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Last year, the Internal Medicine service of the University Hospital of Cabueñes treated nearly four thousand hospitalized patients and another nine thousand in outpatient consultations. It is the service with the greatest care burden, the one with the highest number of medical admissions, but also “the most unknown.”
What does an internist do? In view of everything that the specialty covers, the answer could be that an internist is like a family doctor within the hospital because in this clinical service the most common pathologies are treated, from cases of heart failure to pneumonia, chronic bronchopathies. , urinary infections, kidney problems, skin problems… His is a comprehensive vision of the patient.
A patient who has multiple pathologies. And of advanced age. So, in a region like Asturias, with an increasingly aging population, the workload for the internal medicine service does not stop growing year after year. The management of diseases and the evolution of treatments also influence this exponential growth in the number of patients treated. “It was always the service with the most medical income in the hospital, but now much more,” says Julio Noval, a member of the service since his years as a resident doctor.
To give a recent example. Last Christmas, at the height of the circulation of respiratory viruses, Internal Medicine admitted nearly two hundred patients in Cabueñes. That’s almost half of the hospital’s available beds. “We had patients on all the floors, from zero to the eighth,” when theoretically Internal Medicine only occupies the even fifth and the even and odd seventh. Because “all winters are bad, but this year was worse. We had weekends of seventy admissions,” notes Noval. Except for the pandemic years, last Christmas was undoubtedly the busiest period. This internist said it was influenced by the relaxation in the use of the mask and a vaccination rate that did not reach the expected levels. “A mistake,” he laments, given that both factors reduce the probability of hospitalization and mortality.
24 doctors
Noval is one of the 24 deputies of a service that, since the retirement of Joaquín Morís de la Tassa in 2022, has been headed by Dr. María Jesús Barragán. They also have ten residents -two per MIR year-, a figure that will possibly increase from 2025 with three residents per year.
Internal Medicine has specific sections, such as the autoimmune diseases unit, the infectious diseases unit, and the heart failure unit. It also collaborates with the Traumatology service in an orthogeriatrics section, for the clinical monitoring of patients operated on for hip fractures, which helps avoid possible medical complications and reduce hospitalization times. Part of their work is also interconsultations with surgical services at the Cabueñes hospital and collaborative virtual consultations with Primary Care doctors.
Regarding hospital admissions, the average stay is six days, a “very good” ratio. On the other hand, the waiting list for external consultations is “at one and a half or two months”, although giving priority to the reasons for consultation that require it. Internal Medicine has four outpatient clinics: two for general internal medicine, one for infectious diseases and a fourth for autoimmune diseases.
