Here we will see different healthcare workers that are both primary and supportive in a team-based atmosphere.

Categories of Health Care Providers

• Are typically divided into 3 categories

  • Conventional, core, mainstream

  • Allied health professionals

  • Complimentary or alternative practitioners

• Conventional Medicine

  • Aka orthodox, mainstream, traditional, or western medicine

  • Is a blend of modalities

• Complimentary & Alternative Medicine

  • Practiced by the majority of healthcare providers that are not mainstream

  • Complementary medicine- in addition to other forms of medicine

  • Alternative medicine- typically excludes conventional medicine

  • This may change from country to country

• Chiropractic: Conventional. Complimentary, or Alternative

  • Takes a holistic approach by using non-invasive therapies

  • Not covered by the government

Regulation of Health Care Professionals

• Many are self-regulated by a board of directors

• Title protection

  • They belong to a professional body

  • Are legally entitled to their title

  • Having a regulated title means having a set bar that one has to pass to legally carry the said title

  • They all have a range of skills they can act under

• Performing Controlled Acts

  • Are identified by the Regulated Health Professions Act

  • Many healthcare professional regulations overlap

    • Ex. many healthcare professionals are allowed to give injects such as doctors, pharmacists, nurses, pharmacy technicians

• Exceptions

  • A person with appropriate training providing first aid or assistance in an emergency

  • Students learning to perform an act under the supervision of a qualified person, as long as the act is within the scope of practice of graduates of the student's professional program

  • A person, such as a caregiver, trained to perform an act (e.g.. giving injections to a person with diabetes)

  • An appropriate person designated to perform an act by a religion-for example, a rabbi may circumcise a male child

    • Exclusions also apply in the case of body piercing for jewelry, electrolysis, tattooing, and ear piercing

• Delegated Acts

  • Delegated act- which a regulated health professional transfers legal authority or permits allow another person to carry out a controlled act they are otherwise unable to do

  • The delegate- is properly trained and demonstrated competence in completing the act

  • Acts cannot be subdelegated

    • The person who was delegated cannot delegate the same task

  • Delegation may only occur if it is consensual by the patient

• Complaint Process

  • Regulated professions have a system in place whereby the public can launch complaints against the healthcare provider.

  • A designated committee investigates all complaints, protecting both the public and healthcare providers

  • Healthcare providers found to be at fault may face suspension, an order for additional training, the loss of their license to practice, or even Real proceedings (criminal investigation)

• Education Standards

  • A regulator of a profession has the authority to set educational standards for the training of its professional members

  • The educational process prepares professional members

  • Assures the public that the health care provider is competent to Educational Standards

  • Professional bodies often use competency-based assessment programs to ensure the content and maintenance of practice standards

    • The requirements may include the use of self-assessment tools, participating in continuing education programs, keeping a record of professional activities, or a combination of these.

• License to Practice

  • Many professions, in keeping with provincial and territorial requirements, oversee the licensing of their members.

  • Regulated professions almost always require license renewal annually.

    • May also need peer reviews or other proof of ongoing education.

  • Moving from one province or territory to another can cause issues for some professionals

    • Different provinces may have different rules

• Nonregulated Professions

  • In many professions and occupations, many are nonregulated,

  • People who work within nonregulated occupations do not have federal or provincial legislation governing their occupations

  • Many nonregulated occupations have professional organizations or bodies that award certification when a person completes a set of written or practical examinations

  • When a profession is unregulated, there is no uniform set of requirements

Mainstream Health Care Providers

• Physicians

  • Requirements

    • 2-4 year undergrad

    • Entrance exam Medical College Admissions Test

    • Med school 3-4 years

    • Residency

  • A doctor that specializes in a specific area is called a specialist

  • Specialists only see the patients that are referred

• Family Physician

  • Aka general practitioner, or primary care physicians

  • Have a wide knowledge base

  • Are usually part of a primary care team

• Emergentologist

  • Full-time emergency medicine

  • Emergency departments are now choosing to hire full-time physicians instead of having on-call physicians

• Geriatricians

  • Focus on older people (65+)

  • Typically an internist with additional training

  • Time-consuming

    • Paid less

• Cardiologist

  • Specializes in conditions and diseases of the heart

  • Ranging from abnormal rhythms and heart attacks

  • Do us not do surgery

  • With training May do a cardiac catheterization

• Gynecologist and Obstetrician

  • Specializes in women's health

  • Diagnoses and treats disorders of the reproductive system

  • Obstetricians focus on pregnant women in the delivery of their babies

• Internist and Hospitalist

  • Internists typically diagnose and render surgical treatment for the disease in a person's organs they refer patients to other Specialists to deal with specific organs

  • A hospitalist is a physician usually an internist who oversees the medical care of patients in a hospital

  • The patients typically do not have a family doctor

• Neurologist

  • Treats conditions of the nervous system

  • Does not  perform surgery

• Ophthalmologist

  • Specializes in the disease of the eye

  • May perform surgeries

• Oncologist

  • Deals with all forms and stages of cancerous tumors

  • Develops diagnose and treats and prevents cancer

  • Specializes with people with cancer

  • They may be specialized in radiation therapy, chemotherapy, Gynecology Oncology, or surgery

• Psychiatrist

  • Specialize in mental illness and emotional disorders

  • Can order laboratory and diagnostic tests and prescribe medication

  • Do not perform surgery

• Physiatrist

  • A medical doctor specializing in physical and rehabilitative Medicine

• Radiologist

  • Office session with additional training in the interpretation of Imaging techniques

  • Is primarily a consultant to other Physicians

• Respirologist

  • Aka Pulmonologist

  • Are medical doctors who specialize in diagnosing and treatment of the lungs

  • They performed tests

  • May perform some procedures

Nurses

RNs

• Are required to have a bachelor's degree in nursing

• In 2015 the National Council red shirt examination it's now the Kansas National Examination for registered nurses

• The most complex components of Nursing

• Have some of the most leadership roles

Nurse Practitioners

• Registered nurses with Advanced Training and skills

• Can autonomously diagnose and treat health conditions

• Order and interpret some left her and diagnostic tests

• Describe a wide range of medications

• Must renew their license yearly

Clinical Nurse Specialists

• Nurses who have a master’s/doctorate degree in nursing

• Typically in leadership

Registered Psychiatric Nurses

• Focus on the mental side

• Have diverse practice settings

Licensed Practical Nurse

• Aka registered practical nurse

• Skill set

  • Dressings

  • Dispensing medications

  • Taking charge of units

Physician Assistants

• Are academically prepared Healthcare providers who worked directly under a physician

• The scope of practice ranges from interviewing patients and Health teaching to formatting physical examinations and selecting diagnosed testing

• Cannot practice independently

Pharmacist

• Dispenses medications  response to prescriptions

• Must have a bachelor's degree in pharmacy

• Pass the national board exam

• May also change drug  dosages

Midwives

• Provide prenatal care

• Aid in the delivery

• Provide post-partum up to 6 weeks

Optometrists and Opticians

• Describe a select few medications to treat eye conditions

• Prescribed glasses and eye drops contact lenses

Osteopathic Physicians

• Incorporates more holistic approaches

• Is a nonregulated profession

Podiatrists (chiropodists)

• Podiatrist meaning foot specialist

• They specialize in the diagnosis, assessment, and treatment of foot disorders

Personal Support Workers

• Not regulated

• Certificated programs last up to 2 years

• Works under either an RN or LPN

Psychologists

• They perform noninvasive testing

• Diagnoses for early stages of dementia

Speech-Language Pathologists and Audiologists

• Experts in human communication disorders

• Work with patients with problems hearing, balancing, and sound

Communication Disorder Assistant

• Works with or under a speech pathologist

• They may initiate or carry out diagnostic testing

• Assists with treatments

Respiratory Therapists

• Specialize in caring for those with acute or chronic cardiorespiratory disorders

• Can evaluate, treat, and support both the emerge and inpatients

• Aid in the transportation of patients from one hospital to another

• Are responsible for setting up oxygen therapy and inhalation treatments

Physiotherapists

• Works with the patient to physically get stronger

• Help ease the patient out of discomfort and/or pain

Occupational Therapists

• Works with all walks of life trying to take care of themselves

• They teach them how to take care of themselves in the day-to-day

Physiotherapy Assistants and Occupational Therapy Assistants

• OTAs and PTAs work collaboratively under the direction of PTs or OTs to administer rehabilitation treatments

  • To individuals who are experiencing physical, emotional, or developmental problems.

Administrative Roles

Health Information Management

• Provide leadership and expertise in the management of clinical, administrative, and financial health information in all formats and a variety of settings

• The HIM profession has four domains of practice:

  • Data quality (the collection and analysis of health information, the coding of clinical information, and quality assurance);

  • E-HIM-electronic health information management (the physical to digital conversion of health records, digital cloud storage and distribution of health information, and the management of complex communications systems);

  • Privacy (keeping health information confidential and secure, and Enforcing privacy legislation as it pertains to the information for which they are responsible);

  • HIM standards (records management standards, documentation standards, terminal standards, etc.).

• Health information managers are involved with almost every aspect of health information standards, from data and information collection, analysis, and retrieval, to the destruction of information once it is no longer needed.

Health Office of Administration

• Must know clinical and administrative aspects

Laboratory and Diagnostic Services

• All have to be specialists in their specified field

Alternative Practitioners

• Are typically specialized in chiropractic and complete a set number of hours to be qualified

Volunteer Caregivers

• Friends, family, and volunteers, who are trained to take care of the sick

Practice Settings

Where healthcare is delivered

Care in the Home and the Community

• Refers to the practice of effectively managing the healthcare needs in their home

  • To reduce/ eliminate a stay in the hospital

  • Shorted the time in a long-term care home

• 9/10 people said homecare is what helped them stay in their home permanently

• Are typically publicly funded

Homecare Management in Saskatchewan

• Offered through the province where someone volunteers to be trained

  • They get paid by the government to take care of a friend or family member

  • May choose to take the money to hire someone else to do the care

Clinics

Urgent care and Walk-in Clinics

• Reduce the burden on the ER

• Cheaper than visiting the ED

• Can only refer patients elsewhere for testing/procedures

Ambulatory Care Clinics

• All forms of clinics wrapped into one vehicle

• May include day surgeries and cancer treatment

Outpatients Clinics

• Vary from hospital to hospital

• Depends on the size of the hospital for what they provide

• Tailored for the area

Mental Health Clinics

• Usually, work with other organizations to help outsource and fast-track patients

• Provide access to a mobile crisis team

  • Respond to a geographic area

Harm Reduction Sites or Clinics

• Are guided by strategies, practices, and procedures that reduce harm to others through addiction and misuse

• They test for additives and provide safe equipment

• Provide counseling

Methadone Clinics

• Used to treat those addicted to opioids

• Called opioid replacement therapy

Nurse Practitioner-Led Clinics

• Care for those who do not have access to primary care of any sort

• Provide health and preventative educational services

• May also do referrals

Why Clinics Make Sense

• Cost Effective

  • Earlier discharge from hospitals with clinic follow up

  • Cost less in the patient’s own home

  • Easier to staff

• Timely and Convenient

  • Fewer hospital visits

  • Everything is centralized

• Patient Focus

  • Consider individual needs

  • More experience with specific conditions

Primary Health Care: Issues and Trends

The Ongoing Shortage

• Doctors aren’t taking as many patients

• They only work part-time

• Diversify their skills in another practice

Strategies for Improvement

• Prompt or same-day appointments

• Use of communication technologies

• After-hours clinics

Primary Health Care Groups

Forming a group

• First, they choose the framework

• Second, they get it approved

• Get a formal contract

Basic Structures and Function

• Usually located in one facility

• Objective to treat patients by using the expertise of as many healthcare professionals as required to maximize the patients’ goals

Primary Care Models: Regional Variations

• Family Health Teams is the most effective

  • Are given a physician within a group

  • Are all managed by the same admins

• Community Health Centers

  • Community-based

  • Nonprofit

  • Stress an intersectoral and interdisciplinary approach

  • Important in hard-to-reach communities

  • Provide a central location

Primary Care Groups: Payment Mechanisms

• The more the doctor provides the more they get paid

• Fee-for-service

• Known as basket service incentives

Patient Enrollment and Primary Care Models

• Rostering: requires a certain percentage of patients to formalize their relationships with the groups by signing a form agreeing to be a part of the doctors’ practice

• Signing is voluntary

  • It only entitles the patient to all the services provided by the reform group

  • If they go somewhere else for treatment the assigning doctor may be charged

Telephone Helplines

• All jurisdictions offer confidential help assistance free of charge

• Offered 24 hours 7 days a week

• Are not allowed to diagnosed only ask questions

  • Follow-up is always tried

Community Health Centers

• Formed a centralized clinic who are available 24/7

• The number of nurses is factored by the number of people and their needs

• A physician is always on stand-by if the nurse feels they are unqualified or need a second opinion