Who are the Dumbest Doctors?

We've all heard jokes involving members of several different occupations. They start out something like "An engineer, a mathematician, and a lawyer are riding on a plane..." And the joke ends with one of them being the butt of the joke. These jokes are based on stereotypes of different professions. Well, doctors have this type of joke too, based on different medical subspecialties. Here is an example:

(This example is for illustrative purposes only. It is NOT meant to be disparaging to surgeons. Well, maybe a little ;-)

A surgeon gets on an elevator. An internist sees the open elevator door and comes running down the hall shouting, "Hold the elevator!" The surgeon doesn't want to wait, so he starts mashing on the CLOSE DOOR button. The internist gets there just as the door is almost closed, and sticks his hand in to stop the door.

As he gets in, the surgeon gives him a dirty looks and says, "If you were a surgeon, you would never have stuck your hand into a closing door like that!" To which the internist replies, "You're right. I would have stuck in my head!"

Anyway, the point of all this is to examine the question of which medical subspecialty is the dumbest. Dumb is, of course, relative. Pretty much all doctors have to get through four years of college with a pretty high grade point average, do well on the Medical College Admission Test, and survive medical school. But like any form of education, 50% of the students are in the bottom half of the class, and there is one poor schmoe who graduates at the very bottom. Where do these guys end up?

Well, we doctors have our own stereotypical opinions. Being a Radiologist, I obviously believe that Radiology gets the upper crust. This opinion is not simply an effect of my being a Radiologist. I chose this field because I had a high opinion of it.

So which specialties are looked down upon by other doctors? Let us look at some more doctor jokes:

The Surgeon: Knows nothing, does everything.
The Internist: Knows everything, does nothing.
The Psychiatrist: Knows nothing, does nothing.
The Pathologist: Knows everything, does everything, but a day too late.

Q: How do they pick the Gynecologists and Orthopedic Surgeons?
A: Take the bottom 10% of the medical school class and pith them (i.e., stick an ice pick into their brains and scramble them). The ones that can still walk become the Orthopedic Surgeons, and the rest become Gynecologists.

Orthopedic Surgeons: Strong as an ox, and almost as smart.

Gynecologists only know how to do three operations:
1. Hysterectomy.
2. Ligation of the left ureter.
3. Ligation of the right ureter.
(Putting a metal clip across a ureter, i.e. ligating it, is an occasional mistake made during hysterectomy.)

Q: How do you hide something from a Surgeon?
A: Put it in a book.

Q: How do you hide money from a Cardiologist?
A: You can't.

Alright, enough. I'm starting to digress. Orthopedic Surgeons take a lot of flack because their work requires more physical strength than that of other doctors, and physical strength is perceived to be associated with less intelligence (i.e. football players are dumb jocks). Also, procedures like joint replacement and fixing fractures with screws and metal plates are sort of like what a car mechanic or handyman might do. True, if they do a lot of the same procedure it gets to be pretty routine and mindless, but the same is true of urologists who do a lot of "Roto-Rooter" work on prostates, or Radiologists who read a lot of mammograms.

I have my own opinion of who the dumbest doctors are. Oncologists (doctors who treat cancer). Yes, their work is extremely important. My mother's life was saved 35 years ago by oncologists, and she is still alive and kicking today. And if you are a cancer survivor, and love your oncologist dearly, please do not take offense. But what they do just doesn't take a lot of brains.

A lot of cancer research involves testing of treatment protocols. These involve criteria for when to operate, when to radiate, and schedules for treating with chemotherapy. The result of this research is a series of well defined and accepted protocols for treating various types and stages of tumors. In other words, it's all cookbook. The oncologist uses information about each patient to decide which protocol to use. They gather very little of this information themselves. The surgeon examines the tumor while it is in the patient, and reports where it is invading, and other things which can be determined by direct observation. The pathologist provides a specific diagnosis as to the type of tumor, biochemical information, information on microscopic invasion, and anything else which can be determined by microscopic examination. The radiologist provides pre-operative and follow up information on the location of the tumor, the presence of spread into lymph nodes, and evidence for recurrence. The oncologist merely collects all this information (plus a little more information from talking to the patient and performing a physical exam), and plugs it into an algorithm to determine treatment.

Occasionally a patient will not fall clearly into a treatment protocol. For example, he may have been partially or inappropriately treated elsewhere. Or he may have two different tumors. In these situations, the patient is discussed at a "tumor board", in which a large group of oncologists, surgeons, radiation therapists, and radiologists meet to discuss the situation and come up with a treatment. Generally, if a patient does not clearly fit into a protocol, there is a long unproductive discussion, and they end up just winging it.

There. Now I finally have produced a significant contribution to the field of medicine. A case for oncologists being the dumbest medical specialty. Remember, you heard it here first. Stay healthy.