Absolutely , Today there is need to rethink over importance of clinical signs and symptoms and treatment as per standard guidelines , rather than straightway going for expensive and unwarranted investigation. Laying down importance in clinical skills during internship, even at undergraduate teaching may help

We absolutely need good nurses, good general practitioners, and good internists performing their jobs for personal satisfaction.

Hello Mehmet Rami Helvaci

I am also very much in favour of good internists - for both adult and paediatric cases - as more emphasis is given to investigations and interventions. A lot of these (investigations and interventions) seem excessive to me sometimes and I wonder if someone has applied thought to what is the BEST test or what the patient really wants/needs rather than do everything you can think of is a much more effective and cost-efficient approach.

I had a further thought... one of the major problems I come across is that there is often so much going on with some cases that the person needs this procedure or this test and nobody actually takes ownership or a co-ordinating role. A good internist does that as well.

For making difficult.diagnosis, you should to hire DM Doctor n respective superspeciality stream like Nephro, Gastro, Neuro etc

Sure, to be aware of pathogenesis and Differential diagnosis of many diseases , their similarities and differences , it is better to have internal medicine base and background

Holiastic approch needed for better patient outcome as well patient satisfaction and Doctors satisfaction also

In complex cases the patient often suffers from the 'medical bystander syndrome'. Many superspecilist give advise but at the end no one sees the trees in the wood and a final diagnosis and treatment fails what is very detrimental for the patient. A general superviding internist is more than ever needed.

Yes because General medicine doctors have a good information and knowledge about many diseases and how to make a decision to treat it

Absolutely, good differential from internists is highly valuable.