I derive a great deal of satisfaction from trying to practise general medicine the way it should be done. Holistically… drafting out a problem list with everything from the acute problem to placement and addressing each issue in turn.
That said, the limiting factor is time. Which is affected by manpower. There are times when the patient load is increased and a shortage of manpower is present.
There are times when one small medical team has to take care of 40 patients. Understandably, in the constraints of time and resources, issues get missed, things are a much more rushed, and the stress level builds up.
We really need more good internists. How can this be addressed? It seems to me that despite the slightly increased remuneration (compared to previously, but still paltry compared to the procedural disciplines) and seamless training program for general medicine, it’s a very unattractive field. Boring to the impatient and frustrating to the internists who are forced to compromise on standards (or one cannot finish seeing every patient in a day). How can we make it more attractive? By having more good internists.
Hmmm, looks like we’re in a bit of a pickle.