U.S health care ch.4

health professional

are among the most well-educated and diverse of all labor groups. They work in variety of settings such as schools, insurance industries, athletic training, army, prisons, research labs

physicians

-must be licensed and requirements include: done slightly different depending on states which usually include some type of educational experiences and passing an exam
-Doctor of Medicine (MD) or Doctor of Osteopathic medicine need to complete licensing exam by the national board and completion of supervised internship/residency program

Doctor of Medicine (MD)

-use traditional methods of treatment.
-trained in allopathic medicine
-most are specialist

Doctor of Osteopathic medicine

-use traditional methods of treatment
-emphasize holistic approach (a belief in treating the "whole patient" (mind-body-spirit)
-most are generalist

generalist

primary care physicians (PCPs) or __________ are trained in family medicine/general practice, internal medicine, general pediatrics
-they provide preventive services and treat frequently occurring problems (annual physicals, immunizations)

specialists

seek certification in an area of medical specialization
-requires additional residency training and specialty board exams
-follows after primary care
-requires referral from a primary care physician
-this type of care is episodic meaning only going to see this type of care when needed
-focuses on particular organ system or disease and involves training in hospitals

primary care

focuses on whole person where as specialty care focuses on a particular organ system or disease
-trained in ambulatory care settings such as doctors offices, outpatient settings (patients come and go, not staying over night)
-this type of care is longitudinal meaning long term relationship with care giver, see them a couple times a year

physician work settings

-practice in a variety of settings, most physician contacts occur in office based settings
-more physicians are working as partners or salaried employees in group practices or clinics

aggregate physician oversupply

-currently a surplus of physicians; growth has been mostly for specialists
-shortage of specialists in certain parts of country
-geographic maldistribution; physicians are more likely to concentrate in metropolitan and suburban areas because more patients equals more money in these areas, better technology, rural areas are more likely to have people living there that are poor without insurance, specialist/physicians don't prefer to live in rural areas

specialty maldistribution

-slowed growth in primary care compared to rapid growth in specialty care has led to an imbalance
-42% of physicians are generalists and 58% are specialist
-reasons are because specialists are primarily using this new technology, higher incomes and prestige, and more predictable hours

consequences of specialty maldistribution

-more expensive and invasive medical procedures raise health care costs
-primary care seeks early intervention, so may lead to better health outcomes
-underserved populations suffer most from shortages of primary care physicians

dentists

-diagnose and treat problems related to teeth, gums, and tissues of the mouth
-requires license and doctor of dental surgery (DDS) or doctor of dental medicine (DMD) degree
-can include specialties such as orthodontics, oral surgery, endodontics, etc.
-most practice in private offices, alone or in groups
-increased demand for dental care due to: emergence of dental insurance, population with high dental needs, greater public awareness of dental care, and appeal of cosmetic dentistry

pharmacists

-dispense medicines and provide consultation on use of medicines
-requires a license, a doctor of pharmacy (PharmD) degree, and practical experience
-most work in community pharmacies
-can specialize in areas such as nutrition or nuclear pharmacy

other doctoral-level professionals

1)optometrists (doctor of optometry: OD)-vision care
2)psychologists (doctor of 3)philosophy:PHD)-mental health care
podiatrists (doctor of podiatric medicine: 4)DPM)- deal with conditions of the feet
chiropractors (doctor of chiropractic medicine: DC)- focus on muscular therapy and spine

nurses

-largest group of health care professional
-address patients physical, mental, and emotional needs
-all states requires nurses to be licensed to practice
-nurses work in a variety of settings

registered nurses (RN)

-need associated degree in nursing (ADN)
-Bachelor of science in nursing (BSN)
-they do assessments of patience and consulting with doctors

Licensed practical nurses (LPN)

-to be certified you need state approved program and examination
-they give medication to patience

advanced-practice nurses (APN)

four types of specialization:
1) clinical nurse specialists (CNS)
2) certified registered nurse anesthetists (CRNA)
3) nurse practitioners (NP)
4) certified nurse midwives
-all require education and clinical experience beyond an RN
-have additional duties

Non-physician practitioners (NPP)

-clinical professionals who practice medicine in many areas but do no have an MD or DO (such as NPs, CNMs, Physician assistants)
-receive less training than physicians but more than RNs
-work in close consultation with physicians
-do not engage in the entire range of primary care or deal with complex cases

Physician assistance (PA)

-assist physicians in the provision of care and perform medical procedures under supervision of physicians
-work in primary or specialty care

Nurse practitioner (NP)

-RNs with an expanded role including patient education and prescribing
-primarily work in primary care

value of non-physician practitioners (NPP)

-studies confirm that NPPs provide high quality and cost effective medical care
-greater personal interst in patients, cost less, better communication
-face barriers such as legal restrictions on practice, reimbursement may be indirect, relationship with physicians

allied health professionals

-growth in technology and specialized interventions created the need to train other professional who could serve as a complement to doctors and nurses
-receive training and perform the deliver of health or related services (wide range of qualifications, certificate programs to postgraduate degrees

technicians and assistants (allied health professionals)

-receive less than two years post-secondary education
-under the supervision of technologists/therapists
-examples: physical therapy assistant

technologists and therapists

-more advanced training to evaluate, diagnose, and treat
-teach skills to technicians
-examples: actual physical therapist, occupational therapist, athletic trainers

health services administrators

employed at top, middle, and entry levels of various organizations that deliver health services
-responsible for the operational, clinical, and financial outcomes of the entire organization
-requires bachlors or masters degree from various programs such as:
1) Master of health services administration (MHSA)
2) Master of business health administration (MBA)
3) Master of public health (MPH)
4) master of health administration (MHA)