[Evolution of internal medicine and its specialties in the last decades: an outward view].

Abstract:

:The development of the subspecialties of internal medicine in the western 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 styles, 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 the subspecialist together with the attributes of each category according to an 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 subspecialties but also skilled in clinical epidemiology, informatics, behavior medicine, decision-making, clinical economics, ethics, and problem solving. The American College of Physicians, on the other hand, considers that allowing the community-based general internists to disappear, strengthening the generalist's identity as a primary care-oriented physician who provides no subspecially 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 the best balance between general internal medicine and its subspecialties.

journal_name

Rev Med Chil

journal_title

Revista medica de Chile

authors

Rosselot E

subject

Has Abstract

pub_date

1996-04-01 00:00:00

pages

481-9

issue

4

eissn

0034-9887

issn

0717-6163

journal_volume

124

pub_type

历史文章,杂志文章
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  • [Consensus proposal on the use of 131I in the treatment of thyrotoxicosis and thyroid cancer].

    abstract::A consensus meeting held by the Chilean Endocrinological Society reached to 22 consensus proposals on the use of iodine-131 in hyperthyroidism and thyroid cancer, that are reported in this paper. Some of these propositions are: 1) Hyperthyroidism: A previous 131I uptake test must be performed. A calculated or an ablat...

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  • [Association between glutathione peroxidase levels and clinical manifestations of dengue].

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  • [About the death of Herod the Great].

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  • [Hepatitis B virus vaccine: early and late response in Chileans with high risk of infection].

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  • [Measurement of reliability and validity of clinical instruments].

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  • [Prevalence of risk factors to cardiovascular disease in group of Chilean employees].

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    authors: Lanas F,Del Solar J,Maldonado M,Guerrero MA,Espinoza F

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  • [Antigenic types of circulating rotavirus in children with acute diarrhea in Santiago de Chile].

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    authors: O'Ryan M,Mamani N,Avendaño LF,Cohen J,Peña A,Villarroel J,Chávez A,Prado V,Valdivieso F,Kaltwasser G

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