Someone once told me Medical Physics was 1 of 2 non-physician specialties, but I've never been able to find another.
https://www.abms.org/wp-content/uploads/2020/11/ABMS-Guide-to-Medical-Specialties-2020.pdf
Draft Standards for Continuing Certification — Call for Comments
If you're a doctor certified by one of the ABMS member boards this might be of interest. The draft of the standards they are circulating would require " would require a physician to demonstrate engagement in improving health and health care to remain certified ". When ABIM tried this 8 years ago they basically tried to get everyone to do QA projects which is obviously a little harder if you're in private practice. If you're an interested party, consider leaving comments for the ABMS through the link.
Edit: thanks for the discussion everyone! Remember to take a minute to fill out the survey and make your views known if this applies to you.
Found this posted on another sub:
https://pubmed.ncbi.nlm.nih.gov/31230727/
The telomeres at the end of DNA— which are sort of like aglets at the end of a shoelace—shrink 6 times faster when newly minted doctors are introduced to the new stress of training (long work hours 80-120hrs/week, little sleep, life and death situation etc).
Telomere shortening is a well-known hallmark of both cellular senescence and organismal aging. Telomere length is thus considered one of the most consequential biomarkers of chronological ageing, it’s maximum at birth and progressively decreases with age.
And it is irreversible.
https://www.reddit.com/r/askscience/comments/qy8vpl/comment/hlfmzjd/
Other than being an obvious money grab (Basic TEE Certification anyone), what benefit would this exam provide that having completed a CT Fellowship and Diplomate Status for TEE wouldn’t?
"It's OK to have an opinion, as long as we feel it's the correct opinion", they explained.
Either shorten the fellowships or admit that midlevels should not be able to switch between specialties so easily.
Physician from specialty A: “Only consider this specialty if you can’t see yourself doing anything else”
Physician from specialty B: “Only consider this specialty if you can’t see yourself doing anything else”
Well what am I supposed to do then?!
Has anyone else noticed this? I feel like every specialty dislikes most other specialties, which just makes it so hard to be honest when talking to attendings about your career interests on clerkship.
A list of specialty beef I have so far heard:
- Medicine: hates surgeons because they don’t know how to care for/interact with a non-unconscious patient
- Surgeons: hates medicine because who gives a fuck what a potassium is and who actually wants to talk a patient to death
- OBGYN: hates urology because men
- Urology: hates OBGYN because they are the ureters’ natural enemy
- OBGYN: hates surgery because well, men
- Surgery: hates OBGYN because they’re not real surgeons
- Surgery: hates anesthesia because it’s somehow always their fault
- Anesthesia: too busy scrolling they phone to hate (they’re also just always chill?)
- Neurosurgery: hates medicine because they’re not real doctors
- Neurosurgery: hates other surgery because they’re not real doctors
- Plastics: too busy spending money to care, probably screwing neurosurgery’s wife
- Neurosurgery: hates neurosurgery because, well, neurosurgery
- Plastics: hates general surgery because they’re gorillas who put skin together with fish hooks
- General surgery: hates plastics because who the fuck needs 2 hours to close. Spider-web-ass spinning bitches.
- Palliative care: hates oncology because dear god just let the patient maximize their quality of life before passing
- Oncology: too busy hanging the chemo over the casket to care
- Surgery: hates EM because dumb consults
- Medicine: hates EM because dumb consults
- EM: not sure who they hate, maybe the guy who cut them off on their morning biking commute(?)
- ID: hates surgery because they know .5 antibiotics.
- Surgery: vaguely aware ID is a field. Anyway its ancef time, baby.
- Plastics: hates ortho because they historically called dibs on hand surgery first
- Ortho: hates plastics because hand have bone hand no have plastic thus hand is ortho
- Surgery: hates pathology because they take too long to read active surgery specimen, secretly thinks pathology will eventually be replaced by robots
- Pathology: hates surgery because of their attitude, secretly thinks surgery will eventually be replaced by robots
- Pathology: dislikes radiology because their room is too dark
- Radiology: dislikes pathology because their room is too bright
Any other beef I'm missing??
https://www.abp.org/content/pediatric-hospital-medicine-certification
Please tell me I'm not reading this correctly (apologies for not fully understanding the jargon of medical certification yet). If I wanted to practice general pediatrics inpatient in the future, would I need to pursue additional certification? Or can a board certified general pediatrician still work inpatient?
If this is the future, do you see this being a significant strain on the available workforce? I know many pediatric subspecialties go underfilled, and some research suggests that many fellowships are financially net negative decisions (https://pediatrics.aappublications.org/content/127/2/254)
Edit: Speak of the devil, look what just showed up in my inbox. https://www.medscape.com/slideshow/2019-compensation-pediatrician-6011343?src=WNL_physrep_190529_medstu_comp2019&uac=305007AT&impID=1978438&faf=1#21
23% of pediatricians work in a hospital.
"Hi i'm Andrew I'm a board certified plastic surgeon"
i see this a lot on some videos on social media and youtube
i'm from the UK, you kind of just assume every surgeon is well qualified hence the title of surgeon or dr.
In non-FPA states, or even transitional FPA states, there's a continuing problem of physicians renting out their license and rubber stamping NPs, despite being utterly unqualified to do so. A recent example is the pathologist in Indiana supervising an NP-run MedSpa where they do liposuction.
Unfortunately, many states don't seem to recognize this as an issue and laws haven't been updated to address this growing trend. This is absolutely something that could be incorporated into Board of Medicine rules, despite these typically appearing in Board of Nursing rules governing collaborative agreements. This type of rule may even be easier to pass since it can bypass any nursing politics and go directly into physician and medicine governance.
Only 11 states require supervising physicians to be in the same specialty as the NPs they supervise.
Relevant laws copied below.
Arkansas
FPA*, 17-87-310. Prescriptive authority.(a) The Arkansas State Board of Nursing may grant a certificate of prescriptive authority to an advanced practice registered nurse who:(2) Has a collaborative practice agreement with a practicing physician who is licensed … and who has training in scope, specialty, or expertise to that of the advanced practice registered nurse on file with the Arkansas State Board of NursingFrom the Arkansas DoH website: “The collaborating physician must have training within the scope, specialty, or expertise of the APRN’s practice/specialty.”
Colorado
FPA*, 12-255-112.(4)(b)(I)(A) Once the provisional prescriptive authority is granted, the advanced practice registered nurse must obtain seven hundred fifty hours of documented experience in a mutually structured prescribing mentorship either with a physician or with an advanced practice registered nurse who has full prescriptive authority and experience in prescribing medications. The mentor must be practicing in Colorado and have education, training, experience, and an active practice that corresponds with the role and population focus of the advanced practice registered nurse.
Connecticut
FPA*, Sec. 20-87a. Definitions. Scope of practice.(b)(2) An advanced practice registered nurse having been issued a license pursuant to section 20-94a shall, for the first three years after having been issued such license, collaborate with a physician licensed to practi
... keep reading on reddit ➡The American Academy of PAs have officially voted to start a nation-wide push for independent practice rights. The way I interpreted it was essentially the right to practice medicine with full independence in any specialty just like any residency/fellowship-trained, board-certified physician. That is my interpretation, but I will give you the exact text of their resolution. They are calling for "Optimal Team Practice." What does that mean?:
> Optimal Team Practice reemphasizes the PA profession’s commitment to team-based care, and in an amendment offered on the floor of the House of Delegates, reaffirms that the degree of collaboration between PAs and physicians should be determined at the practice level. It also supports the removal of state laws and regulations that require a PA to have and/or report a supervisory, collaborating or other specific relationship with a physician in order to practice. In addition, the new policy advocates for the establishment of autonomous state boards with a majority of PAs as voting members to license, regulate and discipline PAs, or for PAs to be full voting members of medical boards. Finally, the policy says that that PAs should be eligible to be reimbursed directly by public and private insurance for the care they provide.
https://www.aapa.org/aapa-press-information/pas-vote-advance-profession-meet-modern-healthcare-needs/
- Species: Feline
- Age: 23 months
- Sex/Neuter status: M - neutered
- Breed: F2 Savannah Cat
- Body weight: 18 lbs
- History: At approximately 6 months old, he began to look "squinty". Over time, the peri-orbital irritation became more prominent, and he was taken in to the vet, who referred me to dermatology. Dermatology put him on 8mg of Apoquel BID, and he got somewhat better, but we still could not identify what food it was that caused the issue. Regardless, on the apoquel he was doing okay. About 6 months ago, the apoquel started to not work as well, and I took him back to dermatology. They recommended an exclusion diet, and I did find that tuna seemed to make him worse. However, he still did not improve to normal, and gradually, the apoquel started to not work well at all. He was then switched to a hydrolyzed only diet. He has eaten literally nothing but hydrolyzed protein food now for 45 days, and if anything, is worsening. He has a follow up appointment in two weeks, but recently bloodied his face with scratching. I have been trying apoquel + benadryl, and recently added methylprednisolone 4mg BID for 3 days to see if I could bring it under control. That still didn't work. He continued to worsen to where I gave him 2mg dexamethasone IM last night. I don't know what else to do. I'm afraid I'm going to end up giving him diabetes from the steroids and they aren't really working anyway, and he wont be seen by derm for 2 weeks, and i'm not sure what else they can offer.
- Clinical signs: Blepharitis, periorbital swelling, raggedy coat fur (his littermate is a 33 lb monster of a cat who is insanely healthy), anal irritation with anal hair loss (probably from licking)
- Duration: 18 months, continually worsening
- Your general location: Detroit MI
I welcome any input anyone can offer. I'm a physician and so I have access to pretty much anything, but I'm not a vet, and I don't want to do anything for him that hasn't already been done by my vet on him previously (like the dexamethasone or methylpred) as I don't know whats safe or what isnt.
At this point, I highly doubt this is a food allergy, and its almost like human ulcerative colitis where they have uveitis and anal irritation as well. He's half the size of his littermate. This feels like an autoimmune disease. I just don't know what to call it.
Aside from the eyes, the anal irritation and the raggedy looking coat, he's perfectly normal. No dermatitis an
... keep reading on reddit ➡I haven't seen anyone mention this here, and was wondering how everyone else felt about this.
The American Board of Dermatology Physician Assistants, LLC (ABDPA)™ announced its launch on October 7, 2019. They would like to offer a special certification exam to all PAs working in dermatology. When you complete the 125 question exam, that PA will now be a "Board Certified Dermatology Physician Assistant". Obviously, this exam will cost money ($450).
Luckily (IMO), a couple organizations have publicly denounced this company. This includes the American Board of Dermatology and the Society of Dermatology Physician Assistants.
Personally, I feel like this is just a fancy money grab, and the NCCPA needs to publicly denounce this company ASAP before employers start expecting this type of certification. I could see other people trying this same move in other specialties once they realize how much money there is to gain. The whole "lateral mobility" concept will start to diminish when each specialty has it's own certification exam.
You can easily find all this info by searching "American Board of Dermatology Physician Assistants". I won't mention the creator of this "Board", but you can easily find his name too. A couple source links are below.
Source:
https://www.abderm.org/public/announcements/abd-statement-on-physician-assistant-certification.aspx
https://finance.yahoo.com/news/american-board-dermatology-physician-assistants-110000203.html
My experience of this is mostly in psychiatric cases, where the PA or NP will call themselves a psychiatrist and especially I found at my RTC everyone would refer to them as the psychiatrist, when by definition a psychiatrist has to be a physician, yknow, that’s why they have to go with the PMHNP thing. I remember it being such an alien concept to the staff when I asked to see the actual doctor, never did get that, but luckily I was out of there before long after that, because the whole place was a scam and for profit.
Worst part is that I have a depression and autism combo with legal trouble that often presents itself as “OCD” that is just cognitive rigidities and “ADHD” that is just autism and depression related executive dysfunction. The fact that all I had was a masters social worker playing ClinPsych is a problem in and of itself, but the fact that the PA flaunted herself as the real deal was more destructive than anything else
My name is Dr. Steven Q. Simpson. I’m a Professor of Medicine and Interim Director of the Division of Pulmonary and Critical Care Medicine at the University of Kansas. As a sepsis and quality improvement researcher and educator, I’ve spent decades training hospital providers across the country to aggressively treat sepsis in all its forms. I’m also a member of the board of the American College of Chest Physicians, an organization representing 19,000+ clinicians practicing pulmonary, critical care and sleep medicine.
Sepsis is the body’s response to a life-threatening infection, most commonly caused by a bacterial infection, but it can also be caused by serious fungal or viral infections. In basic terms, your body goes into overdrive to fight an infection and ends up damaging itself. Sepsis does not just happen on its own, meaning a prior infection—like pneumonia or a urinary tract infection, is present in all cases. Sepsis can lead to tissue damage, organ failure and death in many cases. Sepsis strikes more than a million Americans annually and frequently impacts those who are over age 65 or less than 1 year, have a weakened immune system or chronic medical conditions like diabetes. However, it is not uncommon for normal, healthy adults and children to be affected when a seemingly simple infection progresses to severe sepsis.
One of the main challenges of sepsis is diagnosis—often, by the time physicians become aware something is wrong, the disease may be advanced. Sepsis signs and symptoms are not very specific and may at first seem like a simple viral infection, which results in delays in patients seeking medical attention. There is no specific laboratory test that can diagnose sepsis or severe sepsis. Instead, physicians must be astute to recognize the signs and symptoms, recognize the infection and know when the combination is potentially deadly. Early recognition is key to patient survival; delays in delivering relatively simple treatments, such as antibiotics and IV fluids, are associated with increased mortality.
Recently, a consensus statement was released that proposes to redefine the diagnostic criteria of sepsis, and that would eliminate the concept of the systemic inflammatory response syndrome (SIRS). The proposed syndrome would rely on known or suspected infection with a change in sequential organ failure assessment (SOFA) score. Shortly after the new guidelines were published, I released my rebuttal in the journal CHEST, New Sepsis
... keep reading on reddit ➡The other day Joe Rogan had Dr. Peter McCullough on his podcast, a controversial guest. He is an anti-vaxxer, and known for "debunking" current claims about COVID-19, and it's vaccines. Most of his scientific claims involve cherry-picking studies and misusing public databases that wasn't intended to make the claims he tries to make with him. He is so discredited that he is even being used by Baylor to stop using their University as his credentials.
He is most notable for claiming things such as; COVID-19 vaccines are being used as a "depopulation tool" and that a "vaccine Holocaust" is occurring. Of course, Joe Rogan blindly nods and agrees with him throughout whole entire duration of the podcast without questioning him once.
So, when one user on the sub makes a post titled "Something you should know about Dr. Peter McCullough" detailing how much of a fraud and hack this guy is; it rises to the top very rapidly, but not without some controversy. Other users are ready to defend him and Joe Rogan to death, no matter what it takes. As such drama ensues.
Why is it that Rogan fans are over indexed in stupidity? [+57]
[none of that even if true changes anything he said on the podcast. it sounds like you ar
... keep reading on reddit ➡In other words, I wonder if the doctors trained today could alleviate symptoms in their respective specialties without modern medicine or high tech surgeries.
When I was going through residency I kept wondering why there was no grass-roots organization for us as physicians. Nothing for residents/fellows. Other organizations had fees and specific rules, but I wanted something that everyone could join no matter what, and share a voice.
Even though I'm now an attending, I will never forget my residency years and vow to always appreciate residents and fellows in training.
This is why I decided to start American Association of Resident and Fellow Physicians (aarfp.org) as a 3rd year resident.
It is a registered non-profit 501c that aims to advocate for issues impacting our training and practice, while also emphasizing the importance of physician-led care.
Additionally, the importance of trainee well-being will be emphasized, particularly in how it impacts education and providing high-quality patient care.
If no one tries, nothing will get achieved. Which is why I launched this organization and decided to fund this on my own.
All merchandising that represents this organization will be free. You as residents, fellows, students have paid enough, and it's time we band together despite being in different specialties, and show how strong our voices can be.
Join at aarfp.org. If you could, follow the organization on Instagram (aarfporg) and LinkedIn. There’s always strength in numbers. I want others to give ideas/suggestions on how best to move forward and make this organization truly about US (residents/fellows/medical students/attendings).
Note: Medical students, I am not sure if you have such an organization, but I would love for you to join and give us your input because you’re one of us....future residents/fellows and attendings.
#EverySpecialtyOneVoice.
I’m just curious and am sorry if the question is ignorant. I recently just decided to go on a premed track in the US and grew up in a foreign country with a different system. I am interested in EM, IM, CC (generalists) and their continuum care in the hospital. However, I am also looking into PCP as an IM (so the question I asked about FM intrigued me as IM would still mostly work with inpatients).
Please note that I am still exploring many choices! I am in no way saying I will definitely specialize in something before my rotations in med school (if I can get into one lol).
I posted this in r/medical school but I think this sub would probably have more informed thoughts since you guys are actually getting paid lol.
Barring IMG’s, people who care about step 1 being graded want the stratification to get into “competitive specialties” or prestigious institutions ie make more $$$$$.
There’s nothing wrong with this, however the specialties that make the most, have fewer residency spots, making high step 1 scores be the entrance barrier.
We NEED more funding to increase residency spots because patients shouldn’t need to wait months to see dermatologists, urologist and insert other highly competitive highly paid specialty anyway.
Also also the gap between the highest paid and lowest paid specialties, while justified a little by training and difficulty of practice, is mostly determined by how insurance deems what is worth paying for. Or if you completely avoid taking insurance at all (I’m looking at you cash only derms and plastic surgeons).
We NEED other “less competitive” specialties to pay more somehow, and need to get rid of the elitism of how good of a student/doctor you are based on what field you go into, so students can stop chasing cash and prestige. And do what they actually fucking like to do, and not look down on each other.
Tldr; the system of med school and the match is fucked and neither scored boards or pass fail is really fixing the core issue of physician compensation gaps and # residency spots
These are direct quotes that come from the following cnn.com article
- Sanders promises Americans access to the doctors they currently see and more. But his system assumes that doctors will take part. Just as many doctors do not take part in the current Medicare and insurance systems, some would likely sidestep the government program and seek payment on a fee-for-service basis outside Medicare for All.
- While providers would have protections under the plan, they would also have responsibilities. And it is an either-or scenario. Either they enroll as a Medicare for All provider or they go outside the system.
- The bill does specifically envision private agreements — not insurance — between individuals and providers or groups of providers outside of Medicare for All. But providers, once they enter into such agreements, cannot participate in the government program for a year.
- One fact of US health care is that American doctors make more money than their counterparts in other countries. There are many reasons for that, but one clear way to contain the cost of health care is to contain the amount doctors are paid. Granted, they should have a much simpler time being reimbursed under a single-payer system and more of their time will be spent treating patients. But their bottom lines might also shrink. That’s one reason some doctors could opt out. Hospitals too. In the current system, private insurance pays higher rates to hospitals and doctors than Medicare and Medicaid do.
- The federal government would take a much bigger role in assessing the landscape of educating doctors and determining how many specialists are needed in a given field. The US currently has a system that prioritizes specialization over general medicine. And that’s not saving anyone money.
- There are many pages of this bill that deal with sunsetting the bramble of ways the US government currently helps Americans with health care — Medicare, Obamacare, Tricare, federal employee benefits and more — and unifying them in this new plan.
Found this posted on another sub:
https://pubmed.ncbi.nlm.nih.gov/31230727/
The telomeres at the end of DNA— which are sort of like aglets at the end of a shoelace—shrink 6 times faster when newly minted doctors are introduced to the new stress of training (long work hours 80-120hrs/week, little sleep, life and death situation etc).
Telomere shortening is a well-known hallmark of both cellular senescence and organismal aging. Telomere length is thus considered one of the most consequential biomarkers of chronological ageing, it’s maximum at birth and progressively decreases with age.
And it is irreversible.
https://www.reddit.com/r/askscience/comments/qy8vpl/comment/hlfmzjd/
