What is the difference between internal medicine and surgery?

For the distinction between internal medicine and surgery, many people are really confused about whether to see internal medicine or surgery when registering.

Is the disease of a part, such as stomachache, to see a doctor or a surgeon?

Most people think that diseases invisible to the body surface depend on internal medicine, while surgery is visible; If you don't need surgery, go to the internal medicine department. If you want to have an operation, do it.

In fact, the composition of internal surgery in most hospitals is divided into different departments according to the human body system and internal surgery according to different diagnosis and treatment methods.

For example, internal medicine includes respiratory medicine, gastroenterology, cardiovascular medicine, neurology, endocrinology, hematology, infectious diseases, pediatrics and so on.

Medical treatment methods, drugs, interventional therapy, etc. Adjust drugs according to the patient's condition to prevent and deal with side effects and complications.

Surgery is mainly divided into general surgery, cardiothoracic surgery, hepatobiliary surgery, urology, orthopedics, neurosurgery, burns, plastic surgery, microsurgery and so on.

Surgery is a professional department with surgical resection and repair as the main treatment means.

In the past, the division of labor between internal medicine and surgery was very serious, which was called specialization; Now, with the development of medicine, it is gradually developing towards surgeon's surgery and surgeon's internal medicine.

What is the difference between a physician and a surgeon?

Internal surgery comes first! Quality!

Doctor: I'm usually good-tempered, slow-talking and patient. Surgeon: I'm just a gust of wind, even if it blows! Generally, they are short-tempered. If you can do it, don't want BB

Then it's daytime! Chang!

Doctor: Either sit in the consulting room, make rounds or write medical records. Surgeon: during the operation ... during the operation ... prepare for the operation. ..............

also

sign pen

Doctor: You must have a pen in your pocket. You can choose any color. Surgeon: Where is the pen? Where are the pens? I lost it again. It's okay. Go to the doctor and get another one!

and

Attitude towards food!

Doctor: It's time. There are few patients today, so we can eat on time. Surgeon: Eat! Dinner! ! Just have a surgical meal! Eat quickly! !

also

Hands! Wei! Health!

Does the inside and outside attack have a wrist?

(The doctor understands! )

Doctor: Wash it slowly, clean it, and then put it on your ass or armpit. White coats are cleaner in these two places. . ) Surgeon: Wash your hands and elbows! Wear gloves after washing, remember the principle of sterility!

Finally.

Whether you walk fast or slow.

Handsome posture!

Doctor: Take your time, slowly but surely, slowly.

Surgeon: You walk so slowly that you can't run? ! Click, click (playing slippers)

After reading it, what else do you want to say? Welcome to comment!

Some people think that internal diseases and internal organs should be treated with internal medicine.

Some people think that superficial diseases visible to the naked eye should be treated by surgery.

It is obviously wrong to distinguish internal medicine from surgery according to body surface and internal organs. Internal medicine and surgery are not literal.

Internal medicine and surgery are translated from English, and English will help us understand the difference between internal medicine and surgery more easily. Internal medicine is the department that uses drugs. Internal medicine means medicine in English, and it is treated with medicine. So doctors mainly use drugs to treat people, such as pneumonia, gout, hepatitis B, hypertension, diabetes, coronary heart disease, hyperlipidemia and other diseases. These diseases can be treated with drugs, so these diseases should be treated with internal medicine.

With the development of medicine, the division of departments is more detailed, and some departments even see only one disease. Common internal medicines are as follows:

Cardiology: It mainly treats cardiovascular diseases, such as arrhythmia, hypertension, coronary heart disease, heart failure, bradycardia, myocarditis and infective endocarditis.

Respiratory medicine: it mainly treats lung and trachea diseases, such as pneumonia, tuberculosis, chronic obstructive pulmonary disease, asthma and bronchiectasis.

Nephrology: Mainly focus on kidney diseases, such as nephritis, nephrotic syndrome, uremia, renal failure, urinary system infection, etc.

Endocrinology: diseases of endocrine system, belonging to endocrinology, such as hyperthyroidism, hypothyroidism, diabetes, hyperuricemia, gout, osteoporosis, bone metabolism diseases, etc.

Rheumatoid immunology department: it is one of the most miscellaneous departments, mainly dealing with rheumatic immune system diseases, such as systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, polymyositis and dermatomyositis, systemic vasculitis, Sjogren's syndrome and so on.

Gastroenterology mainly focuses on digestive system diseases, such as gastritis, enteritis, constipation, diarrhea, hepatitis, pancreatitis, gastric ulcer, duodenal ulcer, ulcerative colitis, Crohn's disease, gastrointestinal polyps and early gastrointestinal cancer.

Neurology mainly focuses on brain and nerve diseases, such as migraine, cerebral infarction, myasthenia gravis, meningitis, myelitis, trigeminal neuralgia, epilepsy and peripheral neuropathy.

Surgery is the department that carries out operations. Surgery means surgery or a surgical department in English. If translated literally, surgery means surgery. Surgeon's English is surgeon, and the doctor who performs the operation is called surgeon. Therefore, surgeons mainly treat diseases through surgery. For example, tumors, physical deformities, cosmetic surgery, trauma, fractures and other diseases all need surgical treatment, so it is necessary to see a surgeon.

There are many kinds of operations, which can be divided into many departments, and the department settings of each hospital will be very different.

General surgery, also known as basic surgery, is a general surgery in a broad sense, including gastrointestinal, hepatobiliary, pancreatic, abdominal wall, thyroid, breast and even vascular diseases. For example, gastric cancer, intestinal cancer, gallstone, gallbladder polyp, cholecystitis, pancreatic cancer, thyroid cancer, hyperthyroidism, mammary gland hyperplasia, breast cancer, hernia, varicose veins, hemorrhoids, anal fistula, anal fissure, perianal abscess and so on. Many hospitals divide general surgery into gastrointestinal surgery, anorectal surgery, thyroid surgery, breast surgery, hepatobiliary surgery, vascular surgery and so on.

Hepatobiliary and pancreatic surgery: subdivided from general surgery, it mainly focuses on hepatobiliary and pancreatic diseases, such as liver cancer, hepatic cyst, cholecystitis, gallstones, gallbladder polyps, cholangiocarcinoma, pancreatic cancer and pancreatic cyst.

Thoracic surgery: it mainly treats esophageal, lung and mediastinal diseases, such as esophageal cancer, lung cancer, pneumothorax, pulmonary bulla, thymoma and mediastinal cyst.

Orthopedics: Diseases related to bones and muscles belong to orthopedics, such as fractures, bone tumors, scoliosis, intervertebral disc herniation, cervical spondylosis, degenerative arthritis, congenital skeletal malformation, replantation of severed limbs, etc.

Cardiac surgery: it mainly treats heart and great vascular diseases, such as coronary artery bypass surgery, heart valve replacement, congenital heart disease, heart tumor, aortic dissection and so on.

Neurosurgery or brain surgery mainly focuses on brain and nerve diseases, such as intracranial tumor, brain trauma, cerebral hemorrhage, spinal tumor, surgical treatment of epilepsy, cerebrovascular malformation and so on.

Plastic surgery: mainly engaged in plastic surgery, such as rhinoplasty, breast augmentation, buttocks augmentation, double eyelid cutting, liposuction, abdominal plastic surgery, private parts plastic surgery and so on. Large plastic surgery hospitals will be subdivided into different plastic surgery departments according to plastic surgery sites.

What is the difference between internal medicine and surgery? Simply put, internal medicine is mainly about "maintaining, maintaining and upgrading" your "original part". For example, medical treatment is equivalent to "maintenance", while interventional treatment, such as installing stents or plugging defects, is equivalent to "upgrading" your "original" outdated, worn or defective parts.

So, what is surgery? Mainly to "repair, disassemble and replace" your "original accessories". The appendix is inflamed and cut; Bone fracture, with nails and alloy plate connection; If the heart valve is broken, cut it off and replace it with an artificial one; If the whole organ fails, directly change an organ (organ transplantation) ...

In other words, in medical treatment, all the "parts" on your body are basically "original" by you. If you go for surgery, the "parts" on your body may not be "original". There may be fewer "parts", some "parts" may be changed, and even the whole "part" may be "removed" (such as total hysterectomy and bilateral appendectomy). ) or be replaced. Of course, debridement and suture are also surgical work. If the incision is regular and there is no secondary infection, then you are basically the "original match".

It's not that the operation is the operation. Nowadays, minimally invasive technology is developing faster and faster. Surgeons don't have to paddle around with scalpels or electric knives ... Small blades and scissors at the tip of the surgical arm can also perform surgery. On the contrary, with the development of interventional therapy in internal medicine, physicians now also perform operations and use surgical instruments.

If you are sick, how to choose internal medicine or surgery? Let's just say that if you have a "cut" in your body, whether it's opening a ladle or tearing it ... go directly to surgery, these must be surgical work. In other cases, it is recommended to go to the internal medicine department first. If surgery is needed, the physician will tell you which surgery to transfer to. After all, patients don't understand medicine, and they can't be sure whether their diseases need surgery.

For the simplest example, if you have pain in your right lower abdomen and rebound pain, it is probably acute appendicitis, but you are not a professional and cannot be sure. In this case, you can go to the gastroenterology department or the emergency department first, and the physician will determine whether you have appendicitis. If the physician thinks that conservative treatment is not feasible, he will send you to general surgery. If you are in a hurry to go to general surgery, you have to go to internal medicine to prevent pain in the right lower abdomen caused by other reasons. If you meet an unreliable general surgeon, appendicitis that could have been treated conservatively may also get a knife. ...

As for the specific sub-major, it is probably like this. Internal medicine is relatively clear, such as respiratory medicine, digestive medicine, cardiovascular medicine, nephrology and so on. Wherever there is a problem, go there. There are some ambiguities in surgery, such as general surgery. Simply put, as long as orthopedics, urology, cardiothoracic surgery, neurosurgery (some hospitals call it brain surgery), otolaryngology, head and neck surgery and other departments can't control it, they can basically go to general surgery ... they take care of everything there, including thyroid, breast, stomach, intestine, anus ... from neck to buttocks, including body surface injuries and so on. But now many hospitals have a clear division of labor, and general surgery is subdivided into nail surgery, gastrointestinal surgery, anorectal surgery and so on. In fact, there is a big difference.

But personally, if it's not obvious trauma, let's go to the hospital to see internal medicine first. It's up to the doctors to decide whether they need a surgeon to take over. After all, they are more professional than you. Now, I'm afraid no doctor dares to "rob patients" but insists on his own treatment while knowing that patients need surgery. Once there is a problem, he/she can't eat and walk!

Let me tell you a joke about internal medicine and surgery. A group of unknown birds are flying in the sky. Physicians and surgeons discuss what kind of bird this is.

Doctor: from the appearance of birds, they are more like geese, and the possibility of other birds is not ruled out; From the sound point of view, it is also like a wild goose, but it needs further verification; From the analysis of the epidemic trend of regional distribution, it conforms to the living range of geese, but it does not rule out the possibility of other birds. In short, the possibility of geese is very high, but further verification is needed.

The surgeon aimed his gun and shot down a bird with one shot: analyze it, shoot down and dissect one!

Simply put, traditional doctors focus on the analysis of diseases, especially the ability to diagnose and analyze intractable diseases, use theoretical knowledge to diagnose diseases, and then control diseases with drugs according to evidence-based medical evidence. The level of doctors is mainly the ability to diagnose diseases. Internal medicine can be divided into cardiology, respiratory medicine, neurology, endocrinology, hematology, nephrology, gastroenterology, pediatrics and so on. Doctors mostly operate stethoscopes.

The surgeon is basically faced with a relatively clear diagnosis (if the diagnosis is not clear, you can explore by laparotomy! ), more use of surgery to treat diseases. Surgery can be divided into thoracic surgery, general surgery, neurosurgery, orthopedics, breast surgery, urology, plastic surgery, heart surgery, burn surgery and so on. Surgeons basically use knives.

But now, with the rapid development of internal medicine, many physicians begin to perform operations, such as cardiac stent implantation and radiofrequency ablation of arrhythmia. Whether to operate or not is not the difference between an internal surgeon and an external surgeon.

What is the difference between internal medicine and surgery?

This question reminds me of a joke: a soldier was shot by an arrow and went to see a doctor. The doctor picked up a pair of scissors, clicked and cut off the arrow. The soldier asked the doctor that the arrow was still in the meat. What if you don't take it out? The doctor said, "I'm a surgeon. I only care about appearance. " The contents belong to the doctor. "

Another true thing: a patient was punched several times and came to me. I told him that he should see a surgeon. He said, "I suffered internal injuries. Shouldn't I see a doctor? " ? "I am in distress situation.

All majors are gradually branched out from internal medicine, and it is normal to have overlap. When we review the history of medical development, we will find that the earliest doctors were professionals. With the development of medical technology, some doctors may be proficient in this field because they often see a certain kind of diseases, thus accumulating knowledge and experience from generation to generation and gradually forming a specialty. It can be said that internal medicine is the foundation, and almost all other majors are branches slowly developed from internal medicine.

Because of this, although there is a clear division of labor between internal medicine and surgery in some diseases, there are also overlaps in the treatment of some diseases. It is sometimes really difficult to accurately distinguish which diseases belong to internal medicine and which diseases belong to surgery.

I personally summarize the general principles as follows:

All traumatic diseases are classified as surgery. No matter whether there are fractures or wounds, all traumatic diseases are under the care of surgeons. In the dictionary of modern medicine, there is no difference between "internal injury" and "trauma".

All diseases that require traditional surgery or may require surgery are classified as surgery. Such as appendicitis, cholecystitis, pancreatitis, kidney calculi and gastric perforation.

Some diseases that can be classified as surgery can be treated with internal medicine if surgery is not needed for the time being. For example, non-traumatic cerebral hemorrhage can be treated conservatively, mostly in neurology. Acute pancreatitis that does not require surgery for the time being is also accepted by the digestive departments of many hospitals.

Four doctors are carrying out more and more minimally invasive surgery, which is gradually encroaching on the "site" of surgery. For example, atrial septal defect, ventricular septal defect, traditional surgery requires thoracotomy. Now only catheter intervention technology is needed, and physicians can treat it. The wound is small and painless.

Another example is ERCP (endoscopic retrograde cholangiopancreatography) performed by gastroenterologists. Under endoscope, bile duct stones can be removed, and drainage tubes or stents can be placed to relieve bile duct obstruction. No operation, less trauma, short operation time and few complications, which solved many problems that could only be solved by surgery before.

5. Surgeons are also developing to minimally invasive surgery, and the boundary with physicians may become blurred. For example, cerebral hemorrhage is traditionally a craniotomy, and now some patients can also puncture and decompress drainage under CT positioning. Surgeons can do this operation, so can neurologists.

Conclusion: Welcome to pay attention to Dr. Zheng's knowledge and learn more practical medical knowledge every day. In the past, it was actually very easy to distinguish whether to have surgery, surgery was surgery, and the rest were internal medicine, but now it is obvious that this distinction cannot be made because there are more and more operations in internal medicine, and physicians are constantly robbing surgeons of their jobs.

As a physician, let me tell the difference.

The biggest difference is that surgery is far more substantial than internal medicine, because before the development of internal medicine surgery, almost all diseases in internal medicine could not be cured, but surgery was not. Surgery can cure many diseases and relieve patients' pain.

What is often seen after the operation is that the patient's condition is getting better and better, getting better step by step, and then being discharged smoothly.

But this is not the case in internal medicine. It is often seen that patients are getting worse and worse until they die.

So surgery can bring people enough sense of accomplishment, but internal medicine can't. Of course, this situation has changed rapidly in recent years.

Mainly the rapid development of various operations in internal medicine, such as endoscopic surgery in gastroenterology, ERCP, ESD, EMR, POEM, interventional therapy in cardiology, interventional medicine and neurology. Now physicians can also feel the sense of accomplishment of surgeons.

There is a big difference between peacetime and peacetime.

Physicians write medical records far better than surgeons, and all hospitals are the same. Physicians often sigh when reading the medical records written by surgeons.

Physicians are more obedient, surgeons are less obedient, and physicians are generally more obedient.

Physicians are very careful with patients, which is also a point that physicians often complain about surgeons.

But these are not important. As long as the surgeon knows how to operate, one knife means everything, and both social status and economic status depend on this knife.

Surgeons nowadays should dislike physicians very much. Nowadays, physicians have robbed many jobs that originally belonged to surgeons, mainly relying on the progress of drugs and the development of internal medicine and surgery.

Take gastric cancer as an example. Now early gastric cancer can be treated under endoscope, and no surgery is needed at all.

In the past, peptic ulcer often needed surgical treatment, but it changed with the development of drugs.

This is especially true for interventional surgery. Now interventional therapy can be said to be omnipotent, and almost all diseases can be treated with interventional therapy.

The development of all kinds of minimally invasive surgery in the future is definitely the general trend of development and an important direction of medical development.

It turns out that what drugs can do is still very limited, and it still needs surgery to achieve it.

The department that has had surgery is surgery, and the department that has not had surgery is internal medicine.

Now internal medicine can also do some operations, such as doing some endoscopic or microscopic operations.

But if it is only a simple difference, you can still use the above method.

As an oncologist, let me answer your question.

The difference between internal medicine and surgery seems to me to be getting smaller and smaller!

During the internship, I felt that the doctor had just started to make rounds every morning, and the professor asked all kinds of questions, made a preliminary diagnosis and determined the treatment plan. Two hours, three hours.

When I was an intern in internal medicine, I often had this kind of big rounds, and the stressed interns were squeezed out of the door. Back in the doctor's office, the superior doctor began to guide the doctor's advice, which patient should do what examination and prescribe what medicine, and couldn't be more careful! Then, the director makes rounds once a week, and each group comes up with its most complicated and "difficult" cases for discussion. The professors expressed their opinions, and finally the director made a decision. Ok, let's do it! It seems that a physician only needs a stethoscope and a computer. The first feeling that the operation gave me was that every day was full of power. "# # surgery today! You should change the medicine quickly and take out the hook. "This is what my teaching teacher often said when I was an intern. "It seems that surgeons are surgeons, surgeons and surgeons! Therefore, doctors don't like the level of medical records of surgeons, and surgeons look down on doctors and have poor hands-on ability.

However, science is developing! Internal medicine and surgery are more and more alike!

1. Many operations are performed in internal surgery. For example, cardiac surgery in the department of cardiology can do interventional surgery for congenital heart disease and active tumor surgery. For example, the gastroenterology department can do endoscopic resection of early gastric cancer and endoscopic resection of polyps. Doctors who can do CT-guided puncture in respiratory department begin to use their hands, and there are more and more operations.

2. Many diseases need the cooperation of internal medicine and surgery. For example, patients with cancer are treated with chemotherapy in internal medicine to shrink the tumor, so that the tumor volume can reach the surgical guidelines, and then they are sent to surgery, and then they are sent back to internal medicine for adjuvant chemotherapy after surgery. Is this tacit cooperation? !

In a word, there is a difference between internal medicine and surgery, but the difference is getting smaller and smaller.

The difference between the two is that, in popular terms, internal medicine does not need surgery, and surgery needs surgery. Internal medicine and surgery are both parts of medicine, and there are many similarities and similarities, which cannot be completely distinguished. Clinically, doctors must also know the anatomical parts of the human body and some diagnostic methods of surgery, and surgery must also know the anti-inflammatory and rehydration of internal medicine.

Internal medicine mostly examines patients by asking questions, and infers what diseases patients have through laboratory biochemical examination and imaging diagnosis, such as upper respiratory tract infection, pneumonia, cardiovascular and cerebrovascular diseases, myocardial infarction, endocrine system diseases and digestive system ulcers. It is necessary to carry out the diagnosis and treatment of diseases and drug treatment through the cooperation of clinical medical departments and doctors' clinical experience.

But internal medicine is still divided into western medicine and Chinese medicine. At present, western medicine mostly diagnoses diseases through laboratory biochemical examination and imaging diagnosis, while our motherland medicine can diagnose diseases through four commonly used diagnostic methods (observation, smell, inquiry and pulse) through traditional Chinese medicine.

Surgery requires surgery, such as pneumothorax requiring thoracotomy, or cerebrovascular neurosurgery craniotomy, and suppurative appendicitis requiring laparotomy to remove the appendix. At present, the departments of general hospitals at all levels are clearly divided, such as general surgery, oncology, neurosurgery and neurology. Neurosurgery is treated by surgery, such as spinal surgery or craniotomy, which is the most commonly used surgical method.

What is the difference between internal medicine and surgery? In the past, these two themes and other themes were clearly distinguished:

According to the types of diseases, the diseases accepted by surgery include congenital malformation, trauma, suppurative infection, organ function change, tumor and so on. Scalpel, hemostatic forceps and first-class instruments are mainly used, and the treatment is mainly through surgical resection, repair and reinforcement, such as appendectomy, cholecystectomy and tricuspid valve repair.

The internal medicine uses stethoscope, sphygmomanometer, syringe and other instruments. In terms of treatment methods, internal medicine mainly focuses on drug treatment, mainly through oral administration or injection.

However, this statement is not immutable. With the development of medical technology, the boundaries between internal medicine and surgery are gradually blurred, and the businesses of various disciplines are infiltrating each other. For example, many diseases in cardiac surgery, such as coronary artery stenosis, are now solved by cardiac stent, which belongs to the jurisdiction of cardiology. Another example is the treatment of prostate cancer, which can be diagnosed and treated in urology, oncology and geriatrics departments of some hospitals.

As for which department to go to, if you are not sure, you can go to the hospital guidance desk for consultation. Of course, they may not be accurate. According to your illness, you can transfer to other departments. For example, if the patient's stomach is uncomfortable, he can go to the gastroenterology clinic first. After examination, if it is a gastric polyp, it may be transferred to digestive surgery.