Chapter 9

Chapter 9 Physicians, Surgeons, and Podiatrists Significant Points Many physicians and surgeons work long, irregular hours. Acceptance to medical school is highly competitive. Formal education and training requirements are among the most demanding of any occupation, but earnings are among the highest. Significant Points (continued) Training is typically 4 years of undergraduate school, 4 years of medical school, 1 year of internship, and 2 to 7 years of residency and fellowship. Job opportunities should be very good, particularly in rural and low-income areas.  Projected Shortage of Primary Care Practitioners The demand for physicians is projected to exceed supply by 2020 Aging population Greater numbers of Americans have health insurance as a result of the Affordable Care Act (ACA). Many physicians train to be specialists and do not see patients for common health problems. APRNs and PAs Advanced practice registered nurses and physician assistants The number of APRNs and PAs is projected to grow faster than physicians through 2020. Both APRNs and PAs can extend primary care services. Having enough PCPs is important; the U.S. healthcare system requires that referrals to physician specialists be made through PCPs. Work Description Physicians and surgeons Diagnose illnesses. Prescribe and administer treatments. Examine patients. Obtain medical histories. Order, perform, and interpret diagnostic tests. Two Types of Physicians Medical doctor (MD) or allopathic physicians Doctor of osteopathic (DO) or osteopathic physicians DOs Place special emphasis on the body’s musculoskeletal system Preventive medicine Holistic patient care DOs are more likely to work in primary care, although they can be found in all specialties. Physician Specialties Anesthesiologists Family medicine General internists General pediatricians Obstetricians and gynecologists Psychiatrists Surgeons Employment Opportunities Data from Bureau of Labor Statistics, U.S. Department of Labor. May 2014 National Occupational Employment and Wage Estimates. . Internet: http://www.bls.gov/oes/current/oes_nat.htm Education and Training The minimum educational requirement for entry into medical school is 3 years of college. Most applicants have at least a bachelor’s degree. All students must complete undergraduate work in biology, chemistry, physics, mathematics, and English. Students also take courses in the humanities and social sciences. Medical Schools Are Highly Competitive Applicants must submit grade transcripts. Medical College Admission Test (MCAT) scores Letters of recommendation Applicant’s personality, leadership qualities, and participation in extracurricular activities are also considered. Licensure All states require physicians and surgeons to be licensed. All physicians and surgeons must pass a standardized national licensure examination. Physicians licensed in one state usually can get a license to practice in another without further examination, some states limit reciprocity. Certification and Other Qualifications Certification is not required for physicians and surgeons. May increase their employment opportunities An examination after residency is required for certification by American Board of Medical Specialties (ABMS) American Osteopathic Association (AOA) Employment Trends Employment of physicians and surgeons is projected to grow 14% from 2014 to 2024, above average for all occupations. Job growth will occur because of the continued expansion of healthcare-related industries and the growing and aging population. Job Prospects Job prospects should be good for physicians willing to practice in rural and low-income areas because these areas are medically underserved. Job prospects will be good for physicians in specialties that afflict the rapidly growing elderly population. Examples of such specialties are cardiology, radiology, and oncology. Job Prospects in Numbers! Most experts expect that the number of physicians and surgeons will increase by 99,300 from 708,300 in 2014 to 807,600 in 2024. Earnings Earnings of physicians and surgeons are among the highest of any occupation. The number of physicians for common specialty areas and mean salaries are listed in Table 9.1. Data from Bureau of Labor Statistics, U.S. Department of Labor. May 2014 National Occupational Employment and Wage Estimates. Podiatrists Formal training for podiatrists is similar to that of physicians and surgeons, with 4 years of undergraduate school, 4 years of podiatry school, and 1 year of residency. Work Description Specialize in the medical and surgical care of foot, ankle, and lower leg problems. Diagnose illnesses, treat injuries, and perform surgery involving the lower extremities. Treat a variety of foot and ankle ailments, including calluses, ingrown toenails, heel spurs, and arch problems. Specialize in diabetic foot care. Work Environment Most podiatrists work in offices of podiatry. Some work in group practices with other physicians or specialists. Some work in private and public hospitals and outpatient care centers and routinely care for residents in nursing and assisted living facilities. Employment Opportunities There were 8,910 podiatrists in the U.S. in 2014. Podiatry provides excellent opportunities as a health career. Need for lower limb and feet care in those with diabetes and peripheral vascular disease and general podiatric care for the aging population. Education and Legal Requirements Must complete a 3-year residency program. Podiatrists must have a doctor of podiatric medicine (DPM) degree from an accredited college of podiatric medicine. A DPM degree program takes 4 years to complete. Podiatrists must be licensed. Educational Requirements Courses for a DPM degree are similar to those for other medical degrees. Anatomy, physiology, pharmacology, pathology, and other subjects During their last 2 years, podiatric medical students gain supervised experience by completing clinical rotations. Licensing Podiatrists in every state must be licensed. Podiatrists must pay a fee and pass the American Podiatric Medical Licensing Exam (APMLE). Some states also require a state-specific exam. Licenses must typically be renewed periodically, and podiatrists must take continuing medical education to maintain licensure. Certification Many podiatrists choose to become board certified. Requires a combination of work experience and passing scores The American Board of Podiatric Surgery is the certifying agency in podiatric surgery. The American Board of Podiatric Medicine is the certifying agency in orthopedics and primary care podiatry. Employment Employment of podiatrists is projected to grow 14% from 2014 to 2024, faster than the average for all occupations. Because it is a small occupation, the growth will result in only about 2,400 new jobs over the 10-year period. Job Prospects Job prospects for trained podiatrists should be good; there are a limited number of colleges of podiatry. Retirement of currently practicing podiatrists is expected to increase the number of job openings for podiatrists. Earnings The median annual wage for podiatrists was $120,700 in May 2014. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less.