The specialty of internal medicine is specifically focused on the prevention, diagnosis and treatment of diseases in an adult population. Without focusing on a single part of the body or a single system of organs, the doctor internist covers the diagnostics and the treatment of the entire organism and simultaneously treats both the common and the complex and severe diseases in adult patients. Often an individual is treated by a single internist during all stages of the person’s life. The diagnosis and the treatment of the diseases can be performed in the cabinet of the internist or in hospital conditions, depending on the gravity of the disease which is being treated.
The internist is trained in the diagnosis and treatment of a wide range of diseases in adults. Internists can focus on the general practice or on a specialized field of activity. Furthermore, internists are also applicable in hospital conditions where adults with frequent diseases can be treated, in preventive medicine, or in subspecialized institutions (clinics) where they provide general internist care for patients.
Internists apply a number of investigations and examinations depending on the patient’s individual needs, the patient’s disease, age, etc., therefore often these can vary.
Routine physical examination: it is an essential part of the doctor’s familiarization with the general examination of the patient. In doing so, the internist takes a detailed anamneis and performs a general examination of the patient. Here the doctor also becomes familiar with the patient’s habits, such as lifestyle, smoking, diet, intake of medications, alcohol, and physical activity. In this case, the doctor also performs a manual examination of the thyroid gland, the urogenital tract, inspection and palpation of the bladder, auscultation of the heart, auscultation of the lungs and general neurological examination.
Even before the patient complains about some signs and diseases, the internist may refer the patient to specific examinations for diagnose of the disease. Such more common investigations include:
- Cholesterol level and blood lipids: laboratory examinations after 10 hours of hunger, a risk factor for the occurrence of a cardiovascular disease.
- Determination of individuals with high blood pressure: a risk factor for the occurrence of cardiovascular diseases.
- Determination of a thyroid disease: T3, T4, TSH in the blood.
- Obesity: determiniation of body mass index (BMI) and obesity treatment.
- Diabetes: determination of glucose in a hungry person, oral glucose tolerance test (OGTT) and glycosylated hemoglobin (HbA1C).
- Ultrasound examination of internal organs: general echographic examination of the kidneys, bladder, liver, gallbladder, thyroid gland
- Spirometry: determination of the capacity of the respiratory function and screening of patients with COPD (chronic obstructive pulmonary disease) and asthma.
- Breast cancer in the female population: reference to mammography.
- Colorectal cancer: there are several options for screening this type of cancer, especially in risk populations and in case of family burdens.
- Prostate cancer: Determination of PSA as a specific screening test.
In general, the quality of the examination and the correct recommendations received by the patient largely depend on the patient’s future quality of life, as well as the appropriate treatment of the already existing disease in the patient.