Is OMS Looked Down Upon by Other Medical Specialties?

Started by yorta
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yorta

yorta

Full Member
2+ Year Member
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Two experiences prompted me to ask this question:

  1. Recent Lawsuit: An oral and maxillofacial surgeon (OMS) I know was sued because a patient believed he was only a dentist, not qualified to perform a craniofacial surgery, despite the OMS having graduated from a six-year program and holding an MD.
  2. Insight from a Medical Professional: Someone in the medical field informed me that even though OMS graduates from a six-year program have an MD, they are often considered on the same level as a family physician in terms of medical training.

Based on these experiences, I have the following questions:

  1. Prevalence of Misconception: Are these just particular unfortunate experiences or personal opinions, or are they widely shared within the medical community? How severe is this discrimination?
    • Is this a common view or just isolated incidents?
  2. Merit of Critique: Is this prejudice, or does it have some basis? Is the OMS route considered a "shortcut" in the medical field?
    • I personally believe that 8-11 years of postgraduate training with dual doctoral degrees (DDS/DMD and MD) should be more than sufficient to train competent surgeons.
    • Why do some people consider OMS less competent than other surgeons like ENT, neurosurgeons, or plastic surgeons who operate in similar areas?
    • Are these other specialists actually receiving more robust training than OMS?
  3. Handling Discrimination: How have you dealt with this discrimination in your career? What advice would you give to current or future OMS practitioners?

Thank you all for taking the time to read and respond to these questions.
 
At my hospital we split facial trauma with ENT, no anatomical restrictions. Anecdotally, the ED, and other neighboring specialties (Ophtho, NSGY), prefer working with us for various reasons. The ED isn’t looking down on me for being a dentist when they page me to control a bleed, or close a nasty scalp lac, or admit a pan face. Ophtho isn’t making fun of us for being dentists when we do an orbital floor for them. NSGY makes fun of us, but they look down on everyone.

You’ll learn that everyone talks crap about everyone in the hospital. IM talks about surgeons. Surgeons talk about non-surgeons. Nurses talk bad about doctors. Who cares.

And about your first couple of points, no one who actually knows anything about OMFS or FM would ever make that comparison considering how extremely different they are. FM has one of the broadest knowledge bases in medicine, far more medical knowledge than an average OMFS will have.
 
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In my experience, different hospitals rely on oral and maxillofacial surgery more than others. Some don’t have an OMS, but only ENT. Some only have OMS for everything relating to the face. These situations will lead to different perceptions.
Here are some things no one can dispute. It was dentists that pioneered the field of anesthesiology, hence OMS and DA doing anesthesia to today. It was OMS that pioneered the field of facial cosmetics in WW1. OMS is yes, extremely misunderstood by pretty much every dentist and many physicians (except neuro, ENTs, ophthalmology). It doesn’t matter. I’ve been told, per procedure, OMS is the most lucrative profession in all of medicine. Do with that with what you will.
 
Who cares. Everyone in healthcare has a role to play in providing care for patients, and we provide valuable and important services and people are grateful for it. Doesn't matter what a small group of other providers think. I've had only positive interactions with other providers at the hospital.
 
OP…this is so simple to answer…as soon as you learn how to control your ego the better…OMFS is a respected profession doing very important work which some is life altering…do yourself/future self a big favor and stop caring if certain individuals think they are “more important”.
 
yorta said:
Two experiences prompted me to ask this question:
  1. Insight from a Medical Professional: Someone in the medical field informed me that even though OMS graduates from a six-year program have an MD, they are often considered on the same level as a family physician in terms of medical training.
Click to expand...

This can't be real. It sounds effing idiotic. What does "the same level as family med" even mean? I would love an explanation for this. Any way you cut it, it sounds too freaking dumb.

We really respect you guys. I rotated with several OMFS residents when I was a med student and they were awesome. I've only heard good things about you guys, except for when it comes to the providing anesthesia thing of course (from the anesthesiology side), which is another can of worms, entirely.
 
Last edited:
axiumgod said:
You’ll learn that everyone talks crap about everyone in the hospital. IM talks about surgeons. Surgeons talk about non-surgeons. Nurses talk bad about doctors. Who cares.
Click to expand...

Yeah, everyone looks down on us (psych) and don't consider us "real doctors". We're kind of the redheaded stepchild of medicine. Constantly disrespected and underestimated. But I'm cool with it. I would rather sleep on train tracks than do whatever they do.
 
Allsmiles! said:
do yourself/future self a big favor and stop caring if certain individuals think they are “more important”.
Click to expand...
Perio: Does this mean we can be friends?

OMFS:
1736370709308.gif


Perio: Pretty please…?

OMFS:
1736370859686.gif


Big Hoss
 
slowthai said:
except for when it comes to the providing anesthesia thing of course (from the anesthesiology side), which is another can of worms, entirely
Click to expand...
Can someone please open this can of worms for me? I really want to know more. The more I'm prepared for these controversies the less unpleasant surprises I will have later.
 
Allsmiles! said:
OP…this is so simple to answer…as soon as you learn how to control your ego the better…OMFS is a respected profession doing very important work which some is life altering…do yourself/future self a big favor and stop caring if certain individuals think they are “more important”.
Click to expand...
I agree. Thank you for your comments and suggestions. I'm keen on understanding the culture and anticipating any challenges in the field. My issues are a lack of confidence and ego, rather than having too much of them. I need to bolster these traits because I believe they are somewhat needed for becoming an OMS.
 
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yorta said:
Can someone please open this can of worms for me? I really want to know more. The more I'm prepared for these controversies the less unpleasant surprises I will have later.
Click to expand...
Anesthesiology has a blanket belief that the one doing the procedure should never provide sedation/anesthesia at the same time, because they believe that it's too dangerous. On the other hand, OMFS has a very strong record of providing anesthesia safely for a very long time.
 
Is the thought that OMFS aren't as knowledgable as MDs because they went through less training to get their MD? Genuinely asking and not trolling, lol
 
OMFS is a fantastic speciality, doesn’t really matter what other providers think. You’ll get anywhere between “oh I didn’t know dentists manage this” to “OMFS service is the best”. Do your best work, educate yourself like you belong, and enjoy being rich
 
yappy said:
They compete for the same highly compensated procedures after residency.
Click to expand...
I generally don't see periodontists as my competition.
sedation and wisdom teeth are our most compensated procedures - perio rarely does sedation, many of them do wisdom teeth, but not like we do.

The perio i encounter do a lot of single implants; nothing too complicated. Many general dentists do many single implants as well...

Of course, there are some stellar periodontists - the ones you see on social media. They are better than me. But this is the exception, not the rule. Most of the periodontists out there are in DSO-land overtreating perio pockets.
 
yorta said:
Two experiences prompted me to ask this question:

  1. Recent Lawsuit: An oral and maxillofacial surgeon (OMS) I know was sued because a patient believed he was only a dentist, not qualified to perform a craniofacial surgery, despite the OMS having graduated from a six-year program and holding an MD.
  2. Insight from a Medical Professional: Someone in the medical field informed me that even though OMS graduates from a six-year program have an MD, they are often considered on the same level as a family physician in terms of medical training.

Based on these experiences, I have the following questions:

  1. Prevalence of Misconception:Are these just particular unfortunate experiences or personal opinions, or are they widely shared within the medical community? How severe is this discrimination?
    • Is this a common view or just isolated incidents?
  2. Merit of Critique:Is this prejudice, or does it have some basis? Is the OMS route considered a "shortcut" in the medical field?
    • I personally believe that 8-11 years of postgraduate training with dual doctoral degrees (DDS/DMD and MD) should be more than sufficient to train competent surgeons.
    • Why do some people consider OMS less competent than other surgeons like ENT, neurosurgeons, or plastic surgeons who operate in similar areas?
    • Are these other specialists actually receiving more robust training than OMS?
  3. Handling Discrimination: How have you dealt with this discrimination in your career? What advice would you give to current or future OMS practitioners?

Thank you all for taking the time to read and respond to these questions.
Click to expand...

Physicians who do only outpatient stuff are pooled in this same boat: as no better than the family physician.
There are , general surgeons who only do lumps and bumps in ambulatory surgery centers, anesthesiologists who only do endoscopies on ASA 1 and ASA 2 using 2-3 medications, other physician specialties who sign up to work in urgent care, etc.

The truth is that many OMS will only do outpatient stuff; because hospitals suck, in many ways. And yes, after many years of staying in their lane, not being involved in teaching/academia, not collaborating, they probably will lose a lot of their knowledge, and be looked as "lesser than." But this is partly a lifestyle choice, and frankly they are probably better humans for it.
 
The idea that OMS is 'looked down on' by other medical specialties is outdated and largely based on ignorance of what OMS actually entails.
 
Contach said:
Physicians who do only outpatient stuff are pooled in this same boat: as no better than the family physician.
There are , general surgeons who only do lumps and bumps in ambulatory surgery centers, anesthesiologists who only do endoscopies on ASA 1 and ASA 2 using 2-3 medications, other physician specialties who sign up to work in urgent care, etc.

The truth is that many OMS will only do outpatient stuff; because hospitals suck, in many ways. And yes, after many years of staying in their lane, not being involved in teaching/academia, not collaborating, they probably will lose a lot of their knowledge, and be looked as "lesser than." But this is partly a lifestyle choice, and frankly they are probably better humans for it.
Click to expand...
Medicine & surgery is not just about ‘who does the hardest cases’, it’s about providing care, whether that's in an OR, clinic, or ambulatory setting. There are general surgeons who choose to focus on bread-and-butter cases, like there are OMS who prefer to avoid the hospital setting. That doesn’t make either ‘lesser than’... it just means they’re optimizing for lifestyle, risk, and preference. There are plenty of hospital-based surgeons who stagnate in their skill set too. If someone chooses to stay in their lane and avoid trauma or complex cases, that’s a personal choice, not an knock on a specialty.
 
OMFS is respected in the hospital setting for handling the following:
-Acute Stabilization of Trauma.
-Large head and neck odontogenic infection

The majority of Orthognathic, Cleft craniofacial, etc is handled by craniofacial trained surgeons at select locations in the country: plastics, ENT, omfs. Most OMFS don't pursue this additional training. 6 or 4.

The issue with OMFS is we disrespect ourselves. Attendings disrespect resident's time all the time in all programs. 4 vs 6 is still something and they disrespect each other.

What I've noticed is the 6 year guys don't really want the MD but do it because if you have any form of intelligence, its easier to match and move on and just chill.

4 year guys have the bull**** ego from the multiple non-cats they do and try to become this OR gods and lose money the rest of their lives in academics to "prove something".

Its pretty counter-intuitive but that's what our field has become.

Also, 4 year guys are definitely looked down upon by MDs. regardless of where you go. You'll hear it all the time. you just brush it off and move on.
 
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Van Der Woude said:
OMFS is respected in the hospital setting for handling the following:
-Acute Stabilization of Trauma.
-Large head and neck odontogenic infection

The majority of Orthognathic, Cleft craniofacial, etc is handled by craniofacial trained surgeons at select locations in the country: plastics, ENT, omfs. Most OMFS don't pursue this additional training. 6 or 4.

The issue with OMFS is we disrespect ourselves. Attendings disrespect resident's time all the time in all programs. 4 vs 6 is still something and they disrespect each other.

What I've noticed is the 6 year guys don't really want the MD but do it because if you have any form of intelligence, its easier to match and move on and just chill.

4 year guys have the bull**** ego from the multiple non-cats they do and try to become this OR gods and lose money the rest of their lives in academics to "prove something".

Its pretty counter-intuitive but that's what our field has become.

Also, 4 year guys are definitely looked down upon by MDs. regardless of where you go. You'll hear it all the time. you just brush it off and move on.
Click to expand...
All the ego sucks the fun right out of it all. If I met someone and they genuinely looked down on me for my credentials, that speaks to that person being just plain uninteresting and lacking a life outside of their employment. There are too many animals to hunt, cars to drive, places to visit, etc, for anyone to give a rats behind about any of this 4 vs 6 or prestige lol
 
I’ll never forget externing at a cancer program and shadowing a (dual degree) attending who was doing consults where the only thing one patient kept asking him is if her dental insurance would cover the surgery he recommended. At that point I realized we are eternally just glorified dentists.
 
carabelliscusp said:
I’ll never forget externing at a cancer program and shadowing a (dual degree) attending who was doing consults where the only thing one patient kept asking him is if her dental insurance would cover the surgery he recommended. At that point I realized we are eternally just glorified dentists.
Click to expand...

We make so much more money with dental insurance it's hilarious.

Last Month, I worked with an ENT on a joint case. Dude spends 8 hours raising and insetting a fibula, and produce 6k.

I pop in, place 4 implants in the fibula in 30 minutes, and produce 10k.

Not saying it's fair, but that's how the system works. Life is good.
 
carabelliscusp said:
I’ll never forget externing at a cancer program and shadowing a (dual degree) attending who was doing consults where the only thing one patient kept asking him is if her dental insurance would cover the surgery he recommended. At that point I realized we are eternally just glorified dentists.
Click to expand...
Some people don’t actually even know.

We just finished a full soft tissue facial reconstruction using rib grafts done by our plastics trained OMFS attending, not plastics. The pt comes to follow up and asks why are we working out of a dental clinic. They literally did not know.
 
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