1. Chapter 7 Medicine

2. 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.

3. 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

4. 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.

5. 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.

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

7. Family and General Practice

8. 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.

9. 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

10. Pediatrics and Women’s Medicine

11. 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 and pregnancy

12. 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.

13. 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

14. 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.

15. 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

16. 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.

17. 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

18. 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

19. 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.

20. Non-Conventional Practitioners

21. 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 pra ctice –http://www.naturopathic.org

22. 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

23. 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.orghttp://www.acaom.orgwww.nccaom.org