The Internal Medicine (English internal medicine ) deals with the health disorders and diseases of the internal organs and their prevention , diagnosis , conservative and interventional treatment and rehabilitation and follow-up. Internal medicine specialists are also known as internists .
Areas of activity
The specialist focal points of the internists include diseases in particular
- the respiratory organs ( pulmonology )
- of the heart and circulation ( cardiology )
- the digestive organs ( gastroenterology and hepatology )
- the kidneys ( nephrology ),
- of the blood and the blood-forming organs ( hematology )
- of the vascular system ( angiology )
- metabolism and internal secretion ( endocrinology and diabetology )
- of the immune system ( immunology )
- of the supporting and connective tissue ( rheumatology )
Internal medicine also includes:
- Infectious diseases ( infectious diseases and tropical medicine )
- Poisoning (clinical toxicology ),
- solid tumors and hematological neoplasms ( oncology ),
- the monitoring and therapy of seriously ill patients (internal intensive care medicine )
- Investigation of the influence of training and sport on healthy and sick people (internal sports medicine ).
The training regulations for specialists in internal medicine (internists) and the additional training in internal medicine are different in different countries.
The specialist field developed in the 19th century from the general discipline “Special Pathology and Therapy”. Anton de Haën founded a medical clinic specializing in internal medicine as early as 1754 in Vienna.
Most important examination methods in internal medicine
- Physical examination
- Electrocardiogram (EKG)
- Long-term ECG / event recorder
- Long-term blood pressure measurement
- Sonography (ultrasound examinations)
- Laboratory diagnostics
- Bone marrow aspiration
- Cardiac catheterization
- Pulmonary function examination
- Lung biopsy
- Liver biopsy
Current development trends
As a result of the rapid increase in knowledge in its sub-areas, internal medicine is subject to increasing sub-specialization. The fact that the classic, well-trained general internist is being displaced more and more by the representatives of individual sub-areas in many industrialized countries also meets with criticism. In 2007, at the 110th German Medical Congress, it was decided to reintroduce further training to become a specialist in internal medicine without a specialization. The general practice is an independent medical specialty and borders greatly from the internal medicine from, although in the meantime tendencies existed to unite the two disciplines.
In addition to the progressive independence of the organ-related specialist areas, the following trends are emerging:
- In Germany, a division into a specialist and a general practitioner domain, which is associated with sensitive restrictions on the area of competence of general practitioners working internists, is established due to health insurance.
- The methods of internal medicine are becoming more and more invasive, at least in the special areas, so that their complication rates can be compared with smaller surgical interventions. This is particularly true in the field of cardiology and gastroenterology .
- Internal medicine may overlap in some areas. a. with radiology , neurology and laboratory medicine . Since smaller hospitals do not always have their own specialists in these areas, these tasks are carried out by internists.
- Molecular biology is becoming increasingly important due to multiple genetic and epigenetic changes.
The designation " Specialist for internal and general medicine ( family doctor )" could be acquired around 2008 after a resolution of the 110th German Medical Association in 2007 to promote family doctor- centered care in several federal states . However, due to concerns under European law, this specialist designation may no longer be used today following a resolution passed by the 113th Federal Medical Association in 2010. But entitles remains to branch as a contract physician ; then you can only call yourself a doctor or a specialist in general medicine (but not a doctor in general medicine ).
Specialist title internist
The official name in Germany is specialist for internal medicine (optionally also internist ). In order to be allowed to use this professional title, a doctor must complete further training of at least 60 months (5 years) in a recognized further training facility with further training regulations established by the state medical associations. There is also the option of choosing a focus. The further training period is then at least 72 months (6 years). At the end of the training there is an oral exam in both cases. The further training regulations can vary depending on the chamber district, as training sovereignty in Germany is subject to the respective medical associations .
According to the current training regulations, there are the following specialist titles for internal medicine:
- Specialist in internal medicine - this also includes general practitioners internists
- Specialist in internal medicine and angiology : angiologist
- Specialist in internal medicine and endocrinology and diabetology : Endocrinologist / diabetologist
- Specialist in internal medicine and gastroenterology : gastroenterologist
- Specialist in internal medicine and hematology and oncology : hematologist / oncologist
- Specialist in internal medicine and cardiology : cardiologist
- Specialist in internal medicine and nephrology : Nephrologist
- Specialist in internal medicine and pulmonology : pulmonologist
- Specialist in internal medicine and rheumatology : Rheumatologist
- internisten-im-netz.de - The health platform of the professional association of German internists
- bdi.de - Professional Association of German Internists
- dgim.de - German Society for Internal Medicine
- sgaim.ch - Swiss Society for General Internal Medicine
- (Sample) advanced training regulations and (sample) guidelines of the German Medical Association as of March 2008, last accessed: February 25, 2009
- hausarzt-bhi.de - Federal Association of General Practitioners Internists
- Walter Siegenthaler (Ed.): Textbook of internal medicine. Stuttgart and New York 1984 a. ö.
- Walter Siegenthaler (Ed.): Differential diagnosis of internal diseases. Stuttgart and New York 1952 a. ö.
- Rudolf Gross , Paul Schölmerich , Wolfgang Gerok (Eds.): 1000 key phrases internal medicine. Schattauer, Stuttgart / New York 1971; 4th, completely revised edition there in 1989 (= UTB for science / university paperbacks. Volume 522), ISBN 3-7945-1282-0 .
- Gerd Herold and colleagues: Internal Medicine 2020. Self-published , Cologne 2019. ISBN 978-3-9814660-9-6 .
- Willibald Pschyrembel: Clinical Dictionary. 267th edition. De Gruyter, 2017, ISBN 978-3-11-049497-6 . ( Keyword internal medicine, online )
- Axel W. Bauer : Internal Medicine. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 674.
- BDI is sticking to the specialist in internal medicine. (PDF)
- journalmed , June 13, 2007
- Berlin Medical Association on the reintroduction of internists without a focus ( memento from July 18, 2012 in the web archive archive.today )
- Agnieszka Wolf: Further training in internal and general medicine. Thieme, January 30, 2006.
- interests in the KV committees: division is a mistake. ( Memento of the original from March 4, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. North Rhine Association of Statutory Health Insurance Physicians, November 4, 2014.
- Thomas Meißner: Internists Congress: Departure into a new era. In: Ärzte-Zeitung , April 17, 2015.
- Internal medicine / The internist. Professional Association of German Internists, accessed on February 3, 2019 .