When Should We See An Internist?
Internal Medicine is the branch of medicine that retained most of its unified approach and universality on the general medical practice level from prevention to rehabilitation and is the only specialty integrating all others.
Thus, other than complaints concerning a single organ or clearly requiring a specialist, it is best to see an internist with practically all types of complaints for a comprehensive general examination before setting up a diagnosis. In cases where your symptoms are undetermined (feeling of discomfort, weakness, fatigue, changing gastrointestinal complaints, recurring pain, sleep complaints, nervous system complaints, etc.), a general physical examination by an internist may help direct the you to the appropriate specialist.
The best would be if everyone concerned with his or her health would regularly, at least once a year, even when symptom free, would regularly see an internist for a basic physical examination, a blood test and urinalysis.
What Specialists Can Internists Direct Us To?
As medical science progressed, and more and more of the areas dealing with special organs, these separated from internal medicine and became specialties on their own (i.e., cardiology, angiology, diabetology, hematology, gastroenterology, endochrinology, etc.). The opinion was that, as specialties based on internal medicine, they would be more effective.
In setting up a diagnosis, the internists have at their disposal the most varied examination methods and diagnostic imaging (ECG, laboratory, bone density measuring, arteriography, ultrasound, x-rays, etc.). Thus, the internists can direct you to any to any specialty required.
What Happens During a Physical Examination
A physical examination begins with your medical history. The doctor will ask you about precedents, when your symptoms first appeared, previous illnesses and whether any cardiovascular disease, cancer, gastrointestinal, respiratory, metabolic, excretory system, etc. disorders appear in your family medical history. Possible autoimmune disorders, drug allergies and other allergies as well as contagious diseases are also important to mention.
Your physical will also include blood pressure, pulse rate, weight and body mass index measurements. The doctor will check your skin, the color of visible mucous membranes, palpate your thyroid and lymph nodes, check the sensitivity of your abdomen and the size and condition of your liver and spleen and for possible oedema in your musculoskeletal system. The doctor will also examine your chest, lungs and heart by percussion and with a stethoscope.
At this point, knowing your medical history, symptoms and complaints, the internist will define the road you should follow and dtermine the order in which you should have tests done and consult with specialists. The internist will compare the basic laboratory tests (CBC, sedimentation rate, liver function, blood fat level, LDL and HDL cholesterol, blood sugar, sodium, potassium, calcium, phosphorus, ALP, uric acid, bilirubin, iron, iron binding capacity, urinalysis) with the earlier results brought in by the patient (or, in the case of a returning patient, with those found in our files) and continually check for any changes.
If necessary, the internist may send you for various diagnostic imaging, chest x-ray, abdominal and pelvic ultrasound, breast diagnostics, etc.