Hospital/Inpatient = Academic or Private

[WestCoastNative]

Are doctors who work primarily in a hospital setting considered academic or private? I have a feeling that it depends on the certain hospital that one is attending. I know that there are hospitals that're owned by universities/medical schools, but there are also community hospitals. Does this pretty much answer my question; community hospitals are considered private, while school owned ones are academic?

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[gyngyn]

Are doctors who work primarily in a hospital setting considered academic or private? I have a feeling that it depends on the certain hospital that one is attending. I know that there are hospitals that're owned by universities/medical schools, but there are also community hospitals. Does this pretty much answer my question; community hospitals are considered private, while school owned ones are academic?

Many (most) university teaching hospitals are actually private. Public hospitals are owned by the government (city, county or federal). They are often teaching hospitals, but don't have to be.
There is a range of academic affiliation among physicians from full time to voluntary faculty. Academic faculty can be found at any type of hospital and in every practice setting.

 

[WestCoastNative]

Well what exactly are "academic" doctors than?

 

[PTPoeny]

Well what exactly are "academic" doctors than?

Ones that have medical school faculty positions.

 

[NickNaylor]

Well what exactly are "academic" doctors than?

Physicians that have an academic appointment as mentioned above. It has nothing to do with the type of hospital you're working at. Many medical schools are affiliated with public hospitals (most commonly the VA system).

 

[styphon]

"Private Hospitals:" owned by a for-profit organization or other entity
"Public Hospital:" owned by the county/Federal government. These hospitals are not designed for profit, and will often take a loss.
"Academic Physician" works for a university. Can work in private, public hospitals. can work in rural, suburban hospitals. can work in clinics alone. Can be "associate" staff, which often are not paid salaries by schools yet do teaching.

 

[mimelim]

Ones that have medical school faculty positions.

"Private Hospitals:" owned by a for-profit organization or other entity
"Public Hospital:" owned by the county/Federal government. These hospitals are not designed for profit, and will often take a loss.
"Academic Physician" works for a university. Can work in private, public hospitals. can work in rural, suburban hospitals. can work in clinics alone. Can be "associate" staff, which often are not paid salaries by schools yet do teaching.

Academic physicians do not have to be at a medical school or work for a university. Academic as the name implies refers to engagement in higher education and research. Regardless of the facilities or institute that one works at, if you engage in the teaching of residents/medical students or engage in research, most people would consider you to be an academic physician. Of course, this means that the majority are localized around universities and/or medical schools, but that is certainly not exclusive.

 

[WestCoastNative]

Thanks for the replies. Do academic physicians and surgeons naturally have more "zebra" cases? I'm assuming that diversity is what attracts potential employees since it definitely isn't the pay.

 

[ridethecliche]

Side note: There are also not-for profit hospital organizations.

Biggest one I can think of:

http://www.partners.org/about/company-information/default.aspx

 

[Ismet]

I'm assuming that diversity is what attracts potential employees since it definitely isn't the pay.

I think it's more to do with enjoying the teaching and/or research aspect that comes with the job. Some people don't like to teach or would not be good teachers.

It's not always about money.

 

[mvenus929]

Thanks for the replies. Do academic physicians and surgeons naturally have more "zebra" cases? I'm assuming that diversity is what attracts potential employees since it definitely isn't the pay.

Academic physicians *tend* to be more specialized, in that they tend to focus more on a handful of disease processes rather than the whole of their field (because they're doing research on it, etc). They also *tend* to be more up-to-date with the literature because they are involved in the teaching of medical students and residents. So they tend to get the more complex and, yes, zebra cases, compared to physicians who work in the community. But this isn't exclusive, since there are academic physicians in more community practices who refer their patients to the tertiary care facilities when they are complex.

And I agree with Ismet. Academic physicians go into academia because they either like teaching, like research, or both. They're willing to take a pay cut for that aspect of the job.

 

[WestCoastNative]

Do academic physicians teach in a traditional learning environment? I'm a bit confused on that particular aspect. Are they classroom professors, or do they take on residents/fellows in a hospital setting? I have a ton of questions that I'd like answered, could somebody point me to an informative website full of articles that encompass the medical field as a whole? I'm not familiar with the main SDN website as I've only used the forums. Is there something like that available here?

 

[Ismet]

Do academic physicians teach in a traditional learning environment? I'm a bit confused on that particular aspect. Are they classroom professors, or do they take on residents/fellows in a hospital setting?

They can be either or both.

 

[mvenus929]

Do academic physicians teach in a traditional learning environment? I'm a bit confused on that particular aspect. Are they classroom professors, or do they take on residents/fellows in a hospital setting?

Those affiliated with a medical school will often (well, not often, exactly, but not uncommonly) give lectures to the pre-clinical students, or precept the pre-clinical students in the 'how to become a doctor' course that schools have. They may also give specialty-specific lectures to the residents/med students at various times during the year. Some will give more prestigious lectures as guest lecturers at various venues (usually Grand Rounds).

Others are primarily clinical professors, so they will precept students/residents/fellows on the wards or in clinic.

Some will do both. One of the program directors at my med school ran one of the pre-clerkship courses for first year students, gave lectures to the med students while they were on the wards, and served as a clinic and wards attending, plus was the program director for the residency program.

Still others will have more administrative duties than specific teaching. For instance, one of my attendings in med school was a clinic attending, but also served as a Dean for Student Affairs, and was in charge of the fourth year rotation schedule (so she had the final say in whether or not you got credit for an activity). So she taught in clinic, but most of her time was supporting the students, rather than directly teaching them.

 

[WestCoastNative]

Got it, academic medicine can as much be tailored to your preferences as is possible by private doctors. Am I correct in my assumption that there are also physicians and surgeons who do a mix of both academic and private medicine? Off topic question; what's the difference between pathologists and infectious disease specialists?

 

[Ismet]

Got it, academic medicine can as much be tailored to your preferences as is possible by private doctors. Am I correct in my assumption that there are also physicians and surgeons who do a mix of both academic and private medicine? Off topic question; what's the difference between pathologists and infectious disease specialists?

The focus of clinical pathology is the laboratory examination of blood, tissues, etc. Generally examining specimens under the microscope or other analysis. For example, a pathologist would work closely with an oncologist to determine the grade of a tumor.

Infectious disease (ID) is a sub-specialty of internal medicine (or pediatrics), and they do exactly what their title entails. They are specialists on infectious disease and are consulted on complicated patients. ID docs can also further specialize to work with specific infectious diseases, such as HIV. They're basically experts on the diagnosis, treatment, and control of infectious diseases.

 

[WestCoastNative]

The focus of clinical pathology is the laboratory examination of blood, tissues, etc. Generally examining specimens under the microscope or other analysis. For example, a pathologist would work closely with an oncologist to determine the grade of a tumor.

Infectious disease (ID) is a sub-specialty of internal medicine (or pediatrics), and they do exactly what their title entails. They are specialists on infectious disease and are consulted on complicated patients. ID docs can also further specialize to work with specific infectious diseases, such as HIV. They're basically experts on the diagnosis, treatment, and control of infectious diseases.

This is the exact type of thing that initially got me into pursuing a medical degree. Students are prepared for infectious disease boards through a fellowship correct? I know that their salaries are generally in the mid to high 100's. That isn't necessarily low, but I picture that paying off loans can become a bit complicated with that kind of salary. Since its a fellowship, are you allowed to specialize in an internal medicine sub specialty (cardiology, neurology, nephrology, etc.) along with a fellowship in infectious disease to somewhat boost your income potential and achieve a salary in the range of 300-350k?

 

[Ismet]

This is the exact type of thing that initially got me into pursuing a medical degree. Students are prepared for infectious disease boards through a fellowship correct? I know that their salaries are generally in the mid to high 100's. That isn't necessarily low, but I picture that paying off loans can become a bit complicated with that kind of salary. Since its a fellowship, are you allowed to specialize in an internal medicine sub specialty (cardiology, neurology, nephrology, etc.) along with a fellowship in infectious disease to somewhat boost your income potential and achieve a salary in the range of 300-350k?

Why is it always about money? Yeah it may take longer for an ID doc to pay off loans, but it's not impossible.

Someone specializing in both cardiology/neuro/nephro and ID must be super human and lack the need for sleep if you expect them to practice both...they don't overlap. If your goal is to have a salary of 300-350k, skip the 2-3 years of the ID fellowship and specialize in something that will get you the salary you desire.

 

[karayaa]

Are doctors who work primarily in a hospital setting considered academic or private? I have a feeling that it depends on the certain hospital that one is attending. I know that there are hospitals that're owned by universities/medical schools, but there are also community hospitals. Does this pretty much answer my question; community hospitals are considered private, while school owned ones are academic?

If they're involved with teaching or research, they're probably academic.
If they only do clinical work, seeing patients, they could be hospitalists (hospital based internal medicine/family practice), or anesthesiologists (unless they only work at an outpatient surgery center), or emergency medicine (unless at an urgent care), or a surgicalist (hospital based general surgeon), or a sub-specialist (needs a fellowship), in critical care (an intensivist), pulmonology, cardiology. Or a physiatrist, who works in the rehab department. Or a neonatologist, or a radiologist (who could also work at a free standing radiology center).
Have you searched google for hospital-based doctor?

 

[karayaa]

This is the exact type of thing that initially got me into pursuing a medical degree. Students are prepared for infectious disease boards through a fellowship correct? I know that their salaries are generally in the mid to high 100's. That isn't necessarily low, but I picture that paying off loans can become a bit complicated with that kind of salary. Since its a fellowship, are you allowed to specialize in an internal medicine sub specialty (cardiology, neurology, nephrology, etc.) along with a fellowship in infectious disease to somewhat boost your income potential and achieve a salary in the range of 300-350k?

Why would it be hard to pay off loans?
Assume you take out $300,000.
Pay off 50K during residency. Pay 50K/yr after that, you're done in 5 years. You just got to make it a priority.
Or work in an underserved area. Or spend some time in the military.

 

[WestCoastNative]

Why would it be hard to pay off loans?
Assume you take out $300,000.
Pay off 50K during residency. Pay 50K/yr after that, you're done in 5 years. You just got to make it a priority.
Or work in an underserved area. Or spend some time in the military.

Well that's pretty decent actually. I've googled hospital-based doctors before but I'm having a difficult time distinguishing them. Aren't emergency physicians the ones that take care of clinical work? I thought that internists/hospitalists/specialists take care of patients that have already been admitted in.

 

[Ace Khalifa]

Why would it be hard to pay off loans?
Assume you take out $300,000.
Pay off 50K during residency. Pay 50K/yr after that, you're done in 5 years. You just got to make it a priority.
Or work in an underserved area. Or spend some time in the military.

Aren't you forgetting about accumulated interest on the loan...?

 

[Ismet]

Well that's pretty decent actually. I've googled hospital-based doctors before but I'm having a difficult time distinguishing them. Aren't emergency physicians the ones that take care of clinical work? I thought that internists/hospitalists/specialists take care of patients that have already been admitted in.

....what is your definition of "clinical work" if you think only EM docs do it???

There are usually clinic hours for people in IM specialties. I just spent the last month doing that.

 

[mimelim]

Why would it be hard to pay off loans?
Assume you take out $300,000.
Pay off 50K during residency. Pay 50K/yr after that, you're done in 5 years. You just got to make it a priority.
Or work in an underserved area. Or spend some time in the military.

How exactly do you pay off 50k during residency? Even living dirt cheap in a very low cost of living area, that would be difficult. Unless you have a spouse that make a lot....

 

[Ismet]

Why would it be hard to pay off loans?
Assume you take out $300,000.
Pay off 50K during residency. Pay 50K/yr after that, you're done in 5 years. You just got to make it a priority.
Or work in an underserved area. Or spend some time in the military.

You do realize that your salary during residency is only going to be about $40-50,000, right? And you have to do things like pay taxes, rent, buy food, support family, etc with that money. You're not going to pay off $50k during a typical 3 year residency unless you have substantial help.

 

[Winged Scapula]

You do realize that your salary during residency is only going to be about $40-50,000, right? And you have to do things like pay taxes, rent, buy food, support family, etc with that money. You're not going to pay off $50k during a typical 3 year residency unless you have substantial help.

And, the $300K in loans is much higher after interest.

 

[Law2Doc]

Got it, academic medicine can as much be tailored to your preferences as is possible by private doctors. Am I correct in my assumption that there are also physicians and surgeons who do a mix of both academic and private medicine? Off topic question; what's the difference between pathologists and infectious disease specialists?

A pathologist is the guy who tells you you didn't get him enough tissue for him to make a diagnosis. An infectious disease specialist is the guy who wants you to pull all the lines out of your patient with difficult access...

 

[Law2Doc]

You do realize that your salary during residency is only going to be about $40-50,000, right? And you have to do things like pay taxes, rent, buy food, support family, etc with that money. You're not going to pay off $50k during a typical 3 year residency unless you have substantial help.

If he lives in the call room and survives on the various sources of free food in the hospital, I bet he could swing it.

 

[WestCoastNative]

If only it was that easy to pay off loans.. Anyways, isn't clinic work where you see patients that haven't been admitted yet and decide what to prescribe them (if needed), and decide if they should be admitted to the hospital? Seems like emergency medicine to me.

 

[Ace Khalifa]

If only it was that easy to pay off loans.. Anyways, isn't clinic work where you see patients that haven't been admitted yet and decide what to prescribe them (if needed), and decide if they should be admitted to the hospital? Seems like emergency medicine to me.

Working in the ED is NOT the same as working in the clinic. I know this because I work in the ED as a scribe. Clinics are entirely different from the ED and there are a bunch of different things you can do in a clinic.

 

[WestCoastNative]

Working in the ED is NOT the same as working in the clinic. I know this because I work in the ED as a scribe. Clinics are entirely different from the ED and there are a bunch of different things you can do in a clinic.

Wait a minute, are we talking about clinics as in private practices OUTSIDE of the hospital/emergency center? Clinical work IN the hospital is all taken care off by emergency physicians.. right?

 

[Ismet]

If only it was that easy to pay off loans.. Anyways, isn't clinic work where you see patients that haven't been admitted yet and decide what to prescribe them (if needed), and decide if they should be admitted to the hospital? Seems like emergency medicine to me.

Clinic is a place for outpatient follow-up and/or primary care visits. The same IM docs who round in the hospital also can have clinic hours and see outpatients. Generally speaking, clinic = outpatient. It's completely different from emergency medicine. Emergency medicine is for...emergencies. Although some people like to use the ED as their PCP, but that's another situation entirely.

Wait a minute, are we talking about clinics as in private practices OUTSIDE of the hospital/emergency center? Clinical work IN the hospital is all taken care off by emergency physicians.. right?

No, there are outpatient clinics in the hospital or within the hospital system.

I think you would benefit from shadowing doctors in different specialties and actually learning what goes on in the hospital.

 

[mvenus929]

If only it was that easy to pay off loans.. Anyways, isn't clinic work where you see patients that haven't been admitted yet and decide what to prescribe them (if needed), and decide if they should be admitted to the hospital? Seems like emergency medicine to me.

Wait a minute, are we talking about clinics as in private practices OUTSIDE of the hospital/emergency center? Clinical work IN the hospital is all taken care off by emergency physicians.. right?

Again... What is your definition of 'clinical work'? The emergency medicine docs figure out whether or not a patient has to be admitted or whether they can go home. If they have to be admitted, then they need more support or diagnostic tests to make them better. This can include everything from simple IV fluids to invasive procedures up to and including surgery. Once the patient leaves the ED, the ED doc doesn't take care of them anymore. The surgeons, pediatricians, internists, etc that do take care of the patient once admitted to the hospital do all those things, and thus are involved in clinical medicine.

 

[Winged Scapula]

If he lives in the call room and survives on the various sources of free food in the hospital, I bet he could swing it.

We had someone try that once.

 

[Law2Doc]

Wait a minute, are we talking about clinics as in private practices OUTSIDE of the hospital/emergency center? Clinical work IN the hospital is all taken care off by emergency physicians.. right?

I think you have a different (wrong) definition of clinic/clinical work in your head. ED is the ED. Seeing patients in clinic (outpatient or at your office in the hospital) is very different. When residents have clinic shifts they aren't going to the ED. They are seeing patients like in a doctors office. They will manage meds, write/refill scripts, evaluate patients before and after procedures. Do wound checks, maybe send patients for imaging, labs. Every specialty that deals with patients does clinic in some fashion EXCEPT the ED. EDs scope is very different. They exclusively handle patients who come into the ED. They may need to stabilize patients, medicate them, hydrate them, put in lines and tubes, and they need to decide if a patient is likely to be admitted to the hospital, by examination, ordering imaging, labs, and if so what admitting team they need to get to evaluate the patient. They aren't seeing patients in clinic and these patients are single encounters -- they typically don't do follow ups. So yes the ED does assess a certain group of patients that come to the hospital through a certain door, but they hardly have a Monopoly on "clinical work".

Agree with the prior poster who indicated you need to shadow more. Your views of clinical work seem to mirror some of the bad TV shows where the ED doctor seems to do everything in the hospital.