It takes years to educate a physician. The process actually begins in college, with dedication to study and training the mind for the unbelievable challenges that lay ahead. Qualities that are integral to physicians need to be developed and perfected- restraint, self-sacrifice, delayed gratification. This is a weeding out process. Only the best and the brightest get through the screen.
Medical school presents even greater challenges. There are four years of constant study, two of which also contain short apprenticeships which require the students to learn about various medical disciplines, thereby allowing them to understand critical interconnections between these fields. This incredibly taxing process tests them further as the weeding out continues.
The budding physicians choose a specialty before they graduate medical school and begin internship and residency; 3-7 years of training, varying by specialty. It is impossible to convey the rigor and stress of this experience, but at its conclusion, a doctor is produced- someone who is capable of making life and death decisions; someone capable of the most critical thinking regarding the most important aspect of another person's life- their life and health.
For many, the process doesn't end there. Advanced skills and knowledge are acquired during an additional 1-4 years of sub specialty training- making them unquestionably, the most highly qualified people in the world to take care of your medical problems.
Now ask yourself- why would I trust my medical care to anyone other than a physician?
The question regarding who is qualified to administer care is complex and is referred to as the "scope of practice". There are many integral contributors to the healthcare team. There are nurses and nurse practitioners (nurses with additional education and training), nurse anesthetists, nurse midwives, physician assistants, optometrists, chiropractors, psychologists, pharmacists, and the list goes on. These individuals play an important role in delivering healthcare to individuals every day but there remains one unalterable fact-they are not physicians. But, they would like to do the same things as physicians and their specialty societies have spent considerable time, effort and money trying to create the narrative that the care that they provide is equivalent to that which a physician administers. Generally speaking, that is just not the case.
The reasons that these non-physicians want to elevate themselves to physician status are obvious. There is prestige involved and there is also improvement in their income. The fact that there is a shortage of physicians has fostered this situation, and it has been going on for many years, but the Affordable Care Act (ACA, Obamacare) has accelerated this problem several ways.
First, the law specifically recognizes some of these ancillary healthcare providers as equivalent to physicians. The reasons for this are often political and have as much to do with how much money was spent by lobbyists representing these groups as it has trying to denigrate and demean physicians. We all remember in 2009 when President Obama shamelessly informed the American people that doctors would prefer to rip out tonsils rather than take care of a sore throat, or cut off a diabetic leg for money rather than care for the disease.
Second, the ACA is responsible for extending healthcare insurance to millions more people who did not have it, resulting in more people utilizing a system already stretched thin. And third, the ACA puts so many burdens on physicians that consequently, thousands are quitting, making the need for more healthcare providers even greater.
The term “provider” has become part of the healthcare vernacular. Federal and state governments and the insurance companies have blurred the boundaries regarding who may do what. This has resulted in optometrists being able to do eye surgery in Kentucky and Oklahoma with just several hundred hours of training, not the thousands that their physician counterparts- the ophthalmologists log, not to mention their vastly greater fund of knowledge. In Illinois, Louisiana and New Mexico, psychologists who have NO medical training can prescribe drugs. Pharmacists want to do exams on patients and alter drug prescriptions issued by physicians. Nurse anesthetists want to be able to give general anesthesia without the supervision of a physician. Nurse practitioners want equivalency with physicians and wish to work independently. 28 states are set to grant this, and if they acquire a PhD, they want to be called “doctor”. Some of these people can earn this degree online!
Webster’s dictionary defines a doctor as a qualified practitioner of medicine or a physician. Many people aspire to be doctors. PhDs refer to themselves as doctors. So do chiropractors, veterinarians, optometrists, dentists, and psychologists. Look in the phone book and you'll find the computer doctor, the auto doctor, and the travel doctor. The cheese doctor gives out samples in the supermarket. A mother of one of my patients referred to herself as a "doctor of domestic affairs". But the use of this title so arbitrarily and undeservingly, has demeaned it.
So the question that you must ask when receiving healthcare from someone and especially those who introduce themselves to you as doctor, is what medical or osteopathic school they graduated from. If the answer is none, then they are not physicians. You should know that.
Hal Scherz is the President & Founder of Docs4PatientCare. He is a full time pediatric urologist at Children’s Hospital of Atlanta and a clinical associate professor of urology at Emory University.
Please visit http://www.docs4patientcare.
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