• Doctors Behind the Scenes

    Doctors Behind the Scenes

    • There are many doctors who you many never see or remember seeing during your hospitalization who play a crucial role in your care
    • Intensivists – A relatively new specialist who directs the care of patients in intensive care units
    • Emergency Room Physicians – Direct the complex and sophisticated care delivered in the emergency room
    • Radiologist – Physician responsible for interpretation of your x-rays, scans, MRIs, etc
    • Anatomic Pathologist – Interpretation of the numerous tissue biopsies, cytologies, etc are their responsibility
    • Clinical Pathologist – It is not just tissue that needs interpretation but blood tests, urinalysis, spinal fluid, etc. The clinical pathologist is the physician that runs the labs where those tests are performed
    • Physiatrist – The physical therapist who helped you get back on your feet works under their supervision
    • Consultants – A physician from any of the many specialties that your physician, intensivist, or emergency room physician may have called to help them with your care.

    Usually, a person will go to the hospital, get treated, and return home to find they have various and often unexpected bills from the hospital. Some of these bills are from doctors who you may not have realized participated in your care. They may have looked at your x-rays (radiologist), checked a blood or tissue sample for a diagnosis during surgery (surgical pathologist), or even ran your care when you were “out of it” in the ICU (intensivist). You may receive multiple bills for what seems like a single procedure: a radiologist may send a bill for their interpretation of the x-ray (professional component), while the hospital will send a bill for taking the x-ray in the first place (facility component).

    Who are these mystery doctors working behind the scenes?

    Physiatrists Although their name is often confused with psychiatrists, physiatrists deal more explicitly with the functioning of the body rather than the mind. They are specialists in physical rehabilitation after surgery, trauma or illness. These doctors oversee postoperative mobilization plans in addition to supervising physical and occupational therapists.
    ER Attendings The emergency medicine has developed into its own specialty area. ER attendings are probably the closest equivalent to the general practitioner from the early days of medicine. They are trained in a little bit of everything, and see a dizzying variety of conditions and illnesses: they deal with heart attacks, severe asthma attacks, strokes, gun shot wounds and delivering babies. They are also usually the ones to first see trauma patients arriving by ambulance. Although the ER can be an exciting place to work, it doesn’t usually allow much time to get to know or be known by patients.
    Intensivists Itensivists oversee the intensive care unit or ICU. These physicians make split-second, frequently life-or-death decisions, and consult with your doctor (if time allows) to make sure that you receive the appropriate medical care as quickly as possible Chances are that if you are in an intensive care unit, you may never see or even know who this person is.
    Radiologists These doctors read your X-rays, CAT scans, PET scans, MRI’s, and other tests that use radiation and other technologies to form images of your internal tissues and organs. They rarely interact with patients, but make decisions that profoundly affect your care. Your attending will base a significant part of your treatment plan on the radiologist’s findings. Increasingly, radiologists are making direct recommendations for the treatment plan. These are called “interventional radiologists,” and may, for example, perform angioplasty for blocked blood vessels. Interventional radiologists may also perform biopsies of tumors or drain abnormal fluid collections. Hospitals and insurance companies see these doctors as great assets because allowing them to perform these minimally invasive procedures, rather than another specialist or surgeon, saves time and money.
    Pathologists All the skin, blood, bone, and other tissue and fluid samples that are taken during testing make their way to a pathologist. These samples are studied in order to make a determination about what brought you to the hospital. Pathologists fall into two general categories: surgical and clinical. Surgical pathologists will perform invasive procedures to collect certain sample types—organs, tumors or whatever else is deemed necessary to make a proper diagnosis. Clinical pathologists run the labs and do testing on blood, urine and other bodily fluids. Clinical pathologists’ fees are included in the laboratory part of the bill, so shouldn’t receive a separate charge.


    Even though most patients would not be able to recognize who they are and what they do, all of these doctors play an essential role in the proper care of hospital patients. They may be behind the scenes, but the play could not go on without them!

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