Viewpoints on the problem of subspecialization in internal medicine

There is no doubt that the specialisations which were performed during the last two to three decades in the field of internal medicine decisively furthered the scientific progress also in this subject. From the more and more detailed insights into the pathological process connected with this and the opening of more and more far-reaching therapeutic possibilities, however, resulted also with regard to the patients' care an increasingly organ-related medicine, which lost sight of the patient as a subject and personality. It has been omitted that the purely natural-scientifically orientated way of consideration is only one side of medical activity and that for recognition of all aspects of the homo patients internal medicine has to make use also of comprehensions and experiences of arts and social sciences. The synthesis of the two roots, connected with a subspecialization restricted to the necessary measure and its integration into a patient-orientated total concept of internal medicine should be able to reasonably coordinate scientifically explored facts, technical achievements, ethical things and things expected by the patient.