Well need some help (moonpod espcially)

[nbd13]

Well guys its time for me to make a decesion on what i want to do for the rest of my life. heres what i am thinking, either a doctor (D.O.), dentist, or i am thinking a Bone Doctor, i think its called a an orthepidic doc. anyway i am leaning towards the Bone doc or the dentist, i just dont think a family doctor will satisfy me.

heres alittle back ground, i really love the medical feild, half of my family is in it ranging from doctors, dentist, pharamists, chiropractors. My dad is a family doctor (D.O.) and my uncle is a dentist. i really have a passion for the medical feild and have pretty good experinece, i mean i have worked at my dads office for quite awhile and i have learned many things over the years of being a doctors son. The wild card is the dentist part, my uncle is a dentist and it has always caught my intrest.

the schooling is not a big thing to me, i mean to become a dentist its your basic 4 then 4 more of dental school, for a D.O. its 4 years then 4 years of medical then 2 years of a residency, for a othropedic its 4 years of basic, then 4 of medical then 4 of a residency.

so am want any bodys thoughts i am trying to get everyones thoughts here, ita big decesions i have to make!

Moonpod- if you could tell me where you see the othropedic business going that would be great. also any regrets? or are you pretty happy with your decesions? i think i would really love to do this, i am going to sit in on a couple of surgerys this summer. Theres a othropedic guy that has an office in my Dad's building and i have know him my whole life so he will let me sit in on a couple of surgerys.

Also i just had my labrium and rotator cuff repaired in sept and thought it was very intresting! i saw pics of it and loved every mintue of it! that really got me intrested.

Do you specialize in any speicific area? like knees or shoulders?

also what to do you think about the insurance? i mean i knwo thats the hardest part. but do you think it will get worse or better?

thanks to anyone that give me there thoughts!

Nick

[Diesel3443]

Dont forget nick you also have fellowships, and surgical residencies on top of the 4,4,4 as well to be a ortho surgeon.

[nbd13]

are you sure about that? i was pretty sure that it was 4,4,4?

maybe moonpod can chime in here?

thanks Sean!

Nick

[invincible569]

Nick, here are my thoughts on your dilema...

Here's what you need to think about first as it will affect your future for the rest of your life... YOUR FAMILY. Would you see yourself a true family man 15 yrs from now? Do you want that extra time with your future kids and wife to enjoy life or woud you rather be passionate abour your job? Meaning... do you want to get paged in the middle of the night or work the graveyard shift? I'll throw in that famous quote, Would you rather live to work or work to live? I feel that the American way is seeing dollar signs at the end of the rainbow, but in reality money isnt everything when you cant even enjoy it with the people you love the most. Think about your father.. was he a great father to you? Always being there by your side? Would you want your kids to have the same loved life as you? A Dentist and Family Doctor can usually make their own hours after yrs of practice. Even better, is someone like Aged Salt who runs his own business creating his own hours and using that extra time for the his two passions, ZEOvit and his wife. What about an optometrist? or pharmicist? Maybe these arent for you as a routine job would bore you. Maybe you want a challenge where its never the same every day? Think about that for your career too. Heck, why not a plastic surgeon? They are booming in todays world. BUT.. you have to pay the price of not having time for your family... look at Dr. 90210. His wife complains how he is never home. He has a passion for his work, but he only has one thing in mind and that is his job. Hope that helps even though thats probably what you werent looking for.

[nbd13]

Hey Edward great post! thats what i was looking for!

let me say a couple of things in regards to your post, i am a family man and see my self spending time with my family. my dad was a great father, he was there for every sporting even and even coached my teams throughout the year. he was always there atleats it seemed like that to me and my sister. my mom doesnt really complain. and like you said with dentist i knwo they can make there own hours (my uncles a prime explain) my dad sort of makes his own hours, he's at the office 4 days a week plus sat. mourning and has thursdays off.

i am seriously not in it for the money, i really enjoy this type of stuff. i looked through moonpod site today, and i loved all the pics, espically the one with the hip, i even had my dad explain things to me int he pic!

i need a challenge, thus i think this feild suits me. i cant do the same thing everyday, thats why i think the meidical or dental feild is a good choice. and i do not mind being paged in the middle of the night.

also i plan to open my own pratice, like the guy in my dad's building, granted we live in a small town, but i will still talk to him, the orthopeidic doc and see what he says. my dad owns his pratice so he has some freedom there.

i truely think i would be happy doing anyone of the above, although i am leaning towards the orthopedic surgeon at this point.

Sean- on moonpod site its 4,4,4 although he did do a fellowship, but thats not required.

anyhow anyone else have anythoughts?

Aged Salt anythoughts?

thanks guys and again Edward great post!

Nick

[moonpod]

Orthopedics is one of the last "great" fields of medicine IMO. IF you like being a surgeon. It is NOT for everyone. The reimbursement is reasonable to good and business is booming so to speak. There is ALWAYS a demand for musculoskeletal care b/c frankly it's not done very well at the primary care level. It's also good for people who like relatively immeadiate gratification. You KNOW when a surgery has gone well. People get better. You solve problems. It's not like treating hypertension--you treat that, you don't cure it. Finally it's very "techinical". Lots of toys...love toys....it's also a field that is changing constantly. For instance arthroscopy has revolutionized shoulder and knee surgery. Minimally invasive joint surgery (well, that's actually probably mostly marketing), computer assisted surgery (for the 3 dimensionally impaired)...

First off insurance--NOONE knows what the future holds. Canadian or UK style is unlikely. It's not "American" enough.

Second, go to my site and you will see my specialty. Trauma and reconstruction. My hours are very irregular. I live near the hospital--it's a necessity. My life would be miserable otherwise. I clock a lot of hours. Computers are all over the hospital, hence during the downtime I troll the boards. However it can be "bust or boom", sometimes things are slow and I get unexpected time off which I enjoy.

Ortho is 4 yrs college, 4 yrs med school, 5 or 6 years residency (most programs are 5) and most do a year of fellowship. First piece of advice--get an MD not a DO. Outside the midwest DO degrees are not respected. You will have trouble getting into orthopedic residency outside of the few DO run programs in the midwest and the south. It's not "fair", but THAT IS reality. Trust me on that one.

finally, you've got A LONG time to make your decisions. Do well in school, have broad/diversified interests--it'll give you a lot of options. Maybe you'll continue on into medicine, maybe not. Maybe you'll go to med school and become a 'pod, maybe you'll become an interventional cardiologist. Who knows. That's the wonderful thing about the future...you never know what it holds.

[nbd13]

THANKS ALOT!

well i have a couple more questions for you but am on my lunch break from work. i will post them when i get home today.

just alittle update i am watching a complete knee replacement tomorrow which will be VERY intresting and that shoudl shed some light on if i think i could do this for the rest of my life!

i have probably about 10 questions to ask you later if you dont mind. i knwo you are busy, but if you could help me out alittle that would be great!

thanks again Moonpod and to all others that have responded!

Nick

[nbd13]

Alright here we go, sorry if this gets alittle long, but its my future we are talking about, haha!

1. Did you moonlight during your residency? if so which year in your residenecy did you start to moonlight?

2. Are you in a group with other othropedic surgeons? like do you split up the "on call" duties? or are you by yourself? i do not think you are in private practice are you?

3. Do you for-see business to continue to boom in 10-15 years?

4. On average how much free time do you get in a week? a month?

5. do you take any days off? like one day a week? or is it more of you are on call and when you get called in you go?

6. What size town do you work in? small, medium, or large?

7. Are there any added benefits in working in a small, medium, or large town?

8. Do you think the demand for orthopedic surgery will be there in say 15 years? I mean with the longer life excpectancy, I think more people will want joint replacement and so on..

9. Do you think that computers will play a bigger role in 10-15 years? or do you think it will still be more "hands on"

i think thats it, haha sorry for so many questions i just got bored today in school and wrote a couple down.

I also PM'd you with 3 questions that i didnt feel comfortable posting.

thank you again for taking the time to help me out!

anyone else like Aged Salt or any other Doctor or Dentist out there that want to post please go ahead!

thanks once again!

Nick

[moonpod]

1. Did you moonlight during your residency? if so which year in your residenecy did you start to moonlight?

yes. 3rd year. That's standard. You need a license to moonlight.

2. Are you in a group with other othropedic surgeons? like do you split up the "on call" duties? or are you by yourself? i do not think you are in private practice are you?

I am in a group. We cover ourselves in terms of patient calls, but we also cover the hospital which we take a relatively heavy call schedule of a weekend a month and a weekday a week. This is a busy hospital. Level I trauma center.

3. Do you for-see business to continue to boom in 10-15 years?

Yes. The population is getting older (more problems).

4. On average how much free time do you get in a week? a month?

beats me. It's enough.

5. do you take any days off? like one day a week? or is it more of you are on call and when you get called in you go?

I try to make Friday "catch up" day. If I need to I work, otherwise I goof off. The weekends I try to keep open, but there are no sacred cows. I operated all day both days last weekend.

6. What size town do you work in? small, medium, or large?

Los Angeles. Pretty much that's uh, the biggest town eh?

7. Are there any added benefits in working in a small, medium, or large town?

It's all in what you like. L.A. is my home. I grew up here. I've been in lots of other places big and small. None of them were home to me.

8. Do you think the demand for orthopedic surgery will be there in say 15 years? I mean with the longer life excpectancy, I think more people will want joint replacement and so on..

See #3. Hip fractures are becoming an epidemic. Joint replacement and rotator cuff problems are becoming more prevalent. The population is growing. The number of orthopedic surgeons is static to slightly shrinking.

9. Do you think that computers will play a bigger role in 10-15 years? or do you think it will still be more "hands on"

Computers have an increased role, but the technology just isn't ready for primetime. Computer assisted surgery is "cute", but again, it's for the 3 dimensionally impaired right now or for the very complex case. It doesn't really help with the routine, or for surgeons with a good sense of 3d anatomy (which unfortunately isn't as prevelant as one would hope). Additionally they can't figure out if they want to use "visual/photo" systems, or EM guided etc...there are a LOT of technical issues and the software is....pitiful.

[nbd13]

wow thanks again!

1. i never real thought that the number of othropedic surgeons was shrinking. I guess that is sort of good for me in the long run.

2. I figured that as medical advances allowed more people to live longer that the demand for such things as joint replacements would grow, like you said.

3. so to moonlight you need a license? and you get that after your 3rd year? i was hoping to moonlight my 2nd year, but i guess thats not possible?

again thank you so much! i am very excited for tomorrows surgery and cant wait to see what i think. i hope this will help me in determing if this feild is for me or not.

the one thing i like is the fact that you get to work with some many different instruments, which i really like. I like to work with wood now so i think this may help also.

oh yeah 1 more question for you,

1. are there any surgerys that you would suggest i watch? i mean anything specific? i plan on watching quite a bit over the summer. i plan on having the doctor call me when a case comes in like a bad fracture that needs screws and plates, i think that would be intresting to watch.

My dad used to assist this doctor early on in his career, but stoped when he became to busy. anyway he said some of the tools you guys used to use were pretty big. is this still true today?

thanks once again!

Nick

[moonpod]

3. so to moonlight you need a license? and you get that after your 3rd year? i was hoping to moonlight my 2nd year, but i guess thats not possible?

It varies from state to state, but that is the general rule

1. are there any surgerys that you would suggest i watch? i mean anything specific? i plan on watching quite a bit over the summer. i plan on having the doctor call me when a case comes in like a bad fracture that needs screws and plates, i think that would be intresting to watch.

Watch a 'scope (nintendo surgery). Fracture surgery....JMO and obviously I'm colored in this b/c I am a "fracture surgery professional/specialist", it is getting very, very specialized and slowly leaving the realm of "generalists"--except for very routine stuff.

My dad used to assist this doctor early on in his career, but stoped when he became to busy. anyway he said some of the tools you guys used to use were pretty big. is this still true today?

A hammer is a hammer. A drill is a drill.

[nbd13]

thanks once again!

so one more for you know,

1. do specialize in a specfic feild i guess you woudl need to do a year fellowship then also.

oh yeah i was talking to people that made the implants and

2. he basically said in 30 years the demand for orthopedic surgeons will decrease because of the fact that technology will take over. do you think this holds any truth in your opipion? he was saying that they are growing out DNA to replicate the cardiolig in the knee and then you would make a tiny hole and thread it through so to speak.

also the Dr that i watched said that the amount of othropedic surgeons are slowly decreasing due to the fact that the schooling takes so much longer.

Do you think there is any truth to that?

thanks once again.

to bad i dont live closer to you, i would love to watch a couple of your cases just due to your location. i bet you get alot of car acident cases, dont you? plus it would be nice to see a bigger hospital. are you guys a teaching hospital?

thanks once again Chuck!

Nick

[moonpod]

1. do specialize in a specfic feild i guess you woudl need to do a year fellowship then also.

yes

2. he basically said in 30 years the demand for orthopedic surgeons will decrease because of the fact that technology will take over. do you think this holds any truth in your opipion? he was saying that they are growing out DNA to replicate the cardiolig in the knee and then you would make a tiny hole and thread it through so to speak.

BIG maybe. It's not that simple. There are issues with timing and dosing and delivery mechanisms of growth factors. Unless someone gets just plain outright lucky in the lab, it's, really, really complex. It's NOT as straight forward as just injecting a little retrovirus in the knee and that's that. It's already been tried with basically dismal results and the added risks of the "unknown"--what happens afterwards with the retrovirus???? The reality is that to date gene therapy and rudimentary orthopedic problems (ie arthritis) is a big bust. We still cannot grow hyaline (regular) joint cartilage. We can make "hyaline like", but it ain't the same and we can't do it reproducibly and injuries still tend to create mechanical problems that are not as simple to fix as one would hope.

also the Dr that i watched said that the amount of othropedic surgeons are slowly decreasing due to the fact that the schooling takes so much longer.

No. The reason is that the population is growing and the number of trainees is static to slightly decreasing b/c they are controlling the number of "slots" in training programs. They want there to be a demand. When I began my residency, noone was able to stay local. Too impacted. Now it's routine to stay around.

are you guys a teaching hospital?

yes, but not across the board. For instance there are no orthopedic residents. There are surgery, medicine, peds, and ob residents. Some other fields as well. I was an assistant professor at USC for a couple of years and taught residents there, but really I'm not that intersted in academics. My hospital right now is kinda unique. It is the largest private hospital in Los Angeles. It is a partial teaching hospital. It is a level one trauma center. It also happens to be in Beverly Hills, so there's A LOT of money floating around. It was a unique opportunity really b/c we really do take the big trauma's and do a lot of tertiary referral work, but there's also a shall we say...."bling, bling" side to the place.

[OUinLA]

Nick, you play sports, you're on scholarship, you like what you do, but, you won't be able to do it forever. Do you think you will miss it? If so, have you thought about sports medicine?

I miss sports a lot. I gave them up in highschool and have always regreted it. I would love to work in sports in some way (coaching, medicine, therapy, etc). Just wanted to throw that out there for ya.

[nbd13]

hey thanks again sorry it took so long to respond busy day.

so a coupl eof more now for you,

1. So let me get this striaght the amount of orthopods are decreasing slowly because they are controling the amount of avaible slots for new residents. So for me to get into a good residency what are so things to shot for? are they particular in what Medical School you attend? or what your MCAT scores are? i would assume you need to get good grades? another pointers that you recomend?

2. have you seen in an increase in the number of hip fractures?

3. where do you think the general trend of othropedic surgrey is leaning towards? i mean i know you think its leaning towards the relm of specialzation, but other than that do you seen any long term trends?

4. do you think insurance companies are still going to pay for these surgreys?

thanks again Chuck!

Madison- i have thought about that, btu after seeing this surgrey, i am VERY intrested in this feild! plus i think i woudl be well suited for this feild due to the fact that i love how the body works and all the so to speak "ins and outs" of it. plus i think that this feild requires you to be in pretty good shape, which is a plus! i think this may be the feild for me!

i hope to watch many more surgreys this summer to get a better understanding for the feild. also i really want to see a bad fracture. and a scope surgrey since i had that done on my shoulder, i would really like to know what its like.

thanks once again!

Nick