Well, I got accepted to Med School

[tkim]

Is there a shortage of emergency medicine residency-trained ER physicians there?

Actually, there is a shortage.

Legally a licensed physician can practice whatever medicine they wish - it's the point of an unrestricted license.

Practically, though, if you try to practice outside of your specialty, health insurance won't pay you, malpractice insurance won't cover you, hospitals will not grant you credentials or privileges to do so. So, no, not so much.

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[244869]

As tkim mentioned...practicing outside your specialty even as an unlimited scope physician is legally possible but it's rare. Probably mostly happens in rural areas.

Seriously...everyone specializes and major turf wars exist within medicine. A lot of SDNers live in a fantasy land where they think every MD/DO coexist happily where there is mutual respect because they are all "real doctors". This is not the case. Plastics fight with Ortho for the hand, Ortho fights neuro for the spine, Burn fights with plastics....turf is huge in the MD/DO world. And every specialty thinks they are badass and make fun of other specialties...this is what my brother an EM resident said....literally. He said EM makes fun of IM because they can't handle anything emergent, IM make fun of EM because they can't diagnose anything non emergent, EM/IM make fun of surgery because they don't practice medicine anymore...they just cut, everyone makes fun of psych because for the large part they don't practice anything evidence based...they treat based on experience, and it turns out Optho just makes fun of everyone because they have a cushy job. Everyone specializes sooner or later, it just turns out that podiatry specializes sooner rather than later.

 

[podpod]

WOW! well said previous posters. Now that we explored how "unlimited" the MD/DO is, I want to state that DPM has its own form of "unlimited." Pod allows one to be a dermatologist (good luck getting that residency MD/DOers), physiologist/sports med, ortho, surgeon, specialist in diseases that impact the foot (ie diabetes), plastics, and wound care. so in essence ur doing a wide variety of care that requires a MEDICAL SCHOOL curriculum, but ur scope of the body is limited thats all. so if the OP just happens to like feet, all the more power.

also while im sure there is a need for physicians, pods are expected to have a SIGNIFICANT need. so no one going to pod school will be in the poor house esp if ur good at what u do and love it.

to the poster that said there isnt much exploration out of clinical care doesnt mean that it should stop u. if u want to get that phd or other degree im sure it wont be impossible to work in research.

 

[NatCh]

As tkim mentioned...practicing outside your specialty even as an unlimited scope physician is legally possible but it's rare. Probably mostly happens in rural areas.

Seriously...everyone specializes and major turf wars exist within medicine. A lot of SDNers live in a fantasy land where they think every MD/DO coexist happily where there is mutual respect because they are all "real doctors". This is not the case. Plastics fight with Ortho for the hand, Ortho fights neuro for the spine, Burn fights with plastics....turf is huge in the MD/DO world. And every specialty thinks they are badass and make fun of other specialties...this is what my brother an EM resident said....literally. He said EM makes fun of IM because they can't handle anything emergent, IM make fun of EM because they can't diagnose anything non emergent, EM/IM make fun of surgery because they don't practice medicine anymore...they just cut, everyone makes fun of psych because for the large part they don't practice anything evidence based...they treat based on experience, and it turns out Optho just makes fun of everyone because they have a cushy job. Everyone specializes sooner or later, it just turns out that podiatry specializes sooner rather than later.

Yes, everyone makes fun of everyone else but you know who is not getting made fun of right now? Family Practice. Even in this difficult economy people still go see their family practice doctor. However, it turns out people are more reluctant to go see a specialist for anything elective. Many of the specialties have seen quite a drop in business over the last half year. In fact, I was at the park talking to a local hand orthopedic surgeon today while our kids played. He was saying that his practice consists of 75% elective surgeries and those have cut drastically. The rest of his group has had a similar drop in business (and knowing this particular group, they have massive overhead). As a result, his orthopedic group has been going out of their way to be extra-nice to Family Practice hoping to get some referrals! The local large Family Practice group has been getting showered with personal phone calls, thank you cards, and other niceties from numerous specialties all of a sudden. What a change!

 

[244869]

Yes, everyone makes fun of everyone else but you know who is not getting made fun of right now? Family Practice. Even in this difficult economy people still go see their family practice doctor. However, it turns out people are more reluctant to go see a specialist for anything elective. Many of the specialties have seen quite a drop in business over the last half year. In fact, I was at the park talking to a local hand orthopedic surgeon today while our kids played. He was saying that his practice consists of 75% elective surgeries and those have cut drastically. The rest of his group has had a similar drop in business (and knowing this particular group, they have massive overhead). As a result, his orthopedic group has been going out of their way to be extra-nice to Family Practice hoping to get some referrals! The local large Family Practice group has been getting showered with personal phone calls, thank you cards, and other niceties from numerous specialties all of a sudden. What a change!

Yup...specialties that deal a lot with elective procedures are getting hit really hard. And I'm sure tkim has been experiencing this, EM is seeing an increase in patients...although I don't think it is an increase in paying patients...

WOW! well said previous posters. Now that we explored how "unlimited" the MD/DO is, I want to state that DPM has its own form of "unlimited." Pod allows one to be a dermatologist (good luck getting that residency MD/DOers), physiologist/sports med, ortho, surgeon, specialist in diseases that impact the foot (ie diabetes), plastics, and wound care. so in essence ur doing a wide variety of care that requires a MEDICAL SCHOOL curriculum, but ur scope of the body is limited thats all. so if the OP just happens to like feet, all the more power.

also while im sure there is a need for physicians, pods are expected to have a SIGNIFICANT need. so no one going to pod school will be in the poor house esp if ur good at what u do and love it.

to the poster that said there isnt much exploration out of clinical care doesnt mean that it should stop u. if u want to get that phd or other degree im sure it wont be impossible to work in research.

This is true. Podiatry is everything with the feet. In my brothers ER everything feet related go directly to podiatry...they don't even ask ortho...although this is probably not the case if there is a F&A ortho around. AND everyone loves podiatry. According to my brother podiatry is always punctual, nice, and happy to come down for a consult...unlike some other specialties...cough ortho cough.

 

[NatCh]

Yup...specialties that deal a lot with elective procedures are getting hit really hard. And I'm sure tkim has been experiencing this but EM is seeing an increase in patients...although I don't think it is an increase in paying patients...

Do ER docs do their own billing, or are they on the hospital payroll (and if so, do they get paid straight salary or do they get paid by RVU's)? Either way, I'm sure the hospital as a whole is not doing as well as last year. Our local paper ran an article saying how in 2008 our hospital had the first operating loss in four years with a deficit of $615,000. It ran another article saying how crowded their ER has been.

It's also an interesting point from podpod that although we are limited in geographic scope (lower extremity), we are not so limited in the variety of things we can do to the foot.

 

[244869]

Do ER docs do their own billing, or are they on the hospital payroll (and if so, do they get paid straight salary or do they get paid by RVU's)? Either way, I'm sure the hospital as a whole is not doing as well as last year. Our local paper ran an article saying how in 2008 our hospital had the first operating loss in four years with a deficit of $615,000. It ran another article saying how crowded their ER has been.

It's also an interesting point from podpod that although we are limited in geographic scope (lower extremity), we are not so limited in the variety of things we can do to the foot.

From the way my brother describes it, ER docs are salaried. But then again the salary is determined by the contract, which is determined by projected income/losses.

 

[tkim]

Do ER docs do their own billing, or are they on the hospital payroll (and if so, do they get paid straight salary or do they get paid by RVU's)?

It depends on the group and the contract. You could work as a hospital employee, and independant contractor, or a partner in a group practice. Some pay a fixed hourly with production bonuses, some are 'eat what you kill' straight RVU. Billing gets done by either the hospital or the group. The business side I'm not so knowledgeable on.

 

[NatCh]

It depends on the group and the contract. You could work as a hospital employee, and independant contractor, or a partner in a group practice. Some pay a fixed hourly with production bonuses, some are 'eat what you kill' straight RVU. Billing gets done by either the hospital or the group. The business side I'm not so knowledgeable on.

Interesting. I had always assumed ER docs were salaried employees of the hospital, so I'm glad I asked.

 

[ThetaChiNAU]

.

 

[Adam Smasher]

Come on "Adam", show a little humility and a little class. If you learn anything, it's to never burn your bridges.

Although I'm sure everyone will jump all over my post, I have some questions for you. I've been in practice for over 20 years and podiatry was my first choice from day ONE. Therefore, I'm happy with my career choice.

It appears that your career choice was always to obtain your MD degree and after not seeming to obtain success, you decided to change directions and pursue the DPM degree.

Now your decision to stay with the DPM degree almost seems an act of "spite" to prove something.

Are you sure that your plans are really well thought out and that you REALLY want to limit your career to the scope of practice of podiatry vs an unlimited MD license??

As stated, I made my choice a long time ago and I'm happy with my decision. Please make sure that you're REALLY making your decision for the right reason(s).

Not everyone has the ability to be accepted to medical school, and medical school allows you to practice with an unlimited license and also allows you 4 years to decide which field of medicine you want to choose as your specialty, after your rotations. Once you choose podiatric medicine, your path is set.

I've been happy with my decision, I just want to make sure you made your decision for the right reasons.

Dear PADPM,

Thanks for the concern. First off, I didn't really tell the dean to "suck my fat one." I was just using a little poetic license. Secondly, it's a little late for me to be backtracking, so this whole "are you sure you want to do this" discussion is entirely academic.

The way I look at it is this. I could be miserable as a podiatrist, but if I am, I probably would also be miserable as an MD. I think it's a little unlikely that I wake up one day and think to myself "If only I could perform a colonoscopy/deliver a baby/crack open someone's chest!"

It's not about spite. It's more a case of having applied to medical school without fully exploring my options at first, and then discovering something that I think is a more solid choice.

 

[podpod]

This claim is highly spun out of control worse than fox news or msnbc...

the reason why MD/DO want derm is because it makes a lot of money with a very RELATIVELY easy job compared to nearly every other MD/DO specialty.

Podiatrists get to do derm but it is not their sole profession.

Just pointing this out, hopefully to extinguish future spinning of facts and opinions out of control to skew the facts...

I think u misunderstood my post... i was saying that as a pod u can do all of these those things listed in combo with each other so ur basically a "doc of all trades." this is why we need the medical school curriculum that vision 2015 calls for. yea i highly doubt a pod would ever call himself a "podiatric dermatologist," but def u got to know and treat derm issues. hands down, it rocks that we can do all these different tasks or even decide to become an expert in one of the forementioned areas like diabetes or wound care.

 

[jbb]

pwned

Most definately owned