[Reflections on the professional and organizational development of internal medicine]

A steadily increasing body of knowledge has led to the current system of specialization and sub-specialization in medicine. A potential danger is sub-subspecialization and fragmentation of service to patients. Internal medicine must therefore remain undisrupted and given possibilities of growth. The foremost challenge of internal medicine today is to further develop its own diagnostic and therapeutic culture. Traditionally, the internist has been the advocate of rational clinical diagnostics. Clinical diagnostics must remain the starting point of the diagnostic process. Our therapeutic culture is linked in particular to conducting and analysing large clinical trials. Internal medicine is also playing an increasingly important role in the organization of proper care for the old and the dying.