The Complete Guide to Becoming A General Internal Medicine Physician

Chapter 1: What Does a General Internal Medicine Physician Actually Do?

Let's skip the glossy brochure version and get straight to it. A General Internal Medicine Physician - or "internist" - is a doctor who specializes in the prevention, diagnosis, and treatment of diseases in adults. Not just one adult at a time, though. In a typical outpatient clinic, an internist carries a panel of anywhere from 1,500 to 2,500 patients. In a hospital setting, they might round on 15 to 20 patients who are acutely ill. The unifying thread is that the internist is the medical detective and the quarter-back of care for adults with complex, often overlapping, conditions like diabetes, heart disease, hypertension, and chronic lung disease.

Your day, if you work in an outpatient clinic (often called "ambulatory" care), starts early. Many internists are seeing their first patient by 8:00 AM and won't stop until 5:00 PM, with a 20-minute lunch break squeezed in somewhere. You'll see an average of 18 to 22 patients per day, each in a 15 to 20 minute slot. That's the central fact of the job: fast, focused, back-to-back decision making. One patient comes in with a cough that's been lingering for three weeks, the next has a poorly controlled blood pressure that's been creeping up for months, and the next is a 78-year-old woman with dementia, whose son is worried about new confusion. You don't have the luxury of reading a full chart for an hour; you have fifteen minutes to