Primary care physicians establish long-term relationships with their patients – diagnosing illnesses, and prescribing and administering treatment. They provide counseling related to patients’ overall healthcare needs with a practice emphasis on preventive medicine and routine medical care. When needed, primary care physicians refer their patients to a specialist for specific needs. There are three types of primary care providers, and every medical specialist works closely with their patients’ primary care provider. Family Medicine physicians are primary care providers who care for patients of all ages, from the very young to the very old. Pediatricians are primary care providers who specialize in caring for infants and children. Generally speaking, when an individual turns 18 years of age, the pediatrician refers then to another provider. Internal Medicine physicians are primary care providers who specialize in adult medicine, caring for individuals 18 years of age and older.
There are two types of physicians: M.D. or Medical Doctor and D.O. or Doctor of Osteopathic Medicine. There are many subtle differences, but the main difference is Osteopathic Medicine places special emphasis on the body’s musculoskeletal system, preventive medicine and holistic care. Both M.D.s and D.O.s can choose to be primary care providers in family medicine, pediatrics or general internal medicine.
- Private or group practice
- Health organizations
- Urgent or express care centers
- Public health
Most primary care physicians, whether in family medicine, pediatrics, or internal medicine, work in private or group practice clinic settings. Primary care physicians also staff urgent or express care clinics. Their staff may consist of physician assistants nurses, medical assistants, and office staff. Larger practices and clinics may have in-office radiology and lab services. Work schedule will depend on the practice’s or clinic’s established office hours, which increasingly include extended, evening or weekend hours. Physicians usually maintain an on-call service, or rotate on-call hours with other physicians in the practice. While on-call, a physician may deal with many patient concerns over the phone and make emergency visits to hospitals or nursing homes.
According to the Bureau of Labor Statistics, employment of physicians and surgeons, all specialties, is expected to increase 22 percent from 2008 to 2018, much faster than the average for all occupations. There are shortages of primary care physicians in many areas of the country, and Nebraska is no exception. A two-year University of Nebraska Medical Center study found that 50 of Nebraska’s 93 counties are federally designated as primary healthcare professional shortage areas. The report also found that many of the state’s primary care physicians are nearing retirement, just as a growing elderly population is expected to require more medical care. In addition, as health care reform leads more and more people to seek medical care, the need for more primary care physicians will be critical. Many healthcare professionals believe an increased emphasis on all patients having a primary care “medical home” will be key to not only better care for patients, but also for reigning in health care costs.
- Ability to learn complex science, math, and methods and techniques of medicine
- Strong verbal skills
- Good space and form perception, manual dexterity, and general coordination
- Ability to plan, organize and direct others
- Ability to relate to all kinds of people
- Ability to make decisions based on data, observation, and experience
- Scientific curiosity, emotional maturity, and empathy
To be admitted to medical school, a person must complete 3-4 years of pre-medicine subjects, take a preadmissions test called the Medical College Admissions Test (MCAT), and have a high grade-point average. Medical school is typically 4 years in length, after which physicians must complete residency training. The length of the residency for Family Medicine, Pedicatrics, or Internal Medicine will vary, depending on the chosen speciality, and particular program. Beyond residency, a physician may choose to continue their education in specialized programs called fellowships.
Undergraduate premedical students must complete coursework in physicals, biology, mathematics, English and inorganic and organic chemistry.
In medical school, the first two years include laboratory experience and coursework in anatomy, biochemistry, physiology, pharmacology, psychology, microbiology, pathology, medical ethics, and law governing medicine. They also learn to take medical histories, examine patients and diagnose illnesses. During the last two years of medical school, students work with patients under the supervision of experienced physicians in hospitals and clinics. They gain experience in the diagnosis and treatment of illness through rotations in internal medicine, family practice, obstetrics and gynecology, pediatrics, psychiatry and surgery.
To practice, physicians must be licensed. Licensure requires graduation from an accredited college of medicine, completion of at least 3 years of residency, and passing the national board exam – the United States Medicine Licensing Examination.
Programs in Nebraska
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Career information adapted in part from the Bureau of Labor Statistics, US Department of Labor, Occupational Outlook Handook, 2010-2011 Edition, Physicians and Surgeons, on the Internet at www.bls.gov