Make up of things I admit:
-50 % are chronic conditions with a known diagnosis (COPD, CHF, CAD, DM, etc.). Mostly caused by smoking, diet, and medication non-compliance. The healthcare system would likely have improved outcomes and decreased costs if instead of involving an internist we just got these patients a life coach, personal trainer and nutritionist.
-20% are dumps from other services with admission to medicine because the specialists hate dealing with all the social bull**** and/or don't want to come to the ER after 5pm and say "just admit to medicine."
-15% are social admits because our healthcare system sucks and instead of providing resources to EM docs to facilitate placement of patients, we instead have the 3 day inpatient rule for SNF placement.
-10% have actual acute medical problems through no fault of their own. The diagnosis of this is generally pretty straight forward.
-5% have something interesting/confusing that I truly need the broad differential of an internist to help me with before a specialist gets involved as once they get involved they will only be focused on their specialty.
In the ideal medical system most patients would fall under the last category and we would actually use our medicine colleagues for their diagnostic acumen. Instead, the medicine service is the dumping ground of the hospital system. The trash comes in through the ER front door and leaves through the back door which is the Medicine service. It is one continuous assembly line of processed ****, fueled by unrealistic consumer expectation and malpractice attorney cupidity. It's why i'm forced to admit that 85 year old with chest pain because god forbid that one 85 year old dies comfortably in her bed while sleeping from a massive STEMI. Instead we must send her to the assembly line for the million dollar workup only to die 6 months later from metastatic cancer after suffering 4 horrible months on chemo.