According to a recent study on medical discharge records (SDO) [1] in Italy, internal medicine today takes in charge mainly elderly patients affected by complex diseases in phase of exacerbation. The first 4 diagnosis related groups (DRGs), cardiac failure, pulmonary edema, pneumonia, septicemia, confirm the internal medicine role in the management of acutely ill complex and poly-pathological patients. These patients need repeated hospitalization for continuous monitoring and high technological support.