Future of general internal medicine

How do you see the role of general internal medicine in the future?

Akbar Panju: I think I can talk about Canadian general internal medicine and the future is very bright, as I alluded to earlier on [see Evolution of general internal medicine in Canada]. Our patients are getting older, have more diseases, they need a physician who has all the tools, knowledge, and expertise in multiple disciplines of medicine at a very high level. One physician can provide multiple treatments. As somebody has told me recently, if patients do not go through a general internist, they might require 5 subspecialists looking after them: somebody to look after their heart problem, somebody to look after their diabetes, somebody to look after their arthritis. A fully trained general internal medicine specialist can combine all those things, look after the patient, and provide very effective care.

The future is very bright for general internal medicine in Canada. Our trainees now are being trained, and I am in charge of training the general internal medicine as well. Then it is skill sets: for a subspecialist like a cardiologist, a gastroenterologist, they are so specialized, and for them to have the skill sets to provide complete general internal medicine care is becoming challenging, so they leave it to the general internist. I think we need subspecialists. There is a role for subspecialists. We need cardiac angiographers, we need people to do procedures, we need electrophysiology (EP) study people, we need gastroenterologists to do endoscopies. But an effective general internist can do a lot of the work and provide very effective care.

I am very happy that you asked about the future. The future for the next 50 years in my opinion is extremely bright for general internal medicine.