, it is mandatory to dedicate three years to honing practical medical skills like diagnosing, treating, and providing preventive care. The basic training they receive prepares them to start practicing internal medicine under the supervision of a senior doctor. After medical education, doctors can choose either path: general internist or specialized internist. Doctors who manage chronic illnesses or treat various conditions are general internists. Others may opt to receive certification in their desired sub-field, such as cardiology or gastroenterology, and may have to undergo additional training for one or two years.
What is general internal medicine?
General internal medicine is a broad and flexible field. It consists of the two most recognizable types of practice - general internal medicine and hospital medicine. In general medicine, doctors follow a panel of patients over a long time and provide various services like preventive and chronic care in an ambulatory setting. On the other hand, clinical work in hospital medicine often focuses on caring for hospitalized patients. Other practices also fall under primary care medicine, but none are mutually exclusive. For example, general physicians can practice ambulatory and hospitalized patients, specialize in a sub-field, or change their clinical focus during their careers.
Internal medicine physicians usually engage in practices that do not fall under the traditional general or hospital medicine category. For example, some internal medicine physicians build clinical practices where they work within a multispecialty system. These doctors manage patients with complex medical issues, work in urgent care, or engage in rehabilitation or extended-care settings. They might exclusively focus on women's health, point-of-care ultrasound, addiction medicine, or perioperative medicine. Doctors in general internal medicine may also invest much of their time and effort in medical education, schools, or residency settings.
The nature of the training provided by the general internal medicine branch uniquely prepares the doctors to engage in academic and administrative activities. Physicians working in an educational setting contribute heavily to medical education among students and internal medicine residents. Furthermore, they actively research the evaluation of treatment, the effectiveness of medical care systems, public health and safety, and quality improvement. They also take up administrative leadership roles in hospitals, academic departments, and the leadership of medical organizations.
During their combined residency training program, they get experience working in different settings, including university hospitals, community teaching hospitals, intensive care units, subspecialty clinics, and outpatient clinics. Due to their progressive responsibility in training, they acquire various skills and gain competency in ambulatory care. The Accreditation Council on Graduate Medical Education supervises all residency training in the United States.
What are the subspecialties of internal medicine?
Subspeciality training, or fellowship, usually requires two to three years of training beyond the internal medicine residency. All physicians receive the same basic internal medicine training. Doctors who acquire training in a subfield use an appropriate title to refer to themselves. For example, physicians specializing in heart diseases are called cardiologists, and those specializing in childcare are called pediatricians.
The American Board of Internal Medicine has certified various subspecialties. Internal medicine physicians can opt to focus their clinical practice on any of the following:
- Cardiovascular diseases: These comprise any disorders of the heart and vascular system. These doctors treat adult congenital heart disease, cardiac electrophysiology, heart failure, transplant, and interventional cardiology.
- Endocrinology, diabetes, and metabolism: This subfield focuses on diagnosing and treating disorders in the endocrine system and the connected metabolic dysfunctions. Endocrinologists treat hypothalamic disorders, pituitary diseases, parathyroid abnormalities, thyroid diseases, and adrenal cortex dysfunctions.
- Infectious diseases: Physicians can specialize in treating bacterial, viral, fungal, and parasitic infections in any body area.
- Gastroenterology: Doctors have extensive knowledge of the gastrointestinal system, including the esophagus, stomach, small intestine, liver, gallbladder, pancreas, colon, and rectum. Specialists are experts in treating gastroenterology disorders and how they affect the surrounding areas of the body.
Physicians can also opt to work in other fields from the vast list of specialties. Their subspecialty training is broad and deep, enabling them to practice efficiently. Some of these specialties include;
- Hematology: The study of blood and related disorders. Specialists trained in this subspecialty are called hematologists and hematopathologists. They specialize in diseases of the blood and its components like blood and bone marrow cells. Hematological tests can help diagnose infection, anemia, hemophilia, blood clotting disorders, and leukemia.
- Nephrology: Doctors who are experts in nephrology are called nephrologists. They diagnose and treat kidney-related conditions and disorders, and kidney failure. Sometimes, autoimmune and cardiovascular disease, and high blood pressure (hypertension) also affect the working of the kidneys. Nephrologists are trained to deal with such conditions as well. They may perform common tests and procedures like imaging tests, kidney function tests, dialysis, kidney biopsy, and kidney transplant care.
- Oncology: A medicine branch that involves the diagnosis and treatment of cancer. It entails medical oncology (the use of hormone therapy, chemotherapy, and other drugs to treat cancer), radiation oncology (using radiation therapy for cancer treatment), and surgical oncology (the use of surgery and other medical procedures to treat cancer). Oncologists not only diagnose and treat cancer but also help people cope with the stress and anxiety related to it.
- Pulmonary disease: The subspecialty of internal medicine that entails the diagnosis, treatment, and management of the respiratory system (includes the lungs, upper airways, thoracic cavity, and chest wall) disorders. Specialists specializing in this field are called pulmonologists. They commonly evaluate and treat diseases like asthma, chronic obstructive lung disease (COPD), interstitial and occupational lung diseases, lung cancer, emphysema, complex lung and pleural infections, and sleep-disordered breathing.
- Rheumatology: Deals with the diagnosis, prevention, and management of systemic rheumatic diseases, crystalline diseases, vasculitis, spondyloarthropathies, inflammatory muscle disease, osteoarthritis, osteoporosis, recreational sports injuries, soft-tissue diseases, and trauma. Rheumatologists aim to diagnose and treat these conditions early to prevent disability and death.
Common chronic diseases in older adults treated by internists
Various chronic diseases affect adults as they age. Some of the most common ones treated and managed by internists in adults 65 years and above include the following:
- Hypertension or high blood pressure: A condition wherein the force of the blood on the artery walls is constantly high, making it harder for the heart to pump blood. Untreated hypertension can lead to many complications, such as heart attack and stroke. Generally, there are no symptoms, but some may experience headaches, shortness of breath, and nosebleeds.
- High cholesterol: It leads to fatty deposits in the blood vessels, making it tough for the blood to flow. It can increase the risk of heart attack, heart disease, or stroke. This condition, too, produces no symptoms.
- Arthritis: A painful condition of the joints—consisting of 100 types, the most common types being osteoarthritis and rheumatoid arthritis. It causes swelling, inflammation, pain, and joint stiffness that can worsen with time and age.
- Coronary heart disease: A condition in which it is difficult for the blood vessels to supply nutrient-rich and oxygenated blood to the heart. It is usually a result of high blood pressure and high cholesterol. Complications include blood clots, angina, or a heart attack.
- Diabetes: A group of diseases characterized by insulin resistance or insufficient insulin production, resulting in high blood sugar levels. If left uncontrolled, it can cause severe effects on other body parts such as the kidneys, heart, eyes, foot, and skin.
- Chronic kidney disease: Losing kidney function over time leads to severe kidney damage. Chronic kidney disease is caused mainly by type 1 and type 2 diabetes, as well as excessive blood pressure.
- Heart failure: This occurs when the heart cannot adequately pump blood throughout the body. One can develop symptoms like shortness of breath, fatigue, weakness, leg swelling, irregular heartbeat, rapid weight gain, and nausea when it occurs.
- Depression: A mood disorder that causes symptoms such as perpetual sadness, loss of interest in daily activities, hopelessness, angry or emotional outbursts, fatigue, difficulty making decisions, sleep disturbances, and changes in appetite.
- Alzheimer's disease: A progressive neurological disorder that causes difficulties with memory, thinking, making decisions, performing everyday activities, mood and behavior, and social life. It ultimately increases the dependency on other people.
- Chronic obstructive pulmonary disease: Caused by two lung conditions — emphysema and chronic bronchitis. The various symptoms include shortness of breath, coughing, and chest tightness.
How are internists different from family medicine doctors?
Internists are specially trained to treat adults till the geriatric years. They have extensive training in all aspects of adult health care and treatment. Internists are experts in primary care screening and treating common adult disorders such as diabetes and hypertension and managing patients with complex medical conditions.
Compared to internists, family medicine doctors have specialized training to care for all family unit members, from infants to older adults. They have knowledge, skills, and training in adult medicine, pediatrics, mental health, obstetrics and gynecology, and other areas. Family medicine training prepares them for various medical issues, emphasizing wellness, illness prevention, population care, and chronic disease management.
What can I expect when visiting an internist?
What happens when you visit an internist near you mostly depends on your purpose for visiting, but you can expect the following things.
The internist will examine your vital signs. They will check your medical history and prescription list and ask about your symptoms and overall health. They may perform a physical examination to get a comprehensive picture of your health.
Your internist will typically perform the following as part of your physical exam:
- Examine your appearance, including your posture and movement.
- Check your breathing for wheezing, crackles, or shortness of breath.
- Examine your heart for a heart murmur, an irregular heartbeat, or unusual sounds.
- Examine your skin and nails.
- Examine your ears, nose, eyes, mouth, and throat.
The internist may request screening tests like bone density tests or lipid panels for wellness checkups. They may also order the required test for certain conditions, whether a basic urinalysis or something complex, such as an imaging test. They may request a follow-up visit from you or recommend that you see some other healthcare specialist.
If you see other doctors for some health conditions, your internist may consult with them to coordinate your care and check for prescription interactions.
Find the best internist near you in Pearland, Texas
With a wide range of subspecialties and types of physicians available now, finding an internist who is the right fit for you can be challenging. The first step is understanding internal medicine and determining whom you need to see. Zocdoc can help you find some of the best internists near you in Pearland, Texas, within minutes.
You can use the advanced filter search to enter your symptoms, procedures, doctor's specialty, location, date, time, and insurance carrier plan. The results will provide a comprehensive list of internists near you who meet your criteria. Each doctor has a unique profile where you can read about their academic background, medical expertise, services they provide, research interests, languages they speak, and gender. You can further shortlist the list of doctors by reading the verified reviews from previous patients to understand the doctor's care approach and patient management skills.
Want to make finding in-network providers easier? Add an image of your medical insurance card to your account, and Zocdoc will help you select your insurance plan. However, this isn't mandatory. If you would rather skip the upload and want to add your insurance information to your account manually, just pick it from the list provided. For any insurance-related concerns, visit Zocdoc's patient help center.
Once you have picked the best fit, Zocdoc will help you instantly book an in-person or virtual appointment with the internist near you.
All bookings made on Zocdoc are simple, secure, and free!
Internal medicine statistics for Texas
Internists diagnose and treat many conditions affecting the adult population, like diabetes, heart disease, tuberculosis, and cardiovascular problems. The American Diabetes Association stated that in 2021, around 38.4 million U.S. adults had diabetes, with about 1.2 million Americans diagnosed yearly. Research conducted by the same organization shows that Texas alone had approximately 2,694,402 cases, equivalent to roughly 12.4% of the total adult population in the state. Another 621,000 people had diabetes but were not aware of it.
Statistics by the Indiana Department of Health (2019-2021) showed that around 335 people per 100,000 population aged 35 or above died of heart disease in Texas. Regarding TB or tuberculosis, the Centers for Disease Control and Prevention stated that the percentage of people in Texas with TB in 2020 was 12.3%.
According to the U.S. Bureau of Labor Statistics (2023), around 67,210 general internal medicine physicians practiced in the United States. Texas had nearly 2,690 employed physicians.
Sources
WebMD
American College of Physicians[1]
American College of Physicians[2]
American College of Physicians[3]
American College of Physicans[4]
American College of Physicians[5]
State of Indiana
Centers for Disease Control and Prevention
U.S. Bureau of Labor Statistics
American Diabetes Association[1]
American Diabetes Association[2]
Cleveland Clinic[1]
Cleveland Clinic[2]
Cleveland Clinic[3]
National Council on Aging
Harvard Medical School
JOHNS HOPKINS MEDICINE
National Cancer Institute
