What Exactly is 'Internal Medicine'?

Many Americans resolve to get a long-overdue checkup at the start of the new year. But they might be confused as to which one of the following to visit: a primary care physician, a family medicine doctor or an “internist.” Sometimes, the same physician fits all three categories.

To get a better idea of the distinctions, it’s important to fully understand what’s behind “internal medicine.” The physicians who practice internal medicine are referred to by several terms, including “internists” or “doctors of internal medicine.” But don’t confuse them for “interns.”

Internists usually have at least three additional years of postgraduate training that focuses on preventing, diagnosing, and treating diseases that affect adults, including chronic conditions such as heart disease.

(Video: Yariela Enriquez, M.D., an internist with Baptist Health Primary Care, sheds light on the qualifications of a “doctor of internal medicine,” especially as it relates to preventing and treating chronic diseases. Video by Dylan Kyle)

Many primary care physicians are also internists, which may add to the confusion among patients when it comes to their doctors’ official title. Both primary care physicians and internists are fully qualified to preside over your regular physical exams. Internists, though, are sometimes known as the “doctor’s doctor” because they act as consultants to other physicians trying to analyze challenging diagnostic health issues.

Then there’s the “family medicine doctor” who has completed a residency in family medicine. The biggest difference between a family physician and an internist is the age of the patients. Family practitioners usually see all ages — from babies to seniors. Some family medicine doctors choose to deliver babies as well. Internal medicine doctors only see adults, usually age 18 and older.

Prevention is Key
Preventive healthcare is key for internists, family doctors and primary care physicians. This applies both to preventing the onset of chronic disease and preventing existing health conditions from worsening.

“Every time you come in for an annual visit, we focus on prevention,” says Yariela Enriquez, M.D., an internist with Baptist Health Primary Care. “For example, if you have heart disease or high blood pressure, we prevent it from elevating by giving you prescriptions. We also monitor the blood pressure. If we see it’s not controlled, we guide you on eating healthier, exercising, counseling you and adjusting your medication. We try to prevent the consequences of high blood pressure, which can be a stroke or heart attack.”

Subspecialties of internal medicine include allergy and immunology, cardiology (heart diseases), endocrinology (hormone disorders), hematology (blood disorders), infectious diseases, gastroenterology (diseases of the gut), nephrology (kidney diseases), oncology (cancer), pulmonology (lung disorders), and rheumatology (arthritis and musculoskeletal disorders).

Like primary care physicians, internists will refer patients to subspecialists, sometimes for cancer screenings.  “For prevention of cancer, screenings are key,” Dr. Enriquez says. “If we catch it earlier, we can treat it more effectively. We can also refer you to other specialists or sub-specialists in internal medicine if you require additional screenings like a colonoscopy for colon cancer (which would be overseen by a gastroenterologist).”

When Should You See Your Doctor
For most generally healthy individuals, annual visits to their internists, family doctor or primary care physician is recommended for standard physicals, blood lab work and screenings based on gender, age, family history and other factors. But if you are diagnosed with a chronic condition, such as high blood pressure, diabetes or other risk factors for heart disease, your doctor will likely recommend more frequent consultations.

“Obviously, if you’re not feeling well, such as having the flu or a fever, headaches, or an urgent situation when you know something isn’t right, you seek care from a physician right away,” says Dr. Enriquez. “As far as routine visits, if you have a chronic condition, such as diabetes, high blood pressure or heart disease, your doctor will advise you usually to visit every three or four months, or three or four times a year.  For preventive care, you should visit your doctor at least once a year.”

Watch the video now as Dr. Enriquez provides additional insight into “internal medicine.”