What is an internal medicine consultation?
An internal medicine consultation is a general medical examination in which the internal organ systems of adult patients are assessed. It covers listening to the complaint, a physical examination and, where necessary, requesting laboratory tests and imaging. Diabetes, the thyroid, blood pressure, blood lipids, kidney and liver function disorders and anaemia fall within the scope of this specialty.
Internal medicine is a primary specialty that looks at the patient as a whole rather than at any one organ. For this reason it is often chosen as the first point of contact for patients whose complaint cannot clearly be attributed to a particular organ.
The World Health Organization reports that noncommunicable diseases (opens in a new tab), which usually follow a long-term course, led to the deaths of at least 43 million people in 2021, and that this corresponds to 75% of global deaths not related to the pandemic.
At the practice, the service is provided by Dr. Suzan Alp, Specialist in Internal Medicine.
For which complaints is a physician consulted?
- Long-standing fatigue and weakness
- Weight gain or unintentional weight loss
- High or low blood pressure
- High blood sugar, frequent urination, excessive thirst
- Raised blood lipids
- Palpitations, shortness of breath
- Abdominal pain, indigestion, constipation or diarrhoea
- Oedema, swelling in the feet
- Anaemia, pallor of the skin
- Recurrent infections
- Swelling in the neck, hoarseness
- Values outside the reference range found in a test result
- General check-up and follow-up of chronic disease
What happens during the consultation?
- Listening to the complaint and taking a history. When the complaint began, how it has progressed and what makes it better or worse are recorded, together with previous illnesses, operations, family history, all current medication and supplements, and allergies.
- Asking about lifestyle. Eating routine, the intervals between meals, sleep duration and quality, activity habits, smoking and alcohol use.
- Physical examination. Blood pressure, pulse, temperature, height and weight, body mass index, waist circumference; listening to the heart and lungs, examination of the abdomen, the neck and the lymph nodes, and assessment for oedema.
- Requesting investigations. Depending on the complaint and the examination findings, blood tests, urine tests, an electrocardiogram or imaging may be requested. No fixed list of investigations is applied to everyone.
- Assessing the results and drawing up the plan. The findings are considered together; the plan is explained clearly to the patient and given in writing.
In which patients is the consultation different?
- In emergency patients it is not appropriate. In the event of chest pain, shortness of breath, altered consciousness, sudden loss of strength, uncontrolled bleeding or a severe clinical picture accompanied by high fever, go to the nearest emergency department.
- In patients who are pregnant or breastfeeding, follow-up is carried out together with obstetrics and gynaecology, and the investigations to be requested and the medicines that can be used are different.
- In patients under 18 years of age, care lies within the field of paediatrics.
- In patients whose condition requires surgery, who are undergoing active oncology treatment or who are in a psychiatric emergency, follow-up lies with the relevant specialty; this consultation does not replace it.
- In patients with advanced kidney or liver failure, the choice of medicines and the interpretation of investigations are different.
- In patients whose treatment protocol is run by another physician, that plan is recorded, and if a change is needed you are advised to contact the physician concerned.
How often is follow-up needed?
Because every patient’s course unfolds differently, it would be wrong to give a definite answer to this question. Some cases are completed in a single consultation, while in the follow-up of chronic disease monitoring may continue at set intervals. The physician sets how often the follow-ups take place after the first assessment and reviews this at each visit.
What should you bring with you to the consultation?
- The boxes of all your current medication, or a list with the doses
- A list of the vitamins, minerals and herbal products you take
- Test and imaging results from the past year
- If you have them, discharge summaries, operation and procedure reports
- A list of your known allergies
- If you take regular measurements, your blood pressure or blood sugar records
Whether you need to come fasting depends on the investigations to be requested; you can ask when you make your appointment. For detailed preparation, you can see our article How Should You Prepare for a Consultation?.
The World Health Organization (opens in a new tab) reports that medication-related harm affects one in every 30 patients, and that informing patients and involving them in their care may reduce the burden of harm by up to 15%.
What happens after the consultation?
At the end of the consultation you are given a written plan. It sets out the investigations to be requested, recommendations on your eating and activity routine, any change made to your medication, and when the next follow-up is due.
Once the investigation results are available, they are assessed together at a second consultation and the plan is updated if necessary. In chronic disease follow-up, the measurements are repeated at each appointment and the course is monitored.
Risks and points to be aware of
The consultation itself is not an interventional procedure. During blood sampling, bruising at the site, mild pain and, rarely, dizziness may occur.
A large number of investigations is not in itself an advantage. An investigation requested without clinical grounds may produce findings of uncertain meaning and unnecessary anxiety. Investigations are therefore chosen according to the complaint and the examination findings.
A single test result is not assessed on its own. Laboratory reference ranges may differ from one institution to another; results become meaningful alongside the complaint and the examination findings.
Do not stop your current medication or change its dose on your own initiative.
Incomplete information leaves the assessment incomplete. A supplement that goes unmentioned, or a medicine that is forgotten, may change how the results are interpreted.
Results vary from person to person.
When should you see a physician without delay?
If you notice these symptoms, consult a physician without delay:
- Unintentional and unexplained weight loss
- Fever and night sweats occurring together
- Shortness of breath that worsens over days
- Swelling (oedema) in the legs or body that increases over days
- Frequent urination, excessive thirst, dry mouth
- Blood pressure that runs persistently high on home measurements
- Blood seen in the stool or urine
In the event of chest pain, sudden shortness of breath, sudden loss of strength, disturbance of speech or altered consciousness, go directly to the emergency department.
Frequently asked questions
Which diseases does internal medicine deal with?
It deals with diseases of the internal organ systems in adults: diabetes, thyroid diseases, blood pressure, disorders of blood lipids, kidney and liver function disorders, anaemia, metabolic syndrome and how these relate to one another. It is the first point of contact for patients whose complaint cannot clearly be attributed to a particular organ.
Should I come fasting for the consultation?
This depends on the investigations to be requested. Ask when you make your appointment. If you have diabetes, a long fast may not be suitable; please mention this when you make the appointment.
Which tests are requested during the consultation?
No standard list is applied. The investigations needed depend on your complaint, the examination findings and, if you have them, your previous results. If you have results from the past year, bringing them prevents unnecessary repetition.
When will I find out my results?
How long results take to come back varies with the laboratory and the test requested. The second consultation, at which the results are assessed, is scheduled at the first.
I am under follow-up with another physician; can I still come?
Yes. Follow-up already under way is recorded, and the assessment is made without disrupting that plan. If something is found that would require a change in treatment, you are advised to contact the physician concerned.
Can I come for a general check-up?
Yes. Even in people without complaints, an assessment is made according to age, family history and risk factors. There is no fixed screening list applied to everyone, however; what is assessed is decided person by person.
Sources
- World Health Organization, Noncommunicable diseases fact sheet, 25 September 2025. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (opens in a new tab)
- World Health Organization, Patient safety fact sheet, 11 September 2023. https://www.who.int/news-room/fact-sheets/detail/patient-safety (opens in a new tab)
