Description of specialty
Respiratory medicine is concerned with the diagnosis and treatment of a wide variety of diseases of the airway and lungs, their linings and blood vessels, and the muscles and nerves required for breathing (see Respiratory disease areas below). The British Thoracic Society has produced a useful factsheet on the work of respiratory physicians. Respiratory medicine is closely linked to acute and general medicine as respiratory disorders account for approximately one-third of an unselected general medical take. Almost all respiratory physicians are trained in general internal medicine (GIM) as well as respiratory medicine.
This general medical training helps respiratory physicians treat patients holistically and always endeavour to involve patients in their own care. Patient education and self-management is key to the treatment of many respiratory conditions.
Respiratory physicians work in teams with:
- career grade doctors
- doctors in training
- ward-based and outpatient nurses
- respiratory nurse specialists
- respiratory physiologists
- clinical scientists
- secretaries and managers.
Respiratory physicians also work closely with many other specialties, including:
- thoracic surgery
- palliative medicine
- genitourinary medicine
- public health and social services.
Close clinical liaisons have been developed between respiratory physicians and colleagues from disciplines in which multisystem diseases affect the lungs. These include rheumatology, haematology, transplant services, genitourinary medicine, renal medicine and oncology. Respiratory physicians are also increasingly developing collaborations with other specialists, particularly cardiologists, to provide high-quality care for the large number of patients who have multiple comorbidities and/or overlapping symptoms (eg integrated breathlessness clinics).
Respiratory physicians are often involved in multidisciplinary teams (MDTs) and networks of care. The majority of lung cancer MDTs in the 30 cancer networks in England are chaired by respiratory physicians, as are most lung cancer-specific network working groups. Respiratory physicians also work in specific MDTs for mycobacterial diseases, interstitial lung disease (ILD), asthma, chronic obstructive pulmonary disease (COPD) and end-of-life care. Respiratory physicians have also been at the forefront of the drive towards integrated care and increasing numbers of respiratory physicians now contribute to community networks of care, which deliver significant improvements in care quality and patient experience, and reduce costs.