Terms for Doctor Types and Practices

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Writing about medical practices is fun,but far from easy. Presently, medical practice seems in a state offlux. There has always been some jealousy among doctors, but notlike we are seeing today. Many medical organizations are feelingthat they are superior to others and applying pressures to statelegislatures to limit or prevent new ideas from gaining a solidfoothold in the medical community.
It is also surprising that some stateshave provided opportunities for different ideas to flourish, andother states use various means to try to restrict or limit new ideas. Several states in the early days of concierge medicine worked hardto prevent it from getting started. Two states invoked insurancefraud and claimed the practices would avoid state policies ofmedicine without insurance and they succeeded for a couple of yearsuntil challenged in court.
Concierge medicine is growing andbecoming a larger force yearly. When two or more doctors jointogether in a practice, they can often afford a nurse acting inseveral capacities. When I wrote this blog, I was not sure I wouldever be involved with one. However, I am a volunteer peer mentor fortype 2 diabetes patients with a concierge practice and know of fourother peer mentors working with another practice. I have also addedanother physician practice that I now serve as a peer mentor for type2 diabetes patients.
Telemedicine is another growing areathat some practices are working hard to expand and again many statelegislatures are being lobbied heavily to limit the scope of practiceallowed. I have said this before, but it is worth repeating, theword reciprocity is not in the vocabulary of the medicalassociations. Any patient that has a regular doctor and travels toanother state should have the right to confer with their doctor backhome over the telephone, Internet, or other electronic media withoutworry about some doctor in that state complaining that he/she wasdenied access to treating the patient. Yet this is where it seemsheaded.
Yet telemedicine is growing. Even someprivate practices are utilizing telemedicine and using physicianassistants, nurse practitioners, and nurses in areas low in doctorsto do the examinations and then either passing this information ontotheir primary care doctors, or when none are available, writing theprescriptions electronically. Most are in states admittedly allowingthis and encouraging this. Some universities are also following thispractice and have centers organized to do this – Kansas andTennessee are two such states.
Although individual practices arebecoming harder to find, there are still a few in existence, but forhow much longer is the question. Hospitals are slowly putting thestranglehold on private practices and becoming increasinglymonopolistic in their operations. They either hire the doctors outof practices or buy out the practice and establish a clinic. Manyare concerned about the ethics involved as in some areas of thecountry hospitals are establishing clinics and moving hospitals tonew areas, thus abandoning the inner city areas where they have been. Under the current Affordable Care Act, will the physicians be ableto survive financially? Only time will expose the answer.
A simplistic, but accurate descriptionof the various forms of medical practices that a physician can optfor are:
1. Academician: He/she can become an academician and startteaching medical students. 2. Single specialty doctor: The doctor may decide tospecialize in a certain field and then carry on practice in thatfield. 3. Multi-specialty: This happens when within the same company,several medical specialties are employed who are in charge ofdifferent fields. 4. Solo: The medical practice may decide to set up his/her ownclinic, which is a common practice in dentists. 5. Industry: The physician may decide to work for the researchbased activities taking place in the industry and work forpharmacological companies, research labs, and equipmentmanufacturers.6. Hospitalist: Employed and works for a hospital.
Some doctors may fit within two or moreof the practices listed above or may have two or more specialtiesthat he/she is qualified to practice.
I find the following statistics veryinteresting and will quote, “According tothe Bureau of Labor statistics, there were nearly 700,000 doctors inthe United States in 2008. There are many ways to break down thetypes of doctors who practice medicine in the country. Increasingly,more and more medical doctors are becoming specialists, and thenumber of specialists has grown rapidly in the last four decades.According to the American Board of Medical Specialties, there are now24 different categories of specialists that branch off into a totalof 147 and different doctors who can be board certified in theirspecialty. But to handle the doctors in the country in a moremanageable number, there are 6 different medical doctors who seepatients somewhere in the country every day.
1. Doctor of Medicine. Thisis an allopathic doctor, the one who earns an MD degree from medicalschool and represents about 70 percent of all medical schoolgraduates. Many study specialties that concentrate on different areasof the body, such as cardiology, gastroenterology and pulmonology. 2. Doctor of Osteopathy. Thisis the second type of medical doctor who attends a medical school andbecomes an osteopathic doctor. These doctors attend an osteopathicmedical school, which is outnumbered by allopathic medical schools byabout 12 to 1. There is virtually no difference any more in thetraining between the two disciplines, other than a technique calledOsteopathic Manipulative Medicine. This involves manipulation of thejoints and body parts to help in the diagnosis of injury or disease.Many medical doctors with a D.O. degree go on to general practices,in areas like family medicine. 3. Doctor of Dental Medicine. Mostpeople are familiar with dentists, who attend 4 years of dentalmedical school and handle the medical care of the teeth and gums andhave a DMD or in their title. There also are doctors of dentalsurgery who specialize in dental surgery and have a DDS in theirtitle. Many dentists specialize further into areas such asendodontics, orthodontics and pediatric dentistry. This requiresadditional schooling. 4. Doctor of Chiropractic. Thesemedical doctors go to 4 years of chiropractic medical college andspecialize in joint pain anywhere in the body. They have a DCM intheir title. Many chiropractic treatments involve the manipulation ofthe spine and chiropractic doctors work on the principle thatmisalignments trickle down to affect the nervous system. 5. Doctor of Optometry. Thismedical doctor attends four years of optometric medical college andhas an OD in his or her title. They are the primary doctors for thediagnosis and treatment of eye diseases and conditions. 6. Doctor of Podiatric Medicine. Thismedical doctor undergoes 4 years of podiatric medical college andthen a residency program of 2 to 4 years to be able to diagnose andtreat diseases and injuries to the lower leg, including the foot andankle. In 2008, there were 8 accredited podiatric medical colleges inthe country, awarding a DPM to graduates.”