An internist is a medical doctor who specializes in providing comprehensive care for adults. Often called “doctors for adults,” they apply scientific knowledge and clinical expertise to diagnose, treat, and manage health conditions from simple to complex. They are trained to address the wide spectrum of illnesses that affect adults and are not limited to a single organ system. Their work involves building long-term relationships with patients to provide ongoing, personalized care.
The Core Role of an Internist
The primary function of an internist is the diagnosis and management of illness in adults. They are specifically trained to solve challenging diagnostic problems and manage severe, long-term conditions. This makes them particularly adept at caring for patients who have multiple chronic diseases at once, as they can understand how different health issues interact. Their deep training across all of the body’s organ systems gives them a unique perspective on how everything works together.
Internists serve in multiple capacities within the healthcare system. Many function as primary care physicians, providing routine check-ups, preventive screenings, and managing the overall health of their adult patients. They focus on disease prevention and the promotion of wellness by advising on lifestyle factors like diet and exercise. In other situations, they act as consultants to other medical specialists, who may call upon an internist for their ability to analyze complex sets of medical data. This dual role allows them to provide care in both outpatient clinics and hospital settings.
Common Conditions Internists Treat
Internists diagnose and manage a wide variety of conditions in adults. These include:
- Heart disease: Managing various cardiovascular issues, including complex conditions like heart attacks and abnormal heart rhythms. They address problems such as heart failure and angina, and may serve as the primary doctor for monitoring heart health.
- Hypertension (high blood pressure): Managing hypertension is a frequent task for internists, who aim to lower blood pressure to reduce the risk of stroke or heart attack. Treatment often involves a combination of prescribed medications and guidance on lifestyle adjustments.
- Diabetes: Helping patients with both Type 1 and Type 2 diabetes manage their condition through medication, diet, and exercise. They monitor blood sugar levels closely to prevent complications that can affect the nerves, eyes, and kidneys.
- Lung diseases: Treating adults with respiratory problems such as asthma or chronic obstructive pulmonary disease (COPD). They perform breathing tests to assess lung function and can prescribe treatments like rescue inhalers or other medications.
- Kidney diseases: Diagnosing and managing conditions affecting the kidneys, including monitoring for kidney failure. Since kidney health is often linked to other conditions like diabetes and hypertension, internists coordinate care to manage these interconnected problems.
- Joint and rheumatologic problems: Treating musculoskeletal issues such as osteoarthritis and managing autoimmune disorders like rheumatoid arthritis. Their broad training helps them diagnose and create management plans for these systemic conditions.
- Digestive issues: Addressing problems from acid reflux to more severe conditions like pancreatitis and cirrhosis. They diagnose and treat gastrointestinal infections and may recommend dietary changes or medications to alleviate symptoms.
- Infectious diseases: Treating a wide spectrum of infectious diseases, including common illnesses like the flu as well as more complex bacterial, viral, or fungal infections. Their focus is on identifying the root cause to provide effective treatment.
Internist vs. Family Doctor
A common point of confusion for patients is the difference between an internist and a family doctor. While both can serve as primary care physicians, the main distinction lies in their patient populations. Internists are exclusively trained to care for adults, from young adults through the elderly. Their training does not typically include pediatrics, obstetrics, or surgery.
Family doctors, on the other hand, are trained to provide care for patients of all ages, from infants to seniors. Their education is broader, covering pediatrics, gynecology, and aspects of surgery, which equips them to handle the health needs of an entire family unit.
The focus of their training also differs. Internal medicine education provides a deep and comprehensive understanding of adult medical issues, including significant experience in various subspecialties like endocrinology and rheumatology. Family medicine training is broader by nature, preparing physicians to address a wide range of medical issues that might be encountered in a community setting. This makes family doctors well-suited for communities where specialists may not be readily available.
Training and Subspecialties
After completing medical school, a physician must enter a three-year residency program focused specifically on internal medicine. This postgraduate training is dedicated to adult medicine and provides in-depth experience with common general medical conditions as well as the various subspecialties. Upon completion of the residency, the physician is eligible to become board-certified in internal medicine.
While about half of all internists practice general internal medicine, others choose to pursue additional training in a subspecialty, which is known as a fellowship. A fellowship typically requires one to three more years of training beyond the initial residency. This additional training allows an internist to become an expert in a more focused area of adult medicine.
Examples of these subspecialties include cardiology (the heart and vascular system), gastroenterology (the digestive system), endocrinology (hormonal and glandular systems), and oncology (cancer). Other available fellowships include pulmonology (lungs), nephrology (kidneys), and rheumatology (joints and musculoskeletal system).
When to Choose an Internist
An adult who is looking for a primary care doctor, particularly one who can manage complex or chronic health issues, may find an internist to be a suitable choice. Their specialized focus on adult medicine makes them well-equipped to handle the interconnected nature of diseases that often develop in adulthood.
Patients with one or more chronic conditions, such as diabetes or hypertension, could benefit from an internist’s expertise in managing multiple illnesses simultaneously. Individuals with vague or difficult-to-diagnose symptoms may turn to an internist for their diagnostic skills. Because internists are trained to see the big picture of adult health, they can effectively coordinate care, even when it involves multiple other specialists. An internist is a strong option for any adult seeking a physician with deep knowledge of adult-specific health.