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What Is the Future of Internal Medicine?

Robert H. Fletcher, MD, Editor; and Suzanne W. Fletcher, MD, Editor
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Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;119(11):1144-1145. doi:10.7326/0003-4819-119-11-199312010-00013
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Internal medicine faces unsettled times. Formerly the unchallenged leader of medicine, able to recruit the best students with promises of fulfilling patient care, intellectual challenge, and prestige, it now has an ambiguous image, unfilled residencies, and dissatisfaction in practice. Proposals for health care reform, most of which call for half of all physicians being generalists, may have more powerful and disruptive effects on internal medicine than on any other specialty. Either internal medicine will fundamentally alter itself to produce a far larger proportion of generalists than the present 30%, or the specialty as a whole will be forced to shrink in numbers and influence [1].

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