You want to be a doctor in the future, how important is your patients to you?

[pi]

I still think you're off the mark with GPs not being specialists even though you have agreed they are specialists in Primary Care (which is in fact "an area of medicine" without a doubt). The closest you'll get to non-specialists are "General Physicians".

I don't think anyone here is going to say that researchers who are advancing the medical field shouldn't be paid more. I said this in an earlier post too, and I think it's fairly obvious. I do though think this is a govt issue given they control a lot of funding to research (obviously there are other sources too: sponsorships, donations, etc etc). But what this all has to do with doctors (note: many many doctors research too, most in fact), I'm not sure.

I'm not really sure what your point is tbh.

[Random_Acts_of_Kindness]

b) because actual medical specialists, who in many cases have done almost 10 years extra worth of academic work compared to GPs, would I think be rather annoyed if GPs started waltzing around saying they too were medical specialists.

Hi guys. 

This has been interesting to read, despite the amount of beef that is present being able to feed a small impoverished nation. 

Just wondering, I thought GPs had to do more academic work than a Specialist? Would someone be able to give me a rough estimate of how much academic work both have to do (In years)?

Thanks guys.

Much Appreciated.

 

[kandinsky]

I still think you're off the mark with GPs not being specialists even though you have agreed they are specialists in Primary Care (which is in fact "an area of medicine" without a doubt). The closest you'll get to non-specialists are "General Physicians".

I don't think anyone here is going to say that researchers who are advancing the medical field shouldn't be paid more. I said this in an earlier post too, and I think it's fairly obvious. I do though think this is a govt issue given they control a lot of funding to research (obviously there are other sources too: sponsorships, donations, etc etc). But what this all has to do with doctors (note: many many doctors research too, most in fact), I'm not sure.

I'm not really sure what your point is tbh.

lol, can we please move off the specialist issue. It wasn't even the main point. Let's clarify exactly what I meant, and then end this minor point.

It is not a derogatory thing to say that one person is a specialist in one area while another person is a specialist in more general areas who does not necessarily have the same detailed knowledge of the area in which the specialist specialises. Personally I think both types of people are important, and the difference between the two is very important in the way the medical system works. A patient needs to be initially diagnosed (or at least the symptoms have to be noted) and then sent to someone who has more knowledge of the issue and who can use his/her greater understanding to hopefully assist the patient. Naturally in some cases this is not necessary. But in some other cases an expert may be needed for some complication or simply for some procedure in which they specially practice. Now it is entirely possible that the GP might be able to do this procedure-however they might not have the technical resources to do it or the proper understanding of the issue and so need it to be done by another. There is a difference between the two because of utility. I do not mean to say that one can only do one and one can only do the other (as I said, some GPs can probably do some of things specialists can do, but they might not be able to do all of the things specialists can do: but this is not a slight on their knowledge). I mean that for the benefit of society people take up certain roles either out of personal preference or out of the specific needs of the medical system.

No, again I didn't imply that people here would say that researchers shouldn't be paid more. I was just stating what is usually the case to instigate discussion of the issue. I am more interested in having a proper discussion of all the issues. The thing is it's not just governments (they never give researchers enough funding-never in history, unless they're doing something for political purposes). The boards controlling where government funding goes (remember these are usually staffed not by government employees but by people in the medical profession) usually make sure it gets sent to 'safe' projects or projects run by people who have already received grants from that same funding organisation. ARC grants are the most well known example of this. Once you get an ARC grant it is easy to get another one, even if your project is pretty crappy. But it's really hard to get a first one, and getting one usually depends on being allied with a 'big name' in your field. Some professors in certain places are starting to speak out about this, since it is really impeding developments into research in unexpected ways (for instance, not funding projects that have big aims and are original and take a long time to achieve, even if the outcome would be brilliant if successful).

Your point on doctors doing research depends on what you mean by doctors. If you mean GPs, then no. GPs, once in practice, do very little research. I do not think 'most' GPs are writing journal articles and getting published. (I should point out that I'm not sure what you mean when you say 'research'. Research is not just studying. Research in academia is writing and publishing journal articles to peer reviewed journals)

Why should it have anything to do with doctors? Can't a discussion start on one topic and lead into another?

[kandinsky]

Hi guys. 

This has been interesting to read, despite the amount of beef that is present being able to feed a small impoverished nation. 

Just wondering, I thought GPs had to do more academic work than a Specialist? Would someone be able to give me a rough estimate of how much academic work both have to do (In years)?

Thanks guys.

Much Appreciated.

 

It actually depends on the specialist. Some just have FRACP. Others have a PhD and hundreds of publications.

I would also like to point out your use of the words 'academic work'. Here you are equating academic work /research with university study.

In proper terms academic research is, as I said somewhere above, writing and publishing papers in peer-reviewed journals.

Perhaps this is the reason for confusion. Naturally GPs do lots of study and training, but this is not really what people in academia would call research. An honours/masters/PhD comprises of original research undertaken with a supervisor (usually a professor). Some GPs do indeed do one or all of these qualifications, but a PhD (DPhil) isn't really necessary to become a GP. Don't forget there is quite a big difference between being a doctor of medicine and a doctor of philosophy.

[pi]

Let's just agree to disagree on the topic of "Specialists". Your definition and view seems contradictory to the Colleges, but hey, no one really cares about the title any way.

No, again I didn't imply that people here would say that researchers shouldn't be paid more. I was just stating what is usually the case to instigate discussion of the issue. I am more interested in having a proper discussion of all the issues. The thing is it's not just governments (they never give researchers enough funding-never in history, unless they're doing something for political purposes). The boards controlling where government funding goes (remember these are usually staffed not by government employees but by people in the medical profession) usually make sure it gets sent to 'safe' projects or projects run by people who have already received grants from that same funding organisation. ARC grants are the most well known example of this. Once you get an ARC grant it is easy to get another one, even if your project is pretty crappy. But it's really hard to get a first one, and getting one usually depends on being allied with a 'big name' in your field. Some professors in certain places are starting to speak out about this, since it is really impeding developments into research in unexpected ways (for instance, not funding projects that have big aims and are original and take a long time to achieve, even if the outcome would be brilliant if successful).

Ok that's great and I stand corrected, but there's /nothing/ we can do about this. I agree they should be paid more, you agree they should be paid more, that's great and that's really all there is here. I wish I could change the situation, but in reality, I can't.

Your point on doctors doing research depends on what you mean by doctors. If you mean GPs, then no. GPs, once in practice, do very little research. I do not think 'most' GPs are writing journal articles and getting published. (I should point out that I'm not sure what you mean when you say 'research'. Research is not just studying. Research in academia is writing and publishing journal articles to peer reviewed journals)

I don't define doctors as "GPs", I define doctors as "those who have a medical degree".

I know what research means (and for once I agree with your definition hahaha). Even though this wasn't my point, it's worth noting that GPs do part-take in research actually. Sure they may not be publishing regarding new cancer therapies, but there are journals solely on GPs, their practice, and issues that effect them (eg. "Australian Family Physician").

Most doctors do research, whether that be during med school or their training (to become a GP, ED physician, cardiologist, whatever) or whether that be once they are qualified, many do do research at some point (and this is becoming more and more common). And this is what I said.

Why should it have anything to do with doctors? Can't a discussion start on one topic and lead into another?

It's somewhat confusing to post about the funding of researchers in a thread asking about how important patients are to doctors. Feel free to make a new thread and I'm sure there will be more robust discussion.

Just wondering, I thought GPs had to do more academic work than a Specialist? Would someone be able to give me a rough estimate of how much academic work both have to do (In years)?

The GP pathway is shown here http://www.racgp.org.au/download/Documents/Membership/2014/vtjourneytogeneralpractice2.pdf

The Physician pathways vary depending on the College (see each College for their own info), but in general: Med school (5-7 years) -> Intern year (1 year) -> Residency as a BPT (2+ years) -> General Medicine Registrar (1+ year) -> [sit and pass written and then clinical examination] -> Specialty training (3+ years, assuming you get in right away as many people don't) -> Fellowship (? years with research and practicing) -> Consultant Physician (at last)

[kandinsky]

Ok that's great and I stand corrected, but there's /nothing/ we can do about this. I agree they should be paid more, you agree they should be paid more, that's great and that's really all there is here. I wish I could change the situation, but in reality, I can't.


Just because we can't change the situation now doesn't mean there's nothing that can be done about or that it isn't worth discussing. And who says we all can't do anything about it?

I don't define doctors as "GPs", I define doctors as "those who have a medical degree".


And what about all the doctors who have a DPhil in different fields? lol.

I know what research means (and for once I agree with your definition hahaha). Even though this wasn't my point, it's worth noting that GPs do part-take in research actually. Sure they may not be publishing regarding new cancer therapies, but there are journals solely on GPs, their practice, and issues that effect them (eg. "Australian Family Physician").


lol. From my experience once GPs have spent quite a few years in practice they can't be bothered publishing much (not their fault, they're not paid to do it). AFP looks good, but just reading through I noticed that almost all of the articles in all the issues are by researchers at universities.

Most doctors do research, whether that be during med school or their training (to become a GP, ED physician, cardiologist, whatever) or whether that be once they are qualified, many do do research at some point (and this is becoming more and more common). And this is what I said.

Oh yes, I don't dispute this (see above). But you did just say that 'most doctors do research' - which was a bit vague so naturally I responded in the way I did. There is difference, too, between doing research while studying and doing research while in practice. Very different.

It's somewhat confusing to post about the funding of researchers in a thread asking about how important patients are to doctors. Feel free to make a new thread and I'm sure there will be more robust discussion.

But while we're on the point...   I understand what you mean, though. Maybe I should start a new thread somewhere. Thought there might have been some post-grad biomed people here who could have put forward their thoughts.

[pi]

I honestly don't think there is anything I can do about the research situation right now. I wish I could, but I can't.

And what about all the doctors who have a DPhil in different fields? lol.

Are you talking about medical doctors (MBBS/MD/etc.) who have also got a PhD? If so, good for them! Many RACP/RACS Fellows decide to do a PhD (or a research MD) in their chosen area to boost their chances of becoming a consultant (or for interest, or more likely for both!). But PhDs in medical areas are not limited to just those Fellows who want to become Consultant Physicians or Surgeons, you'd be surprised which medical doctors may have completed a PhD along the way (especially those coming through graduate medical school pathways).

If we're talking about other professionals with a PhD, eg. someone non-medical with a PhD in something in geology, I think that's beyond the scope of this thread (and fairly irrelevant). But good for them too.

lol. From my experience once GPs have spent quite a few years in practice they can't be bothered publishing much (not their fault, they're not paid to do it). AFP looks good, but just reading through I noticed that almost all of the articles in all the issues are by researchers at universities.

Oh yes, I don't dispute this (see above). But you did just say that 'most doctors do research' - which was a bit vague so naturally I responded in the way I did. There is difference, too, between doing research while studying and doing research while in practice. Very different.

The difference is as mentioned in your first paragraph I have quoted: there is no longer a need to "progress up the ladder" so many might not be bothered. Of course, this is simply speculation given I'm not even in the training pathway (let alone anywhere near a consulting position), but that would be my guess as to what the difference is for trainees vs GPs (most Physicians I know continue to research and co-author publications in some regard). Either way, they have part-taken in research as doctors, whether they are active researchers or not isn't something I can confidently comment on.

I also think it's worth noting that many doctors aren't very passionate about research (rather than "not be bothered"), and I guess that's fine too.

[kandinsky]

I honestly don't think there is anything I can do about the research situation right now. I wish I could, but I can't.

Are you talking about medical doctors (MBBS/MD/etc.) who have also got a PhD? If so, good for them! Many RACP/RACS Fellows decide to do a PhD (or a research MD) in their chosen area to boost their chances of becoming a consultant (or for interest, or more likely for both!). But PhDs in medical areas are not limited to just those Fellows who want to become Consultant Physicians or Surgeons, you'd be surprised which medical doctors may have completed a PhD along the way (especially those coming through graduate medical school pathways).

If we're talking about other professionals with a PhD, eg. someone non-medical with a PhD in something in geology, I think that's beyond the scope of this thread (and fairly irrelevant). But good for them too.

The difference is as mentioned in your first paragraph I have quoted: there is no longer a need to "progress up the ladder" so many might not be bothered. Of course, this is simply speculation given I'm not even in the training pathway (let alone anywhere near a consulting position), but that would be my guess as to what the difference is for trainees vs GPs (most Physicians I know continue to research and co-author publications in some regard). Either way, they have part-taken in research as doctors, whether they are active researchers or not isn't something I can confidently comment on.

I also think it's worth noting that many doctors aren't very passionate about research (rather than "not be bothered"), and I guess that's fine too.

haha - I wasn't urging you specifically to do something. I meant that the more people talk about it in our generation the more likely it is that something will be done about it by a government (still unlikely though).

Yep I agree. After all, PhDs work the same way in Medicine as they do in other areas- an extra qualification which means a few more opportunities. I know of some doctors with PhDs who are both practitioners and professors at university level, which must be extremely rewarding. (I was just pointing out that you don't have to do an MD to be called a 'Dr' by law in my comment above-yes it was irrelevant and a bit of a perverse joke on my part)

I would encourage everyone thinking of doing medicine to also do post-grad level research. However, as you say, that level of research isn't within the area of interest of many people, and nobody should really undertake a PhD unless they're genuinely passionate about that area. This isn't because they aren't capable of it; it is more because doing research of that kind (writing papers etc) is a very different way of 'studying' (I don't really think it can be called that, but we'll stick with it even though research is more 'original contribution' to a field) to what everyone does from high school up to start of honours.

I think, as we seem to agree, the amount of research done by someone depends on their level of interest. Some will do no research. Others will do a lot. I expect there are quite a few people in medicine who are more interested in dealing with people than in the research side. But again, as you say, research isn't something people have to do-and the ones who do it are interested in doing it and enjoy it. I admit 'can't be bothered' was a bit strong (that said, it's still probably true for some haha- it's certainly true even of some academics who are paid to write papers!!)

[Tomw2]

Let's just agree to disagree on the topic of "Specialists". Your definition and view seems contradictory to the Colleges, but hey, no one really cares about the title any way.

And contradictory to pretty much everyone with actual medical knowledge and experience. But yeah, I'll leave it there too - some people like to cling to certain ideas regardless.

[kandinsky]

And contradictory to pretty much everyone with actual medical knowledge and experience. But yeah, I'll leave it there too - some people like to cling to certain ideas regardless.

bahaha this old thing.

I rather enjoy being 'ad-hominemed' all the time.

It amused me that every time I referred to or used the views of people "with actual medical knowledge and experience" (a rather hilarious phrase in itself) they were dismissed as lunacy.

I really don't think anyone read my definition of the terminology of a specialist carefully.

I couldn't care less about how the term is used by wikipedia or the colleges or "pretty much everyone with actual medical knowledge and experience". I was never arguing on that point. If someone wants to call themselves a specialist, in the sense that having a degree and a certificate nominally 'makes' a person a specialist, that's fine.

My argument was about the terms and the roles they describe. It is something I would argue about anyone in any field. The sort of narrow-mindedness that says 'I have done a course in this, therefore I know all and am an expert' is what I detest. No proper scholar, however well regarded, however leading in his or her field, would claim to be a specialist, as there is always too much in a field for one person to know or to seek to know. 'Knowing', in the way academics see it, is not simply learning - it is also advancing the field by inquiry. A person cannot know things they have not yet discovered, even if their research may lead to that discovery. Just because a person is regarded as a specialist by others, does not mean that they see themselves as specialists. This is particularly true of certain professors; for them, "actual...knowledge" often does not exist. The  things written in books are often useless and heavily disputed in any field. Not many people really see themselves as specialists, even if they are so called. Medicine and science, like all others, are still rapidly changing fields. The only people who cling to certain ideas are the ones who claim that no terminology or definition can be disputed and that all things that are currently known are known correctly.

[pi]

*sigh*

I think you should instead say "Specialist Physician" (as opposed to a "General Physician" which is different to a "General Practitioner"), we'd all be happier that way

[thushan]

Ahh, no need to be so finicky. The only reason people give a damn about what is a "specialist" and what is a "generalist" is because specialists are perceived by some to be better than generalists.

General Practice is perhaps a bit of a misnomer. It's not really the jack of all trades as it used to be - it really should  be called Community Practice or Family Practice, because what FPs (not calling them GPs now for the sake of the argument) specialise in is family medicine, just as occupational physicians specialise in occupational medicine, and travel physicians specialise in travel medicine.

The only 'generalists' I can think of is a general surgeon and a general physician. General surgeons are your classic jack of all trades, whereas general physicians are probably not so much; what they specialise in is inter-systemic internal medicine.

Anyhow, much of a muchness, who gives a damn.

[Harru!]

lol

/thanks for the sarcastic tone in your responses/

I'm sorry but a GP isn't a specialist. A specialist is a specialist. We can debate the meaning of the word specialist if you like. If you want to be a specialist you specialise and practice in one specific area. If you are a GP you send patients with symptoms you are not so sure about to specialists so that they get the right diagnosis. The job of a GP is to generalise and to be able to pick up many, many things. But, as I said, once these things are picked up (depending on how serious they are, of course), they usually send the patient to a specialist.

ok if we follow that definition, we should be able to say specialists can be GPs cuz they are train to be able to pick up many, many things and generalising shouldn't be a problem for them since you implied generalised skills that are not difficult to acquire and maintained compare to specialised skills that specialists have.

However, we don't see this occurring in the real world. Probably because specialists don't have the specific knowledge and the specific training to practice general/family medicine and their area of medicine is quite different from general/family medicine. Let's use an example: a heart surgeon is deemed a specialist in a specific area of medicine. Given their specialized profession, acquiring inferior generalised skills of a GP/family doctor and picking up the many, many things of general/family medicine shouldn't be much of a hassle right? Wouldn't it be nice for some heart surgeons to have a sudden change in career if they want it and become a GP. Too bad it doesn't work like that given that the skills of a practicing GP is quite a specific skill set to a heart surgeon's and there's not much that can be transferred. If it was easily transferable then we would allow specialists to practise general medicine. Therefore general medicine is a specific area of medicine, especially it cannot be easily and quickly picked up. Therefore kandinsky you have failed to provide an adequate definition of a GP. Therefore you have failed to provide solid deductive reasoning in your premise since you have contradicted yourself when you have applied your definition of a specialist to the role of a GP.

Sure it's all good when everyone can make up their definitions but it would be nice when people can follow their own definitions for the sake of consistency.

Another note:

bahaha this old thing.

I rather enjoy being 'ad-hominemed' all the time.

oh thats cute. you identify a logical fallacy. good on ya. do you want a gold star with that? 
it's good you were able to spot it. ad hominems are counter-productive to a constructive discussion. however you failed to respond appropriately  and failed to give a mature response. You should acknowledged that it was a personal attack and it is something that is not appreciated. Instead you reacted to it. This jeopardise the flow of the discussion and making it disjointed and displeasing for others to further discussed.  Hence, pi's understandable sigh:

*sigh*

Here's my two cents for this thread.

Edit: Pi's sigh - it needs to be heard

[kandinsky]

ok if we follow that definition, we should be able to say specialists can be GPs cuz they are train to be able to pick up many, many things and generalising shouldn't be a problem for them since you implied generalised skills that are not difficult to acquire and maintained compare to specialised skills that specialists have.

However, we don't see this occurring in the real world. Probably because specialists don't have the specific knowledge and the specific training to practice general/family medicine and their area of medicine is quite different from general/family medicine. Let's use an example: a heart surgeon is deemed a specialist in a specific area of medicine. Given their specialized profession, acquiring inferior generalised skills of a GP/family doctor and picking up the many, many things of general/family medicine shouldn't be much of a hassle right? Wouldn't it be nice for some heart surgeons to have a sudden change in career if they want it and become a GP. Too bad it doesn't work like that given that the skills of a practicing GP is quite a specific skill set to a heart surgeon's and there's not much that can be transferred. If it was easily transferable then we would allow specialists to practise general medicine. Therefore general medicine is a specific area of medicine, especially it cannot be easily and quickly picked up. Therefore kandinsky you have failed to provide an adequate definition of a GP. Therefore you have failed to provide solid deductive reasoning in your premise since you have contradicted yourself when you have applied your definition of a specialist to the role of a GP.

Sure it's all good when everyone can make up their definitions but it would be nice when people can follow their own definitions for the sake of consistency.

Another note:
oh thats cute. you identify a logical fallacy. good on ya. do you want a gold star with that? 
it's good you were able to spot it. ad hominems are counter-productive to a constructive discussion. however you failed to respond appropriately  and failed to give a mature response. You should acknowledged that it was a personal attack and it is something that is not appreciated. Instead you reacted to it. This jeopardise the flow of the discussion and making it disjointed and displeasing for others to further discussed.  Hence, pi's understandable sigh:
Here's my two cents for this thread.

Edit: Pi's sigh - it needs to be heard

I do want a gold star!

Ye lol. I really feel like a moderator should delete this entire thread.

Well everyone was attacking me. Felt I should have my fair share!

P.S I never said that general medicine can be easily picked up or learnt, nor did I say it was transferable. I never made any suggestion that GPs have inferior knowledge. I don't actually agree that specialists have any kind of superior knowledge. There are great merits in knowing about many things. I was just arguing about the problem in the terminology. It doesn't really matter what the people do. I agree with the points you make about specialists: in one of my earlier spots I made the same points. Again I don't want to discuss terminology any more. There was a discussion earlier about the problems of specialisation. It is an interesting area, and not just in medicine. There are arguments which suggest there are way too many specialists nowadays in all fields (i.e people working on minute areas and unable to see the wood for the trees). Pretty disturbing arguments, too. Serious problems in many levels of education at the moment. Who knows where education is heading.

Can we all agree to discuss something else that is useful and beneficial to us all and to completely avoid the specialist/generalist debate? (since it is a debate on terminology and hence will never really be resolved !) We were discussing the relationship between medical research/medical practice before. That could be interesting. New thread?

p.s thanks for your points thushan

[EspoirTron]

I think this thread has just progressed with pointless argument without any real benefit being drawn from the comments being made.