Adult (Not Internal) Medicine

The term internal medicine originated from the German Inneren Medizin, which came into common usage in the 1880s [1]. Internal medicine in Germany was distinguished from “clinical medicine” because of its new emphasis on experimental physiology and chemistry rather than the progression of disease manifestations [1].

Unlike most specialists, who are clearly identified by technique (for example, surgery), body part (for example, ophthalmology), or target population (for example, pediatrics) [1], internists are commonly confused with interns and are frequently asked by patients and friends, “Exactly what does internal medicine mean?” Although everyone understands the meaning of the word family and ascribes value to it, the word internal suggests something mysterious, unseen, and quite possibly unpleasant.

In recognition of this problem, the American College of Physicians has developed a brochure entitled “Internal medicine. Doctors for adults. Where we fit in today's primary care picture” [2] and a campaign to educate the public on the role and function of the internist. An analogous but far less ambitious campaign was undertaken more than a decade ago, when the upsurge in primary care internal medicine was just beginning and the distinction between the diagnostic consultant [3] and the primary care internist needed to be clarified. At that time, Kurtz and Goodman [4] argued that internists, including both generalists and subspecialists, should be called adult medicine specialists.

Many years later, it still seems that an unhelpful or poorly descriptive name should be changed, not …