¿Qué es Medicina Interna? / What is Internal Medicine?

Internal Medicine can be defined as a medical specialty devoted to the comprehensive care of adult patients, focused in the diagnosis and non surgical treatment of diseases affecting internal organs and systems (excluding gyneco-obstetrical problems) and the prevention of those diseases. This position paper reviews the history of Internal Medicine, the birth of its subspecialties and the difficulties faced by young physicians when they decide whether to practice as internist or in a subspecialty. In Chile as in most occidental countries formal training in a subspecialty of internal medicine requires previous certification in internal medicine but the proportion of young physicians who remain in practice as general internists appears to be considerably lower than those who choose a subspecialty. The main reasons for this unbalance can be related to financial advantages (by the practice of specialized technologies) and the patients' tendency to request direct assistance by a professional thought to be better qualified to take care of their specific problems. Training programs in internal medicine should consider a greater emphasis in comprehensive outpatient care instead of the traditional emphasis for training in hospital wards.

Doenças e trabalho: um olhar sobre a construção da especialidade medicina do trabalho / Diseases and work: a view on the formation of the specialty occupational medicine

Analisa a constituição de um campo de saber específico que revela um processo de aspectos e facetas variadas que se inter-relacionam mutuamente. Tal processo é uma importante face da produção intelectual juntamente com a trajetória dos médicos, os lugares de onde eles estão falando, os veículos que utilizam nas suas produçções, os diversos contextos históricos do país, os diferentes momentos da história da medicina e da ciência, entre outras questões.

A gênese de uma especialidade: o processo de profissionalização da oftalmologia / The origin of a specialty: the professionalization of ophthalmology

Analisa como ocorreu o processo de construção de uma especialidade médica no Brasil na segunda metade do século XIX. Pretende mostrar de que forma um grupo de médicos passou a se autodenominar oftalmologistas, sendo reconhecidos como especialistas em doenças oculares pela sociedade e por seus pares.

Visión histórica crítica de las instituciones psiquiátricas de Tucumán (Décadas del '30 al '70) / Historical critical vision of psichiatric institutions at Tucumán (1930-1970)

Antecedentes: escasos y dispersos. Objetivo: lograr que la experiencia singularmente vivida por los psiquiatras, protagonistas o testigos de los comienzos de la psiquiatría en Tucumán, queda escrita en la memoria colectiva. Lugar de aplicación: Facultad de Psicología de la Universidad Nacional de Tucumán. Diseño: descriptivo. Metodología: cualitativa. Técnica: entrevista semidirigida. Resultados: descripción de los inicios de la psiquiatría como especialidad médica y de sus instituciones en Tucumán, del período precientífico que la antecedió y del contexto sociopolítico que la determinó. Conclusiones: En el devenir histórico de las instituciones manicomiales se pudo distinguir claramente un proceso que fue desde una posición hegemónica como "instituciones totales" (Goffman), cerradas y aisladas, a su status actual de hospitales psiquiátricos, más abiertos e integrados a una red de servicios de creciente complejidad.

Notas para la historia del Manicomio General de México, década de los 40's / Notes for the history of The General Insan asylum of Mexico in the 40's

Con motivo de la inauguración del Pabellón Central del Manicomio General, en la década de los cuarenta, se inició una nueva etapa en la vida de esta institución, ya que éste contaba con una unidad de neurocirugía, un departamento de oftalmología, electroencefalografía, rayos X y otros servicios. Es la época de los tratamientos de choque, que se describen ampliamente. Exitos y fracasos son señalados por el autor, que vivió esta importante época de la psiquiatría en México

Evolución de la medicina interna y sus especialidades en las últimas décadas: una mirada al exterior / Evolution of internal medicine and its specialties in last decades: an outward view

The development of the subspecialties of internal medicine in the wetern world is reviewed from a historical perspective, focusing on the case of the United States of America. During the last decades, changes both in society and in medicine as a whole have prompted a great dispersion of medical practice style, not always well-defined in their contents and goals, and ranging from primary care to ultra specialization. The definition of the general internist and of subspecialist together with the atributtes of each category according to, American College of Physicians' task force group are commented upon. Some of the possible reasons accounting for a decreased interest in general internal medicine during the eighties together with figures supporting a recent reversal of this trend are given. New proposals have originated in government as well as in medical circles to promote the development of general internists, conceived as physicians knowledgeable in the classic sunspecialties but also skilled in clinical epidemiology, informatics, behavior medicine, decision-making, clinical economics, ethics and problem solving. ACP, on the other hand, considers that allowing the community-based general internists to disappear, strenghtening the generalists' identity as a primary care-oriented physician who provides no subspecialty care, becoming hospital-based generalists who act mainly as consultants, or becoming fully trained subspecialists who also provide primary care, are all rejectable options. These arguments illustrate the fact that even in highly developed societies a degree of indefinition remains as to best balance between general internal medicine and the subspecialties