I spent yesterday at Mayo Clinic Jacksonville, doing morning report, presenting grand rounds and giving an “inspirational” talk to the graduating residents.  As I prepared for that talk, I have reflected on my career thus far in internal medicine.  The following thoughts contributed to my talk (implicitly, not explicitly.)

I am an internist without a subspecialty; I am a specialist.

I have many “hobbies” in internal medicine.

Internal medicine probably changes more rapidly than any other specialty.

Internal medicine requires a fully developed combination of detective prowess and empathy.  We all love solving the complex problems in internal medicine, but we also understand the responsibilities of the doctor side of the doctor patient relationship.  The complete internist becomes a master of both.

I believe an internist’s value exceeds current payment.  We need more internists without a subspecialty, whether they work in hospitals, in their office, or both.

While I still slip and use the phrase general internal medicine, the word general is redundant and not necessary.  Internal medicine is a great specialty.

Internists are not primary care physicians, although we can do primary care.

Many subspecialists remain internists; unfortunately, many eschew their internist roots.

Time for a few quotes:

“The good physician treats the disease; the great physician treats the patient who has the disease” – Sir William Osler

“No greater opportunity or obligation can fall the lot of human being than to be a physician . In the care of the suffering he needs technical skills, scientific knowledge, and human understanding, he who uses these with courage, humility, and wisdom will provide a unique service for his fellow man and will build an enduring edifice of character within himself. The physician must should ask of his destiny no more than this, and he should be content with no less. ” – Tinsley R. Harrison

“Time personally spent with the patient is the most essential ingredient of excellence in clinical practice. There are simply no short cuts and no substitutions.” – Philip Tumulty

One nephrologist I met yesterday described himself as a militant internist.  I liked that phrase, because that is what I am.  I love the field for many reasons.

I am an internist.  I cannot imagine a greater profession.