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in the most prevalent clinical conditions and in systemic and rare diseases&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the Azores on the 29<span class="elsevierStyleSup">th</span> of April 2018&#44; the Portuguese and Spanish Societies of Internal Medicine agreed to develop the present declaration&#44; which reaffirms the importance of internal medicine for the future of health systems and manifests&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Their commitment to creating high-value practical training that contributes to the sustainability of the health system&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Their commitment to preserving the specialty&#39;s global and cohesive nature&#44; promoting the creation of areas of competence and not that of new specialties&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0030" class="elsevierStylePara elsevierViewall">The need to change the current hospital model and promote new organizational models based on multipurpose departments governed by internists&#46; These models should include differentiated&#44; multidisciplinary and multiprofession units&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0035" class="elsevierStylePara elsevierViewall">The importance of reinforcing the need for leadership by the internists in numerous areas of healthcare activity&#58; hospital emergency departments&#44; intermediate care&#44; oncologic and nononcologic palliative care&#44; continuous care and long-term care&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0040" class="elsevierStylePara elsevierViewall">The need to extend hospital programs for co-managing surgical patients&#44; led by internists&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">The need to promote the creation and development of outpatient hospital medicine units &#40;outpatient centers&#44; rapid diagnostic units and home hospitalization&#41; that ensure alternatives to hospitalization for specific populations&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7&#46;</span><p id="par0050" class="elsevierStylePara elsevierViewall">The affirmation of the importance of the internist in the integration of care and in the management of chronic diseases in coordination with primary care and other care levels&#44; as well as with social services&#46; It is urgent that we start to consider health and social care as a whole&#44; due to the increasing difficulty of separating health problems from social problems&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8&#46;</span><p id="par0055" class="elsevierStylePara elsevierViewall">By recognizing internal medicine&#39;s capacity to perform diagnostic techniques and its autonomy for treating diseases within its spectrum of intervention&#44; any restriction on its ability to prescribe is rejected&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">9&#46;</span><p id="par0060" class="elsevierStylePara elsevierViewall">The importance of internal medicine for integrating teams for preparing&#44; implementing and monitoring national clinical practice guidelines and the importance of internal medicine&#39;s participation in the organization of health programs and reforms&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">10&#46;</span><p id="par0065" class="elsevierStylePara elsevierViewall">The affirmation of internal medicine&#39;s importance in teaching undergraduate and graduate courses in universities and its importance in scientific research&#46;</p></li></ul></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">In conclusion</span><p id="par0070" class="elsevierStylePara elsevierViewall">This document affirms the role that internal medicine seeks in constructing an effective&#44; inclusive&#44; efficient and sustainable health system and alerts us to the importance of strong political support for this set of strategies to enable its effective implementation&#46;</p></span></span>"
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DOI: 10.1016/j.rceng.2018.11.012
Internal Medicine and its future in health systems. Positioning Statement of the Spanish Society of Internal Medicine and the Portuguese Society of Internal Medicine
La Medicina Interna y su futuro en los sistemas de salud. Posicionamiento de la Sociedad Española de Medicina Interna y de la Sociedad Portuguesa de Medicina Interna
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A. Zapatero Gaviríaa, L. Camposb, R. Gómez Huelgasa, J. Araújo Correiab, J. Díez-Manglanoa,
Corresponding author
jdiez@aragon.es

Corresponding author.
, V. Barretob
a Sociedad Española de Medicina Interna, Spain
b Sociedad Portuguesa de Medicina Interna, Portugal

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