What’s In A Name?

Have you ever wondered what the difference is between the different medical specialties? Aren’t all doctors, doctors? Why can’t your podiatrist help with your cold? Or, why can’t your OB/GYN remove your bunion? Well, let’s try to decipher what all of these different terms mean and how it may help you understand how to most effectively direct your care.

I will start with the basic division of doctors: medicine and surgery. You may think, “Aren’t they all medical doctors?” The answer to that is, yes. Anyone with an MD or a DO degree is a medical doctor; however, we think of ourselves as being in medicine or surgery. The residencies in the teaching institutions are structured differently in each category and the approach to the patient is different. This difference is easy to understand. In medicine, we use medications to treat patients and sometimes small minor surgical procedures like skin biopsies. Surgeons, however, treat patients with surgical procedures and occasionally medications.

Under the heading of medical doctors, you will find your primary care physician who can refer you on to the specialist you need. Primary care doctors are pediatricians (treat kids only), internists (adults only), and family practice (adults and kids). Some young women use their gynecologist as a primary care doctor, but ob/gyns are actually specialists, and if you have any medical problems that aren’t gynecologic, you need an internist or a family practitioner.

For the medical subspecialties, the training is completed after the residency in most cases. The same subspecialties can be found for both pediatrics and internal medicine:

Cardiology: diseases of the heart and circulatory system. Cardiologists perform procedures such as heart catherizations, angioplasty and stents.

Nephrology: diseases of the kidney. Nephrologists do procedures like kidney biopsies and dialysis.

Pulmonology: diseases of the lung. Most pulmonologists are also board certified in critical care, and would take care of you in the intensive care unit. They do bronchoscopies (looking into your lungs with a camera) and lung biopsies.

Endocrinology: diseases related to hormones (most commonly diabetes and thyroid). Endocrinologists also perform thyroid biopsies.

Rheumatology: diseases related to arthritis and autoimmune diseases like lupus. Rheumatologists can do joint injections and aspirations (taking a fluid sample out of a joint).

Gastroenterology: diseases of the digestive system and liver (GI doctors for short). Gastroenterologists do colonoscopies and liver biopsies among other procedures.

Hematology/Oncology: diseases of the blood and cancers. Hematologists and oncologists perform bone marrow biopsies
and administer chemotherapy.

Infectious disease: These specialists treat all types of infection including HIV, MRSA, other viruses, bacteria and fungal diseases.

Out of the surgical field come many specialties. Some are completed after a general surgical residency and some have their own residency.

General surgery: These surgeons perform most abdominal surgeries like hernia repairs and removing the gallbladder. They also do breast biopsies and breast cancer surgeries and some neck and thyroid surgeries. Some will narrow their fields to one type of surgery even though there is not yet an official subspecialty in some of these areas.

Cardiothoracic surgery: heart and chest surgeries. Some doctors specialize with one or the other, but most do both.

Urology: Kidney and bladder surgeries and surgeries related to the male reproductive organs, including the prostate.

Orthopedic surgery: surgery of the bones and joints. They can sub-specialize to do neck and back surgeries.

Neurosurgery: surgeries of the brain and spinal cord. They also do neck and back surgeries, overlapping with orthopedic surgery.

Obstetrics/Gynecology: surgeries of the female reproductive organs and delivering babies. As mentioned earlier, these doctors also function as primary care doctors for some women.

Vascular surgery: surgeries related to the blood vessels, such as the carotid arteries in your neck and the aorta.

Otorhinolaryngology: ENT for short! The medical terms can be translated: oto (ear), rhino (nose), laryngo (throat). Surgeries of these body parts and the neck. Some people call ENTs “head and neck surgeons”.

Plastic surgery: this one is obvious! But some may choose to specialize in certain areas such as facial plastic surgery. Either way, make sure your plastic surgeon is board certified.

Ophthalmology: They treat diseases of the eye with both medications and surgical procedures, but I list it here because the residency is structured like a surgical residency.

Colorectal surgery: surgeries of the colon and rectum. Generally NOT referred to as proctologists! They also do colonoscopies.

My last category of specialties consists of medical specialties that do not require a full 3 year internal medicine residency first. They usually do one year of internal medicine before specializing.

Radiology: They read and interpret X-rays, ultrasound, MRIs, and CAT scans. Some do procedures using dye; they are called interventional radiologists.

Dermatology: diseases of the skin, hair and nails. Some are dermatologic surgeons who do a procedure called Moh’s surgery for certain types of skin cancers.

Radiation Oncology: They use radiation beams to treat cancers.

Physical Medicine and Rehabilitation: They treat musculoskeletal and spinal cord injuries without surgery.

Neurology: diseases of the nervous system and brain. They do lumbar punctures (spinal taps) among other procedures.

Anesthesiology: They put you to sleep for surgery and outpatient procedures like colonoscopies. They also run pain clinics and do epidural injections.

It is always important to understand what type of specialist you are seeking, or more importantly, referred to.

Another note, do your research when it comes to specialist. Your friend, neighbor or doctor may refer you to a specialist, but it is always useful to do your own research. Make sure the physician understands your needs, goals and that you are comfortable with his/her manner.

I hope this helps everyone get to the right doctor!