What is the difference between IM and EM?

[profunda]

I mean, it's obvious EM knows things IM dont know, such as emergency procedures and diagnostic pattern recognition. But what can a genearl IM do/know that a general EM doc doesnt do/know? (please disregard subspecialties).

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[madcadaver]

Profunda-

I think the short answer to your question is that IM docs spend a lot of time managing chronic diseases (cardiovascular, diabetes and its complications, COPD, cancer, etc) and screening/ preventative medicine for all of the above as well. ER docs deal with the acute exacerbations of these problems but don't manage them over the long term and have little to do with screening for and preventing them.

MadC

 

[profunda]

yeah, but I mean what about hospitalist internist?

 

[ckent]

There a very significant difference between the mindset and knowledge base of a general internist and EM physician. I would argue that when it comes to non-pregnant non-surgical adults, internists know a lot more then EM physicians because not only do IM physicians have to know how to stabilize patients, IM physicians also have to be able to know how to generate a broad differential and know how to w/u patients while an EM physician can think in terms of whether or not their patient is sick enough to warrant admission and w/u and not worry about the actual disease process. EM physcians do have to know how to treat a lot broader base of patients though (kids, pregant women, surgical patients), and the ER isn't the place for management of chronic conditions, so it's not like the ER physician should be faulted for not knowing things that a general internist should know.

 

[Whisker Barrel Cortex]

IM docs need to know how to actually diagnose and treat people instead of figuring out if they need to be admitted or not.

 

[profunda]

That makes sense. Thank you ckent.

Originally posted by ckent
There a very significant difference between the mindset and knowledge base of a general internist and EM physician. I would argue that when it comes to non-pregnant non-surgical adults, internists know a lot more then EM physicians because not only do IM physicians have to know how to stabilize patients, IM physicians also have to be able to know how to generate a broad differential and know how to w/u patients while an EM physician can think in terms of whether or not their patient is sick enough to warrant admission and w/u and not worry about the actual disease process. EM physcians do have to know how to treat a lot broader base of patients though (kids, pregant women, surgical patients), and the ER isn't the place for management of chronic conditions, so it's not like the ER physician should be faulted for not knowing things that a general internist should know.

 

[DrQuinn]

A lot of people say that any internist can work in the ED... that likely isn't true. EM docs (residency trained, anyways) have a completely different mindset than do any other specialty. A GS resident or IM resident can work in the ED, but if you look at how many patients they see, and the cost of their workup, compared to an EM resident, you will see a large disparity. Anyone can go up to the patietn chart, grab one, and see a patient, get the workup, and come up with a disposition, but not everyone can do it as quickly OR efficiently as someone EM trained. Reverse it, and it is obvious that an EM resident cannot give quite the differential for certain presentations that an IM resident can.

Q, DO