Why a General Internist is Important to Your Care

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By: Kathleen Smalky M.D.

Why? What a familiar question. It's rare that a day goes by without a patient or family member asking me, "Why?" What they're really asking is, "Why am I seeing you?" And, by the way, "Who are you and what do you have to do with my cancer care?"

Great questions. Let's see if I can succinctly answer them. I'm a general internist, trained in the medical care of common adult illnesses such as diabetes, hypertension and asthma. At M. D. Anderson, I provide inpatient and outpatient medical care of common adult problems within the uncommon setting of cancer diagnosis, treatment, management and survivorship.

What does that have to do with your cancer care?

Cancer occurs within the "total you." Treatment of your cancer occurs within your unique body and personal construct. Your cancer specialist wants you to be as healthy and as medically stable as possible while working with you to treat your cancer. Having a general internist as a member of your cancer health care team frees your cancer specialist to focus on your cancer's treatment and process. This all translates into teamwork for total patient care.

Early on, I might be asked to provide feedback about your overall health or to medically maximize any pre-existing medical illnesses, such as diabetes, hypertension or asthma. Later, it might be to address new medical issues that arise or to manage those pre-existing illnesses -- especially if they're changing as a result of your cancer treatment.

During the surveillance and survivorship phases of your cancer care, my focus is optimal management of your medical problems, maximization of health, application of appropriate health maintenance and preventive screening, and careful observation for  new complications from treatment such as chronic pain, lymphedema and hypothyroidism.

I hope this helps explain "why" it might be important that you see a general internist while receiving care at a cancer center.

In your cancer care experience, have you seen a general internist? What's your perspective on involving a general internist in your cancer and survivorship care?  

I'm eager to share my observations and experiences with you as I go about my clinical care activities. I'll keep you updated on conferences I attend, my clinical research activities and medical literature searches. If anything special interests you, please leave a comment to let me know.
Oh, that reminds me, I came across an article last week about breast cancer survivorship care by primary care physicians. Maybe I'll summarize it next time. I'd love to get your reactions.

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