Hospitalists

[MaseratiGT]

How common are DPM hospitalists?

I'm going to guess that the number of practicing podiatric physicans who are hospitalists is negligible, but I was wondering what you guys have seen.

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[Feli]

What exactly do you mean?

DPMs who go around rounding on inpatients and doing surgery all day every day? I'd say that's extremely rare. Most pods have a clinical practice (most private, some are hospital-based), and then they go to hospital or surg center to do their OR cases. Most will also have a hospital (or multiple hospitals) where they do inpatient consults and round on their clinic patients when they are admitted.

I guess if a podiatrist's clinic was hospital-based, they only do surgery at that hospital, and they only do consults there, that is what you mean by "DPM hospitalist"? That is a situation for a few DPMs, but not too many... probably mostly just the residency directors/attendings at big academic centers.

Hospitalist is a term usually used for internal med docs who take care of and round on the medical inpatients at their hospital.

 

[MaseratiGT]

What exactly do you mean?

DPMs who go around rounding on inpatients and doing surgery all day every day? I'd say that's extremely rare. Most pods have a clinical practice (most private, some are hospital-based), and then they go to hospital or surg center to do their OR cases. Most will also have a hospital (or multiple hospitals) where they do inpatient consults and round on their clinic patients when they are admitted.

I guess if a podiatrist's clinic was hospital-based, they only do surgery at that hospital, and they only do consults there, that is what you mean by "DPM hospitalist"? That is a situation for a few DPMs, but not too many... probably mostly just the residency directors/attendings at big academic centers.

Hospitalist is a term usually used for internal med docs who take care of and round on the medical inpatients at their hospital.

Yep...that's exactly what I was asking.

 

[gasolino]

an ER resident here. where i'm currently training in the bronx, our podiatrists are under the surgical department and admits pt for their surgeries (thru us in the ER, well all specialty admits thru us, no direct admission in my hospital). They also work in pod clinics under our HMO umbrella. Pod residents also cover the orthopedic deparment in off hours (no ortho resident, we have IM, Peds, ER, FP, Gen surg, Rads, and of course pods.... i believe 4 yrs program). So to me they're hospitalist? (i think the strict definition of hospitalist is IM docs who only do inpatient). All surgeon typically like mention above, will have their clinic practice and perform surgeries where they're priviledged.

 

[jonwill]

an ER resident here. where i'm currently training in the bronx, our podiatrists are under the surgical department and admits pt for their surgeries (thru us in the ER, well all specialty admits thru us, no direct admission in my hospital). They also work in pod clinics under our HMO umbrella. Pod residents also cover the orthopedic deparment in off hours (no ortho resident, we have IM, Peds, ER, FP, Gen surg, Rads, and of course pods.... i believe 4 yrs program). So to me they're hospitalist? (i think the strict definition of hospitalist is IM docs who only do inpatient). All surgeon typically like mention above, will have their clinic practice and perform surgeries where they're priviledged.

Agreed

 

[JEWmongous]

an ER resident here. where i'm currently training in the bronx, our podiatrists are under the surgical department and admits pt for their surgeries (thru us in the ER, well all specialty admits thru us, no direct admission in my hospital). They also work in pod clinics under our HMO umbrella. Pod residents also cover the orthopedic deparment in off hours (no ortho resident, we have IM, Peds, ER, FP, Gen surg, Rads, and of course pods.... i believe 4 yrs program). So to me they're hospitalist? (i think the strict definition of hospitalist is IM docs who only do inpatient). All surgeon typically like mention above, will have their clinic practice and perform surgeries where they're priviledged.

Is that St.Barns or Wycoff?

 

[krabmas]

Is that St.Barns or Wycoff?

Wycoff is in Brooklyn or queens, but not the bronx

 

[gasolino]

st barnabas, bronx, NY.

 

[Osteodog]

There are no DPM hospitalists. I'm a DO, DPM and in order to be a "hospitalist" you need to be either an IM doc, FP doc or peds doc. A DPM does not have the license or the training to be a hospitalist.

 

[165007]

There are no DPM hospitalists. I'm a DO, DPM and in order to be a "hospitalist" you need to be either an IM doc, FP doc or peds doc. A DPM does not have the license or the training to be a hospitalist.

so you're saying that most of the hospitalists are DOs, since most cant match into competitive residencies.

 

[Osteodog]

so you're saying that most of the hospitalists are DOs, since most cant match into competitive residencies.

Huh? Not sure where you got that. Most hospitalists are MD's as most physicians are MD's. It is harder to match into competitive residencies as a DO in part because there are far more competitive residencies which are run by MD's. There are, however, many DO grads who match into "competitive" residencies each year (in my class of 2008, for example, some of my colleagues got residency spots in fields such as neurosurgery, diagnostic radiology, interventional radiology, anesthesia, ER, etc.).

Being a DO does not preclude you from entering into any specialty that you want to.

 

[OSUDDS]

why in the world would a DPM want to be a hospitalist? i dont think the op knew the true definition of a hospitalist when posting.

 

[165007]

why in the world would a DPM want to be a hospitalist? i dont think the op knew the true definition of a hospitalist when posting.

Sorry for an incomplete response, I was in a hurry to go somewhere.

We all know that most MDs and DOs want to specialize and make more money with better schedules, therefore leaving most of the uncompetitve spots for less qualified candidates who cant match.

From what stats show, for example, DERM & other top fields, have accepted mostly MDs not DOs.

So what I meant to say in my last post was, "most DOs are hospitalists" and not "most hospitalists are DOs".

 

[Osteodog]

I think you might be confused as to what a hospitalist is. I think you mean most DO's are in primary care, which is true. A hospitalist is a type of doctor that works for a hospital (or a company who contracts with a hospital) and sees inpatients. They are usually internal medicine docs, but they can also be family practice or pediatric docs. In all cases they are either MD's or DO's. I don't know if there are other types of hospitalist docs, but I don't think so.

I think that it's true that DO's have a harder time getting into more competitive residencies because most of these are controlled by MD's who may have some bias. Not only that, but some of these programs are unprepared to decipher the COMLEX scores that we typically submit. I took both the COMLEX Step 1 and 2 as well as the USMLE 1 and 2 for this very reason. Conversely, there are competitive DO programs that will only take DO students (such as anesthesia or neurosurgery at Riverside County Hospital.

But, like I mentioned in my last post, there are plenty of DO students who match into tough specialties and the vast majority of these are allopathic programs.

 

[diabeticfootdr]

There are no DPM hospitalists. I'm a DO, DPM and in order to be a "hospitalist" you need to be either an IM doc, FP doc or peds doc. A DPM does not have the license or the training to be a hospitalist.

I consider myself a DPM hospitalist. I am employed by a hospital, see inpatients, ED and ICU consults, operate in the OR, and run a hospital-based wound center.

And, Prof. Larry Harkless (Dean of the new CA school) uses the term "podiatric hospitalist" frequently. He was one as well, while at Univ of Texas.

LCR

 

[Osteodog]

I've never heard of a DPM hospitalist, but as you've described it I guess it makes sense. It seems as though there are hospitalists and DPM hospitalists. Good to know.

 

[gasolino]

if you're implying that DO have a harder time than US MD grads to match at an allopathic specialty residencies that's definitely true, why wouldn't they take their graduates first. We do however also have our own specialty residencies. My guess is most hospitalists could be FMG or IMG. My hospital entire IM (which takes massive amount of residents each year.... in the 40s or more i think) and our peds department take only International graduates. Remember, a third of US residencies are filled by foreign graduates. Another thing about DO is we on average have more 2nd career med students/older students than US MD schools, add that to the fact that DOs are geared toward primary care (FP,IM,Peds) of course we'll have a high percentage of primary care DOs (shortest residency and we're taught a unique skills, OMT, that is built for primary care use). We all now this prior to deciding to go to the DO route. I don't see this as a knock to DOs. As we all now, once med school is over, title doesn't mean much, you're more defined by your specialty.

 

[Feli]

...DOs are geared toward primary care (FP,IM,Peds) of course we'll have a high percentage of primary care DOs (shortest residency and we're taught a unique skills, OMT, that is built for primary care use). We all now this prior to deciding to go to the DO route. I don't see this as a knock to DOs. As we all now, once med school is over, title doesn't mean much, you're more defined by your specialty.

This is an important point.^

A lot of people, especially pre-meds, look at MD and DO as basically the same thing now... if you don't get into MD school, you apply to DO. That may be the modern state where it's now sometimes used as a backdoor into any specialty, but for those genuinely interested in the actual osteopathic philosophy, I believe it is geared strongly towards primary care. It's not as if you will be shunned if you end up as a DO trying to match a specialty outside of IM/FP/Peds, but as I understand from talking to a few older attending DOs at the hospital I was training at durning 3rd year, it actually was that way not real long ago. When they went to DO school, it was assumed from the start that you were interested in, and ultimately headed for, primary care. From what I heard, their classmates who tried to match surgery, path, rad, etc were not looked upon very favorably.

...I was never really interested in DO school, haven't done a ton of reading, and could somewhat innacurate, but I do agree that a lot of students fail to realize that DO training is intended to be geared towards primary care. I have found that out more and more as I've rotated with DO students and attendings. Things seem to be gradually shifting since there are now a few dozen DO residencies for specialties outside of IM/FP/ER/Peds and many other DOs try to match with allopathic non-PC residencies. However, I think the original philosophy, not just grades, boards, politics, or degree name, is still the major reason so many DOs go into primary care...

 

[MaseratiGT]

I consider myself a DPM hospitalist. I am employed by a hospital, see inpatients, ED and ICU consults, operate in the OR, and run a hospital-based wound center.

And, Prof. Larry Harkless (Dean of the new CA school) uses the term "podiatric hospitalist" frequently. He was one as well, while at Univ of Texas.

LCR

YAY! Thanks for the backup!
What you described, Dr. R., is EXACTLY what I was wondering! I just didn't know if anyone actually DID it!

Thanks again!

 

[bkpa2med]

This is an important point.^

A lot of people, especially pre-meds, look at MD and DO as basically the same thing now... if you don't get into MD school, you apply to DO. That may be the modern state where it's now sometimes used as a backdoor into any specialty, but for those genuinely interested in the actual osteopathic philosophy, I believe it is geared strongly towards primary care. It's not as if you will be shunned if you end up as a DO trying to match a specialty outside of IM/FP/Peds, but as I understand from talking to a few older attending DOs at the hospital I was training at durning 3rd year, it actually was that way not real long ago. When they went to DO school, it was assumed from the start that you were interested in, and ultimately headed for, primary care. From what I heard, their classmates who tried to match surgery, path, rad, etc were not looked upon very favorably.

...I was never really interested in DO school, haven't done a ton of reading, and could somewhat innacurate, but I do agree that a lot of students fail to realize that DO training is intended to be geared towards primary care. I have found that out more and more as I've rotated with DO students and attendings. Things seem to be gradually shifting since there are now a few dozen DO residencies for specialties outside of IM/FP/ER/Peds and many other DOs try to match with allopathic non-PC residencies. However, I think the original philosophy, not just grades, boards, politics, or degree name, is still the major reason so many DOs go into primary care...

Your a bit misinformed. Roughly 20% of my class goes into FP. The others specialize and many go for IM programs that have decent fellowships. Also, OMM should not be used as a treat all modality. It has it's place in every field, except lets say radiology. Personally, I'm not a studentDO who is gun-ho about OMM, but I like to think of it as another diagnostic tool. Besides that, you need to understand that it's a medical philosophy. Allopathic medicine, in the old days, was not what it was today. When people speak of the body as a unit with the ability to heal itself is something, that we call today, known as our immune system.

I hope I didn't offend you, just wanted to get somethings straight.