Doctors can be categorized in a number of ways. Some physicians specialize in specific illnesses, patient populations or portions of human anatomy. Others remain generalists, treating the patient as a whole person and attending to all of their routine medical needs. Internists fall into that category, a group known as primary care physicians. Their skills and duties are among the most varied of all doctors.
The term "internists" is used for doctors of internal medicine. That's the study and treatment of conditions occurring within the body's interrelated internal systems, including the digestive tract, glands and major organ systems. Many specialists, including endocrinologists, cardiologists and gastroenterologists, are internists who went on to additional training in a narrower subspecialty. Others remain generalists, working in hospitals, clinics and private practice. While family doctors work in obstetrics and pediatrics, internists usually care solely for adults. From adolescence to old age, an internist can act as any adult's primary doctor.
Internists have a broad understanding of how the human body works, or fails to work. Their primary role is to coordinate a patient's care from the "big picture" perspective, whether providing direct care or referring patients to other physicians for specialized needs. They're the consummate diagnosticians, and they draw on their knowledge of the relationships among the body's systems to make connections between symptoms and potential causes. Specialists, with their deeper but narrower training, can often miss these larger connections to problems outside their scope of practice. In collaborative treatment situations, the internist takes overall responsibility for the patient's care.
General internists in private practice typically deal with a consistent group of patients for years. In hospitals, internists called hospitalists are crucial caregivers for a transient inpatient population. Hospitalists monitor and treat patients who have been admitted to the hospital for various reasons, assessing their condition and following up on their initial diagnosis and treatment. Often, conditions which are vague or ambiguous come into focus over a period of days as treatments are attempted and discarded, or as new symptoms present under the hospitalist's watchful eye. The hospitalist can direct a patient to specialists after confirming a diagnosis, or to critical care or intensive care units if the patient's condition deteriorates rapidly.
Only family physicians have a broader scope of practice than internists, considering their pediatric and obstetric duties. Internists ideally treat the whole person, devoting attention to prevention and wellness as well as treatment. An internist is competent to treat routine problems of the eyes, ears and reproductive system, digestive difficulties, diabetes or other glandular dysfunctions, the nervous system and even basic mental health. Although internists can become certified in adolescent medicine as a subspecialty, they are primarily doctors for adults.
Doctors of internal medicine vary widely in their earning potential. Primary care physicians, including general internists and hospitalists, tend to earn only moderate salaries by medical standards. A 2011 special issue of "Modern Healthcare" magazine reviewed 16 major physician salary surveys, finding average salaries ranging from $188,500 to $236,544 per year for general internists. Hospitalists were in the same range, with averages from $190,333 to $236,600. Some subspecialties of internal medicine can command much higher salaries. For example, gastroenterologists' average salaries ranged from $355,484 to $468,571 per year, while invasive cardiologists earned $373,500 to $532,000 per year.
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