Sunday, September 28, 2008

An agenda to dissolve general Internal Medicine as a unique specialty? Say it isn’t so!

In several previous posts I’ve mentioned the external forces and unintended consequences that threaten Internal Medicine as a specialty. Well now it appears their’s a deliberate agenda afoot to eliminate the specialty of IM. That agenda is stated in an article from a recent issue of the journal Academic Medicine. (You can read the full text here if you’re registered with Medscape). The author has an obvious conflict of interest: He’s a professor and chair of Family Medicine.

Simply stated, the proposal is to “merge” the specialties of Family Practice, Pediatrics and Internal Medicine, a euphemism for the dissolution of Peds and IM as unique, stand alone specialties.

For example:

Because the new discipline would provide continuous, comprehensive health care for an individual through his or her entire lifetime, it would naturally incorporate models and processes of care that integrate the known effects of genetic factors, health risks, lifestyle choices, prenatal and natal factors, and disease processes over a person's complete lifespan. From a professional perspective, additional efficiency and cost saving would also be gained by creating a single set of standards and mechanisms for initial board certification and continued maintenance of certification

So what’s this “new discipline” he’s describing? It’s Family Practice!

How will medical students making career choices react to this? They’ll think long and hard before entering a specialty that’s under consideration for dissolution in 20 years!

I issue this challenge to the American College of Physicians and the Society of General Internal Medicine: Tell us in no uncertain terms that you intend to support general Internal Medicine as a unique specialty for the long haul. If you can’t do that it’s time for us to form a new organization that will represent the highest traditions and professional interests of our specialty.


Anonymous said...

"I issue this challenge to the American College of Physicians and the Society of General Internal Medicine"

The SGIM is powerless, and the ACP is all too willing to ignore the plight of the office-based Internist. Instead of focusing on true issues facing us (e.g. reimbursement, paperwork & authorization hassles, and countering unreasonable patient & family expectations), they are like politicians, and only pander to the uninformed masses, touting to reduce medical errors & espousing the virtues of the EMR.

They are a USELESS organization, and only serve to steal money from internists for a bogus certification or outdated "FACP" status that nobody under 40 gives a crap about.

And as for the ABIM, they've done NOTHING to counter the hundreds of useless "boards" that will certify someone in almost any esoteric bogus field, diluting what it actually means to be board-certified in something like IM.

Anonymous said...

IM is a specialty so large that it could be reasonably divided into its components, such that each one is a separate specialty, and yet someone is seriously talking about merging it with other specialties? It could stand more differentiation and there's a call to give it less?

Is this bizarro world?

Well gee, why don't we get rid of medical specialties altogether, and make all physicians interchangeable. That would "standardize" medicine, wouldn't it?