According to The National Heart, Blood, and Lung Institute's COPD - Learn More Breathe Better program, there are over 12 million Americans that have been diagnosed with COPD - or Chronic Obstructive Pulmonary Disease. However, it's estimated that the same amount of people live with it daily, but have yet to be discovered. It's the job of Pulmonologists to monitor these patients and all others with respiratory conditions. And the path towards learning how to become a Pulmonologist begins and ends with dedication.
Delicate and complex, when the lungs become compromised, a host of symptoms may follow that include difficulty breathing, excessive coughing, and chest pains. When ignored, the overall health and life of an individual can take a turn for the worst, resulting in detrimental yet avoidable consequences. Pulmonologists are specially trained to address the diseases and conditions that affect the chest and lungs, which include pneumonia, tuberculosis, emphysema, and serious infections of the chest.
What is a Pulmonologist?
A pulmonologist (sometimes referred to as a pulmonary disease specialist) is a physician who specializes in the diagnosis and treatment of conditions and diseases associated with the lungs. Pulmonology is a subspecialty of internal medicine, which also involves the evaluation of the bronchial tubes and the upper respiratory tract, including the nose, pharynx and throat.
Pulmonologists are primarily trained to:
While not all acute respiratory conditions or chronic respiratory diseases require the expertise of a pulmonologist, patients who seek the assistance of this type of specialist often suffer from one or more of the following medical conditions: chronic asthma, COPD (Chronic Obstructive Pulmonary Disease), bronchitis, cystic fibrosis, hemoptysis, obstructive sleep apnea, pleural effusion, sarcoidosis, tuberculosis, and lung cancer.
Pulmonologists who treat patients with asthma are in a position to prevent a great number of unnecessary deaths. According to the American Academy of Allergy, Asthma & Immunology, an estimated 250,000 people die prematurely from asthma each year; and nearly all of these deaths were avoidable.
When seeing a new patient, a pulmonologist typically identifies physical symptoms by conducting a physical examination. They may use a stethoscope to listen to the lungs; analyze the airways using a bronchoscope; or measure lung capacity with a spirometer. The doctor may then decide to order blood tests or perform a diagnostic imaging scan to pinpoint a patient's medical condition, which helps to narrow down the best treatment approaches.
A pulmonologist may focus his or her care on adults, or solely concentrate on treating children, which requires an additional three years of postgraduate fellowship training in Pediatric Pulmonology.
According to pediatric pulmonologist Jason Fullmer, MD, FAAP, FCCP, pulmonologists who treat children will often assist neonatologists in the care of infants with respiratory issues who are in the intensive care unit, which ranges from diagnosing rare lung diseases to assisting with oxygen therapy for infants.
"We help the treating neonatologist know when a child is ready for discharge and can help with home equipment needs (for example, home oxygen)," said Fullmer in a profile posted on HandtoHold.org. "We also play a big role in educating families about disease processes and goals of care."
A doctorate degree is the entry-level educational requirement for pulmonologists.
Step by Step Educational Path of a Pulmonologist
Pulmonologists find employment in a variety of work settings, including hospitals, emergency care centers, specialty care clinics, critical care facilities, pediatric care centers, outpatient clinics, the military, and government agencies, such as the Department of Veterans Affairs. Some go on to start a private practice, or join an office-based group of physicians.
In academic circles, pulmonologists are hired to conduct clinical and basic research of the respiratory system. Those with an interest in scientific research may pursue a job that studies the causes and possible treatment options for diseases such as lung cancer and pulmonary tuberculosis. Colleges and universities also hire pulmonologists to teach.
Employers hiring pulmonologists typically seek the following qualities in a job candidate:
In addition to meeting the educational and training requirements of a potential employer, pulmonologists may consider the following suggestions on how to increase the chances of being accepted into a salaried position:
There are also plenty of associations dedicated to various pulmonology specialties and professionals, such as the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD); American Association for Bronchology and Interventional Pulmonology (AABIP); and the National Association for Medical Direction of Respiratory Care (NAMDRC).
According to Medscape's Pulmonologist Compensation Report (2014), a pulmonologist earns an average yearly income of $258,000, which falls slightly below the middle amongst all other physicians' salary earnings.
A work environment or the type of employer dictates the average salary earned by a pulmonologist. Medscape also reported that those who worked in office-based single-specialty and multispecialty groups represented the highest earners (between $281,000 and $289,000). Pulmonologists employed within an academic or government setting made the least amount of money with a median salary of $185,000.
Location additionally plays a role in how much income a practicing pulmonologist makes. The highest earners typically live in the North and South Central regions of the United States (earning $295,000 and $281,000, respectively), whereas pulmonary doctors in the Northwest are generally paid the lowest salaries ($218,000) [3].
The job outlook for pulmonologists shows promise. According to the U.S. Bureau of Labor Statistics (BLS), the number of jobs for physicians is expected to grow by 18 percent from 2012 to 2022, which is faster than the average for all other occupations. Increasing worldwide pollution and constant changes in the environment means that humans are left susceptible to a variety of diseases associated with allergens, toxins, and infections of the lungs, which places pulmonologists in high demand.
Additionally, the American Thoracic Society (ATS) states that respiratory disorders are the leading cause of hospital admission in children, which means an increased number of physicians is needed to address pediatric pulmonary care needs. The ATS also reports a critical shortage in pediatric pulmonologists, citing an abundance of employment options awaiting physicians in both the academic medicine and private practice sectors.
Starting a Private Practice
While working as an employee has its own set of benefits and level of job security, pulmonologists who establish a private practice typically do so to enjoy the freedom of owning their own business. Those who start their own pulmonology business have a chance to create a more flexible work schedule; have better control over the way they treat patients; and often significantly increase their earning potential.
According to Medscape, self-employed pulmonologists also earned more ($289,000) in 2013 than those who were employed ($233,000) by a facility (like a hospital) with differences seen in the type of practice setting a doctor pursued.
In order to become a medical entrepreneur, there are a few important points to note:
Start-up costs: Fleshing out a budget plan and financial strategy for starting a private pulmonology practice is one of the first things a physician needs to do. Self-employed pulmonologists are responsible for renting office space, purchasing tangible goods (such as medical equipment and office furnishings), securing business permits, obtaining insurance and hiring staff, when needed. Financing options include tapping into a nest egg, applying for a loan (from local and/or commercial banks), and borrowing from a lending company.
Location: A private clinic has a better chance of thriving if it is located in an area that provides easy accessibility, low competition, and a thriving population of potential patients.
Paperwork: Although the amount of paperwork is less for self-employed pulmonologists (when compared to those who work for an employer), 35% of pulmonary doctors in private practice still spend at least 10 hours per week on paperwork and administrative tasks [4]. While this task is essentially paid for when a doctor is in a salaried position, self-employed doctors are not. It is also the responsibility of a doctor in private practice to organize and keep well-ordered files on patients, as well as deal with insurance companies and other entities to make sure they are paid.
Advertisement: To spread the word about a new private practice, marketing and promotional efforts may include newspaper ads, a listing in the Yellow Pages, a website presence, social media accounts, and passing along business cards.
However, one of the best ways to expand the client roster of a private practice is word-of-mouth advertising, as in benefiting from recommendations that come from satisfied patients who sing the praises of a physician who consistently delivers excellent care, consideration, and advice.
Also, a pulmonologist who networks with other physicians and the public by attending conferences, workshops, job fairs, asthma support groups, and other speaking engagements, has a better chance of increasing the number of business referrals they receive.
At some point, pulmonologists with aspirations of expanding their business must work on building their team, which may include hiring a receptionist, medical assistant, office manager, and more assistants and doctors as the private practice grows.
It is also not uncommon for pulmonologists to merge private practices and work as a group to provide a wider scope of services and expertise to their patients. For example, Pulmonary & Sleep Medicine Associates, which is the oldest and largest pulmonary practice in South Metro Atlanta, represents the merging of two private practices that now provide a full range of pulmonary, critical care and sleep medicine services to the region,
Becoming a pulmonologist means entering a fulfilling career field that helps people live and breathe a little easier (literally). Opportunities to find employment are abundant, and are expected to continue to grow in the coming decade, especially in regards to the pediatric subspecialty. Upon completing a rigorous educational path to gain the necessary skills and experience to effectively diagnose and treat patients with pulmonary issues, both self-employed and salaried physicians earn over a six-figure median salary with varying benefits.
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