episode 32. Internal Medicine: The Tell All

Tying tubes, nonconsensual hysterectomies, withholding medical care without contraception use…these are just a few ways that forced sterilization has occurred in the United States. The history of forced sterilization is sewn into the fabric of US history, and has played an insidious role in this country. This episode, we learn about the eugenics movement, its impact on communities of color and how these issues continue to manifest today. Then join us in our Feminist Corner as we discuss forced sterilization in the context of abortion bans and how healthcare providers play a key role in protecting patients from experiencing this blatant violation of human and reproductive rights.

Feminist Corner:

If the “expert” specialties, which one would you most like to do?

How would you reckon with going into a specialty within internal medicine that doesn’t have many women knowing that you going into it could help change the culture of that specialty?

Listen to the episode, discuss these questions with friends and family, let us know what you think!

Show Notes:

What is Internal Medicine? 

  • The American College of Physicians defines an internist, or Internal medicine physicians, as specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. 
  • Internists collect information from the patient, from their bloodwork and labs, from the patient’s medical record and then they bring all that information together to try and figure out what diagnosis is most likely given all those things. 

What subspecialties fall under internal medicine?

  • Cardiology, Pulmonology, Nephrology, GI, endocrine, hematology-oncology, rheumatology (autoimmune diseases), infectious disease.
  • Women’s health (separate from gynecology), adolescent medicine, allergy/asthma/immunology, critical care medicine, geriatric medicine, sleep medicine and sports medicine. 

History of IM:

  • Root of the words “internal medicine” is German!
  • Specifically, in the 17th century, there was an English doctor named Thomas Sydenham who was called “the English Hippocrates” and he was the one to develop this concept of nosology, or the study of diseases. 
  • In the 19th century, internal medicine really took off, because doctors started to collect enough knowledge of different body systems that it was reasonable for them to know a good amount about each. 
  • In the 1830s, medicine started to specialize in large cities. It happened first in Paris but in France as a whole before that, medical practitioners were either physicians, surgeons or apothecaries.
  • There was a group of practitioners outside the mainstream called “experts” that consisted of a bunch of things including: dentists, oculists, midwives, hernia surgeons, bonesetters and lithotomists.
  • So then specialities started to peel off like obstetrics, opthalmology, pediatrics, etc. and this also started happening in other European cities like London, Edinburgh, Vienna, and the like.
  • In the East, much medicine was based on herbal remedies, healers and similar practitioners. 
  • In China,  one of the legendary founders of Chinese civilization Huangdi, wrote a canon of IM called the Huangdi Neijing in the 3rd millennium BCE. 
  • In Japan, the medicine transformed from performing religious incantations to remove the influence of evil spirits on the body to more healer-based, herbal-based natural remedies too. 
  • In the US, specialties evolved when intense professional competition led to medical elites to use science and research to branch off into different specialties.

Women in IM:

  • In 2018, the Association of American Medical Colleges or AAMC reports that within IM, the subspecialty with the most women was Med-peds with 52.8% identifying as women. 
  • The specialties with the fewest are interventional cardiology at 7.7%, general cardiology at 14.1%, GI at 17.6%.

 

Sources:

Echenberg D. La spéciatisation médicate: aussi vieille que l’Antiquité! Médecine interne générale: perspective canadienne [A history of internal medicine: medical specialization: as old as antiquity]. Rev Med Suisse. 2007 Nov 28;3(135):2737-9. French. PMID: 18214228.

History of medicine – Insulin. (n.d.). Encyclopedia Britannica. Retrieved January 24, 2022, from https://www.britannica.com/science/history-of-medicine/Insulin

Medical Specialties with the Most & Least Women Physicians | Staff Care. (2021, October 26). https://Www.Staffcare.Com/Locum-Tenens-Blog/News/Women-in-Medicine-Specialty-Choices/. Retrieved January 24, 2022, from https://www.staffcare.com/locum-tenens-blog/news/women-in-medicine-specialty-choices/

Weisz, G. (2005). Divide and Conquer: A Comparative History of Medical Specialization (1st ed.) [E-book]. Oxford University Press.

What is a Doctor of Internal Medicine, or Internist? | ACP Newsroom | ACP. (n.d.). https://Www.Acponline.Org/Acp-Newsroom/What-Is-a-Doctor-of-Internal-Medicine-or-Internist-0. https://www.acponline.org/acp-newsroom/what-is-a-doctor-of-internal-medicine-or-internist-0

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2 thoughts on “episode 32. Internal Medicine: The Tell All

    1. Hey! Just fixed the issue, sorry! Since we’re medical students ourselves, we try to stay as on top of the website as we can but sometimes we don’t update it as often as we’d like. Thanks for commenting and letting us know though! We hope you enjoy the episode and consider subscribing on a podcasting app if you like it!

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