General internal medicine in Belgium: to be or not to be?

Does general internal medicine in Belgium have a future? This question, which was recently raised in an editorial in this journal (1), is pertinent. Medicine is becoming increasingly technical and complex, leading to progressive specialization and even ‘super-specialization’. For instance, a cardiologist may focus on revalidation, transplantation, interventional cardiology, electrophysiology, echocardiography, or the like. Consequently, internal medicine is split in more and more pieces. This ‘centrifugal’ evolution may raise the questions: are we experiencing the demolition of internal medicine (fi g. 1)? Is there still a need for general internal medicine? We believe there is. General internal medicine should reassume its rightful role at the core of internal medicine (fi g. 2). A patient cannot be divided in several pieces. He or she is more than just his or her atrial fi brillation or his or her diabetes mellitus. A general internist is perfectly placed to deal with patients with combined pathologies, with complicated or multisystem diseases, or with ill-defi ned symptoms. Patients deserve an integral approach, including consideration of psychosocial issues. The general internist should be ‘the master of complexity and cocoordinator of chaos’ (2). He or she is the detective of