Doctors often work in teams. That means that there may be more doctors working to take care of your health behind the scenes than you may know. One of my goals as House Call Doctor is to shed light onto how we function as doctors on the other side. Our health-care system is a complex and intertwined system, and you may not even be aware of how many physicians and specialists have been previously involved in your own care. What doctors do may be somewhat of a mystery—especially specialists. Even though there are more specialties than I can even count, today I’d like to discuss the five doctors that you didn’t know you needed. These are all physicians who attend medical school for four years, and then residency ranging anywhere from 3-5 more years. It may surprise you. 1. Radiologist: Radiologists interpret your x-rays, CT scans, MRIs, PET scans, and other imaging modalities. Women, all your mammograms are interpreted by a radiologist. Wondering if you broke a bone? The radiologist is the one that determines that once reading your x-ray. They are also often the first ones to diagnose some types of cancers when discovered on imaging— that’s right, sometimes they are the ones who diagnose cancer. Some subspecialists, called interventional radiologists, can also can perform minimally invasive procedures, such as angiography (using a catheter to inject dye into a blood vessel in order to make it visible on x-ray), kyphoplasty (a procedure where stabilizing cement material is injected in the spine for those with collapsed or fractured vertebras), and chemoembolization (directly injecting chemotherapy into a tumor). Most stay behind the scenes but are involved with your care. 2. Pathologist: Pathologists examine human tissue, often under the microscope. If you’ve ever had a skin lesion sent for a biopsy, the pathologist is the one who determines if it is cancerous or not. If you’ve had a surgery where an organ was removed, like the uterus or appendix, it is often sent to the pathologist after removal in the Operating Room, in order to make certain the tissue is normal. Women, all of your pap smears are examined by the pathologist. Pathologists have vital roles in our network of care. 3. Gastroenterologist: For all of you age 50 and higher, you have likely been referred to a gastroenterologist for your screening colonoscopy every 10 years (or sometimes sooner depending on any findings). If you haven’t had a colonoscopy yet, please ask your doctor for a referral. Of course they do more than just colonoscopies: they treat Hepatitis, cirrhosis, Inflammatory Bowel Disease (like Crohn’s and Ulcerative Colitis), problems with the esophagus, they remove retained biliary stones after gallbladder surgery, biopsy the liver, perform upper endoscopies to look inside the esophagus and stomach, stop stomach ulcers from bleeding, and more. 4. Anesthesiologist: If you’ve ever had to go under the knife, you’ve been under the care of an anesthesiologist. They are responsible for your health immediately before, during, and post-surgery. They make certain that your heart and lungs are functioning properly every step of the way during procedures and surgeries. They provide their services for those undergoing major surgery with “general anesthesia,” provide “regional anesthesia” for more localized pain-relief, and “conscious sedation” for those who simply need pain or anxiety relief for smaller procedures. A specialist isn’t always necessary, but PCPs are well aware of when and which specialist to refer to when it is needed. Women who require epidurals or anesthesia before C-Sections have been cared for the anesthesiologist, and so has anyone who has had a hernia repair, gallbladder removal, tonsillectomy, hysterectomy, or appendix removal—all very commonly performed surgeries. 5. Primary Care Physician (PCP): It never ceases to amaze me how many patients tell me that they haven’t had a primary care doctor in years. Most PCPs perform cervical cancer screenings; therefore, there’s often no need to see the OB/GYN surgeon for a pap smear. Most PCP’s are adept at performing minor skin procedures, such as freezing off warts, performing a biopsy of suspicious lesions, and removing ingrown toenails. They are also well-trained to recognize common skin ailments, everything from eczema to allergic reactions. We are the ones who coordinate your care and manage your chronic care conditions. We manage your diabetes, high blood pressure, depression, low back pain, migraines, heart disease, and everything in between. We keep track of you prevention screenings—when you are next due for your mammogram, colonoscopy, osteoporosis screening, vaccines, etc. We are also your first-line of defense against your acute conditions—abdominal pain, burning with urination, cough/cold symptoms, headaches, body aches, etc. We are truly your detectives, and we are adept at and experienced at problem solving. For those of you with PPO insurance, you may have the opportunity to visit any specialist you desire. How do you know when you need to see a specialist, and which specialty to see? So you have a rash – who do you seek, a dermatologist or allergist? Your PCP tells you that your kidney functions are diminished, but is that a cause for alarm? A specialist isn’t always necessary, but PCPs are well aware of when and which specialist to refer to when it is needed. Source
