title: [Internal medicine: challenges and opportunities at the beginning of a new century].
abstract: Internal medicine was born at the end of the nineteenth century as the result of the great amount of medical knowledge that accrued. The word "internal" has a great meaning and symbolism that underscores a holistic view of the patient. After some years of fruitful work, internal medicine experienced the appearance of subspecialties. This meant a great technological advance but increased the costs of services and deteriorated patient-physician relationship. These tactics along with world sanitary changes, offer a unique opportunity for the resurgence of Internal Medicine. Nowadays the internist has the image of an expert able to treat patients with diseases that involve several organs or systems or to serve as a consultant for complex medical problems. The new threats of the specialty are Family Medicine and hospital physicians. The areas in which the internist should acquire expertise to cope with the new sanitary requirements are also analyzed.
authors.affiliation: Hospital José Carrasco Ortega, del IESS, Apartado 510, Cuenca, Ecuador. sanchezp@etapaonline.net.ec
authors.forename: Paúl
authors.initials: P
authors.lastname: Sánchez
mesh_terms: D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D007388:Internal Medicine / Q000266:history / Q000639:trends*