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Letters |4 December 2007

The Declining Number and Variety of Procedures Done by General Internists

Join Y. Luh, MD; Bernard M. Karnath, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, and The University of Texas Medical Branch at Galveston, Galveston, TX 77555-0144.

    Potential Financial Conflicts of Interest: None disclosed.

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TO THE EDITOR:
We read with interest the article by Wigton and Alguire (1) on the declining number and variety of procedures done by general internists. On the basis of experiences at our own institutions, we propose that this notable decline can be linked to the American Board of Emergency Medicine's decision, in 1990, to restrict board certification to those who are emergency medicine residents (2). This has led to an increased number of emergency medicine residencies to fill the demand for emergency department (ED) physicians, which has, in turn, competed with the access that internal medicine residents have for ED experience during their residency. Emergency medicine rotations have traditionally been months where internal medicine residents had more opportunities to perform procedures (such as central-line placement, intubations, lumbar punctures, paracentesis, pulmonary artery catheter placement, and even chest tube placement in some institutions).
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Luh JY, Karnath BM. The Declining Number and Variety of Procedures Done by General Internists. Ann Intern Med. 2007;147:814–815. doi: 10.7326/0003-4819-147-11-200712040-00020

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Published: Ann Intern Med. 2007;147(11):814-815.

DOI: 10.7326/0003-4819-147-11-200712040-00020

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2007 American College of Physicians
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