Presente y futuro de la medicina interna / Present and future of internal medicine

RESUMO

To mention the crisis of Internal Medicine has become a commonplace, that is extremely wrong, because Internal Medicine is stronger than ever, with many recent and important contributions like randomised clinical trials, meta analysis, evidence-based diagnosis, cost-benefits analaysis, etc. We consider as Internists the General Internist, the sub-specialist and the primary care physician. Among them, it is the General Internist who needs to redefine his working areas, that are progressively moving from the hospital into ambulatory care. Internal Medicine is stretched by 3 strong vectorial forces: 1. Its own development and technological progress. 2. Economical factors trying to limit increasing costs. 3. Social forces demanding a better quality of care Internal Medicine shall need to equilibrate all these forces and be prepared to solve future challenges such as demographic changes, including an ageing population, the compression of morbidity, increasing demands of better care and quality of life, contemption of excessively high cost and now technical and ethical problems. The internist should be the best prepared specialist to cope with these challenges; but to better assume them, deep changes in pre and post graduate medical education are needed