Honestly? I used to wonder what do internal medicine doctors do myself. My neighbor kept mentioning her "internist" and I nodded like I knew exactly what that meant. Truth was, I pictured someone doing... well, internal stuff. Maybe poking around organs? Turns out it's way more fascinating and complex than that.
Let me break this down for you based on what I've learned from doctors and patients over years of health writing. Internal medicine physicians are like expert detectives for adult bodies. They specialize in preventing, diagnosing, and treating diseases inside adults - no kids, no surgery, just pure medical puzzle-solving.
A Day in the Life: What Does an Internal Medicine Doctor Actually Do?
Picture Dr. Alvarez, an internist I shadowed last year. Her mornings start at the hospital - 7AM sharp. First stop: checking on three admitted patients. One recovering from pneumonia, another with uncontrolled diabetes, and a third with mysterious abdominal pain no one's figured out yet. She adjusts medications, orders tests, and coordinates with specialists.
By 10AM, she's at her clinic. The waiting room's packed. First up: Mr. Thompson, 68. His blood pressure's creeping up again. They chat about his salt intake while she adjusts his meds. Next: Young Sarah, 32, complaining of crushing fatigue. Dr. Alvarez orders thyroid tests and screens for depression. No rushing - she spends 25 minutes digging into Sarah's lifestyle.
After lunch? Three more physicals, a telemedicine consult, and reviewing lab results. She calls a patient about concerning cholesterol numbers personally. "Better than an automated message," he later told me.
| Time | Activity | Tools Used |
|---|---|---|
| 7:00-9:00 AM | Hospital rounds (inpatient care) | Stethoscope, EMR system, coordination with nurses |
| 9:30-12:00 PM | Clinic appointments (primary care) | Diagnostic skills, prescription pad, patient education materials |
| 1:00-3:00 PM | Preventive physical exams | Screening questionnaires, vaccination supplies, BMI calculator |
| 3:00-5:00 PM | Chronic disease management & follow-ups | Lab result analysis, medication adjustment protocols, glucose monitors |
What surprised me? The sheer mental gymnastics. In one hour she switched from diabetes management to cancer screening to mental health evaluation. No wonder they need 3 years of residency after medical school.
Diseases They Tackle Daily
Internal medicine doctors handle the heavy hitters - the conditions that land adults in hospitals. Their bread and butter includes:
- Heart warriors: Hypertension management (nearly 40% of their patients), heart failure, cholesterol issues
- Metabolic masters: Diabetes control (they manage over 80% of type 2 cases in adults)
- Lung experts: COPD, asthma, pneumonia
- Gut gurus: Acid reflux, IBS, liver disease
- Infection investigators: From stubborn UTIs to complex infections in immunocompromised patients
My aunt's internist caught her early kidney disease last year through routine blood work - something her busy OB/GYN had missed. That's the value of having someone focused solely on adult medicine.
"We're trained to connect dots other doctors might miss," Dr. Reynolds told me. "When a patient comes with fatigue, we consider 50 possibilities - not just the obvious ones."
Beyond Treatment: Their Unexpected Roles
What do internal medicine doctors do besides prescriptions? Way more than you'd think:
Preventive Care Specialists
They're your health quarterbacks. At your annual physical (which you should absolutely schedule), they'll:
- Screen for cancers - colon, breast, prostate
- Update vaccinations - flu shots, pneumonia vaccines
- Assess fall risks if you're over 65
- Run depression/anxiety screenings
| Preventive Service | Frequency | Why It Matters |
|---|---|---|
| Blood pressure check | Every visit | Prevents strokes and heart attacks |
| Diabetes screening | Every 3 years after 45 | Detects early when reversible |
| Colon cancer screening | Starting at 45 | Second leading cause of cancer death |
| Bone density scan | Women 65+, men 70+ | Prevents debilitating fractures |
Chronic Disease Coaches
My dad's internist spends more time teaching than treating. When dad was diagnosed with diabetes, she mapped out:
- How to prick his finger without pain
- Which carbs spike blood sugar fastest
- Emergency signs requiring ER visits
- Simple foot checks to prevent amputations
Medical Detectives
When symptoms don't fit neatly, that's their sweet spot. One patient I interviewed saw 4 specialists for dizziness. Her internist finally connected it to a medication side effect plus dehydration. Case closed.
Where You'll Find Internal Medicine Doctors Working
Their workplaces might surprise you:
- Private clinics: 60% work in outpatient settings (your typical doctor's office)
- Hospitals: As "hospitalists" managing admitted patients
- Academic centers: Teaching med students while seeing patients
- Corporate settings: Some large companies employ them directly
- Nursing homes: Managing complex elderly patients
During the pandemic, I watched our local hospital's internists transform into ICU frontliners overnight. Their broad training became literal lifesavers.
How Internists Differ from Other Doctors
Let's clear up confusion - I used to mix these up constantly:
| Specialty | Patients Treated | Focus Areas | Training Length |
|---|---|---|---|
| Internal Medicine | Adults only (18+) | Complex diseases, prevention, diagnosis | 3-year residency |
| Family Medicine | All ages (newborns to elderly) | General care for common illnesses | 3-year residency |
| Pediatrics | Children only (0-21) | Child development, pediatric diseases | 3-year residency |
| Specialists (e.g., Cardiologist) | Adults with specific issues | Deep expertise in one organ system | 3-year IM residency + 3-year fellowship |
Here's the key: Your internist is your adult health quarterback. They'll refer you to cardiologists or gastroenterologists when needed but coordinate the overall plan.
Dr. Kaur explained it perfectly: "Family doctors know a little about everything. I know a lot about everything inside adults."
Subspecialties: When Internists Drill Deeper
After residency, many internists pursue fellowships. Common subspecialties include:
- Cardiology: Heart and blood vessel experts
- Gastroenterology: Digestive system specialists
- Endocrinology: Masters of hormones and diabetes
- Nephrology: Kidney disease authorities
- Infectious Disease: Detectives for puzzling infections
My cousin's gastroenterologist actually trained as an internist first. That foundation helps him understand how gut issues affect the whole body.
When Should You See an Internal Medicine Doctor?
Based on patient interviews, here's when they're most valuable:
For Ongoing Health Management
- You need a primary care doctor as an adult (especially after age 40)
- You have multiple chronic conditions
- You take 4+ medications regularly
- Specialists give conflicting advice
For Mysterious Symptoms
Like when:
- Fatigue persists despite normal thyroid tests
- Abdominal pain eludes diagnosis
- Unexplained weight changes occur
- Multiple mild symptoms suggest autoimmune issues
A friend spent years with mysterious joint pain. Her internist finally diagnosed lupus after connecting seemingly unrelated symptoms. Life-changing.
Choosing Your Internist: Practical Tips
Finding the right fit matters. Here's what patients wish they'd known:
- Insurance compatibility: Verify they accept your plan before booking
- Communication style: Some prefer blunt facts; others want gentle explanations
- Office logistics: Average wait times, after-hours availability
- Hospital affiliations: Where they admit patients if needed
Personally, I switched doctors after mine rushed through appointments. My current internist? She runs late because she gives every patient full attention. Worth the wait.
| Factor | What to Ask | Red Flags |
|---|---|---|
| Availability | "How soon can I get routine appointments?" | >4 week wait for physicals |
| After-Hours Care | "Who handles urgent issues nights/weekends?" | Only directs to ER with no coverage |
| Technology Use | "Can I message you through a patient portal?" | No electronic records or online access |
| Communication | "How do you deliver serious news?" | Dismisses questions or concerns |
Your First Visit: Insider Expectations
New patient visits typically last 60-90 minutes. Expect:
- Deep history dive: Prepare family health history and past surgeries
- Medication review: Bring actual pill bottles (dosages matter!)
- Head-to-toe exam: More thorough than quick sick visits
- Preventive plan: Screening recommendations tailored to you
Pro tip: Write questions beforehand. I always forget mine otherwise. Good internists welcome prepared patients.
Common Questions Answered
Do internal medicine doctors perform surgery?
Nope! They're nonsurgical specialists. But they might remove small skin lesions or do joint injections in-office.
Can they treat children?
Generally no - that's pediatricians or family doctors. Some see teens 16+, but always check first.
How often should healthy adults visit?
Annually for physicals. More often if managing chronic issues. Don't wait until something's wrong!
What's the difference between internist and "internal medicine"?
Same thing - "internist" is just the doctor title. But it confuses everyone because it sounds like "intern."
Do they replace OB/GYNs for women?
Not at all. They coordinate with OB/GYNs for comprehensive care but don't do Pap smears or deliver babies.
The Real Value: Why This Specialty Matters
Here's what finally clicked for me: Internal medicine doctors are adult health architects. They see how blood pressure affects kidneys, how diabetes hurts nerves, how depression worsens heart disease. While specialists focus on one organ, internists see the whole ecosystem.
My 70-year-old uncle credits his internist for adding 10 quality years to his life. By managing his heart disease, diabetes, and arthritis together, he avoided hospitalizations that plague his friends.
So when people ask what do internal medicine doctors do? I say: They keep adults thriving through life's complex medical journey. And honestly? We're lucky to have them.
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