What is an endocrinologist? An Endocrinologist is an Allopathic medicine (MD) or Osteopathy (DO) trained Physician that is a Medical specialist in the treatment, diagnosis, and care of health disorders and diseases related to hormones, the Endocrine system Gland, and Hormone imbalances. They take care of patients with Endocrine health system conditions such as:
- Thyroid disorders
- Bone diseases
- Pituitary disorders
- Lipid disorders
- Adrenal disorders
|Why See Endocrine Doctor||What Do They Treat||Common Medical Tests|
|Education and Training||Subspecialties||Covid 19 Effects|
Why would you see an Endocrinologist?
Endocrinology encompasses a wide variety of organs that secrete hormones. These include - the adrenal glands, hypothalamus, ovaries, testicles, pancreas, parathyroid glands, Thyroid gland, pineal gland, pituitary gland, pancreas, and thymus. An individual that has a health disease or health disorder in any of the aforementioned areas may require workup, treatment, and care by an endocrinologist. In order to see an endocrinologist, one must get a referral from a general practice health physician or primary care doctor. There are several symptoms that may point to a health disorder that is endocrine in origin, these include:
- Dry skin
- Brittle nails
- Weight gain
- Growth impairment
- Weight loss
What diseases and disorders does an Endocrinologist treat?
Due to the variety of organs within the endocrine system, endocrinologists treat a large variety of different health diseases and disorders. This includes aiding in the care of a cancer of the endocrine system. The top five most frequently treated health conditions by endocrinologists include:
- Thyroid disease, including hyperthyroidism and hypothyroidism health disorders
- Diabetes mellitus
Besides Thyroid hormone testing, what other tests do Endocrine system specialists perform?
Endocrinologists order a large variety of tests to help aid in the diagnosis of different health conditions and cancer. This includes more common tests such as MRI (magnetic resonance imaging), CT (computed tomography), US (ultrasound), CBC (complete blood count), kidney function tests, and liver function tests. For each endocrine organ, there are an immense number of health tests that provide insight into how the organ is functioning. For each endocrine organ these include:
- Thyroid gland: Thyroid hormone levels (t3 and t4), Thyroid antibody levels (such as TPO), radioactive iodine uptake (RAIU) scan, and doppler scan
- Pituitary gland: prolactin level, cortisol level, insulin stress test, and dexamethasone suppression test
- Adrenal gland: antidiuretic hormone test and water deprivation test
- Pancreas: Insulin level, IGF-1 (Insulin-like growth factor), HbA1C (hemoglobin A1C), other diabetes tests
- Parathyroid gland: calcium levels, parathyroid hormone levels
Education and training
The training to become an Endocrinologist is exceptionally long and challenging. First, one must complete a bachelor's degree along with the required prerequisite courses for admission to Medical school. Additionally, extracurricular involvement including leadership, volunteering, shadowing, teaching, and research is very encouraged. The medical school entrance exam, MCAT, must also be completed.
Once admitted to Medical school, students commonly spend the first two years in classroom-based learnings while the last two years are spent in hospital-based practical health rotations. While in medical, numerous national board examinations such as the Step and COMLEX exams must be completed and passed.
After completion of four years of medical school, one must begin more focused training in residency. Prior to Endocrinology specific training, a three-year internal medicine residency must be completed. Once the internal medicine health residency is complete, then the doctor can complete an Endocrinology fellowship. After fellowship is complete, the doctor must take the Endocrinology board examinations to be a fully licensed and boarded endocrinologist. Endocrinologists primarily see patients in an outpatient clinic setting although some physicians may also work in the hospital.
What are the Endocrinology health subspecialties
- Diabetes and metabolism
- Endocrine oncology
- Endocrinology nuclear medicine
- Gender reassignment
- Pediatric endocrinology
- Reproductive endocrinology
- Thyroid disease
Are there Endocrinologists that specialize only in single medical conditions such as Hyperthyroid and Hypothyroid
The majority of Endocrinology physicians treat all of the Endocrine system medical disorders and health conditions. However, in larger cities with big academic hospitals, there may be Endocrinologists that specialize in one of the many medical Endocrine system disorders, such as diabetes. This requires several different Endocrinology doctors to work in one location, so that no matter the type of endocrine disorder, patients may have access to an Endocrinologist that treats their disease. This type of practice may not be as feasible in more rural areas where Endocrinologist doctors may be more few and far between thus requiring Endocrinologists to treat all varieties of disorders.
Job outlook and salary for Endocrine system specialists
According to a study published by the Journal of Clinical Endocrinology and Metabolism, the demand for Endocrinologists exceeds the supply by over 15 percent. The aging patient population as well as doctor retirement in the future will only exacerbate the need for more Endocrinology doctors. This continued shortage indicates that the future job outlook for endocrinologists is exceptional with excellent job security.
There are many sources that give an estimate of the average salary for an Endocrinologist:
- According to the Medscape Physician Compensation Report 2020: $236,000
- According to AAMC Careers in Medicine, academic Endocrinologists may make the following:
- Assistant professor: $184,000
- Associate/Full professor: $234,000
Innovations in Endocrinology health
Some of the greatest recent news worthy innovations in the field of Endocrinology are associated with the treatment of diabetes. The first is the hybrid closed-loop Insulin delivery system to treat type 1 diabetes. This technology allows for direct communication between a glucose monitoring device and an Insulin pump. Previously, type 1 diabetics needed to use their glucose monitor to check blood sugar levels, then decide how much Insulin is necessary to inject. The new closed-loop Insulin system automates the process, making the disease much easier to manage.
Another innovation in the news of diabetes treatment is aiming to replace the dysfunctional cells that normally make Insulin. Researchers are working on creating a small implantable device that contains functional beta cells and can produce Insulin based on the body’s glucose levels. This device would reduce the maintenance required by patients to treat the disease and allow for an overall better blood glucose control preventing many of the terrible complications of the disease.
COVID impact on Endocrinology practice
Since the beginning of 2020, coronavirus has had a huge impact on jobs nationwide. Physicians and other healthcare related jobs are no exception. Overall, medical practices in the U.S. report a fifty-five percent decrease in revenue and a sixty percent decrease in average patient volume since the beginning of the coronavirus crisis. Due to this drastic decrease in revenue, medical practices and hospitals have furloughed and laid off employees including 43,000 healthcare workers in March 2020 alone. Nine percent of independent medical practices state they have at least temporarily closed their practices. As social distancing guidelines remain in effect, remote patient engagement has soared and increased by an astounding two hundred twenty five percent.
Endocrinologists see a large number of their patients in an outpatient clinic setting. With the coronavirus pandemic, Endocrinologists had to move the majority of their practice to a virtual telemedicine health setting. This comes with unique challenges such as ensuring that patients have enough medication to balance their health conditions, especially when outpatient labs may not be open to check hormone levels. Additionally, Endocrinologists need to manage the health of their hospitalized patients, including patients that have a coronavirus diagnosis. Although the coronavirus pandemic greatly affected and changed the way Endocrinologists practice, many hope and expect that their practice will return back to normal pre-coronavirus volumes shortly.
Callie Torres is a Captain in the United States Air Force and a resident at Wash U/Barnes Jewish Hospital in St Louis. She is a freelance writer with many published medical articles as well as multiple peer-reviewed medical publications