[Internal medicine: problems and perspectives].

The professional status of the internist is changing. For instance, subspecialists and general practitioners are conducting more and more the traditional activities of internists. The number of certifications in general internal medicine in Switzerland over recent years has decreased. The same phenomenon is observed in other countries and particularly the USA, where surveys show unquestionable disappointment among internists with the quality of their working life arising from concerns over a private life-invading profession, low income, increasing administrative burdens and loss of clinical decision-making autonomy. Has the internist still a place in our health care system, and what would be the effect of disappearance of internists on the quality and the costs of medicine? The Swiss Society of Internal Medicine seems unable to solve this disaffection problem unaided, since it also interests general practitioners and consequently all the disciplines oriented toward primary care and family medicine.