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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 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