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Pods as physicians

Discussion in 'Clinicians [ RN / NP / PA ]' started by ussdfiant, Nov 27, 2002.

  1. ussdfiant

    Physician Moderator Emeritus 10+ Year Member

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    Even though I am an allopathic student, I was disheartened to see that here on SDN pods have been included as "Healthcare Professionals" instead of with the MD/DO forums. As I am studying for my Behavioral final I read something that supports this forum move. The following is from Kaplan & Sadock's Synopsis of Psychiatry , Eighth edition, p.183

    "In addition to physicians, health care personnel include nurses, dentists, psychologists, social workers, podiatrists, speech therapists and vocational therapists."

    My knee-jerk reaction is to say that none of the professionals named on that list are doctors (nurses and speech therapists?). Is it any wonder that the "professional" status of pods is in question? After reading this, I would say that pods aren't physicians. Any comments?
     
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  3. dim sum

    dim sum Member
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    pods are physicians, no different than a specialized MD/DO..........
    seems to me (from reading this forum) the only different is in the income bracket (for the same length of training...........bad deal)
     
  4. ussdfiant

    Physician Moderator Emeritus 10+ Year Member

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    Pods are not the same as MD/DOs in that they do not receive the same medical training. MD/DOs spend 4 years being trained as generalists who have had a rotation in most medical specialties and then go on to specialized training. Pods are specialized from the start and (for better or worse) are stuck from day 1 of pod school. Right now I would love to be a Radiologist, but what if one day in my 3rd year I do a Peds rotation and decide I want to be a Pediatrician. What if later on I do an Optho rotation and decide I want to be an Opthomologist? With my generalist education I can hold off choosing a specialty until I have seen them all. All that is to say that I think that the to ability to choose a career path after participating in a variety of specialties is a HUGE difference between MD/DOs and DPMs. How many first year pod students (on average) know enough about the various medical specialties to make a lifelong commitment to one on the first day of school?
     
  5. cg2a93

    cg2a93 Senior Member
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    I think this is a interesting question. I am a 4th year student , and I have pondered this very question. Why are we (podiatrist) so gung ho on being called physician? Here is what I come up with.
    It all comes down to money, in order for podiatrist to have parity with MD/DO in insurance reimbursement you have to fall in the physcian category (they get paid the most). That is why we fight so hard to be label that term.
    The term itself really means nothing if you think about it in the real world. A GP , nurse pracitoner or dentist is going to treat a bacterial infection the same way I would, thats order abxs accordingly. Lets face it the ama which for the most part is main stream medicine does not consider podiatrists physcians although we have the same rights and responsibilities within our respective scopes of practice and held to the same standards as a "physcian". When we are sued by a patient for malpractice(hopefully this doesnt happen) the defense "I am not a physican", will not stop the jury from slapping your but with a huge judgement. Other than that its more about ego than anything else.
    Now lets move on to the issue of training. I will be the first to tell you 3rd and 4th year for pod school is different than med school or DO school. In pod school your 3rd and 4th year can be easy as pie or hard as hell depending on the externships you choose. One externship exposed us to plastic sx (which was one of the coolest specialties I have been exposed to, although I wouldnt want to do it for a living), ortho, gen surg, and rheum plus podiatry. We would round at 5:30am to 6ish with gen surg (which I hated) then go to round with podiatry(usually avg 10 patients in house) at 6:30ish depending on how long gen surg rounds lasted. Then go to pod clinic until 2:00pm. After clinic we would cover the service we were assign to where you just didnt observe you participated fully ( for some reason when I get there they become busy). Those clinics would generally end around 7ish depending on the day and service and if you were not on any service for that afternoon you had podiatry preop or postop clinic. After that you had to catch up with the pod residents and do inhouse or ER consults, notes and any scutwork they came up with for you. After that, preop and post op case discussion and journal club . I wouldnt get out of the hospital until 10:30 or later sometimes just to do it all over again. Now that was a bi*ch! Another externship I had we started at 8:oops:oam and was done by 3:30pm and no weekends, you cant get any easier tha that. 3rd year our clinics start at 9:00am with class at 7:30am and we would get out the latest 4:00. Compared to the 3rd yr Med students I see in the hospital who bust their a** all day and some weekends (some saturday and sunday nights). There is a big difference in our education. Internal med rotation in the 4th yr for us at some hospitals is the watered down version although I hear different things at different hospital. In the 3rd year our internal med rotation (phys diag) is not even worth mentioning compared to med students 3rd year rotation. With that been said, Med student are NOT better trained than pod students we are the best trained at what we do and they are the best trained at what they do. I am just as competant to do a podiatry residency as they are to do internal med residency or whatever specialty they choose. (more to come)
    CG
     
  6. efs

    efs SDN Advisor
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    ussdfiant,

    You are bringing up an old question taht has had a lot of debate among educators. Generalist vs specialist training. Which is better? I'm not sure there is an easy answer.

    Generalist training has a number of beneficial aspects to it, though specialist training seems to be a more recent trend, especially as complexity has increased.

    This is not only true in the medical fields. Years ago Army officers usually spent their first few years working in the combat arms fields (infantry, armor, field artillary,etc.) before being moved into more specialized areas. It was thought that this early training would benefit them well in their later endeavors. May very well be true, but as more specialized areas have opend up, they are now pushed into specialization at an earlier stage.

    Early specialization also has some benefits. The biggest drawback that I see is that there is less choice in what they may do later.

    You can argue for or against either side of this. It does not diminish what people are capable of.
     

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