Can an Internist Care for My Asthma?

If you need a primary care physician to help get control of your asthma symptoms, you may want to consider seeing an internist.

Internists are known as “doctors for adults.” An internist can provide any adult the majority of their care in either a hospital or the outpatient clinic. In addition to caring for asthma and other respiratory diseases like COPD, internists provide comprehensive care across all spectrums of disease including women’s health, mental health, and prevention. An internist may perform a preoperative evaluation for a surgical colleague if an asthmatic needs surgery.

After medical school, internal medicine physicians complete a general residency in internal medicine and must pass an exam sponsored by the American Board of Internal Medicine to become board certified. In order to become a pulmonologist or respiratory care specialist, a physician must first complete an internal medicine residency and then complete additional training.

An internist treats many many different conditions and problems. In addition to asthma, your internist probably treats many of the following diseases:

• Allergic rhinitis
•  Anxiety
• Arthritis
• Atopic dermatitis or eczema
• Constipation
• Depression
• Diabetes
• High blood pressure
• Hyperlipidemia
• Pneumonia
• Rashes

Hopefully, your internist will assist you in obtaining better asthma control. There are a number of advantages you may want to consider including:

• One doctor who can treat or lead the treatment of all of your medical problems.
• Consulting a specialist when needed.
• Making referrals based on who you are likely to interact with best.
• Helping you to sort through different recommendations from a specialist.
• Helping you understand and implement specialty recommendations.
• Provide screening and treatment for other medical conditions.

An internist should be able to treat your asthma up to a point. You may want to consider seeing an asthma specialist like an allergist or pulmonologist in any of the following scenarios:

• You had a life-threatening asthma attack or were admitted to an intensive care unit.
• One or more hospitalizations for asthma that you or your doctor cannot identify what the trigger was.
• Poorly controlled asthma that does not respond to treatment over 3–6 months.
• You want an evaluation for allergy shots.
• You need oral steroids more than once per year.
• You have moderate persistent or severe persistent asthma.
• You need more education than your internist can provide.

Patients may not always be referred appropriately. Sometimes your doctor may just need to be nudged. If you think you might benefit from subspecialty care do not be afraid to ask. Some doctors may not be up to date with the latest recommendations for when a referral is appropriate.

The answer will probably depend on who you ask. Some research evidence demonstrates that there are small but measurable differences. If you fall into any of the previously mentioned scenarios or just want a specialist’s opinion, you should discuss a referral with your internist.

Pediatrics is not a large part of internists' training. While most internists will probably be comfortable treating kids age 16 and older, this is not universal.