BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Classic: Acute care is a branch of secondary health care where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery. In medical terms, care for acute health conditions is the opposite from chronic care, or longer term care.
Modern: Acute care is active, short-term treatment for a severe injury or episode related to illness, an urgent medical condition or recovery from surgery.
Posted on September 8, 2025 by Dr. David Edward Marcinko MBA MEd CMP™
Primary – Secondary – Tertiary Care
By A.I. and Staff Reporters
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In medicine, there are four levels of care: primary, secondary, tertiary, and quaternary. The levels of care refer to the complexity of the medical cases that doctors and healthcare providers treat and the skills and specialties of the providers.
Primary care involves consulting with a primary care provider. Secondary care refers to seeing a specialist such as a dermatologist, neurologist or oncologist. Tertiary care is specialized care in a hospital setting such as brain surgery, renal dialysis or heart surgery.
Quaternary care is thus an advanced level of specialized care.
Classic: Sometimes used as an extension of tertiary medical and surgical care in reference to advanced levels of medicine which are highly specialized and not widely accessed by most patients.
Modern: A higher level of specialized care within a hospital. Experimental medicine and some types of uncommon diagnostic or surgical procedures are also considered quaternary care.
According to the Wonca International Dictionary for General/Family Practice -Quaternary Prevention [QP] – is defined as: ‘Action taken to identify patient at risk of over medicalization, to protect him/her from new medical invasion, and to suggest to him interventions, which are ethically acceptable’.
Examples: Types of quaternary care include: experimental medicine, procedures and uncommon and specialized surgeries. This includes sub-specialty services such as advanced trauma care and organ [heart, lung, liver, kidney, etc] transplantation.
When you visit health clinic or hospital for a medical appointment, you’ll be seen by a doctor, healthcare provider and/or medical prescriber. But what do these words really mean?
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Doctors / Physicians
Doctor of Medicine (MD), Doctor of Podiatric Medicine (DPM), Doctor of Osteopathy (DO, or Doctor of Dental Surgery (DDS/DMD). Doctors, also known as physicians, have extensive prescription privileges across various specialties. They can diagnose medical conditions, prescribe medication, and oversee the overall management of patient care. Doctors include general practitioners, specialists such as cardiologists or dermatologists, and surgeons. Their prescription authority encompasses a wide range of medications to address acute and chronic health conditions, ranging from antibiotics to specialized treatments for complex diseases.
A medical provider is a general term that encompasses a wide range of education levels, skill-sets, and specializations. A provider could be a Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Doctor of Medicine (MD), Doctor of Podiatric Medicine (DPM), Dentist (DDSDMD) or Doctor of Osteopathy (DO).
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Medical Drug Prescribers
Generally, psychologists and therapists do not have prescription privileges. They focus on psychotherapy and counseling rather than medication management. However, some jurisdictions may grant limited prescription rights to psychologists who undergo additional training and certification. Like psychologists, therapists typically do not have prescription privileges. They focus on providing counseling and psychotherapy to address mental health issues and emotional concerns.
Psychiatrists are medical doctors (MD/DO) who specialize in the diagnosis and treatment of mental health disorders. They have full prescription privileges and can prescribe a wide range of medications to manage psychiatric conditions.
In most cases, physical therapistsdo not have the authority to prescribe medication. They primarily focus on rehabilitation and physical interventions to improve mobility and function.
Nurse practitioners are advanced practice nurses with the authority to diagnose, treat, and prescribe medication independently in many states and countries. They undergo extensive education and training, which allows them to provide a wide range of healthcare services, including medication management.
Similar to nurse practitioners, psychiatric nurse practitioners have the authority to prescribe medication for mental health conditions. They specialize in psychiatric and mental health care, offering comprehensive treatment that may include medication management.
Chiropractors primarily focus on diagnosing and treating musculoskeletal disorders through manual adjustments and therapies. They do not have surgical or prescription privileges in most jurisdictions.
Optometrists are trained to diagnose and treat vision problems, including prescribing corrective lenses and medications for certain eye conditions such as infections or inflammation.
Registered nursestypically do not have prescription privileges. They work under the direction of physicians and nurse practitioners, assisting with patient care but not prescribing medication themselves.
Dentists have limited prescription privileges related to dental care, such as antibiotics or pain medications for dental procedures. However, they do not have the authority to prescribe general medications outside of their scope of practice.
Nutritionists typically do not have prescription privileges. They specialize in providing dietary advice and counseling to promote health and well-being through nutrition but do not prescribe medication.
Depending on their scope of practice and legal regulations in their jurisdiction, nurse midwives may have limited prescription privileges for certain medications related to prenatal care, childbirth, and postpartum care.
Posted on April 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A 2020 analysis of Doximity’s physician compensation data found that men physicians make an estimated $2 million more than women over the course of their careers.
Men physicians outearned women physicians by at least 10% across all specialties, except pediatric cardiology (9.2%) and nuclear medicine (3%).
Specialties with the largest gender pay gaps were: oral and maxillofacial surgery ($568,789 vs. $395,687), pediatric pulmonology ($282,272 vs. $227,958), allergy and immunology ($329,634 vs. $268,938), urology ($515,850 vs. $424,733), and ophthalmology ($468,515 vs. $387,295).
Specialities with the smallest gender pay gaps were: nuclear medicine ($394,231 vs. $382,431), pediatric cardiology ($334,384 vs. $303,622), pediatric gastroenterology ($293,771 vs. $264,135) hematology ($358,736 vs. $320,938), and medicine/pediatrics ($283,034 vs. $253,019).
Posted on February 22, 2009 by Dr. David Edward Marcinko MBA MEd CMP™
A Medical Inventor and Bio-Engineering Pioneer
By Dr. David Edward Marcinko; FACFAS, MBA, CMP™
[Publisher-in-Chief]
OK; let’s get this right out into the open. Although I did a little reconstructive bone and traumatic joint surgery in my career, I am not a cardio-vascular surgeon, nor am I a cardiologist, or even a nephrologist. But, I did treat more than my share of diabetic, alcoholic or other patients on renal dialysis and was well aware of the immense contributions of Willem Kolff to the profession. Therefore, I was saddened to learn of his recent passing at age 97. You see, Dr. Kolff not only developed the well known blood cleansing process that is now portable; he was also originator of the artificial-heart.
About Willem Johan Kolff; MD
When Willem Johan Kolff began work on the artificial kidney, few believed it possible. To draw a patient’s blood, cleanse it of toxins and return it seemed beyond the expertise of the most sophisticated medical centers. In the beginning, Dr. Kolff had no resources to draw upon. He was the sole internist in a small-town hospital, in the middle of the occupied Netherlands, during wartime. Materials were in short supply. The first 15 patients to receive the treatment failed to recover, but Dr. Kolff persevered. The dialysis treatment he pioneered and since perfected saved the lives, and limbs, of hundreds of thousands of patients, all over the world.
Dr. Kolff went on to design the heart-lung machine that made open-heart surgery possible. He pioneered artificial eyes, ears and arms, and for 25 years led the effort to develop the artificial heart. In 1982, a heart designed under his supervision was successfully implanted in Barney Clark, an event that captured the imagination of the world. All this was accomplished before such medical media stars as Dr. Robert Jarvik [Kolff’s student at the University of Utah in 1971] were lauded on TV, and then ignominiously dissed, for never having actually practiced medicine on real patients. In fact, Jarvik never pursued a medical internship, is not licensed to practice and can’t legally prescribe. Just imagine that!
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