In his editorial [1], Dr. Goldman offers some attractive reasons for replacing the term internal medicine with one that is more accurately descriptive and compatible with current health care delivery systems. But I am not yet persuaded.

That some patients do not fully understand the nature and functioning of the internist is so, but Dr. Goldman's characterization of the numbers of patients who do understand as "the occasional patient" is, I respectfully suggest, literary hyperbole, intended to create interest and emphasis but lacking actual verification. If my informal sampling is the equivalent of Dr. Goldman's informal survey, I can testify that my experience differs dramatically from his.

As for being confused with the hard-working intern, this certainly occurs, but I have never found the task of explaining to be herculean; a few light moments with a patient, briefly describing the role of internal medicine, can afford a wonderful opportunity to initiate a sound physician-patient relationship, neither a burden nor a bad skill for internists to acquire.

Perhaps the label adult medicine might distinguish internists from family practitioners; because family practitioners also treat adults, however, it could produce even more confusion.

The term internal medicine has some important advantages largely overlooked by Dr. Goldman. Most of us would agree that slavish adherence to the past is not deserved or desired. But by continuing to be known as physicians specializing in "internal medicine," we maintain the continuity of a spectacularly illustrious tradition, preserving an alliance both with giants like Osler and with generations of internists loved and revered by their patients. That is not niggling public relations. Through that history, we borrow from the distinction of these predecessors and impart to ourselves a patina that the term "adult medicine" somehow seems to lack badly.