[General medicine, internal medicine in hospitals]

The great progress that has been made in medical knowledge in the last fifty years has led to the birth of various new medical specialities and, consequently, to the institution within hospitals of specialised departments and services. A little at a time, General Medicine has lost responsibility for almost all the main sectors of medical pathology, with the result that there has been a serious deterioration in the importance and prestige of the discipline. Today there is a tendency to consider General Medicine departments as a direct hospital projection of everyday medical practice and hospital medicine is required to fill in the serious gaps in extra-hospital welfare and medical structures. The image and functions of General Medicine within hospitals need reassessing. Major hospitals, which already house the main specialist wards, should be given specialist Internal Medicine departments too. A limitation should also be set on the number of unjustified admittances (which mainly go to General Medicine wards) by means of efficient registration services able to filter patients. General Medicine has a number of important tasks outside the diagnosis and treatment of hospitalised patients. It has an important didactic function geared to the practical medical training of students in their final years, of newly graduated doctors, of those specialising in internal medicine, those specialising in clinical and scintific research, and in the updating of general practitioners outside the hospitals.