Internal medicine: interview with Dr Francisco Martínez Peñalver

The medical speciality of internal medicine has made dramatic advancements in recent decades. We are witnessing a trend towards ever-personalised treatment as a result of technological developments.

Hospital Ochoa’s Dr Francisco Martínez Peñalver has over 20 years of experience in internal medicine and took the time to answer a few questions about his field.

 

Why is internal medicine relatively unknown by the public?

Until recently, the medical specialty of internal medicine was only present in hospitals. We were the diagnosticians who worked behind the scenes. There was a trend for other specialties, such as cardiologists, endocrinologists or nephrologists, to open their own private practices, whereas internal medicine was kept away from the public eye. We were only called when there was an interdisciplinary need for an internist to pool together the findings of all the other specialties involved.

This has changed. People are increasingly aware of our work, also partly thanks to television shows such as Dr. House. The Spanish Society of Internal Medicine, especially since the appearance of Covid, has taken a step forward and has devoted itself to the task of educating the public on what internal medicine physicians do.

 

How would you define the role of an internist?

We are like an orchestra conductor with several important roles. When a patient has a health issue affecting several organs, the internist brings together all relevant medical branches. We are also the official diagnosticians, so to speak. We are the final link for patients who have been unable to obtain an accurate diagnosis. We also provide support for all other medical specialties when needed. And another field in which we are very involved is infectious diseases.

 

How has internal medicine changed over the last few decades?

Immensely. When I started my speciality in 2004, internal medicine was characterised by professors who knew the textbook by heart but were uncomfortable with issues not covered in the medical literature.

In the last 20 years, the speciality has come a long way. Nowadays, a multitude of diagnostic tests such as ultrasound scans can be performed. This was unthinkable two decades ago. Internal medicine has modernised to the point where it is now one of the specialties to publish research and innovate medicine the most.

 

Is personalised medicine the future?

Absolutely. One must understand that we live in a world of globalised medicine in which health protocols have been standardised to raise the quality of healthcare for millions of people. At the same time, technology and artificial intelligence allow us to personalise patient care more than ever before, which is key as the same disease may affect people differently.

The challenge then become discerning when to employ these same universal standards and when to apply personalised care. Of course, other factors come into play here, such as empathy or innovation, but I think providing personalised medicine offers added value.

 

What can we expect from this specialty in the future?

Internal medicine must continue to innovate and apply these innovations. Earlier I mentioned how an ultrasound is a hugely useful technique that was inexistent not so long ago. This is just one example of how much the speciality has advanced. Other innovations being developed today will prove similarly ground-breaking in the future.

Furthermore, I think that instructing other medical specialties in new diseases such as SIBO (Small Intestinal Bacterial Overgrowth) is something that helps move medicine forward a lot. Another example of innovation is hormone replacement therapy, a taboo subject in Europe, but not so in the United States. We have acquired the knowledge of how to apply it and now we are passing it on to other specialists.

 

What does Hospital Ochoa’s Internal Medicine Department do on a daily basis?

We are a young team. We review all hospitalised patients on a daily basis, the vast majority of which are surgical. We ensure that their medication is correct throughout all stages of treatment, and that they are stable during and after surgery. We also offer 24-hour support to the Emergency Department.

In addition, we support the Outpatient and Emergency Wards by monitoring patients, paying extra close attention to those with more complex health issues. Our overall purpose is to offer support wherever we can provide added quality of care.