A physician is a man or woman who is licensed to practice medicine. They are also called medical doctors. Ear, nose, and throat specialists have years of extra training and experience to make them experts in treating problems with these parts of the body. They are called ENT specialists, or otolaryngologists.     

Personal Skills
To be a great physician a doctor needs to have many personal skills. They need to be intelligent, very understanding, on-task, kind to their patients, a fast note-taker, and have good dexterity. Also they must pay close attention to their patient. Most of all they need to enjoy their patient with his or her needs. Caring is the key. The doctor needs to care for their patient and the rest will follow.                 

The Job
Usually doctors work in clinics, offices, or hospitals. The good aspect of being an ENT physician is being able to treat the patient and make them well again, either with surgery or other treatments. The bad aspect of the job is seeing patients with problems that doctors can’t help. Luckily, most of the time doctors can help. Most physicians work 12 hours a day in a clinic or office. When they work in hospitals, they sometimes have to work 24-hour shifts. The doctor’s responsibilities are to make sure every one of their patients gets treated.  

History
This specialty goes back to about the 1950’s or 1960’s. Dr. William Oster, Dr. Blair, and Dr. Kennedy all created new techniques and invented new tools for other physicians to use. Back then, physicians didn’t have as many good antibiotics for patients. Years later, researchers finally invented better antibiotics for sick people. Also doctors started treating patients earlier, instead of waiting until the patient got even sicker. One thing that doctors didn’t have was the Cochlear Implant. Doctors now use it for restoring hearing. Children who are born deaf can have their hearing restored so they can hear again. Also adults who are getting old and are starting to lose hearing can get a Cochlear Implant, so they can hear again.  

Schooling
All students who want to become an ENT specialist need to start by graduating from high school with high grades. Pre-medical students need to go to an undergraduate college for about 4 to 5 years. They also need to earn a Bachelor’s degree or even better, a Master’s degree. Once they finish college with high grades, they need to take a test called an MCAT, (Medical College Aptitude Test). They need to have a very high score to be able to go into medical school. The students are in medical school for 2 to 4 years. Depending on what specialty they want to go into, determines how many years the students will be in medical school. They need to have an experienced doctor interview them to see if they know a lot about medicine. After medical school, the students go into residency. Residency is much different than medical school. They can be in residency for 2 to 6 years depending on what specialty they want to go into. The students work in hospitals with other doctors and help them treat their patients. Also in residency the students must take more tests to see if they have the knowledge to become a great ENT. If they do, the state gives them a license so they can legally practice medicine as a doctor.  

Tonsils and Adenoids
Tonsils are the two big masses of tissue on the sides in back of the throat, and visible to the naked eye. Adenoids are two smaller masses high in the throat behind the nose. A doctor would need a scope to see the adenoids because they are so high up in the throat. If tonsils or adenoids get infected, they may trigger an airway obstruction or repeated bacterial infections. Usually if this happens, children or adults get their tonsils or adenoids taken out. The most common reason why the tonsils and adenoids are removed is because of infections or becoming too large. Abscesses around the tonsils, tonsillitis, and infections of small pockets within tonsils are all reasons that the tonsils and adenoids are affected. Usually the infected tonsils produce a foul-smelling cheese-like formation. Those can make the tonsils sore and swollen.

Diseases
Otitis Media is inflammation of the middle ear. It is often referred to as a middle ear infection. Babies, kids, and even adults can get it. It can occur in one or both ears. Usually children get it more often than adults. It most often occurs in winter or early spring. Otitis Media is very serious, because the earaches are very severe and a child could develop hearing loss from it. If a child loses his or her hearing, it may affect learning and delay speech development. If hearing loss is treated effectively, the child’s hearing could resort to normal. Otitis Media is also serious because the infection can spread to nearby structures in the head. It is very important to recognize the symptoms of Otitis Media. Parents should get immediate attention from their physician.

Tools         
The tools that most ENT physicians use is a stethoscope, so doctors can hear a patient’s breathing; an otoscope, so doctors can see inside the child’s ear; and an ophthalmoscope, to see into a patient’s eyes. A machine that helps diagnose problems is called an M.R.I. It takes special x-ray pictures of the brain and other parts of the body. When a doctor wants to test a patient, he or she will usually take a small amount of blood. Then, the doctor will send the blood to a laboratory for tests. Lots of times the test can tell what is wrong with their patient.  After the doctor figures out what is wrong, they can prescribe medicines that will help.   

Health Care Facilities 
In the United States, there are about 200,000 medical professionals. In the 20th century, doctors practiced alone in an office. Now, almost all physicians practice in groups, usually in clinics. The physicians who work together may include a primary care physician, specialists, labs, and equipment for diagnosing diseases. The United States has about 6,100 hospitals with more than 1,000,000 beds. To save money, hospitals have more “out patient” services. Also the doctors are letting patients go home the same day they come in. The time the patient is in the hospital includes lab tests, computerized imaging, x-rays, diagnostic tests, and treatments.

Who I Interviewed And What I Learned I interviewed Dr. Chris Yang on January 9th, 2006 in his office. Dr. Yang, an ENT physician, was a great choice because he loves children and is involved with treating patients who have problems with the ear, nose, or throat. Introduction Chris has been a physician for six years, which includes residency. He was in residency for 5 years for his specialty. He said, “When you attend Medical School it could be for as many as 8 or even 10, years and can be as little as 3 years, depending on what specialty you go into.” His work combines treating in clinics, and treating patients with medicines he prescribes.  ENT is a complex specialty. Training and Schooling Dr. Yang wanted to do something surgical. When he went into Medical School he had the choice to decide on what specialty he wanted to go into. You decide what specialty you want to go into depending on your strengths and weaknesses. He had the strengths to be an ENT. When he headed towards college, he had it in his mind that he wanted to be an ENT physician. He was in college for 5 years. The students in college must take a test called an MCAT to get into medical school. Going into residency is based on how the students’ interview was, and their test scores.   Characteristics To be a good Physician, you must care for people, and study about what is best for your patient. “Care first and the rest will follow,” he said.     History ENT was originally a branch of surgery, traditionally with the ears. Ear infections were very common back then. They were complicated ear infections because antibiotics weren’t common. About 20 years later, newer antibiotics became more common. Doctors also started treating patients earlier. William Oster, Dr. Blair, and Dr. Kennedy, created new techniques for other doctors to use. They also designed new tools for other doctors to use.         Today ENT has become a diverse specialty, because of new technology; ENT doctors are able to treat diseases a lot better. Physicians have come up with a Cochlear Implant to restore hearing. Back then they didn’t have Cochlear Implants for treating children who are born deaf, or older adults who lose their hearing. Finding new medicines, and paying insurance bills are only a few things that doctors have problems with today. Future In the future, there will probably be more effective, less invasive, and quicker surgery. Doctors will also have better tools to use in the future. Surgery The medication that makes patients drowsy before surgery is called Versed. (Also known as Midazolam). It’s used while patients are awake and waiting to have surgery. It helps relieve anxiety. It comes in a liquid and it is commonly used for treating kids who are going into the operating room so that they are more relaxed.    Tonsillectomy and Adenoidectomy takes 5 to 15 minutes. Usually it depends on how difficult it may be. The actual time patients are in the operating room is longer because it takes several minutes for the anesthesiologists to put patients to sleep. It also takes time for patients to awaken.    Some common surgeries are:      •    Septoplasty (straightening out septum of nose to help breathing): 45 to 90 minuets •    Myringotomy with ear tube placement  (ear tubes): 5 minutes •    Sinus Surgery: between 1 to 3 hours depends on difficulty Once the anesthesiologists begin giving intravenous and gas anesthetics, a patient will fall asleep within seconds.        For children to have a good recovery the doctors wait until a child is about age 4 before tonsillectomies unless they are having SEVERE difficulty breathing due to enlarged tonsils. Otherwise, there is no reason for someone to have his or her tonsils taken out. Really, it depends on when the patient starts having difficulty with the tonsils. Most people don’t have their tonsils taken out. Only 10% of children and adults to get their tonsils taken out.                To take the tonsils out, most doctors use Coblation. It is a surgical wand that uses radio waves to turn salt solution into a stream of ions. These ions don’t get hot, but can cut through tissue. These energized ions create a focused “Plasma field” at the end of the wand that doctors use to do surgery.          There are many advantages of this surgery compared to the older ways of taking out tonsils. One is the controlling bleeding. There is much less injury to the normal surrounding tissues that are left behind. This leads to less pain and faster healing.       I would like to thank Dr. Yang for taking time from his busy schedule to let me interview him.  I enjoyed myself and learned a lot!

Bibliography American Academy of Otolaryngology.  Doctor, Please Explain Tonsils and Adenoids Alexandria, VA: Head and Neck CO., 2004    American Academy of Otolaryngology. Doctor Please Explain Is My Childs Hearing Normal American Academy of Otolaryngology. Doctor Please Explain Sore Throats Alexandria, VA: Head and Neck Surgery Co., 2 005.   Cosgrove, Holli. (Editor) “Ear, Nose, and Throat Specialists” Encyclopedia of Careers and Vocational Guidance.  2000. Schomp, Virginia. If You Were A Doctor New York: Marshall Cavendish., 2001       Yang, Chris. Personal Interview. January 9, 2006

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