Doctors of internal medicine ("internists") are medical specialists who focus on adult medicine and have had special study and training focusing on the prevention and treatment of adult diseases. At least three of their seven or more years of medical school and postgraduate training are dedicated to learning how to prevent, diagnose, and treat diseases that affect adults. Internists are sometimes referred to as the "doctor's doctor," because they are often called upon to act as consultants to other physicians to help solve puzzling diagnostic problems. While the name "internal medicine" may lead one to believe that internists only treat "internal" problems, this is not the case. Doctors of internal medicine treat the whole person, not just internal organs.

Definition of an internist

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Doctors of internal medicine may be referred to by several terms, including "internists," "general internists" and "doctors of internal medicine." They are not to be confused with "interns," who are doctors in their first year of residency training. Although internists may act as primary care physicians, they are not "family physicians," "family practitioners," or "general practitioners," whose training is not solely concentrated on adults and may include surgery, obstetrics and pediatrics. General internists practice medicine from a primary care perspective but they can treat and manage over 90% of all ailments.

Internal medicine subspecialists may also practice general internal medicine, but usually focus their practice on their particular subspecialty (like cardiology or pulmonology).

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30 minutes south of Boston :: Massachusetts :: New England Physician Recruitment Center
Needed to join well-established multispecialty group practice of 40+ physicians, 30 minutes south of Boston. Position is full-time office-based practice. Affiliated with several large multispecialty groups
Waterbury and Thomaston :: Connecticut :: New England Physician Recruitment Center
Medicine Associates with locations in Waterbury and Thomaston, Connecticut seeks BC/BE internist or internist/endocrinologist to join busy six-physician practice with focus on outpatient care. The practice
20 miles west of Boston :: Massachusetts :: New England Physician Recruitment Center
BC/BE Internist sought by well-established Primary Care group located 20 miles west of Boston. Collegial atmosphere, suburban environment. Shared call 1:15. Guaranteed salary leading to stockholdership

Current Opinion in Internal Medicine - Current Table Of Contents

Breastfeeding and allergies: time for a change in paradigm?.
Page: 539DOI: 10.1097/MCI.0b013e32831dae43Authors: Duncan, Joanne M; Sears, Malcolm R
New aspects in allergic contact dermatitis.
Page: 547DOI: 10.1097/MCI.0b013e32831dae50Authors: Mortz, Charlotte Gotthard; Andersen, Klaus Ejner
Contemporary approaches to the identification of athletes at risk for sudden cardiac death.
Page: 552DOI: 10.1097/MCI.0b013e32831daee4Authors: Drezner, Jonathan A

pubmed: 0003-4819

In the clinic. Influenza.
Hessen MT In the clinic. Influenza. Ann Intern Med. 2009 Nov 3;151(9):ICT5-1-ICT5-15; quiz ICT5-16 Authors: Hessen MT PMID: 19894285 [PubMed - in process]

Archives of Internal Medicine current issue

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In This Issue of Archives of Internal Medicine [In This Issue of Archives of Internal Medicine]

Adverse Events in Randomized Trials: Neglected, Restricted, Distorted, and Silenced [Editorial]
Ioannidis, J. P. A.
Women's Cardiovascular Health: Prevention Is Key [Editorial]
Oertelt-Prigione, S., Regitz-Zagrosek, V.
Nondaily and Social Smoking: An Increasingly Prevalent Pattern [Commentary]
Schane, R. E., Glantz, S. A., Ling, P. M.
Going Off-label Without Venturing Off-Course: Evidence and Ethical Off-label Prescribing [Commentary]
Largent, E. A., Miller, F. G., Pearson, S. D.
The Potency of Team-Based Care Interventions for Hypertension: A Meta-analysis [Review Article]
Carter, B. L., Rogers, M., Daly, J., Zheng, S., James, P. A. Background  Team-based care is the strategy that has had the greatest effect on improving blood pressure (BP). The purpose of this systematic review was to determine the potency of interventions for BP involving nurses or pharmacists. Methods  A MEDLINE search for controlled clinical trials that involved a nurse or pharmacist intervention was conducted. Mean reductions in systolic (S) and diastolic (D) BP were determined by 2 reviewers who independently abstracted data and classified the different intervention components. Results  Thirty-seven articles met the inclusion criteria. Education about BP medications was significantly associated with a reduction in mean BP (–8.75/–3.60 mm Hg). Other strategies that had large effect sizes on SBP include pharmacist treatment recommendations (–9.30 mm Hg), intervention by nurses (–4.80 mm Hg), and use of a treatment algorithm (–4.00 mm Hg). The odds ratios (95% confidence intervals) for controlled BP were: nurses, 1.69 (1.48-1.93); pharmacists within primary care clinics, 2.17 (1.75-2.68); and community pharmacists, 2.89 (1.83-4.55). Mean (SD) reductions in SBP were: nursing studies, 5.84 (8.05) mm Hg; pharmacists in clinics, 7.76 (7.81) mm Hg; and community pharmacists, 9.31 (5.00) mm Hg. There were no significant differences between the nursing and pharmacy studies (P ≥ .19). Conclusions  Team-based care was associated with improved BP control, and individual components of the intervention appeared to predict potency. Implementation of new hypertension guidelines should consider changes in health care organizational structure to include important components of team-based care.
Reporting of Safety Results in Published Reports of Randomized Controlled Trials [Original Investigation]
Pitrou, I., Boutron, I., Ahmad, N., Ravaud, P. Background  Reports of clinical trials usually emphasize efficacy results, especially when results are statistically significant. Poor safety reporting can lead to misinterpretation and inadequate conclusions about the interventions assessed. Our aim was to describe the reporting of harm-related results from randomized controlled trials (RCTs). Methods  We searched the MEDLINE database for reports of RCTs published from January 1, 2006, through January 1, 2007, in 6 general medical journals with a high impact factor. Data were extracted by use of a standardized form to appraise the presentation of safety results in text and tables. Results  Adverse events were mentioned in 88.7% of the 133 reports. No information on severe adverse events and withdrawal of patients owing to an adverse event was given in 27.1% and 47.4% of articles, respectively. Restrictions in the reporting of harm-related data were noted in 43 articles (32.3%) with a description of the most common adverse events only (n = 17), severe adverse events only (n = 16), statistically significant events only (n = 5), and a combination of restrictions (n = 5). The population considered for safety analysis was clearly reported in 65.6% of articles. Conclusion  Our review reveals important heterogeneity and variability in the reporting of harm-related results in publications of RCTs.
Sex-Specific Trends in Midlife Coronary Heart Disease Risk and Prevalence [Original Investigation]
Towfighi, A., Zheng, L., Ovbiagele, B. Background  While recent data indicate that stroke prevalence in women at midlife is double that of similarly aged men in the United States, little is known about current sex-specific trends in symptomatic cardiovascular disease. This study aimed to determine sex-specific midlife prevalence of myocardial infarction (MI) and risk of future coronary heart disease. Methods  We assessed the sex-specific MI prevalence and the Framingham coronary risk score (FCRS) among US adults aged 35 to 54 years who participated in the National Health and Nutrition Examination Surveys (NHANES), cross-sectional, nationally representative surveys, during 1988 to 1994 and 1999 to 2004. Results  In both epochs, men aged 35 to 54 years had a higher prevalence of MI than similarly aged women, but the gap narrowed in recent years as MI prevalence decreased among men and increased among women (2.5% vs 0.7% in NHANES 1988-1994 [P < .01] and 2.2% vs 1.0% in NHANES 1999-2004 [P < .01]). Among men, the mean FCRS showed an improving trend (8.6% in NHANES 1988-1994 vs 8.1% in NHANES 1999-2004 [P = .07]), while among women, the mean FCRS worsened (3.0% in NHANES 1988-1994 vs 3.3% in NHANES 1999-2004 [P = .02]). Temporal trends in FCRS components revealed that men had more improvements in vascular risk factors than women, but diabetes mellitus prevalence increased in both sexes. Conclusions  Over the past 2 decades, MI prevalence has increased among midlife women, while declining among similarly aged men. Also, although the risk of future hard cardiovascular events remains higher in midlife men compared with midlife women, the gap has narrowed in recent years. Greater emphasis on vascular risk factor control in midlife women might help mitigate this worrisome trend.

Current Opinion in Internal Medicine - Current Table Of Contents

Breastfeeding and allergies: time for a change in paradigm?.
Page: 539DOI: 10.1097/MCI.0b013e32831dae43Authors: Duncan, Joanne M; Sears, Malcolm R
New aspects in allergic contact dermatitis.
Page: 547DOI: 10.1097/MCI.0b013e32831dae50Authors: Mortz, Charlotte Gotthard; Andersen, Klaus Ejner
Contemporary approaches to the identification of athletes at risk for sudden cardiac death.
Page: 552DOI: 10.1097/MCI.0b013e32831daee4Authors: Drezner, Jonathan A
How to break the vicious circle of antibiotic resistances?.
Page: 560DOI: 10.1097/MCI.0b013e32831dabd1Authors: Leone, Marc; Martin, Claude
Benefits of high-protein weight loss diets: enough evidence for practice?.
Page: 566DOI: 10.1097/MCI.0b013e32831daebdAuthors: Brehm, Bonnie J a; D'Alessio, David A b
Chronic pancreatitis.
Page: 572DOI: 10.1097/MCI.0b013e32831daddaAuthors: Conwell, Darwin L; Banks, Peter A

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