why we can't stop people from walking all over doctors?

[trapperjohn]

it really annoys the crap out of me how hmo's, lawyers, psychologists, optometrists, PAs, and orthodontists have been able to walk all over the medical profession in the past decade. as someone about to start my MS1 year this fall, it really pisses me off. for one, NO ONE should be able to perscribe medicine or perform comsmetic surgery unless you went to MEDICAL SCHOOL and specialized. why do dumb a** psychologists with only some BS or MA degree feel they should perscribe medicine?? and even worse is why they are winning these battles in court to do so. Why is there not a strong medical lobby group that can persuade the obviously corrupt government to stop letting greedy blood thirsty lawyers mop the floor with the medical profession. i know layers are a huge lobby group, and can argue well, but can't the medical profession do anything??? The real annoying thing is that almost the entire general public knows that parasitic laywers are completly wrong, and that businesses and greedy HMO execs should not take advantage of the medical profession. its like these greedy a-holes saw a gold mine in the 90s with the medical profession and took full advantage of it. i hate this craze of everyone trying to take away rights and privaledges from doctors. and i hate how doctors are too weak to do anything about it.

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[Blake]

Fight the power !

 

[adiddas125]

Well this is why we went into medicine right? We want to make a difference in whatever interests us...

 

[IlizaRob]

Typical pre-med post. While I agree with you that doctors are often taken advantaged of, that does not mean that just because you are a doctor you are always in the right. Doctors do stupid things (fraud, malpractice). There has to be oversite somewhere. Hopefully when you transition from theoretical medicine (first two years) into clinical medicine you will become more open-minded and realize that everyone has their place. Just because an orthodontist did not go to medical school does not mean that they were not sufficiently trained in doing what they do including prescribing medication. Sounds more like an ego to me.

 

[med-i-cal]

Now if this has to do with psychologists being able to give away meds, yeah, I'd think that's a problem. The psychologists that I know receive no training in pharmacology, which I would hope would be required. I know this is true for an undergrad psych degree, as almost no undergrad institutions offer pharm. This should be for the health of the patient.

As for everyone else in the medical profession, I'm not sure how optometrists, PAs, and orthodontists have walked all over the medical profession. Maybe you can explain that part a little bit better? I'm glad they exist since optometrists and PAs can be considered to be primary care providers, which help to lessen the work-load of the PC-Physicians'. Orthodontists are specialized dentists, just like a GI is a specialized IM. They have paid their dues, and they have the proper training to do what they do, again, I don't see the problem here...

 

[zbruinz]

don't doctors have lobby groups?

 

[tupac_don]

it really annoys the crap out of me how hmo's, lawyers, psychologists, optometrists, PAs, and orthodontists have been able to walk all over the medical profession in the past decade. as someone about to start my MS1 year this fall, it really pisses me off. for one, NO ONE should be able to perscribe medicine or perform comsmetic surgery unless you went to MEDICAL SCHOOL and specialized. why do dumb a** psychologists with only some BS or MA degree feel they should perscribe medicine?? and even worse is why they are winning these battles in court to do so. Why is there not a strong medical lobby group that can persuade the obviously corrupt government to stop letting greedy blood thirsty lawyers mop the floor with the medical profession. i know layers are a huge lobby group, and can argue well, but can't the medical profession do anything??? The real annoying thing is that almost the entire general public knows that parasitic laywers are completly wrong, and that businesses and greedy HMO execs should not take advantage of the medical profession. its like these greedy a-holes saw a gold mine in the 90s with the medical profession and took full advantage of it. i hate this craze of everyone trying to take away rights and privaledges from doctors. and i hate how doctors are too weak to do anything about it.

They are not weak, they are too busy working. Also all these other professions, podiatrist, chiropractors, lobby much more than physicians. They give money to politicians, and they advertise a lot more than physicians. Plus I think that a lot of other professions, are nicer to patients, may attention to them more, and I think pts respond to that. What is atrociuos that they think they should have the same rights as a doctor without going thru the same rigors. I am surprised you are throwing in orthodontists in there, they are bonafide professionals, and I don't see how they infringe on the medical profession.

Also I think the big outrage is that other professionals want to do thing that are lucrative, not things that doctors do that are not lucrative. You don't see optometrists lobbying to take care of glaucoma or get medical management of eye diseases, they want to do surgery.

Also some basic things, you really don't need the extensive training of a doctor to perform. However, it does come with the territory. Hey a doctor worked for it, so it' only right that some thing that a doctor does are protected.

But doctors should absolutely lobby more, for protecting their rights.

 

[tupac_don]

Now if this has to do with psychologists being able to give away meds, yeah, I'd think that's a problem. The psychologists that I know receive no training in pharmacology, which I would hope would be required. I know this is true for an undergrad psych degree, as almost no undergrad institutions offer pharm. This should be for the health of the patient.

As for everyone else in the medical profession, I'm not sure how optometrists, PAs, and orthodontists have walked all over the medical profession. Maybe you can explain that part a little bit better? I'm glad they exist since optometrists and PAs can be considered to be primary care providers, which help to lessen the work-load of the PC-Physicians'. Orthodontists are specialized dentists, just like a GI is a specialized IM. They have paid their dues, and they have the proper training to do what they do, again, I don't see the problem here...

I dont' think it is a problem what these professionals do. I think the problem is that they are trying to get out of their "pre-ordained" shell and expand (ie. PA's/NP's want more autonomy, optometrists want to do surg., CRNA's are pretty much doing everything anesthisiologists are doing, except they don't have the final word).

As far a orthodontist are concerned, I cant' see either how they infringe on medical profession, they are bonafide specialized dentists.

 

[Jack Daniel]

I'm speaking off the cuff here, so please folks, chime in if I'm way off-base:

This idea that access to all medicines should only be through a MD is not the only way to run a healthcare system. Folks in other countries have access to a broader selection of medicine through the pharmacist without a physician's prescription. Are they recklessly endagering their lives? One could argue this is a good way to keep costs down.

The fact that physicians have such a monopoly on medicine is the result of past political maneuvering and boxing out the competitors. It doesn't surprise me that other professions are now gaining practice rights using the same techniques. At some level, it even seems fair.

As for the creation of HMOs, I think physicians and the patients had a hand in creating this page in American history. HMOs were developed to control out-of-control costs.

As for the lawyers--I'm all for tort reform and controling professional liability.

Just my off-the-cuff comments.

 

[trapperjohn]

orthodontists, although extremely specialized, i heard have begun doing facial cosmetic procedures. with pa's, optromitrists, and psychologists, i think its been mentioned above how tyheyre infringing on doctors rights. i just think there are several dues you have to pay in order to perscribe medication or perform operations. when people have a little knowledge of pharmocology, but not an extensive one, they dont know about the different medical conditions and complications that certain medications they perscribe to the patient can cause. And it seems as though for the longest time, up until a decade ago, they appreciated and recognized this fact. i just wonder what went wrong in the 90s where doctors lost this priveldge? and i dont think we can assume these groups have training enough to be able to perscribe medicine or operate, or else whos to say that a barber shouldnt also be able to do neuro surgery, or a manicurist couldn't be a hand surgeon. if psychologists want to perscribe meds, then they should quit their job, take the mcat and apply to med school, graduate, then do a residency in psychiatry. oh wait, they probably already tried this in undergrad, couldnt get in, and choose to go to grad to to be psychologists. then they hold a grudge against doctors and say "i want to get to know my patients and not treat them like crap the way all doctors do." this was the case for more then half of the premed drop outs at my undergrad.

 

[zbruinz]

not to sound mean or anything, but those other health professions shouldn't try to take the doctor's privileges because they didn't work for it like doctors did. If they failed to become doctors, then tough luck for them.

 

[chef_NU]

Doctors don't deserve government protection so they can monopolize certain services. If patients don't feel comfortable with seeking out a licensed physician because they can get equivalent care for less money, let them. Just because you went to medical school doesn't mean that you can automatically stifle any innovation in medically related procedures. Maybe it doesn't take 9 years to train a surgeon to do hernia repairs. Maybe a year of training is sufficient to educate someone and give them enough experience to get equivalent results to an M.D. surgeon. That isn't underhanded, it's called market incentive and innovation. Quit bitching about the government not protecting your special priviledge. If you can't do your job better than someone less educated and cheaper than you, then you don't deserve to be a successful doc.

 

[chef_NU]

And yes, if a barber wants to open a neurosurgery shop, let him. I doubt he'll have many patients though.

 

[DW3843]

try not to jump all over me and flex some anonymous internet muscle

I only mention this so you don't go around looking like you don't know what you're talking/writing about, and I thought it was just a typo at first.

It's prescribe not perscribe

 

[WildcatDMD]

it really annoys the crap out of me how hmo's, lawyers, psychologists, optometrists, PAs, and orthodontists have been able to walk all over the medical profession in the past decade. as someone about to start my MS1 year this fall, it really pisses me off. for one, NO ONE should be able to perscribe medicine or perform comsmetic surgery unless you went to MEDICAL SCHOOL and specialized. why do dumb a** psychologists with only some BS or MA degree feel they should perscribe medicine?? and even worse is why they are winning these battles in court to do so. Why is there not a strong medical lobby group that can persuade the obviously corrupt government to stop letting greedy blood thirsty lawyers mop the floor with the medical profession. i know layers are a huge lobby group, and can argue well, but can't the medical profession do anything??? The real annoying thing is that almost the entire general public knows that parasitic laywers are completly wrong, and that businesses and greedy HMO execs should not take advantage of the medical profession. its like these greedy a-holes saw a gold mine in the 90s with the medical profession and took full advantage of it. i hate this craze of everyone trying to take away rights and privaledges from doctors. and i hate how doctors are too weak to do anything about it.

One of the most uneducated arguments I've seen on here in a long time. You don't want to be anesthetized the next time you have a dental procedure done? After all, no one besides a physician could possibly understand pharmacology enough to administer and prescribe medications. And I would love to see an article showing an orthodontist performing facial cosmetic surgery, that would be OMFS, and they are trained to to facial surgery.

 

[IlizaRob]

if psychologists want to perscribe meds, then they should quit their job, take the mcat and apply to med school, graduate, then do a residency in psychiatry. oh wait, they probably already tried this in undergrad, couldnt get in, and choose to go to grad to to be psychologists. then they hold a grudge against doctors and say "i want to get to know my patients and not treat them like crap the way all doctors do." this was the case for more then half of the premed drop outs at my undergrad.

It continues to boggle my mind that some people seem to think that the reason why an individual did not go to medical school was because they tried and failed.

 

[rockit]

Arguments here aside, most of the med students I know LOVE to get walked over. The prevalining attitude is "get along to get along" and nobody ever stands up. Most of the people I know can be manipulated and pushed over very easily. As a group, doctors need to grow a backbone.

 

[njbmd]

it really annoys the crap out of me how hmo's, lawyers, psychologists, optometrists, PAs, and orthodontists have been able to walk all over the medical profession in the past decade. as someone about to start my MS1 year this fall, it really pisses me off. for one, NO ONE should be able to perscribe medicine or perform comsmetic surgery unless you went to MEDICAL SCHOOL and specialized. why do dumb a** psychologists with only some BS or MA degree feel they should perscribe medicine?? and even worse is why they are winning these battles in court to do so. Why is there not a strong medical lobby group that can persuade the obviously corrupt government to stop letting greedy blood thirsty lawyers mop the floor with the medical profession. i know layers are a huge lobby group, and can argue well, but can't the medical profession do anything??? The real annoying thing is that almost the entire general public knows that parasitic laywers are completly wrong, and that businesses and greedy HMO execs should not take advantage of the medical profession. its like these greedy a-holes saw a gold mine in the 90s with the medical profession and took full advantage of it. i hate this craze of everyone trying to take away rights and privaledges from doctors. and i hate how doctors are too weak to do anything about it.

Hi there,
As soon as you get to your medical school, join the Medical student division of the AMA. Last month, I joined about 450 medical students and fellow residents in Washington, DC where we went to Capitol Hill to lobby for legislation that would change the formula that determines our reimbursement.

By joining AMPAC, you will learn the issues that directly impact you as a future physician. We lobbied for a study of the present student loan system with emphasis on debt cancellation for physicians that serve in underserved areas. You can also participate in lobbying efforts in your local and state legislature that will help fight encroachment by mid-level practictioners.

Go to the AMA website and get familiar with the medical student sections and join instead of being annoyed, you can actually do something to try to help the situation.

njbmd

 

[PoorMD]

Typical pre-med post. While I agree with you that doctors are often taken advantaged of, that does not mean that just because you are a doctor you are always in the right. Doctors do stupid things (fraud, malpractice). There has to be oversite somewhere. Hopefully when you transition from theoretical medicine (first two years) into clinical medicine you will become more open-minded and realize that everyone has their place. Just because an orthodontist did not go to medical school does not mean that they were not sufficiently trained in doing what they do including prescribing medication. Sounds more like an ego to me.

Orthodontists are extremely talented surgeons!!! How could anyone be angry about the specialized work they do??

And psychologists have TONS of experience in treating people with schizo, depression, mania, anxiety, etc. They have a big time support role, just like psychiatrists. Does it actually bother you that these professionals can treat patients with meds?

Psychologists generally do not perscribe meds, they normally have psychiatrists do that.. but an orthodontist is a DDS (read, doctor of dental surgery) and they are trained with some in-depth anesthesia (mandibular nerve blocks) that you would never even know how to do unless you as an MD student went into gas residency.

 

[MacGyver]

Whats going to happen in the long term unless things change soon is that medical schools will have to change to reflect the invasion of turf by midlevels

A medical school that prides itself on producing family doctors wont survive long term, because the turf invasion is so severe now that nobody in their right mind would choose to go 150k in debt and complete a 3 year residency when in fact you can do the EXACT SAME THING as an NP or PA with only 2-3 years training after college.

What will happen is that medical schools will become "specialist only" factories. They will still produce neurosurgeons and such, but the days of medical schools producing family doctors, pediatrics, and other primary care disciplines are drawing to a close. Take a look at recent match trends. Fewer and fewer people going into primary care.

The writing is on the wall. PAs/NPs/midlevels have basically proven that the medical school model of producing primary care practioners is fraudulent. They have proven that its foolish to go 150k in debt to learn the same skills that you can get in 2 years after college with a fraction of the training time.

IN the future, doctors will only be super subspecialists. You will go to a PA/NP/midlevel for entry level primary care, and that person will refer to doctor/specialists if necessary.

Medical schools will be the long term losers here. We dont need 170 medical schools just for specialists. In the future, many medical schools will be closing. I predict long term we will have maybe 30 or 40 medical schools who produce all the subspecialists in the country.

 

[Hoya11]

Arguments here aside, most of the med students I know LOVE to get walked over. The prevalining attitude is "get along to get along" and nobody ever stands up. Most of the people I know can be manipulated and pushed over very easily. As a group, doctors need to grow a backbone.

I agree, great post.

There is something deeper than just economics going on. People are losing the respect for the MD degree that it once had. THe healthcare system is a mess, and we are inevitably at the top of the system, so we are blamed and intruded on by others who think they can help the problem.

 

[Chronic Student]

PA student here,

I must admit this post pissed me off, quite a bit. Just got off a 14 hour shift in my Ob/Gyn rotation, working side-by-side with Medical students. The same amount of work, knowledge and skills are expected of me with 1/2 of the training. We are given no breaks and we are graded on the same scales and tests, other than the shelf exam.

I have earned the respect of the attendings, residents and the Medical students that I work with because I bust my butt and know my s..t.

I would bet that you have no idea what you are talking about.

Have you laid hands on a patient, delivered a baby, sutured lacs, comforted a patient who was close to death or taken an ancephalic baby from the arms of a mother who suffered an IUFD. You might hold your opinions until you have worked with some of these people that you villify and see what they have to offer.

Who the hell do you think are hiring the PA's anyway! If you're mad, be mad at the doctor's who utilize them and by the way, should you be allowed to PRESCRIBE medications when you can't even spell it.

Most of the folks who hold those jobs that you mention are happy with their scope of practice and want no more. There will always be some who push the envelope, this is true of the medical profession as well. You are painting with a very broad brush and are already starting Med school with an attitude that will get you in dutch eventually.

Rant over,

-Mike

 

[trapperjohn]

PA student here,

I must admit this post pissed me off, quite a bit. Just got off a 14 hour shift in my Ob/Gyn rotation, working side-by-side with Medical students. The same amount of work, knowledge and skills are expected of me with 1/2 of the training. We are given no breaks and we are graded on the same scales and tests, other than the shelf exam.

I have earned the respect of the attendings, residents and the Medical students that I work with because I bust my butt and know my s..t.

I would bet that you have no idea what you are talking about.

Have you laid hands on a patient, delivered a baby, sutured lacs, comforted a patient who was close to death or taken an ancephalic baby from the arms of a mother who suffered an IUFD. You might hold your opinions until you have worked with some of these people that you villify and see what they have to offer.

Who the hell do you think are hiring the PA's anyway! If you're mad, be mad at the doctor's who utilize them and by the way, should you be allowed to PRESCRIBE medications when you can't even spell it.

Most of the folks who hold those jobs that you mention are happy with their scope of practice and want no more. There will always be some who push the envelope, this is true of the medical profession as well. You are painting with a very broad brush and are already starting Med school with an attitude that will get you in dutch eventually.

Rant over,

-Mike

even though youre expected to learn the same stuff in two years that doctors do in 4, you will not have that experience. and doctors go at least a total of 7 years with residency. and there is a reason for that. going to school for two years means that you should not act or perform the work of a doctor. it is a known fact PAs are trying to expand their role and PRESCRIBE medication and treat patients. they shouldnt. go to school for 7 years if you want that. i'm not about to start a 7 or more year path of education in which i'll be 200 grand in debt so some PA like yourself can think he knows just as much as i do and should be doing the same job. you and all other people who think they have the same rights as doctors should realize what you are. YOURE NOT DOCTORS.

i was way off when i critisized orthodontists, but i stick by what i said about psychologists, PAs, and optomitrists.

 

[Chronic Student]

Shame on me, I just realized you're a troll!

Ding, ding, ding...

-Mike

 

[divertete]

it really annoys the crap out of me how hmo's, lawyers, psychologists, optometrists, PAs, and orthodontists have been able to walk all over the medical profession in the past decade.

Ok, WildcatDMD alluded to this, but I've gotta chime in and put a stop to it. Orthodontists are the specialized dentists that straighten teeth (i.e. braces). You are thinking of oral and maxillofacial surgeons. They go through 4 years of dental school plus 4 years of residency (including EXTENSIVE training in pharmacology, anesthesia, etc.) OR 6 years of residency (that includes medical school, and they receive their MD degree). They do much more than pull teeth; they are trained to perform extensive reconstruction of the face and jaw after traumatic injury, and are often included as part of the medical team.

Now whether or not they should be performing cosmetic surgery is an issue you may debate. Just please don't bash the wrong profession!

 

[Callogician]

My opinion:

I respect all individuals who contribute positively to society, be they janitors, teachers, computer scientists, receptionists, or neurosurgeons. I feel that the roles of different professionals should be determined by both market forces and appropriate legal regulation to ensure safety, quality, and the relative absence of corruption. What specific regulations should be in place? I do not have the expertise necessary to answer this question, and I may be biased given my present career path.

 

[Chronic Student]

That was one of the most intelligent posts I've read in a long time, very eloquently stated.

-Mike

 

[Diceman M.D.]

Actually, that's not an unreasonable projection. I think there would be a lot of people who would actually welcome a change like that. After all, medicine is always evolving and changing - those qualities are essential to its continued development and for improving healthcare overall. And the roles of healthcare providers and their services are always changing as well. As our technology and knowledge improves, doctors WILL really need to specialize more and more and leave more and more of the general stuff to other types of healthcare workers. And there will always be demand, even for the sub-sub-subspecialists. There are simply too damn many people in America and the world.

Whats going to happen in the long term unless things change soon is that medical schools will have to change to reflect the invasion of turf by midlevels

A medical school that prides itself on producing family doctors wont survive long term, because the turf invasion is so severe now that nobody in their right mind would choose to go 150k in debt and complete a 3 year residency when in fact you can do the EXACT SAME THING as an NP or PA with only 2-3 years training after college.

What will happen is that medical schools will become "specialist only" factories. They will still produce neurosurgeons and such, but the days of medical schools producing family doctors, pediatrics, and other primary care disciplines are drawing to a close. Take a look at recent match trends. Fewer and fewer people going into primary care.

The writing is on the wall. PAs/NPs/midlevels have basically proven that the medical school model of producing primary care practioners is fraudulent. They have proven that its foolish to go 150k in debt to learn the same skills that you can get in 2 years after college with a fraction of the training time.

IN the future, doctors will only be super subspecialists. You will go to a PA/NP/midlevel for entry level primary care, and that person will refer to doctor/specialists if necessary.

Medical schools will be the long term losers here. We dont need 170 medical schools just for specialists. In the future, many medical schools will be closing. I predict long term we will have maybe 30 or 40 medical schools who produce all the subspecialists in the country.

 

[automaton]

hey it's not the PAs fault that medicine overtrains us. we spend a full year learning about stupid molecules that only dorky phds in bowties care about. not to mention ochem, physics, all that other crap that has nothing to do with anything.

but even with that i would disagree with macgyver about primary care being taken over. i worked in a family practice with MDs and PAs and the knowledge gap is HUGE. there is no way a primary care PA will take over an MD's job. no offense but the PA was pretty useless unless it was like viral URI or something. she didn't even know how to read an EKG and she was several years post-graduation. but of course more serious PAs can advance their knowledge, and if they are motivated then going to PA school is like a shortcut, and not a bad idea. Truth is though, i don't think PAs, NPs, CRNA, or whoever, are really as dedicated to advancing their knowledge as MDs. they'd rather just go home and watch must see tv and show up the next day with the same level of info, and will probably retire that way.

 

[trapperjohn]

i agree. i never said there was anything wrong with PAs, only when they, or any non doctor, think theyre at the level of the doctor.

 

[DrZee]

i agree. i never said there was anything wrong with PAs, only when they, or any non doctor, think theyre at the level of the doctor.

Agreed. I once overheard a podiatrist claiming she had gone to "medical school" in New York. Unfortunately for her, the other person she was talking to was actually an MD who had done their residency in NY and wanted to know which institution she went to. Finally she said new york college of podiatric medicine (NYCPM), but she didnt back down, instead saying that it was affiliated with some bigshot medical school and they have merged or something, hence it was as good as having gone to that bigshot institutions medical school. Can anyone believe this? this podiatrist was bragging about how she had gone to "medical school" when in fact it was podiatry school?? and all the people there had believed her until this MD had asked which school. I personally think this is happening too often, people without MD degrees making claims that are not always true. I mean for gods sake, some Chiropracters sell themselves as more qualified than orthopedic surgeons sometimes.

I would also like to add my support to the dental professionals here. Dental students receive a very detailed curriculum in the anatomy, and everything else of the head and neck (and the rest of the body) as well as any MD out there so if they wanna inject some botox or do surgery on the head/neck area, they are welcome to it. Hell they worked for it as much as (or more) than some people in beverly hills claiming to do "cosmetic" procedures. Many medical schools today have shared anatomy labs for medical and dental students so we know they are learning from the same books. No objection to that at all.

Nurses are great by the way. Nurse Practitioners can be very useful to medical practices. I can agree to some limited prescription writing by psychologists as the need for mental health care in any form is rising and well there just isnt enough psychiatrists (esp. Child Psychiatry) to go around. Maybe they should let pediatricians do a short second residency to be better able to handle child psychiatry cases as well. That would lessen the burden and need.

I just cringe when unqualified individuals make ugly claims and then demand legal protection for it. MDs should really move out of the shadows and do some lobbying. I will most likely join AMA this fall as well.

 

[DrZee]

See, even I am a little hesistant about everything to with the status of the medical profession

 

[sanford_w/o_son]

if psychologists want to perscribe meds, then they should quit their job, take the mcat and apply to med school, graduate, then do a residency in psychiatry. oh wait, they probably already tried this in undergrad, couldnt get in, and choose to go to grad to to be psychologists. then they hold a grudge against doctors and say "i want to get to know my patients and not treat them like crap the way all doctors do." this was the case for more then half of the premed drop outs at my undergrad.

not to pwn you or anything, but the branch of psychology that deals with abnormal conditions and has an interest in prescribing meds (clinical psych) has lower grad school admission rates than med school. one is less likely to be able to enter training to be a clinical psychologist than to be a doctor. so in your unforgiving world of stable professional hierarchies with rigid boundaries, perhaps lesser-qualified psychiatrists should give up their right to prescribe meds and clinical psychologists with their superior abilities should be trained to prescribe meds?
other branches of psych are a different story, but they don't have an interest in meds.

 

[IlizaRob]

Agreed. I once overheard a podiatrist claiming she had gone to "medical school" in New York. Unfortunately for her, the other person she was talking to was actually an MD who had done their residency in NY and wanted to know which institution she went to. Finally she said new york college of podiatric medicine (NYCPM), but she didnt back down, instead saying that it was affiliated with some bigshot medical school and they have merged or something, hence it was as good as having gone to that bigshot institutions medical school. Can anyone believe this? this podiatrist was bragging about how she had gone to "medical school" when in fact it was podiatry school?? and all the people there had believed her until this MD had asked which school. I personally think this is happening too often, people without MD degrees making claims that are not always true. I mean for gods sake, some Chiropracters sell themselves as more qualified than orthopedic surgeons sometimes.

I would also like to add my support to the dental professionals here. Dental students receive a very detailed curriculum in the anatomy, and everything else of the head and neck (and the rest of the body) as well as any MD out there so if they wanna inject some botox or do surgery on the head/neck area, they are welcome to it. Hell they worked for it as much as (or more) than some people in beverly hills claiming to do "cosmetic" procedures. Many medical schools today have shared anatomy labs for medical and dental students so we know they are learning from the same books. No objection to that at all.

Nurses are great by the way. Nurse Practitioners can be very useful to medical practices. I can agree to some limited prescription writing by psychologists as the need for mental health care in any form is rising and well there just isnt enough psychiatrists (esp. Child Psychiatry) to go around. Maybe they should let pediatricians do a short second residency to be better able to handle child psychiatry cases as well. That would lessen the burden and need.

I just cringe when unqualified individuals make ugly claims and then demand legal protection for it. MDs should really move out of the shadows and do some lobbying. I will most likely join AMA this fall as well.

Im sorry but I have to jump in here. I am a second year podiatric medical student at Des Moines University in Iowa. While I would not tell people that I go to medical school I would say that I go to podiatric medical school. We sit in the same classes as the DOs and yes, even disect together in anatomy. 3rd and 4th years are spent in rotations inlcuding IM, FP, ER, etc. followed by a 3 yr surgical residency. Im not trying to say that we are internal med doctors, but give us a little more credit. Our 7 year training is extensive in all the basic sciences, pharm, neuroatatomy, path, phys and all other systems. Please familiarize yourself before you bash a profession just for not having the "MD" degree.

All this talk about other professions moving in on an MDs territory is nothing more than the sentiments of the typical "doctor" ego. Extensive research and analysis of training and competence is done before legislation regarding scope of practice of a particular medical profession is changed. Despite popular belief on SDN, medicine can be taught outside the medical school. Advancements in knowledge and competence by any medical professional only qualifies the standard of care for our patients.

 

[trapperjohn]

7 years of training to be a footdoctor?? good lord!! how can you have any motivation to learn about neuroanatomy? talk about overtraining. and weren't there some posts earlier that said MDs were being overtrained???

 

[IlizaRob]

7 years of training to be a footdoctor?? good lord!! how can you have any motivation to learn about neuroanatomy? talk about overtraining. and weren't there some posts earlier that said MDs were being overtrained???

lol. I see your point. But you have to remember that there are many systemic diseases that manifest themselves in the foot first. Im not sure I would want to go to a foot doc for a foot problem who did not understand the entire physiology and anatomy of the body just incase I had a more serious condition that would involve an appropriate referal. It also helps out you MDs when we are educated enough to have an intelligent consult and can tell you what is wrong with the patient before we refer them over. We are licensed to order labs and diagnose any condition but then need to refer it out to the proper specialist.

On a side note, the foot and ankle are more complicated than one might expect. Im currently reading a 2100 page text book that is completely focused on just foot and ankle surgery. Fascinating stuff though.

 

[gerido]

Im currently reading a 2100 page text book that is completely focused on just foot and ankle surgery. Fascinating stuff though.

I understand the need to egg your own future profession up, but this is too much. You're a tool

 

[IlizaRob]

I understand the need to egg your own future profession up, but this is too much. You're a tool

I was merely pointing out that feet are more complicated than one might think. Myself included. No need to get upset.

 

[rockit]

An IM doc is supposed to know all of Harrison's, a textbook that is obsolete by the time it gets to print. I'm sure they'd cheer if it was only 2100 pages.

 

[IlizaRob]

An IM doc is supposed to know all of Harrison's, a textbook that is obsolete by the time it gets to print. I'm sure they'd cheer if it was only 2100 pages.

Wow. Ok, everybody put down their keyboard axes for a second. I dont know why you are all so defensive. I did not mean to sound condescending nor was I trying to compare specialties here. I was only saying there is more to the foot than meets the eye as I was making an attempt to justify the amount of years a pod spends in training. I know the neurosurgeon has to know a great deal as well as the IM doc, FP, ortho etc. So does the lawyer for that matter. What is with the constant contention on SDN?

 

[DW3843]

relax, people. relax.

 

[DrZee]

Im sorry but I have to jump in here. I am a second year podiatric medical student at Des Moines University in Iowa. While I would not tell people that I go to medical school I would say that I go to podiatric medical school. We sit in the same classes as the DOs and yes, even disect together in anatomy. 3rd and 4th years are spent in rotations inlcuding IM, FP, ER, etc. followed by a 3 yr surgical residency. Im not trying to say that we are internal med doctors, but give us a little more credit. Our 7 year training is extensive in all the basic sciences, pharm, neuroatatomy, path, phys and all other systems. Please familiarize yourself before you bash a profession just for not having the "MD" degree.

All this talk about other professions moving in on an MDs territory is nothing more than the sentiments of the typical "doctor" ego. Extensive research and analysis of training and competence is done before legislation regarding scope of practice of a particular medical profession is changed. Despite popular belief on SDN, medicine can be taught outside the medical school. Advancements in knowledge and competence by any medical professional only qualifies the standard of care for our patients.

I didnt and dont mean to bash the entire field of podiatry, merely the individuals who misrepresent themselves to others (which in this case was a podiatrist I was listening to). And even though you may have sat "in the same classes as the DOs and yes, even disect[ed] together in anatomy" that does not mean you can call yourselfs DO's or claim to have gone to medical school without explaining further. By the same line of reasoning, should dental students who take some shared classes with medical students, also claim they went to "medical school"??
My concern is that although more lay people are aware of the intricate differences between health care professionals than before, There are still people out there who may not know and who risk being fooled by appearances and packaging. In this case, the fake "medical scholar" from new york had managed to convince the people in the vicinty that she was a physician. Had it not been for a discerning individual who poked additional questions that she would have kept on fooling some people. I am absolutely not saying this is characteristic of non-physician people. I am saying this misrepresentation is characteristic of certain personalities that seek attention. No disrespect meant for the field, just some practitioners who do improper things.

 

[IlizaRob]

I didnt and dont mean to bash the entire field of podiatry, merely the individuals who misrepresent themselves to others (which in this case was a podiatrist I was listening to). And even though you may have sat "in the same classes as the DOs and yes, even disect[ed] together in anatomy" that does not mean you can call yourselfs DO's or claim to have gone to medical school without explaining further. By the same line of reasoning, should dental students who take some shared classes with medical students, also claim they went to "medical school"??
My concern is that although more lay people are aware of the intricate differences between health care professionals than before, There are still people out there who may not know and who risk being fooled by appearances and packaging. In this case, the fake "medical scholar" from new york had managed to convince the people in the vicinty that she was a physician. Had it not been for a discerning individual who poked additional questions that she would have kept on fooling some people. I am absolutely not saying this is characteristic of non-physician people. I am saying this misrepresentation is characteristic of certain personalities that seek attention. No disrespect meant for the field, just some practitioners who do improper things.

I agree.

 

[bgabes]

i just finished posting to some students considering my med school- today politicians, lawyers, and administrators dictate to physicians how to practice medicine instead of vice-versa; but I've seen plenty at my school (maybe not isolated to my school) that contributes to this...is it just me or does anyone ever get the impression many of the faculty even (or esp) deans at their schools are relatively clueless to society outside the hospital (ie in their understanding of politics, interpersonal skills, etc)? I think putting down other health professionals (ie PAs, pharmacists, etc); however, does nothing other than to further emphasize this point. I agree it's ridiculous some nurses CRNAs start out making more than established academic pediatricians for example (a field i'm thinking of goign into) and many dentists make 2-3x/hr than a generalist physician (for real, check the stats) but I can't help but think the same conservative mentality which permits physicians (and frustratingly even nurses as I've experienced) to talk down upon other health professionals (or med students) does nothing other than to further show how removed medicine is from the rest of society.

 

[dara678]

not to pwn you or anything, but the branch of psychology that deals with abnormal conditions and has an interest in prescribing meds (clinical psych) has lower grad school admission rates than med school. one is less likely to be able to enter training to be a clinical psychologist than to be a doctor. so in your unforgiving world of stable professional hierarchies with rigid boundaries, perhaps lesser-qualified psychiatrists should give up their right to prescribe meds and clinical psychologists with their superior abilities should be trained to prescribe meds?
other branches of psych are a different story, but they don't have an interest in meds.

i'm sorry, i still don't think anyone has the right to prescribe meds unless they know about the entire systemic effects that a medication can induce. even if you have extensive pharmacology classes in clinical psych grad school, you don't learn the entire anatomy and pathophysiology of the human body. and meds have effects on EVERYTHING.

so, clinical psych is harder to get into than med school? interesting thought ... of course you could factor into that the lower number of programs making the admission rate lower. also there's no way you can compare med school and grad school applicants because there is no standardized test evaluating both fairly. so no need to talk about "lesser-qualified psychiatrists".

 

[deuist]

Trapperjohn, what are you talking about when you mention the psychologists? First off, no one is advocating prescribing rights for someone with a BA or MS in psychology. They can't even call themselves psychologists until they get a Ph.D., perform an internship, and get licensed. The total time required to get through all that training is at least 6 years post-college. Even then, psychs can't get prescribing rights until they have undergone extensive post-doc training in pharmacology (450 hours in Arizona), followed by a internship under a psychiatrist. When they finally do get prescribing rights, psychologists are restricted to dispensing only mental health drugs and only under the guidance of a board certified psychiatrist---meaning that they have fewer privileges than physician assistants. The big reason that some states allow psychologists to give meds is because of the high demand for psychiatrists. Unfortunately, so few MDs want to enter psych that many areas are extremely under served and need to fill the void some how.

 

[sanford_w/o_son]

so, clinical psych is harder to get into than med school? interesting thought ... of course you could factor into that the lower number of programs making the admission rate lower. also there's no way you can compare med school and grad school applicants because there is no standardized test evaluating both fairly. so no need to talk about "lesser-qualified psychiatrists".

the lower number of programs is indeed a big factor in the equation. i have no personal association with clinical psych or psychiatry. my statement about "lesser qualified psychiatrists" was the outcome of applying a rigid logic of meritocracy to decide professional boundaries, as trapperjohn suggests we should do.

i think such statements are ridiculous not because they get wrong the status ordering among professions concerning what they can medically do, but because they take for granted that such a status ordering is a simple result of training and ability and don't take into account economic, social, and political factors. and i'm suprised to see so many people buy into this simplistic view. m.d.s appropriated their "doctor" title (which means "teacher" in latin) from university professors to give their profession legitimacy in a time when its value was quite questionable (and often harmful). was the true "training and ability" behind doctors' decisions why people continued to go to them to have their blood let or leeches applied, or did that have more to do with the questionable-but-self-confident claims to professionalism that doctors made at the time? obviously there have been substantial advances in medicine since that time that give it a legitimate medical value to society, but we can still see the economic/social/political concerns of doctors at work when they dubiously try to discredit the medical ability of nure-anesthesiologists to give anesthesia, podiatrists to treat conditions of the foot with relationships to other parts of the body, clinical psychologists to pharmacologically treat mental conditions with a limited range of drugs, etc. politically powerful lobbying organizations such as the ama have played a large role expanding the jurisdiction of physicians while trying to curtail the jurisdictional claims of others. this has been and still is a political process.

so my big point is that idealilzed debates like this fail to reflect how medical professions actually attain their jurisdictions of practice until you consider the competing economic/social/political interests of different professions as reflected in history. there are many cases where decisions on professional boundaries have only been loosely based on "ability and training," when it has been considered at all.

 

[VCU07]

i'm sorry, i still don't think anyone has the right to prescribe meds unless they know about the entire systemic effects that a medication can induce. even if you have extensive pharmacology classes in clinical psych grad school, you don't learn the entire anatomy and pathophysiology of the human body. and meds have effects on EVERYTHING.

so, clinical psych is harder to get into than med school? interesting thought ... of course you could factor into that the lower number of programs making the admission rate lower. also there's no way you can compare med school and grad school applicants because there is no standardized test evaluating both fairly. so no need to talk about "lesser-qualified psychiatrists".

If you need to know the entire systemic effects drugs can have on the human body, then why so can PAs or NPs prescribe after little pharmacology education? Do med schools or PA programs teach any kind of pharmacotherapy before their students go to rotations? I am not trying to start any trouble, but I still do not understand how PAs and NPs can prescribe via a 2 yr post bac degree while pharmacy is 2-4 yrs undergrad and 4 yrs of professional school.

 

[OMFSCardsFan]

i agree. i never said there was anything wrong with PAs, only when they, or any non doctor, think theyre at the level of the doctor.

I think it's hilarious that you seem to think you're going to learn everything you'll ever need to know in medical school. Education is a process that continues long after you finish school. Medical school doesn't make you a physician, which is why, in most cases, interns have the reputation of being next to useless. Medical school gets you an M.D. and a title of "Doctor", but it doesn't make you a physician. This comes with time, experience, and the continued pursuit of learning.

Just like most blanket statements, one saying that M.D.s are always better than PAs is ridiculous. There is nothing about medical school which gives an M.D. a golden key to the treatment of patients, making them any more competent than a knowledgeable PA working in the same environment.

But on the up side, your "holier than thou" attitude is sure to make you a lot of friends in your lifetime...

 

[Hoya11]

MDs need to realize that even though they can score better on tests and spend years in training, academia is not the real world, and these things arent the be all end all of providing good healthcare. There IS something wrong with our system that it makes us work so hard and long and focuses on the wrong things, and many people are turned off by this.

On the other end of the spectrum, Non-MDs need to realize that we have had extensive specific training in areas that you have not, and equating whatever you did to "going to medical school" is just simply untrue. Have you had endless encounters walking into a room with a patient with any general problem in the world? No