Internal medicine is devoted to internal diseases that occur in adults and, in some cases, adolescents. A doctor who specializes in internal medicine is called an internist and is trained in primary care. Internists are experts in diagnosis, treat chronic illnesses, promote health through strategies such as wellness education and try to prevent disease. In addition to general internal medicine, many subspecialties exist. For example, rheumatologists treat diseases such as arthritis, cardiologists treat diseases of the heart and gastroenterologists treat diseases of the stomach and intestinal system. All of these specialists, however, begin their careers in internal medicine and receive the same training.
Internal Medicine Basics
Internists are similar to family practice doctors in some ways. The internist treats a very broad range of diseases and medical conditions, but the focus is on adult medicine. An internist might treat the same patient for many years, managing both common and complex, long-term illnesses such as heart disease, cancer or diabetes. Some internists specialize in the treatment of the elderly, while others may focus on older adolescents. An internist might take care of people who have substance abuse problems, skin conditions or problems with the nervous system. The University of North Carolina at Chapel Hill notes that some internists may also expand their practices to include procedures such as draining an abscess.
Invasive or Interventional Internists
Internal medicine specialties break down into two basic groups: those who perform invasive procedures similar to surgery and those who treat patients medically. In the first group are specialists such as gastroenterologists, pulmonologists and interventional cardiologists. Gastroenterologists perform procedures such as colonoscopies to diagnose rectal cancers and treat patients who have other gastrointestinal problems. You might see a gastroenterologist for heartburn or ulcers, for example. Pulmonologists diagnose lung cancer using bronchoscopies and other tests, and manage people who have asthma or other pulmonary problems. Interventional cardiologists perform heart catheterizations and treat people with all sorts of heart disease and vascular problems.
Medical Treatment Specialists
Medical specialists in internal medicine include hematologists, oncologists, endocrinologists, nephrologists, and specialists in infectious disease, hospice and palliative medicine. Hematologists specialize in diseases of the blood and might treat patients with problems such as leukemia or hemophilia. Oncologists provide medical treatment for various kinds of cancer. Endocrinologists typically treat patients with diseases such as diabetes or thyroid conditions. Nephrologists specialize in medical treatment of the kidney, such as kidney failure that requires dialysis. Internists who specialize in infectious disease might manage patients with AIDS, tuberculosis or other serious infections. In hospice and palliative medicine, internists provide care to people at the end of life or help keep them comfortable when treatment is no longer possible.
Other Internal Medicine Specialties
Some specialties in internal medicine are less common. For example, an internist might specialize in congenital heart disease – a subspecialty of cardiology. Another subspecialty in this field is advanced heart failure and transplant cardiology. These doctors work with patients who have severe heart failure, are awaiting or have undergone heart transplants. Cardiac electrophysiology is yet another subspecialty focused on the heart – in this case, the electrical rhythms of the heart. Sleep medicine and sports medicine are two other internal medicine specialties. In the first, the internist treats patients who have sleep disturbances such as sleep apnea. Internists who work in sports medicine are expert in diagnosing and treating sports or exercise injuries. Transplant hepatology combines internal medicine and gastroenterology; these doctors treat patients who need or have had a liver transplant.