[The role of internal medicine in health services--time for retirement?].
Internal medicine is more than a hundred years old, even in Norway. Its intellectual fundament originates from nineteenth century medicine in Germany. Traditionally, these German physicians covered the entire field of medicine. However, due to lack of therapeutic remedies their main emphasis was on diagnosis and prognosis. During the last sixty years the tremendous increase in medical knowledge has led to a strong tendency towards organ specialization. The generalists in hospitals have met competition from general practitioners and specialists in geriatrics. At the same time their domain has steadily shrunk as the number of medical hospital beds has been reduced. Although not to the advantage of the patients, progress is wiping out the hospital generalists. Most (90%) hospital doctors are now organ specialists, although the majority of patients admitted to medical departments have diseases in more than one organ system. Therefore, generalists should be at least as equally appreciated as the organ specialists. To save the generalists the educational system must be changed. The two types of specialists should follow their own educational paths qualifying to separate and independent competence areas (general or organ-specific). Medical departments should be encouraged to maintain general sections in addition to the organ-specific sections. The generalist and the organ specialist should be professionally united in their efforts to develop internal medicine as a discipline.
Hjort
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PF
Avdeling for samfunnsmedisin, Statens institutt for folkehelse, Oslo.
Stene-Larsen
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G
D005194:Family Practice; D005858:Germany; D049672:History, 19th Century; D049673:History, 20th Century; D007388:Internal Medicine / Q000193:education / Q000266:history / Q000639:trends; D008511:Medicine; D009664:Norway; D013038:Specialization
Indremedisinens rolle i helsetjenesten--moderfaget som må på gamlehjem?