Chapter 7 Medicine Objectives After studying this chapter

Chapter 7 Medicine

Objectives After studying this chapter the student should be able to: • Describe the responsibilities and work of each profession. • Classify the types of specialties in each profession. • Discuss the environment in which the work takes place. • Identify any adjunct personnel who assist the professionals with their work. • Compare and contrast the following factors among the professions: educational requirements, employment trends, opportunities for advancement, salary potential, and career ladders. • Describe the differences in licensing, certification, and registration for careers of interest. • Identify the professionals who do similar tasks or have similar responsibilities. • Discuss the advantages of the national organizations to which professionals belong. • Explain the concept and functions of interdisciplinary teams.

Doctors: The Perceptions • Many physicians and surgeons work long, irregular hours. • Highly competitive entrance • Typical education and training requirements – 4 years of undergraduate school – 4 -5 years of medical school and 3 to 8 years of internship and residency • Demanding, high pay, lot of opportunities in rural and low-income areas. • Cost of training is a serious consideration

Doctors: The Realities • Physicians and surgeons diagnose illnesses and prescribe and administer treatment for people suffering from injury or disease. • Physicians examine patients, obtain medical histories, and order, perform, and interpret diagnostic tests. • Depending on the type of physician - they counsel patients on diet, hygiene, and preventive health care.

Doctors: The Realities There are two types of CONVENTIONAL physicians: MD (Medical Doctor) and DO (Doctor of Osteopathic Medicine). • MDs also are known as “allopathic physicians. ” – Allopathy is treatment of disease with drugs that oppose symptoms • DOs might place special emphasis on the body’s musculoskeletal system, preventive medicine, and holistic patient care (depends on the DO school) • DOs are most likely to be primary care specialists, although they can be found in all specialties. • About half of DOs practice general or family medicine, general internal medicine, or general pediatrics.

Doctors: Areas of Specialty Anesthesiologists focus on the care of surgical patients and pain relief.

Family and General Practice

Doctors: Areas of Specialty • Family and general physicians often provide the first point of contact for people seeking health care, by acting as the traditional family physician. • They assess and treat a WIDE range of conditions, from sinus and respiratory infections to broken bones.

Doctors: Areas of Specialty • General internists diagnose and provide nonsurgical treatment for a wide range of problems that affect internal organ systems, such as the stomach, kidneys, liver, and digestive tract. • Internists use a variety of diagnostic techniques to treat patients through medication or hospitalization. • Focus on adult patient population only

Pediatrics and Women’s Medicine

Doctors: Areas of Specialty • General pediatricians care for the health of infants, children, teenagers, and young adults. – They specialize in the diagnosis and treatment of a variety of ailments specific to infant - young people; track patients’ growth to adulthood. • Obstetricians and gynecologists (OB/GYNs) specialize in women’s health and childbirth – They are responsible for women’s general medical care, the reproductive system and pregnancy

Doctors: Areas of Specialty • Psychiatrists are the primary mental healthcare givers. – They assess and treat mental illnesses through a combination of psychotherapy, psychoanalysis, hospitalization, and medication.

Doctors: Areas of Specialty • Surgeons specialize in the treatment of injury, disease, and deformity through operations. • There are many types of surgeons • A “general surgery” residency is usually 5 years and then specialty surgeons (i. e. cardiovascular, plastics, neurosurgeons, etc. ) require the 5 years + more years of training

Doctors: Areas of Specialty • Other physicians and surgeons work as a variety of other medical and surgical specialists, including allergists, cardiologists, dermatologists, emergency physicians, gastroenterologists, ophthalmologists, pathologists, and radiologists.

Work Environment • Many physicians work in small, private offices, clinics or group practices • Others work in hospital and surgical settings or a combination of the above • Often assisted by a small staff of nurses and other administrative personnel (i. e. medical coding/billing), MAs, CNAs, etc. • Generally work 50+ hrs/wk and on call

Employment Opportunities Physicians and surgeons held about 661, 400 jobs in 2008: • 12% were self-employed • About 53% of wage-and-salary physicians and surgeons worked in offices of physicians • 19% were employed by hospitals • Others practiced in federal, state, and local governments, educational services, and outpatient care centers.

Educational and Legal Requirements • The common path to practicing as a physician requires – MCAT entrance exam is required – 8 years of education beyond high school – and 3 to 8 additional years of internship and residency. • All states, the District of Columbia, and U. S. territories license physicians. • Medical students must pass 2 USMLE exams before they are able to practice or be placed in a residency • Must pass a board certification exam in chosen specialty

Employment Trends and Prospects • Employment is expected to grow much faster than the average for all occupations. – Employment of physicians and surgeons is projected to grow 22% from 2008 to 2018 – Numbers likely to increase: ~65, 000 in 2008 to 800, 000 in 2018 • Job opportunities should be very good, particularly in rural and low income areas. • We know that there is expected to be a shortage of primary care physicians

Earnings • How much a doctor earns depends on many things (area of country, specialty, etc. ) • In 2009, physicians practicing primary care had a total median annual compensation of $200, 000 • Physicians practicing in medical specialties earned about $400, 000.

Non-Conventional Practitioners

Naturopathic Physician • Naturopathic Physicians (ND or NMD) – 4 year Doctoral degree; trained as primary care physicians (OR and WA) or specialist; licensed in 17 states, the District of Columbia, and U. S. territories – Focus on treating the cause of the disease or illness, not suppressing symptoms with medications – Learn preventative and lifestyle medicine, nutrition, botanicals (herbs) nutraceutical and prescription medications, homeopathy and minor, in office surgical procedures – Must pass 2 NPLEX exams before practicing (similar to USMLE); does not require a residency for practice – http: //www. naturopathic. org

Chiropractic Doctors (DC) • Chiropractors have a Doctoral degree in chiropractic medicine – Called “Physical medicine” doctors – Manipulate bones that are not in alignment with proper body structure; nutrition; cannot prescribe prescription medications or perform surgeries – Believe that proper structure of the bones and nerves have a large impact on health and wellness – https: //www. acatoday. org

Chinese Medicine Practitioners • Traditional Chinese Medicine or Classical Chinese Medicine (MSOM/ LAc) – Use acupuncture, movement (tai qi and qi gong), Chinese herbal formulas and nutrition used to treat illness and diseases – Believe that energy imbalances in the body illnesses/disease – Master’s degree and few Doctoral programs – http: //www. acaom. org and www. nccaom. org