Aspiring doctors who are looking for a specialty that offers a lot of variety, work availability in a number of settings and that helps a wide range of patients may find that the position of an internist is the best option for them. Internal medicine is a general specialty dealing with the entire internal organ system of the body, making it a rewarding career for those who like to problem solve, interact with patients and provide multiple levels of care including prevention, acute care, inpatient and clinical.
What is an Internal Medicine Specialist?
An internal medicine specialist is commonly called an internist. They focus on internal medicine to provide long-term care and can work with a broad range of patients presenting with minor to complex illnesses. Internists work with adults to diagnose and treat cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They may also treat common problems of the eyes, ears, skin, nervous system and reproductive organs. They offer disease prevention, wellness and common treatments as well as manage more complex medical problems.
An internist must have knowledge regarding the entire body and commonly works alongside other specialties to provide complete patient care. During medical school it has been said that internal medicine is an intellectual medical specialty as diagnoses and treatments are based on discussions with patients, instead of tests and procedures.
An internal medicine doctor can specialize in a sub-specialty of care, learning a particular process more in depth in order to help with specific problems, diseases or offer specific treatment. Sub-specialties require additional training and certification, mentioned below.
Sub-specialties for internal medicine include:
Understanding the Educational Path to Becoming an Internal Medicine Specialist
Internists are required to have a doctorate degree earning either an M.D. (doctor of medicine) or a D.O. (doctor of osteopathy).
Step by Step Educational Path of an Internal Medicine Specialist
The Career Path to Becoming an Internal Medicine Specialist
Internists can work in private practices like an office or clinic, in hospitals or in nursing homes. Each of these areas provides different levels of patient interaction, sees varying levels of acuity in patient needs and has responsibilities based on the organization or setting.
Different settings, hospital types, team sizes and requirements of the job mean that internists can find a lot of difference in work week, hours and schedule, duties and responsibilities, patient demographics and case load, and more. Hospitals in large cities that have small internist teams will require longer work hours, more overnights and less days off than private practice settings that have more regular hours or even hospitals with large teams on each floor that split the duties and work load.
Characteristics of a good internist:
Work Environments
In a recent study, internists reported that they spend 30-40 hours per week seeing patients. This averaged to 50-75 patient visits per week, though some reported as high as 124 patients or more per week. Each patient was seen for between 13 and 20 minutes, on average.
The figures above vary based on the nature of the internists work. Some internists spend the majority of their time working in hospitals while others operate out of clinics or private practices. Internists are hired at physician’s offices; general medical and surgical hospitals; outpatient care centers; colleges, universities and professional schools; home health care service providers; psychiatric and substance abuse hospitals and by management companies or providers that specialize in placing doctors in practices or hospitals that they manage.
Salary
Internists are in the lower third of specialties for income with a mean income of $185,000. Only 10% of internists earn $300,000 or more while about 16% earn $100,000 or less. The income gap between male and female internists is 18% which is less than many specialties.
One factor of internist salary ranges is the work setting. The mean income of some of the most popular settings for internists is as follows:
Internist salary can also be affected by their hiring situation:
Salaries are affected by the geographical location of the internist as well. Internists earn the most in South Central (Texas, Oklahoma and Arkansas) and earn the least in the North East. The top paying states for internists are South Dakota, North Dakota, Montana, Missouri and Kansas paying an annual mean wage between $238,190 and $250,000.
An Internist who is a Hospitalist
An internist that chooses to work primarily at a hospital is called a hospitalist. They will focus on giving care to patients who have been admitted to the hospital for various lengths of time and a range of reasons. While the patients are at the hospital, the internist will coordinate and manage their care by working with nurses, ancillary support, specialists and their primary care physician in order to help the patient towards discharge. After discharge the patient returns to the care of their primary care physician for follow-up and long-term treatment.
A hospitalist spends their shift doing rounds, visiting patients, talking to nurses and staff, and coordinating care with other specialists in order to help patients. In this setting, patients are in much more acute conditions that an internist would see at a private practice or clinic. A private practice doctor might see people for regular check-ups, cold or flu symptoms, other discomfort or ongoing concerns. In the hospital setting they see patients who have developed significant problems like respiratory infections, cardiovascular disease, organ failure. Their job in these situations is to provide holistic care to the patient, ensuring that they are given the treatments and care they need to recover without putting any unnecessary strain or risk on the body.
In the hospital setting an internist may have to work longer hours, more days in a row in order to provide a continuum of care to the patients that are admitted. However, in some hospital settings, internists are given the same number of days off as their work shift, evening out their schedules to 40 hours a week. The 40 hours may come with one, long, 80-hour work week followed by the same number of days off. This makes it a good schedule for those who seek to maintain separate interests outside of the work environment including time with family, travel and hobbies.
In this way, choosing the place where an internist practices drastically changes their interaction with patients. Internists who choose to work in a clinical or private practice setting will likely see the same patients for many, many years. Internists in the hospital setting will see patients for the length of their stay in the hospital only – longer than an emergency room doctor, but not as long as a primary care physician.
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