I agree with Dr. Goldman [1] that the word internist is widely misunderstood and that adult medicine offers enhanced perspicuity regarding internists' role in providing both primary care and specialty consultation to adults.

I wish to point out, however, that not all internists limit their practices to adults. In my case, I elected a pediatric subinternship in medical school and completed residency rotations in pediatrics and adolescent medicine. During emergency-department rotations in residency, I saw all patients, regardless of age, and treated most ambulatory pediatric problems without consultation; I also provided first-line response on the code team for all patients. Therefore, I am perfectly comfortable providing primary care to any patient, although I seek consultative guidance sooner when treating children with complex illnesses than I would for an adult with a similar problem.

In some practice settings, internal medicine subspecialists may be called on to provide pediatric consultation to pediatricians or family physicians. One study guide [2] reflects this reality when it includes questions on children, primarily in its sections on infectious diseases and cardiology but sometimes in the sections on neurology, endocrinology, hematology, and dermatology.

The desire to emphasize the internist's central role in adult medicine should not eclipse recognition of many internists' broad primary-care practices.