PAIN MANAGEMENT PROFESSIONALS
A pain doctor, also called a pain specialist or pain management specialist, is a medical doctor (M.D.) or doctor of osteopathy (D.O.) who specializes in pain medicine. Pain medicine is a medical specialty that focuses on the evaluation, treatment, and prevention of pain.
Pain doctors specialize in the management of pain as a symptom of disease and primary pain disorders. They treat patients who experience pain related to a specific cause and patients who suffer pain as a primary condition.
Pain management specialists often serve as consultants to other physicians and health care providers (e.g., physical therapists) and coordinate patient care. They diagnose conditions, provide treatment (e.g., prescribe medication and rehabilitation services, perform procedures to relieve pain), and counsel patients and their families. Pain doctors work in a variety of settings, such as private practices, hospitals, and pain clinics.
American Chronic Pain Association – https://www.theacpa.org/pain-management-tools/resources/professional-groups/
American Academy of Pain Medicine – http://www.painmed.org/patientcenter/organizations/
American Pain Society – http://americanpainsociety.org/
INTERVENTIONAL PAIN PHYSICIANS
An interventional pain anesthesiologist should be double board certified in both anesthesiology and pain management. This type of physician can treat all levels of pain through minimally invasive techniques such as injection therapy, radiofrequency ablation or spinal cord stimulation.
Interventional pain anesthesiologists provide treatments such as epidural steroid injections, nerve blocks, radiofrequency ablation, spinal cord stimulation, facet joint injections, lumbar sympathetic plexus blocks, and trigger joint injections. All procedures are done on an outpatient basis.
Interventional pain management is different from other pain management practices because it emphasizes the importance of a precise diagnosis so treatment can begin immediately. Rather than just prescribing medication or only recommending physical therapy, an interventional pain management specialist utilizes all sources of treatment to eliminate pain in the fastest and most effective way possible for each individual patient.
American Society of Interventional Pain Physicians – http://www.asipp.org/
SPORTS MEDICINE PHYSICIANS
Sports medicine doctors work with athletes on a variety of issues in multiple settings. Individuals who wish to pursue this profession should learn about the specific education and fellowship requirements for this field. Sports medicine doctors are either orthopedic surgeons or primary care physicians who prescribe treatments for professional and amateur athletes. They’re trained to address issues associated with nutrition, sports psychology, and substance abuse and may also counsel athletes on injury prevention. In addition, they sometimes focus on special groups of people, such as young children or the elderly.
Sports medicine doctors may also work alongside physical therapists to create rehabilitation plans or with athletic trainers to develop appropriate exercise regimens. While orthopedic surgeons are trained to perform surgery, primary care sports medicine doctors do not operate on athletes but can expedite referral to a surgeon if surgery is required. Sports medicine doctors may work in a variety of environments, including hospitals, medical clinics, physical therapy practices, high schools, colleges and universities, and professional sports organizations.
American Medical Society for Sports Medicine – https://www.amssm.org/
American Orthopaedic Society for Sports Medicine – https://www.sportsmed.org/aossmimis
American Sports Medicine Institute – http://www.asmi.org/
A neurosurgeon is a physician who specializes in the diagnosis and surgical treatment of disorders of the central and peripheral nervous system including congenital anomalies, trauma, tumors, vascular disorders, infections of the brain or spine, stroke, or degenerative diseases of the spine. The education and training to become a neurosurgeon is rigorous and extensive and includes the completion of:
Four years of pre-medical education at a college or university
Four years of medical school resulting in an M.D. or D.O. degree
One year internship in general surgery
Five to seven years in a neurosurgery residency program
Some neurosurgeons complete a fellowship after residency to specialize in a particular area Continuing education — annual meetings, conferences, scientific journals, research — to keep up with advances made in the complex field of neurosurgery
Because neurosurgeons have extensive training in the diagnosis of all neurological diseases, they are often called upon by emergency room doctors, neurologists, internists, family practitioners and osteopaths for consultations.
An orthopedic surgeon is a surgeon who has been educated and trained in the diagnosis and preoperative, operative, and postoperative treatment of diseases and injuries of the musculoskeletal system. Orthopedic surgeons work closely with other health care providers and often serve as consultants to other physicians. Orthopedic surgeons often are involved in education (e.g., medical school professors) or research. They may practice in an orthopedic or multi-specialty group, or in a solo practice. Orthopedic surgeons treat a number of conditions that affect the bones, joints, muscles, ligaments, tendons, and nerves. These conditions include the following:
- Bone tumors
- Cerebral palsy
- Club foot, knock knees, bow legs, bunions, hammertoes
- Fractures, sprains, and strains
- Muscle, ligament, and tendon damage
- Spine disorders (e.g., sciatica, scoliosis, ruptured disc)
Physicians entering the field of orthopedic surgery may choose to practice general orthopedic surgery, or can specialize in one of the following areas:
- Foot and Ankle
- Joint Replacement
- Musculoskeletal Oncology
- Reconstructive Surgery
- Shoulder and Elbows
- Sports Medicine
- Trauma and Fractures
Plastic surgeons perform operations that change the shape or appearance of part of a patient’s body. They not only perform cosmetic surgeries such as nose jobs or face lifts, but they also perform reconstructive surgeries for patients who have injuries from a car crash or other accident or for those with birth defects.
The specific procedures a plastic surgeon performs depend on his specialty. For example, cosmetic surgeons may perform breast augmentations or liposuction. Craniomaxillofacial surgeons treat conditions in the face and head such as cleft palate. Burn surgeons remove dead flesh, graft new skin and work to minimize scarring on burn victims.
Plastic surgeons must maintain their license to practice medicine. This involves completing continuing education credits and staying current on new surgical techniques and advances. Specific continuing education requirements vary by state.
PHYSICAL MEDICINE SPECIALISTS
Physical medicine and rehabilitation, also known as physiatry or rehabilitation medicine, aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. A physician having completed training in this field is referred to as a physical medicine specialist. Unlike other medical specialties that focus on a medical “cure,” the goals of the
physical medicine specialists are to maximize patients’ independence in activities of daily living and improve quality of life.
Physical medicine specialists are experts in designing comprehensive, patient-centered treatment plans, and are integral members of the care team. They utilize cutting-edge as well as time-tested treatments to maximize function and quality of life for their patients, who can range in age from infants to octogenarians.
Physical medicine specialists practice in a variety of clinical settings, including inpatient and outpatient facilities. They have a broad range of knowledge including musculoskeletal, neurological, rheumatological and cardiovascular systems.
Doctors of Osteopathic Medicine, or DOs, are fully licensed physicians who practice in all areas of medicine. Emphasizing a whole-person approach to treatment and care, DOs are trained to listen and partner with their patients to help them get healthy and stay well.
DOs receive special training in the musculoskeletal system, your body’s interconnected system of nerves, muscles and bones. By combining this knowledge with the latest advances in medical technology, they offer patients the most comprehensive care available in medicine today.
Osteopathic physicians focus on prevention, tuning into how a patient’s lifestyle and environment can impact their wellbeing. DOs strive to help you be truly healthy in mind, body and spirit—not just free of symptoms.
From their first days of education and training, DOs learn to:
- Look beyond symptoms of illness and disease to examine the whole patient.
- Partner with patients to help prevent illness and injury.
- Use their hands to diagnose illness and injury and increase your body’s natural tendency
A podiatrist is a doctor of podiatric medicine (DPM), a physician and surgeon who treats the foot, ankle, and related structures of the leg. Podiatrists complete four years of training in a podiatric medical school and three years of hospital residency training. Their training is similar to that of other physicians. Podiatrists may go on to complete fellowship training following their residency.
Podiatrists can focus on many fields, including surgery, sports medicine, wound care, pediatrics, and diabetic care.
A rheumatologist is an internist or pediatrician who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles, and bones causing pain, swelling, stiffness, and deformity.
Autoimmune conditions occur when the immune system sends inflammation to areas of the body when it is not needed causing damage/symptoms. These diseases can also affect the eyes, skin, nervous system, and internal organs. Rheumatologists treat joint disease similar to orthopedists but do not perform surgeries. Common diseases treated by rheumatologists include osteoarthritis, gout, rheumatoid arthritis, chronic back pain, tendinitis, and lupus.
Many rheumatologists also conduct research to find a cause of and better treatment of a rheumatic disease.
Rheumatologists must complete four years of medical or osteopathic education followed by three years of residency training in either internal medicine or pediatrics. Some rheumatologists are trained in both. After residency, they must enroll in a rheumatology fellowship for two – three years to learn about chronic musculoskeletal and autoimmune conditions and their treatment.
Rheumatologists then take a board examination to become board certified in rheumatology. Thiscertification/exam has to be retaken every ten years. Physicians are also required to participate in a certain amount of continuing medical education on a yearly basis.
A chiropractor is a health care professional focused on the diagnosis and treatment of neuromuscular disorders, with an emphasis on treatment through manual adjustment and/or manipulation of the spine./
Most chiropractors seek to reduce pain and improve the functionality of patients as well as to educate them on how they can account for their own health via exercise, ergonomics and other therapies to treat back pain.
Chiropractors focus on the intimate relationship between the nervous system and spine, and hold true the following beliefs:
- Biomechanical and structural derangement of the spine can affect the nervous system
- For many conditions, chiropractic treatment can restore the structural integrity of the spine, reduce pressure on the sensitive neurological tissue, and consequently improve the health of the individual.
The treatment concept of chiropractic is to re-establish normal spinal mobility, which in turn alleviates the irritation to the spinal nerve and/or re-establishes altered reflexes.
Veterinarians diagnose and treat diseases and dysfunctions of animals. Specifically, they care for the health of pets, livestock, and animals in zoos, racetracks, and laboratories. Some veterinarians use their skills to protect humans against diseases carried by animals and conduct clinical research on human and animal health problems. Others work in basic research,
broadening our knowledge of animals and medical science, and in applied research, developing new ways to use knowledge.
Most veterinarians diagnose animal health problems, vaccinate against diseases, medicate animals suffering from infections or illnesses, treat and dress wounds, set fractures, perform surgery, and advise owners about animal feeding, behavior, and breeding.
According to the American Medical Veterinary Association, 77 percent of veterinarians who work in private medical practices treat pets. These practitioners usually care for dogs and cats but also treat birds, reptiles, rabbits, ferrets, and other animals that can be kept as pets. About 16 percent of veterinarians work in private mixed and food animal practices, where they see pigs, goats, cattle, sheep, and some wild animals in addition to farm animals. A small proportion of private-practice veterinarians, about 6 percent, work exclusively with horses.
American Veterinary Medical Association – https://www.avma.org/Pages/home.aspx
A research scientist is a scientist who works primarily with gathering knowledge and understanding research. While many scientists are employed in applied scientific fields that involve development and design work, a research scientist typically can be found in academic settings or similar areas. Because these scientists are engaged in pure research work that may not have immediate application in the business or consumer world, they tend to rely on grants and funding from academic and charitable foundations. Research scientists typically perform experiments, make observations, and create detailed papers of their findings for peer review and publishing.
Much of what any research scientist does is based on the fundamentals of the scientific method. Normally under the purview of an academic or research organization’s approval, this scientist will create experiments that include both control and experimental groups. He or she will record responses based upon the introduction of a variable into both groups. The research scientist will typically draft a proposal for such experimentation, and he or she may be required to have these
proposals reviewed by peers within the field to determine the validity and methodology of the research work.
Most research scientists have advanced university degrees in their target subject, typically having earned post-graduate recognition in their chosen field of study. They normally work in a lab environment, but these environments can vary, depending on the scientific specialty. Psychology labs may simply be a bank of computers, while botanical or zoological labs are set up to safely house living specimens. Research scientists typically work regular daytime hours, but they should expect that travel, field work, and irregular hours may be required from time to time by the particular subject matter of the research performed.
Most of the time, registered nurses (RN) work for hospitals or medical clinics. They may also work for other organizations, such as outpatient facilities, rehabilitation centers, or senior centers. Their main job is to promote wellness and health.
To become RNs, they must have an associate degree in nursing (ADN) or a bachelor’s degree
in nursing (BSN). Some employers require candidates to have prior experience as an RN. They must have a license from their state’s board of nursing. In order to administer medications, some states require that RNs pass a medication administration exam. They must follow standards of care and practices. They must be able to use various medical instruments.
They may be required to travel to visit patients at their homes. They must be able to work in a team environment. They must have excellent interpersonal and communications skills.
They must follow doctors’ instructions. They may be required to attend various workshop, classes, or conferences to improve their skills as RNs. They must read professional journals to keep
themselves up to date with current medical findings and technology. They may have to renew their nursing licenses regularly, depending on the states where they are practicing as RNs. They may be required to train, coach, or mentor new or more junior nurses.
American Nurses Association – https://www.nursingworld.org/
A physician assistant (PA) is a licensed medical professional and caregiver. who typically works in a clinic, doctor’s office, or hospital. The PA can perform many of the routine work that doctors might otherwise perform, thus allowing the physician to spend more time with non-routine cases and patients. In many jurisdictions, a PA is licensed to perform routine diagnoses and to write prescriptions.
The PA will typically be tasked with seeing patients who present with routine sicknesses or injuries. The PA normally assesses the situation and then treats the patient, according to medically accepted standards and practices. The PA may determine that the patient requires more specific care and will bring in a physician to escalate the care. A PA can perform regular procedures, such as stitching up minor cuts and setting small fractures or breaks. The PA may also assist a physician in preliminary prep work on patients.
To be a PA, a person must normally have a bachelor’s degree in biology or a similar field. He or she may also need a post-graduate education that is similar to, but not quite as stringent as, that required by regular physicians. The PA must also pass board certification exams and keep these licenses up-to-date through any required continuing education. Most physician assistants work in a clinical environment during regular business hours of the week.
American Academy of Physician Assistants – https://www.aapa.org/
A rehabilitation specialist usually works in a medical entity that encourages development for clients who have mental illnesses or mental disabilities. The rehabilitation specialist will usually create plans for individuals in order to help them adapt to daily living. The specialist may teach and help the clients in areas such as personal grooming skills, communication, and recreational activities. This person also teaches how to cope with daily living. The specialist may provide opportunities for the client to socialize and participate in activities. This may involve carrying out research in order to determine the availability of programs and what programs will be most suited for the patient’s needs.
The position sometimes involves working in an office where clients will be brought to the specialist. In other positions, the job requires providing these services in the home of the patient. In this case, a valid driver’s license will be needed. The rehabilitation specialist may have a single patient or multiple patients who are visited on different days of the week. Plans should be adapted to patient needs in terms of the skills they need to develop and the goals they want or need to achieve. A patient personality is needed for this job, as some clients may be difficult to deal with. When the specialist notices changes in the behavior of the client, this behavior should be reported to the supervisor or a medical provider.
Strong communication skills are needed in order to be able to communicate with the client, families of the client, and the patient’s medical providers. Generally, this is a full-time position. This position typically requires a bachelor’s degree and experience in a related field
International Association of Rehabilitation Professionals – https://rehabpro.org/
National Rehabilitation Association – https://www.nationalrehab.org/
National Association of Rehabilitation Providers and Agencies – https://www.naranet.org/
Functional Medicine is a systems biology–based approach that focuses on identifying and addressing the root cause of disease. Each symptom or differential diagnosis may be one of many contributing to an individual’s illness. A diagnosis can be the result of more than one cause. For example, depression can be caused by many different factors, including inflammation. Likewise, a cause such as inflammation may lead to a number of different diagnoses, including depression. The precise manifestation of each cause depends on the individual’s genes, environment, and lifestyle, and only treatments that address the right cause will have lasting benefit beyond symptom suppression.
Functional medicine takes into account the personalization of healthcare, as each patient care plan is distinct and unique. The relationship between patient and practitioner effectively becomes a partnership; every aspect of a patient’s medical history is reviewed in detail. Much like integrative medicine, functional medicine treats the individual rather than the disease.
Often, individual genetic and environmental research is conducted to obtain a deeper knowledge of the patient’s health status. Understanding the biochemical individuality of a patient can lead to the underlying causes of disease and furthermore, the prevention of additional health risks in the future.
Integrative Healthcare is an approach to care that seeks to integrate the best of Western scientific medicine with a broader understanding of the nature of illness, healing and wellness. Easily incorporated by all medical specialties and professional disciplines, and by all health care systems, its use not only improves care for patients, it also enhances the cost-effectiveness of health care delivery.
A practical strategy, integrative medicine puts the patient at the center of the care and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health. Treating the whole person addresses both the patient’s immediate needs as well as the effects of the long-term and complex interplay between a range of biological, behavioral, psychosocial and environmental influences are addressed. This process enhances the ability of individuals to not only get well, but most importantly, to stay well.
The defining principles of integrative medicine are:
- The patient and practitioner are partners in the healing process.
- All factors that influence health, wellness and disease are taken into consideration.
- The care addresses the whole person, including body, mind, and spirit in the context of community.
- Providers use all appropriate healing sciences to facilitate the body’s innate healing response.
- Effective interventions that are natural and less invasive are used whenever possible.
- Because good medicine is based in good science, integrative medicine is inquiry-driven and open to new models of care.
- Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount.
- The care is individualized to best address the person’s unique conditions, needs and circumstances.
- Practitioners of integrative medicine exemplify its principles and commit themselves to self- exploration and self-development.
Academy of Integrative Health and Medicine – https://www.aihm.org/
Neurotherapy, also called neurofeedback (NFB), EEG biofeedback, or brainwave training is a type of alternative therapy, more specifically a type of biofeedback that uses realtime displays of electroencephalography (EEG) to illustrate brain activity. By recording brain wave activity using sensors placed on the head, a practitioner can gather information about why an individual may be having clinical symptoms based on what is happening in their brain. States of
neurophysiological over-arousal or under-arousal can contribute to why a client may be manifesting symptoms of anxiety, depression, obsessive compulsive disorder (OCD), attention deficit disorder (ADD), and a variety of other stressful conditions. Once initial information has been gathered, neurofeedback can be used to track brain wave activity, and train the brain to operate more efficiently by providing visual and auditory feedback to the client as their brain wave patterns improve and self-regulation occurs.
Neurotherapy is for individuals who:
- Are looking for a natural alternative to medication
- Do not respond well to traditional treatment approaches
- Would benefit from this form of treatment as an adjunct to psychotherapy
- Are interested in increasing healthy brain function to improve attention and cognition and reduce stress
Neuro Developmental Treatment Association – https://www.ndta.org/
American Society of Neurorehabilitation – https://www.asnr.com/i4a/pages/index.cfm?pageid=3293
Naturopathists or naturopathic doctors work in naturopathic clinics or private practice, while some also work in hospitals. They may treat their patients’ illnesses using conventional as well as alternative medicine, and they diagnose and treat injuries and a variety of illnesses.
A doctorate degree and prior experience are generally required for this position, and clinical research experience is highly beneficial. They may use both modern scientific medicine and naturopathic treatments and must emphasize treatment using both natural and traditional forms as requested by their patients. They must take their patients’ emotional and mental conditions into consideration in addition to physical health and maintain the philosophy of treating the whole person rather than only the symptoms.
Strong communication and interpersonal skills are important in this position, and a background check and drug test may also be necessary. Naturopathists are encouraged to keep their skills and knowledge up-to-date by reading professional journals and attending conferences, and flexibility may also be required to be on-call on a rotating basis.
A psychiatrist meets with patients and determines if a mental disorder is present. An evaluation of the patient’s symptoms, behavior, and past medical history will be carried out. Tests may also be performed to determine any issues that are present. The psychiatrist will also help the patient to manage, ease, or heal a disorder, which may be done by administering treatments or medications.
Throughout treatment, the care that is administered should be evaluated to determine if the treatment is working. It may also be necessary to work with the patient’s other health providers, in order to gather feedback and to determine what sort of care should be administered. In some cases, the psychiatrist may also recommend that the patient meets with a psychologist, so that counseling services can be provided. It is also important to keep a strong network of resources.
A psychiatrist also helps to prevent mental disorders from occurring. This can be helpful, especially to people who have gone through traumatic events. Strong communication skills are necessary, in order to work well with patients, patients’ families, and other medical providers.
The psychiatrist will educate the patients and the patients’ families as to the various aspects of the illness and how they can be cared for at home.
The psychiatrist should be licensed as a board-certified psychologist. Graduation from an accredited medical school of psychiatry is also necessary.
American Psychiatric Association – https://www.psychiatry.org/
Association for Academic Psychiatry – https://www.academicpsychiatry.org/
The American College of Psychiatrists – https://www.acpsych.org/
Psychologists employ their education and knowledge of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) to provide diagnostic interviews, psychological testing, and individual and group psychotherapy. They may work as part of a multidisciplinary team, and consult with other professionals regarding patient care. These other professionals vary depending upon the type of psychologist. For instance, a school psychologist may work with teachers, social
workers, counselors, and doctors. Psychologists may also communicate with family members and other care providers. Additionally, they conduct a significant amount of verbal interviews, as well as collaboration with other professionals; report writing is extensive and need to be clear as a medical record, as well as for other care providers when necessary.
Psychologists may work part time, full time, or on a contractual basis; as a result, hours may vary considerably from position to position. Some psychologist positions may require travel to a variety of locations as part of consultations or meetings with other professionals, seminars, and professional conferences.
Psychologists must have either a clinical or counseling doctorate in psychology, although some positions may accept a master’s degree. Many positions may require the degree to be from an American Psychological Association (APA)-accredited school. Also required are a license for the applicable state and malpractice insurance. Experience in providing therapy, or at least an internship, is preferred. More prestigious positions, or those accepting a master’s degree, may require up to 15 years of experience.
A dermatologist is a medical doctor who specializes in diagnosing and treating diseases and conditions involving the skin, nails and hair. A dermatologist can treat common conditions such as acne and skin rashes, as well as diagnose and treat more serious diseases. Dermatologists traditionally work as specialists in private practices, with many of their patients referred by primary care providers when this doctor’s expertise is required.
Dermatologists frequently treat patients by examining the affected topical areas of the skin; these examinations may require the doctor to gently remove small surface layers of skin for further examination. The dermatologist may recommend or prescribe topical medication to help ease discomfort and restore the skin; in some cases, it may be necessary to prescribe
antibiotics to deal with possible infections. Dermatologists also take samples and perform biopsies of moles, surface cysts and other skin anomalies to check for cancer in patients. If a serious condition is discovered, the doctor recommends and performs treatments such as surgical removals of affected areas, radiation treatment or chemotherapy. In these situations,
typically the dermatologist consults with an oncologist and conducts further testing to determine if any cancers have spread.
Like other physicians, a dermatologist must complete an undergraduate degree and then four years of medical school. Dermatologists typically specialize in this area during medical school and then complete a residency and internship in the field; they also must obtain and maintain licensing to work as a physician.
ADMINISTRATORS and BUSINESS PROFESSIONALS
Although their responsibilities depend on the size of the medical practice where they work, practice administrators are typically expected to implement the policies and procedures that keep the medical office running smoothly. They are often responsible for staffing and scheduling, ensuring compliance with regulations, managing the revenue cycle and helping to oversee the security procedures that guard the private information of the business and its patients. Practice administrators also recommend ways to lower overheads and improve efficiency and supervise non-clinical staff like receptionists, secretaries, medical billers and medical coders. In smaller offices, they may be expected to fill in when the office is short- staffed. As is often the case with other managerial positions, practice administrators may also be asked to step in and mediate issues with office personnel, defuse a customer service problem or handle a dispute with an insurance company.
Practice administrators need to be good managers. They must communicate clearly with patients, office employees, insurance company representatives and medical staff. They need to be capable of managing employees with different personalities and backgrounds effectively. Conflict resolution and multitasking skills are necessities. Attention to detail is also vital, as is the case with most healthcare careers. In fact, the most successful practice administrators have a thorough understanding of the ins and outs of medical administration that enables them to identify and proactively tackle the unique issues healthcare offices face.
American Association of Healthcare Administrative Management – http://www.aaham.org/
Healthcare Administrators Association – https://www.hcaa.org/
Healthcare Business Management Association – https://www.hbma.org/
American College of Healthcare Executives – http://www.ache.org/
American Health Information Management Association – http://www.ahima.org/
Healthcare Financial Management Association – https://www.hfma.org/