User:DBetty/Sandbox
From Wikipedia, the free encyclopedia
Internal medicine is the medical specialty concerned with the diagnosis and nonsurgical treatment of unusual or serious diseases, especially where there is difficulty in diagnosis or management. In North America, specialists in internal medicine are commonly called internists. Elsewhere, especially in Commonwealth nations, such specialists are often called physicians, in the older, narrow sense of the word (in North America, physician now commonly applies to any medical practitioner).
Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Many are in consultant practice, only seeing patients referred by other medical practitioners, to help solve complex problems in diagnosis or management. Because of this tradition, internists have sometimes been described as the "doctor's doctor".
Formerly, many internists were not subspecialized (general physicians in Commonwealth parlance), and would see any complex nonsurgical problem; this style of prectice has become much less common.
In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and neurologists specialize respectively in diseases of the gut and the nervous systems. Specialist or consultant pediatricians and geriatricians could also be described as internists who have subspecialized by the age of their patient, rather than by organ system.
Internists have a lengthy clinical and scientific training in their areas of medical interest, and have special expertise in the use of drugs or other medical therapies (as opposed to surgery). While the name "internal medicine" may suggest that internists only treat problems of "internal" organs, this is not the case. Internists are trained to treat patients as whole people, not mere organ systems.
Contents |
[edit] Education and Training of Internists
The training and career pathways for internists vary considerably across the world.
First, they must receive the "entry-level" education required of any medical practitioner in the relevant jurisdiction. In all developed countries, entry-level medical education programs are tertiary-level courses, undertaken at a medical school attached to a university. Depending on jurisdiction and university, entry may follow directly from secondary school or require pre-requisite undergraduate education. The former commonly take five or six years to complete. Programs that require previous undergraduate education (typically a three or four year degree, often in Science) are usually four or five years in length. Hence, gaining a basic medical degree may typically take from five to eight years, depending on jurisdiction and university.
Following completion of entry-level training, newly graduated medical practitioners are often required to undertake a period of supervised practice before full licensure, or registration, is granted, typically one or two years. This period may be referred to as "internship" or "conditional registration". Then, internists require specialist training in internal medicine or one of its subspecialities. In North America, this postgraduate training is often referred to as residency training; in Commonwealth countries, such trainees are often called registrars.
Training in medical specialties typically takes from three to six years, and sometimes more, depending on specialty and jurisdiction. Any medical practitioner who completes specialist training in internal medicine (or in one of its sub-specialties) is an internist, or a specialist physician in the older, narrower sense. In some jurisdictions, training in internal medicine is begun immediately following completion of entry-level training, or even before. In other jurisdictions, junior medical doctors must undertake generalist (un-streamed) training for one or more years before commencing specialization. Hence, depending on jurisdiction, an internist (specialist physician) often does not achieve recognition as a specialist until twelve or more years after commencing basic medical training — five to eight years at university to obtain a basic medical qualification, and up to another six years to become a specialist.
==
The ancient hierog;yph
|
may be the source of the modern prescription symbol
The American Medical Association, established 1847, uses physician in this broad sense to describe all its members.
Nurse practitioners (NPs) are not generally described as physicians; the American College of Nurse Practitioners do not describe themselves this way. However, some nurse practitioners may perform work similar to that of some physicians, especially in primary care.
Surely a good authority in this matter would be and certainly they do not describe themselves in this way.
[edit] Meanings of the word physician
[edit] Physician = any medical practitioner
[edit] Physician = specialist (or subspecialist) in internal medicine
(physicians in the broad sense)
(physicians in the narrow sense)
Most countries have some method of officially recognizing specialist qualifications in all branches of medicine, including internal medicine. Sometimes, this aims to promote public safety by restricting the use of hazardous treatments. For example, in Australia, only specialist physicians (internists in USA) or specialist dermatologists may lawfully prescribe istretinoin (this is a powerful drug useful in treating severe acne, but may cause severe and varied types of adverse drug reaction). Other reasons for regulating specialists may include: standardization of recognition for hospital employment, restriction on which practitioners are entitled to receive higher insurance payments for specialist services, and, as occasionally alleged, restriction of specialist numbers to reduce competition.
[edit] more (draft) content on pediatrics later
Pediatrics (also spelled paediatrics) is the branch of medicine that deals with the medical care of infants, children, and adolescents. The upper age limit ranges from age 14 to 21, depending on the country.
A medical practitioner who specializes in this area is thus known as a pediatrician (also spelled paediatrician).
[edit] Etymology
The word pediatrics means healer of children. The word derives
From Template:AGr. Template:Term + -iatrics
From Template:Etyl Template:Term + Template:Term
ics, and English suffix formingnouns related to an area of activity or practice (eg athletics)
from two Greek words: παῖς (pais = child) and ιατρός (iatros = doctor or healer).
[edit] Differences between adult and pediatric medicine
Pediatrics differs from adult medicine in many respects. The obvious body size differences are paralleled by maturational changes. The smaller body of an infant or neonate is substantially different physiologically from that of an adult. Congenital defects, genetic variance, and developmental issues are of greater concern to pediatricians than they often are to adult physicians.
Many inherited diseases are more often treated by pediatricians than by adult physicians because only recently did the majority of these patients survive into adulthood. Well-known example are the thalassemias, sickle cell anemia and cystic fibrosis. Issues revolving around infectious diseases and immunizations are also dealt with primarily by pediatricians.
Childhood is the period of greatest growth, development and maturation of the various organ systems in the body. Years of training and experience (above and beyond basic medical training) goes into recognizing the difference between normal variants and what is actually pathological.
Treating a child is not like treating a miniature adult. A major difference between pediatrics and adult medicine is that children are minors and, in most jurisdictions, cannot make decisions for themselves. The issues of guardianship, privacy, legal responsibility and informed consent must always be considered in every pediatric procedure. In a sense, pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances only, though this is in legal flux and varies by region.
