Scope of Practice

We in medicine talk a lot about our “scope of practice”.  I think that people outside of our world have no idea what the heck we are talking about.  I’d like to explain what us doctors mean by this, so if you hear this phrase you aren’t surprised. 

I think “scope of practice” has replaced “specialty”.  Back when doctors still made house calls in their horse and buggies, delivered babies in the family bed and got paid in chickens, they pretty much covered all specialties of medicine.  When you were the only doc for 300 miles, you had to do it all. 

Things changed.  We have new fangled drugs and machines and huge quantities of knowledge in all the different medical specialties that keeps changing daily.  It’s practically impossible to keep up in one specialty, much less all the fields of medicine. 

Our training programs have gotten longer and longer.  Lots of specialties even have sub specialties.  The subspecialties even have subspecialties these days.  Of course, you have to go to a special center to see a super sub specialist.  Out in the areas where docs are scarce, there tend to be more “general-specialists”. 

When you pick up the phone book, you might do a little research about what some of those specialties are before you make that call.  Most times the receptionist will be fairly nice when they answer the phone and you have called an inappropriate office.  But you should hear what they say when you hang up. 

Some help:

Pediatrics:  kids – usually up to age 18.  May precede a subspecialty

Internal Medicine: grown-ups – usually starting after age 18

Obstetrics (OB): pregnant women

Gynecology (GYN): women’s reproductive organs

Urology: kidney, bladder and male reproductive organs

Gastroenterology: the digestive tract

Cardiology: the heart and circulatory system

Ophthalmology: eye doctors

Otolaryngology: ear, nose and throat

Rheumatology: joint and connective tissue diseases

Orthopedics: bone and joint problems

So, if you’re a man with back pain, please don’t call an OB/GYN.  {It happened again today.}