Health Care Careers - Physician
Physicians are the foundation of all health care systems. Physicians diagnose and treat illnesses. Aside from helping patients overcome illness, physicians help people maintain good health with preventive care. Regular checkups from a family physician or pediatrician help people stay healthy. However, physicians do much more than simply provide physical examinations. They take medical histories and order, perform, and evaluate diagnostic (used in diagnosis) tests. If the tests show irregular results or indicate the presence of a disease, the physician will decide upon a course of treatment that may include medication, a surgical procedure, or therapy of some sort.
A SAMPLING OF SPECIALTIES
Here are just a few areas of medical specialty and what parts of the body they involve:
Anesthesiology: anesthesia or drugs used to make an individual lose consciousness/feeling (as when undergoing surgery)
Cardiology: the heart
Dermatology: the skin
Gastroenterology: the stomach and the intestines
Gynecology: the reproductive systems of women
Neurology: the brain and nervous system
Obstetrics: pregnancy and childbirth
Oncology: cancerous growths and tumors
Ophthalmology: the eyes
Orthopedics: the bones
Otolaryngology: ears, nose, and throat
Pediatrics: care of children
Psychiatry: the human mind and behavior
Radiology: the use of radiation to treat disease
Thoracic: the midsection of the body
Urology: urinary tract
There are two different kinds of physicians and that difference lies in their training. The most common type of physician is a doctor of medicine (M.D.). M.D.s are also known as allopathic physicians. There is also the doctor of osteopathic medicine (D.O.). Both types of physicians use all accepted methods of treatment to treat patients; however, because of their training in osteopathy, D.O.s tend to pay closer attention to a patient's musculoskeletal (muscles
and bones) system and employ holistic (treating both the body and the mind) care.
Both M.D.s and D.O.s can specialize in a variety of areas. There are primary (initial) care specialties that include general internal medicine and general pediatrics. There are also what are categorized as medical specialties, such as cardiology, dermatology, obstetrics/gynecology, and pediatric cardiology. Surgery in and of itself is a specialty; there are general surgeons as well as surgeons who specialize in neurological surgery, plastic surgery, or thoracic surgery. Beyond these, there exist numerous other areas of specialty that include anesthesiology, emergency medicine, psychiatry, and radiology.
Approximately seven out of ten physicians work out of an office-based private or group practice. This can include health care clinics and HMOs (health maintenance organizations). When physicians work in a private or group practice, they will also have privileges to admit and supervise the care of their patients who require hospitalization and/or surgery. There are physicians who do not have outside practices and work on staff at a hospital. They are often known as attending physicians. Physicians can also be found working for the federal government, in government-funded hospitals and clinics, or for the Department of Health and Human Services. Most physicians who are on staff at hospitals that are associated with medical colleges also function as instructors at those colleges.
SPOTLIGHT ON PEDIATRIC CARDIOLOGY
Dr. Sean G. Levchuck is a pediatric cardiologist. He diagnoses and treats heart ailments in children from infancy through twenty-one years of age. Many of the heart problems that children suffer from are known as congenital (existing at birth) heart disease. In fact, eight out of every 1,000 children are born with a heart ailment. One of the most common ailments that pediatric cardiologists such as Dr. Levchuck treat are holes between the heart chambers.
Congenital heart disease can be treated with surgery, but often, a pediatric cardiologist can close the hole using a catheter (plastic tubing). Medication can also be used to treat congenital heart disease or to prevent arrhythmias (irregular heartbeats) from occurring. But, if the hole is too large to be treated with either of these techniques, a pediatric cardiologist will make sure the child is healthy enough to undergo surgery. A surgeon will then operate under the direction of the pediatric cardiologist to mend the hole in a child's heart.
In addition to seeing patients in a private office and making rounds in hospitals to check on the status of any patients he has admitted, Dr. Levchuck spends time in the cath lab, doing catheterizations on his patients. Catheterizing a patient enables Dr. Levchuck to open a closed valve in a child's heart or to simply get a better idea of what is happening in and around the heart.
Dr. Levchuck became a pediatric cardiologist because he found cardiology very interesting, especially congenital heart disease. And he loves helping children. To become a pediatric cardiologist, Dr. Levchuck went to medical school and then served a three-year residency in pediatrics. To specialize even further, he did a three-year fellowship in pediatric cardiology at a different hospital. He says that the hardest thing about his job is "the fact that some kids die; that's always the worst part." But, Dr. Levchuck says, "we can help everybody in some way, which is not how it has always been. Dramatic advances [in pediatric cardiology] have been made, especially in the last ten years."
There are only about 1,700 pediatric cardiologists in the world.
Physicians are often supported by physician assistants. Physician assistants are trained and certified to perform many duties that normally would be carried out by a physician, such as treating cuts and burns or setting broken bones. Physician assistants are also able to interpret lab tests, and they may even make preliminary diagnoses. Like physicians, physician assistants often specialize in a certain type of medicine, such as pediatrics or surgery. Physicians also work directly with nurses (see entry) and medical assistants, who perform clerical and organizational duties as well as assist doctors with procedures.
Training to Be a Physician
There is a great deal of education and training involved in becoming a physician of any type. First, an individual must earn a bachelor's degree with a focus on pre-medical studies. Toward the end of undergraduate studies, people wishing to enter medical school must take the Medical College Admission Test (MCAT). After gaining admission to a medical school, medical students then spend two years on classroom studies, taking courses such as anatomy and histology. The following two years are spent working in clinics and hospitals learning acute, chronic, preventive, and rehabilitative care under the supervision of physicians. Students rotate through different areas of care, such as internal medicine, psychiatry, and surgery in order to have a well-rounded knowledge of medical care.
After graduating from medical school, both M.D.s and D.O.s do internships (supervised practical experience) for one year. (Often, a M.D.'s internship will be considered the first year of residency.) The internship is followed by a residency (advanced training in a medical specialty) in a particular area, such as internal medicine or pediatrics, that can last two years or more. Physicians who wish to specialize even further, such as going into pediatric neurology, must do a fellowship (advanced study and research) that can be an additional three or more years. After this training is completed, physicians must pass a licensing exam. Beyond that, to become a certified specialist by the American Board of Medical Specialists (ABMS), an additional exam must be passed.
Because of the demanding nature of both the training and daily activities of physicians, individuals entering this field need to be very motivated and determined. In order to deliver quality care and truly help patients, physicians should have a good bedside manner (the ability to put a patient at ease and communicate effectively) and strong decision-making abilities.