Start & Run a Medical Practice. Michael Clifford Fabian
in a professional qualification, and designation, and subsequent practice as a medical doctor. Even though a person becomes a medical doctor, it might end up that he or she actually has nothing to do with medicine.
The length of time and type of training can be dependent on the background of the individual, the institution, and the geographic location. It also depends on whether you factor in the education undertaken in order to get to the point of starting medical school, and all the training that occurs after the medical degree is completed.
The term “physician” does not always mean the same thing as “medical doctor.” In some countries, particularly the United Kingdom (UK), a physician is a medical doctor who has done further training to become a specialist in general conditions relating to the adult (very similar to a pediatrician who is a specialist for children). The North American equivalent of the UK physician would be an internist, or a specialist in internal medicine. For the purpose of this book, I will be using the terms “medical doctor,” “doctor,” and “physician” interchangeably; all these terms referring to the same person.
One really confusing term also common in the UK, Ireland, and that region of the world is the designation “Mr.,” which is used for doctors who have completed their surgical training and are now a consultant surgeon. They revert back to the “Mr.” from “Dr.” The equivalent would obviously apply for females as well.
The term physician is not only limited to a medical doctor. Certainly in North America, other health-care providers who utilize the nomenclature “physician” include podiatrists (i.e., foot specialist who has not gone through traditional medical school), osteopaths (i.e., a different training route to conventional medical school) and naturopathic physicians.
2. Allied Health Professions
Including a description of careers similar to medicine in this book is essential for several reasons. Firstly, for those individuals still deciding on what exactly to do in the health-care field, this will give an overview of the professions that are close in many ways to being a medical doctor. In addition to a description of what these professionals actually do, in some cases I have also provided more practical information, particularly relating to the collaborative nature of the allied health professions.
I have interacted with other health-care professionals who are similar to medical doctors in many different ways, and in a variety of clinical situations. The following examples will be both from my professional experiences, as well as personal encounters, with these individuals whose careers overlap significantly with medicine.
While many people initially pursue a career in medicine, there are many obstacles along the way, particularly relating to the application process and the associated competitive nature. I am a firm believer in that things happen for a reason, and if a person doesn’t become a medical doctor, it wasn’t meant to be! The limited number of seats for the vast number of applications is not restricted to medicine. Gaining acceptance into professional programs is just as hard — sometimes harder — for some of the careers that follow.
In terms of setting up a practice, I feel all the mentioned professionals could benefit from much of what is covered in this book — offices often function in a very similar fashion. The array of allied health fields with their own specialized and unique training are expanding rapidly, and I will not be able cover everything, and everyone, in the confines of this book, but I will certainly include the most common professions.
As you read through the different fields in the following sections, please keep in mind that I am primarily covering the professions similar to medicine in terms of an office setup. There are many domains that are closely affiliated with medicine, but they usually do not practice in the office setting. Some examples are paramedics, surgical assistants, and pharmacists — for this reason we will not discuss them in the following sections.
There are so many opportunities in exciting professions that are similar to medicine in many ways, including the practice and office setup. Some of them may have dimensions that you were not aware of, but the following sections are just a brief outline of the multitude of allied heath professions. It is for this reason that I feel parts of this book will benefit health-care providers other than just medical doctors, who plan to set up an office, wish to find out more about setting up a practice, or are just considering a career in a health-care related field
2.1 Audiology
An audiologist primarily assesses hearing and the things associated with hearing. Audiologists are experienced with a battery of basic and advanced testing relating to the ear and hearing. They are experienced with hearing-aid devices and prescribe them when needed after the necessary investigations, sometimes in collaboration with physicians. Their practices can branch out into the occupational work environment, hospitals, academic domain, or even into involvement with the music and entertainment industry. They might work independently, in an academic setting, or in a health-care facility.
Audiologists work closely with physicians in many situations. The office setup is often identical to a doctor’s office in terms of functionality. I have shared offices with audiologists, had them work in my office, as well as had a close working relationship with them in their independent offices.
2.2 Chiropractic
While in otolaryngology practice, I referred patients to chiropractors when the need arose. While the practice of otolaryngology might assess conditions related to thyroid, salivary glands, voice box (larynx), neck glands, and tumors, problems related to the spine and muscles are something that otolaryngologists don’t commonly take care of. With patient problems associated with the spine and muscles, depending on the situation for the patient, I would refer them to a chiropractor for assessment and treatment. Other options for referral of these patients were to orthopedic surgeons or physiotherapists — all depending on what the actual problem was.
Chiropractors go through rigorous training just like medical doctors, and there is much overlap in terms of assessment and treatment, particularly with physicians who deal with muscular skeletal problems (e.g., orthopedic surgeons, rehabilitation medicine specialists, and family physicians). Chiropractors do not generally work in hospitals, prescribe medicine, or do surgery. They may, however, perform acupuncture; something medical doctors do less often themselves.
Chiropractors’ offices can look, and function, the same as any of their medical colleagues, or they can share facilities with other health professionals.
2.3 Dentistry
The dentistry field is very similar to medicine in so many ways, although the equipment needed to set up a dental office is vastly more complex and expensive than the average medical office. There are, however, some exceptions in the medical field in which cost can be comparable to a dentist’s office; ophthalmology and cosmetic surgery being two such examples. I have a dentist friend who has always been envious of the minimum start-up cost of an average medical doctor’s practice compared to that of a dentist!
I am aware of several individuals who have struggled between choosing a career in medicine versus dentistry. The medical school and dental school curriculum are so much alike, especially during the earlier years of training. Many universities across the globe combine the initial stages of the training of medical and dental students and integrate their initial basic science training. In fact, some schools have a combined college of medicine and dentistry with a single integrated administration.
I think everyone who is reading this book is very familiar with what dentists do, or at least I hope so! However, I am not sure if everyone is aware of the scope of their practice and know that dentists can specialize in many areas, where there is little differentiation in the way they practice compared to their medical colleagues. Oro-maxillo-facial surgery (otherwise known as oral surgery) is one such example. Dental surgeons typically do an additional four years of training after dental school and spend much of their time gaining exposure to medicine alongside their medical trainee colleagues. They operate, admit their patients, do surgery, and take care of them just like medical