Doctor's in

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Dear Ace, I read that the University of Virginia School of Medicine just graduated 21 students of internal medicine this year. But I’m confused; isn’t all medicine internal?—Tangled Innards

Dear Innards, You obviously have not attended medical school lately, because you are forgetting about acupuncture, dermatology, and telemedicine (similar to phone sex but with a less gratifying clinical angle). There’s also the possibility that internal docs are just practicing medicine on themselves, not on other people. But in the case of UVA, these 21 young internists are distinguished from 20 pediatrics trainees and 15 students of emergency medicine, among other specialized doctors making up the 139 members of the Class of 2009. Congratulations Class of 2009! Now Ace can track you down at parties to tell you about his aching spleen.

Internal medicine is defined as “the branch of medicine dealing with the diagnosis, management, and nonsurgical treatment of diseases, especially of internal organ systems.” But in practice an internist is basically a go-to physician, the primary care doctor you consult whenever things go awry in body or mind, or when you want to prevent malady in general. In today’s hospitals, however, an internist might refer you to a more specialized doctor, depending on your problem. Subspecialties of internal medicine include nephrology (think kidneys), endocrinology (think hormones), cardiology (think heart), and gastroenterology (think digestive system, then giggle). Internists licensed in these specialties have usually completed an additional several years of training, as if the usual eight-year track of medical school plus residency isn’t enough. In contrast, Ace is grateful that his private investigation diploma is nothing more than a sign on the door and an ad in the paper.

All this doctor talk reminds Ace of an old joke: “Q. What’s the difference between a general practitioner and a specialist? A. One treats what you have; the other thinks you have what he treats.” Well right now Ace has a case of loneliness that can only be treated by “Mandy” and her 1-900 number. There’s a reason specialists earn so much money.

You can ask Ace yourself. Intrepid investigative reporter Ace Atkins has been chasing readers’ leads for 20 years. If you have a question for Ace, e-mail it to ace@c-ville.com.

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