Different Doctors
What They Do and How Much They Earn
There are dozens of different medical specialties. Keeping them straight can be a chore, made worse by the fact that new fields such as geriatrics—care of older patients—are constantly being invented. Here’s a guide to remembering what different kinds of doctors do.
Primary Care Doctors
Primary care doctors trained in general medicine and should be able to manage most medical problems without consulting a specialist. When the problem is more complicated or when it requires special expertise, a primary care doctor can recommend referrals to specialists and coordinate the recommendations of different specialists.
The three main types of doctors practicing primary care medicine are internists for adults, pediatricians for kids and family practitioners for people of all ages. Doctors in all three fields are themselves specialists, having undergone three or four years of training after medical school, although they aren’t usually referred to as specialists. General practitioners, who may have no training after a one-year internship—or in the case of the State of Louisiana, no training after medical school—are also considered primary care doctors. Some specialists like cardiologists spend some of their time seeing referral patients and some of their time doing primary care.
Primary care doctors have traditionally been the lowest paid and the lowest status doctors. This is changing as the country moves more in the direction of managed care. In HMOs, primary care doctors have taken on greater responsibility acting as so-called “gate-keepers,” blocking access to specialists unless they approve it.
Specialists
The following table lists various specialties and briefly describes what the doctors do. The major fields are listed in bold type. Subspecialties of major fields are listed below them. To be a cardiologist, for example, a doctor must first train for three years in internal medicine, then do a three year fellowship in cardiology. Some specialties not listed are a combination of two or more fields. For example, a pediatric cardiovascular surgeon performs heart operations on children. A radiation oncologist gives X-ray therapy for cancer patients.
What Different Specialists Do Speciality What They Handle Family Practice General Medicine Pediatrics General Medicine for Children Internal Medicine General Medicine for Adults Allergy Allergies, Asthma The Heart Endocrinology Hormone Problems, Diabetes Gastroenterology The Stomach, Liver and Intestines Geriatrics Problems of the Elderly Hematology Blood Problems Infectious Diseases Infections Oncology Cancer Nephrology The Kidneys Pulmonary The Lungs Rheumatology Arthritis and Other Joint Problems Surgery General Surgery Cardiovascular Surgery Heart Surgery Colorectal Surgery Colon and Rectal Surgery Neurosurgery Brain Surgery The Eyes and Eye Surgery Orthopedics Bone and Joint Surgery Otolaryngology Ear, Nose and Throat Surgery Plastic Surgery Thoracic Surgery Chest and Lung Surgery Urology Urinary Tract Surgery, Prostate Problems Vascular Surgery Surgery on Veins and Arteries Anesthesiology Anesthetics for Surgery Dermatology The Skin Emergency Medicine Emergencies Neurology The Brain and Nervous System Obstetrics/Gynecology Delivering Babies/Female Organs Psychiatry Psychological Problems Radiology X-rays Rehabilitation Rehabilitation After Illness or Injuries How Much Money Do Doctors Earn?
The incomes of doctors in different specialties varies widely. Most primary care doctors earn around $100,000 per year, general practitioners a little less, internists a little more. The higher paying specialties tend to be the ones in which the doctors perform lots of procedures or operations, because it is by doing procedures that doctors make the most money. Endocrinologists do relatively few procedures and don’t earn much more than internists. Cardiologists, on the other hand, perform stress tests and angioplasties and a few hours of procedures generates more profit than the rest of the week in their office. They average around $200,000 per year. Surgeons similarly earn most of their money in the operating room. Some surgical specialists like orthopedists and neurosurgeons make more than $300,000 per year.
Because of the enormous debts that most medical students now graduate with many of the best students have sought training in procedure-oriented fields. This contributed to the relative glut of specialists and deficiency of primary care doctors we have in this country. Less than a third of doctors in this country are in primary care, compared to 50-70% in every other developed country. The situation has started to improve a little because HMOs and other managed care plans are trying to cut down on the number of specialists in their plans in order to cut costs.
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