Download Healthcare professionals

Healthcare Professionals
Aisha Syed
Healthcare is comprised of many professions that work on different levels to care
for their patients. Some healthcare professionals have tasks that vary from complicated
surgical procedures, to changing a baby’s diaper. This chapter will discuss some of many
professions that make up the healthcare system. Nevertheless, when we think of healthcare
professions we assume that only nurses and physicians are involved. While physicians and
nurses are a vital part of the healthcare system there are many other professions that
makeup the healthcare field. This chapter will discuss the duties, skills, and educational
level of many healthcare professions.
The chapter which follows is divided into seven sections. The first of these
sections contains Healthcare Professionals, which will include medical doctors, doctors
of osteopathy, and nurses. The section will also discuss the differences between a medical
doctors and doctors of osteopathy. The second section describes the official medical
specialties.
The next section is on Nursing, including different types and their duties,
skills, and educational background. The fifth section will discuss other licensed
professions like, Rehabilitation specialists, Occupational therapist, and Physical therapist.
The sixth section will cover Healthcare Managers. This refers to the people that are
providing services instead of care. The last section will discuss controversy between
physician, nurse practitioners, and physicians assistant.
Healthcare Professionals
There are hundreds of healthcare professions that array from medical doctor to
dietitian. Similarly, 11.6 million people work in healthcare in the US which includes
778,000 physicians where 5 percent are Doctors of Osteopathy2, 2.1 million registered
nurses, and 160,000 dentists1. The remaining are involved in research, care-giving,
teaching, or administration1.
Doctors prevent, treat, and advise patients to keep healthy. Nevertheless, doctors
can be categorized in two groups, medicine as practiced by MD’s, known as allopaths
(traditional) and Doctor of Osteopathy, DO2. The majority of doctors practice allopathy.
There are 15 accredited osteopathy schools compared to over 120 medical schools.
According to New England Journal of Medicine, osteopathic philosophy focuses on a
patient-centered approach, where it is based on prevention along with concentrating on the
patient as a whole, rather than individual parts of the body separetly2. In addition, the body
is used to assist in healing the body with the manipulation of bones, muscles, and tendons.
This technique used by DO’s is not practiced by most MD’s. An osteopath focuses on the
symptoms and its treatment rather than the disease only. Both forms of doctors use
medicines, surgery, and standard methods of treatment; however the approaches for the
doctors are slightly different1. Osteopaths have the same specialties as MD’s (see
Specialty section for further information).
MD’s and DO’s have the same level of education, training, and residency
programs, however there are many more MD’s then DO’s. In addition, MD’s and DO’s
attend separate and different schools that have variation in curriculum. Many more MD’s
enter into specialty where many DO’s enter in primary care. Whatever type of doctor a
patient chooses, they should realize that both physicians meet the same standards, but have
different approaches in treatment.
Those who desire to attend medical should pursue a pre-medical curriculum in
undergraduate and then apply to medical school or osteopathic school. Most medical
schools take four years to complete however, there are schools that allow for a completion
of both pre-medical and medical school in six to seven years4. Typically, in medical
school the first two years are spent in the classrooms and laboratories, the next two years
are spent in the hospital learning and training under supervision. After graduation medical
students enter a residency program, research programs, or may decide to teach.
The largest health professional group is nurses. There are different levels such as:
licensed practical nurse, nurse practitioner, registered nurse, and nurse midwife. These
topics will be discussed in detail later in the chapter.
Graduate Medical Education Year
1
2
3
4
5
6-7
Family Practice
Pediatrics
Subspecialties
Internal
Medicine
Dermatology
Neurology
Ophthalmology
Psychiatry
Obstetrics
Surgery
Colon-Plastic-Thoracic
Neurosurgery
Orthopedic Surgery
Otorhinolaryngology
Urology
Medical Specialties
Primary and specialty care received by a patient may include ambulatory care
(primary), secondary (specialty), and tertiary. Primary care refers to care received when
needed for example, you go to a primary care physician for a cough or cold in addition to
immunizations. Primary care aims for prevention and focuses on the maintenance of high
quality of life3. Some key points that primary care concentrates on include: disease
prevention, early detection of disease to eliminate further and or serious problems,
educates the patient, advises the patient for better health, and refers the patients to other
providers for the appropriate times3. Some examples of primary care physicians include
internist (internal medicine) and pediatricians. The primary care provider offers a wide
array of services to their patients such as: physical exams, health screenings, and
immunizations, infection assessment, advise on different conditions and many others
health-based advise3. Primary care providers are essential to the healthcare system;
however, they may be less paid then the other specialty doctors or surgeons. Primary care
physicians provide direct care to patients, which is the difference between secondary and
tertiary care.
Secondary care is often referred to as specialty care. Normally, a patient receives
care from their primary care giver; moreover if a specific problem arises the patient will be
referred to a specialist. Secondary care is often provided in hospitals and allows for long
term care3. Similar to primary care providers, specialists deal with diagnosis, prognosis,
and treatment3. In addition, secondary care concentrates on one specific part of the
patient’s body. There are several types of specialties (and there are subspecialties which
are not included for example cardiology):
SPECIALTY
Allergy and Immunology (formed in 1971)
DESCRIPTION
Study, diagnosis, and treatment of
disorders of the immune system, including
allergy, immune deficiency, and
autoimmune disease.
Anesthesiology (1938)
Use of anesthetic agents to prevent pain
during surgical or other painful procedures
Colon and Rectal Surgery (1935)
Surgical treatment of disorders of the anus,
rectum, and intestines
Dermatology (1932)
Diagnosis and treatment of disorders and
diseases of the skin
Emergency Medicine (1979)
Treatment of patients suffering from
sudden, life threatening injury and illness.
Family Practice (1969)
Comprehensive care of individual of all
ages on a long-term basis.
Internal Medicine (1936)
Non-surgical diagnosis and treatment of
disorders of the internal organs.
Medical Genetics
Study, prevention, diagnosis, and treatment
of genetic disorders.
Neurological Surgery (1940)
Surgical treatment of the nervous system,
including the nerves, brain, and spinal cord.
Nuclear Medicine (1971)
Use of radioactive substances to diagnose
and treat disease.
Obstetrics and Gynecology (1930)
Diagnosis and treatment of disorders of the
female reproductive system and
management of pregnancy, labor, and
childbirth.
Ophthalmology (1917)
Diagnosis and treatment of disease and
disorders of the eyes.
Orthopedic Surgery (1934)
Diagnosis and surgical treatment of
disorders of the bones, muscles, and
associated structures.
Otolaryngology (1924)
Study, diagnosis, and treatment of disease
of the head and neck.
Pathology (1936)
Study of the nature of disease and the
changes it causes in the body.
Pediatrics (1933)
Study of the growth and development of
children, as well as diagnosis and treatment
of disease in children.
Physical Medicine and Rehabilitation
(1947)
Treatment of disorders by physical means,
Plastic and Reconstructive Surgery (1939)
Surgical treatment, to repair superficial
such as heat, cold, and radiation.
parts of the body.
Preventive Medicine (1948)
Study and use various measures to prevent
disease by immunization and other
controls.
Psychiatry and Neurology (1934)
Study of the mind and the treatment of its
disorders.
Radiology (1934)
The use of x rays and other radiation to
treat disease.
Surgery (1937)
Use of various procedures called operations
to treat and diagnosis disease and injury.
Thoracic Surgery (1948)
Surgery of the chest, including surgery of
the heart, lungs, and chest wall.
Urology (1935)
Diagnosis and treatment of diseases of the
urinary tract in female and the urogenital
tract in males.
Source: American Board of Medical Specialties, Encarta ® Online Encyclopedia 2001.
Primary care is synonymous with promoting health and prevention of disease,
secondary care specializes in certain areas such as dermatology or orthopedic surgery, and
tertiary care provides highly specialized care like intensive-care.
Alternative Healthcare
The definition of alternative medicine is not clear cut, but the previous written
chapter by Anna Rosenfeld discusses some of the professions that are considered as
alternative medicine today. Chapter three discusses chiropractors, acupuncture, Chinese
medicine, homeopathy, naturopathy, massage therapist, hypnosis, and biofeedback.
Nursing
Nurses are a vital part of the healthcare system. Next to doctors nurses are most
familiar with the patient’s cases. Nevertheless, there are several levels of nursing who
have different skills and qualifications. The two main categories of nurses are Licensed
practical nurses or LPNs and Registered nurses or RNs.
There are approximately 700,000 licensed practical nurses that provide different
types of care4. LPN’s provide for patients in hospital, nursing homes, and extended care
facilities4. LPNs do not have the same education and training as an RN; however provide
the physicians and other nurses assistance with patient care. Some of the duties that a LPN
performs include: record keeping of the patient, taking blood pressures, care of newborns,
administer medications, bathe patients, and other tasks that are needed by the physicians4.
LPNs work a 40 hour week, but not all nurses work the usual nine to five, most nurses
have to work odd hours because patients need 24 hour care. Most nurses are first to arrive
and assist a patient and if they seem necessary they will call a physician for duties they
cannot perform such as prescribing medication. Nurses also feel stressed and strained
similar to doctors because they have risks involved with their job. Some risks include
injuries, sleep deprivation, and emotional problems.
An LPN can receive their education through trade, technical, and vocational
schools4. The length of the program is one year in addition to a high school diploma.
After the completion of the program the nurses are certified by the state to practice.
Registered Nurses or RNs are extremely important in health care. They work hand
in hand with physicians and administering medications to patients4. Nurses are likely to
work on several different patients at one time in intensive care unit or a children’s ward.
Registered nurses can work in a variety of environments such as patient’s homes, schools,
public clinics and other community related areas4.
RNs differ from LPNs by the level of education and training received. RNs either
attend nursing school after graduating high school. RNs usually complete a four year
bachelor degree or receive an associate degree to be properly certified to practice nursing
where LPNs do not need a bachelor’s degree to practice. Indeed most RNs work part-time
with varying times in different areas of health care. Nevertheless, LPNs and RNs
educational background and duties vary so their tasks are different also but both nurses are
essential to doctors and their areas of work.
HEALTH CARE PROFESSIONALS
DESCRIPTION
Anesthesiologist Assistant
Assists the anesthesiologist in developing
and implementing the anesthesia care plan
Art Therapist
www.arttheerapy.org or www.atcb.org
Uses drawings and other art/media forms to
assess, treat, rehabilitate patients with
mental, emotional, physical, and/or
developmental disorders
Athletic Trainer
Are involved in prevention, recognition,
evaluation, management, treatment,
rehabilitation, organization, administration,
and education.
Audiologist and Speech-Language
Pathologist
Audiologist determines what type of
hearing loss a person has and what can be
done to assist the person. A pathologist
evaluates speech, language, and swallowing
skills of people to determine any
communication problems and treats them.
Blood Bank Technology-Specialist
Tests blood group for antigens, investigates
abnormalities, supports physicians in
transfusion, and performs blood collection
and processing.
Cardiovascular Technologist
Reviews patient history and performs
cardiovascular and therapeutic services.
Clinical Laboratory Science/Medical
Technology
www.aspc.org
Counseling-related Professions
www.nbcc.org
Perform complex analyses, fine-line
discrimination, and error correction.
Deal with human development concerns
through support, therapeutic approaches,
consultation, evaluation, teaching, and
research.
Cytotechnologist
Email:[email protected]
Prepare cellular samples for study under
microscope and assist in diagnosis of
disease by examining the samples.
Dental-related Occupations
Include Dental Assistant, Dental hygienist,
www.ada.org or www.aads.jhu.edu
and Dental Laboratory Technician.
Diagnostic medical Sonographer
Provides patient services in use and
interpretation of ultrasound procedures.
Dietitian
www.eatright.org/caade
Integrate and apply the principles derived
from the sciences of food, nutrition,
biochemistry, physiology, food
management, and behavior to achieve and
maintain the health status of the public.
Electroneurodiagnostic Technologist
Taking and abstracting histories, applying
adequate recording electrodes and using
EEG, EP, and PSG techniques;
documenting the condition of the patients.
Emergency Medical Technician-Paramedic
Email: [email protected]
Practice out-of-hospital medicine in
conjunction with medical direction. The
asses and provide medical care, goal is to
prevent death due to injury or illness.
Genetic Counselor
www.fadeb.org/genetics
Health Information Management
Consulting individuals with birth defects or
genetic disorder.
Related to the management of health
information and the systems used to collect,
store, process, retrieve, analyze,
disseminate, and communicate that info.
Kinesiotherapist
Treats the effects of disease, injury, and
congenital disorders through the use of
therapeutic exercise and education.
Medical Assistant
Work under the supervision of physicians
in their offices or other medical settings.
Medical Illustrator
Create visual material designed to facilitate
the recording and dissemination of medical,
biological, and related knowledge.
Music Therapist
www.musictherapy.org
Music is used within a therapeutic
relationship to address individuals’
physical, psychological, cognitive, and
social needs.
Nuclear Medicine Technologist
Uses nuclear properties of radioactive and
stable nuclides to make diagnostic
evaluations and provide therapy.
Occupational Therapy
Uses purposeful activity and interventions
to achieve functional outcomes to
maximize health of injured or ill.
Ophthalmic Dispensing Optician
Fit corrective eyewear, including glasses
and contact lenses.
Ophthalmic Laboratory Technician
Cut, grind, edge and finish lenses and
fabricate eyewear.
Ophthalmic Medical
Technician/Technologist
Orthoptist
www.orthoptics.org
Assists ophthalmologists by administration
work and collection of data.
Evaluation and treatment of disorders of
vision, eye movements, and eye alignment
in adults and children.
Orthotist and Prosthetist
Rehabilitation of the physically challenged.
www.oandp.com/academy or
www.oandp.org
Perfusionist
www.amsect.org
Physical Therapy
www.apta.org
Conduct extracorporeal circulation and auto
transfusion equipment temporarily.
Help improve patients’ strength and
mobility, relieve pain, and prevent
permanent physical damage.
Physician Assistant
Prepared to practice medicine with the
supervision of a licensed doctor of
medicine or osteopathy.
Radiologic Technology
Deliver prescribed doses of radiation to
patients for therapeutic purposes.
Rehabilitation Counselor
Determines and coordinates services to
assist people with disabilities.
Respiratory Care
Provides respiratory care.
Surgical Technologist
Assist surgeons to provide surgical care.
Therapeutic Recreation Specialist
Uses various interventions to treat physical,
www.nrpa.org/branches/
cognitive, emotional, and social conditions
associated with illness, injury or
disabilities.
Health Professions Career and Education Directory. American Medical Association, 2000.
Other Licensed Professionals
Besides doctors, nurses, and administrators there are other professions that are
important to the health care system. Rehabilitation counselors, Occupational therapists,
and Physical therapist are some of the few licensed professionals that are not given very
much attention in the medical field. Each profession plays an important role to its patients
and with their specialized care they provide.
Rehabilitation counselors have various backgrounds which include public health
nursing, social work, and school counselining5. Rehabilitation counselors work with
persons who have a disability, where they encourage psychological, emotional, and
economic growth5. Furthermore, counselors aid patients who have other disabilities such
as mental and emotional along with physical. Some additional tasks of rehabilitation
counselors include: assist patients in locating and keeping employment, break down social
barriers that the society creates for disabled individuals, aid in the disabled to create a bond
between themselves and family and friends, they assist in training individuals so they are
more independent, and encourage good job performance and progress in daily living4,5.
There are a range of jobs and areas that a counselor may be employed however, they must
be certified through the Commission on Rehabilitation Counselor Certification (CRCC) in
addition to training programs that last up to two years. Approximately 43 million
Americans have some disability and having rehabilitation counselor’s assist with their
lives, jobs, and relationships the disabled will have better quality of life5.
Occupational therapists are similar to Rehabilitation counselors because they both
assist disabled individuals and aid them into a “normal” way of life. First, the patient is
evaluated to observe the type of therapy needed with tests which measure the skills of the
person. After the tests are interpreted the treatment or training begins with education,
consultation with the individual and or their family5. Victims of accidents which have left
them disabled are assisted with therapy by skills such as weaving, knitting, and other
intricate projects. Other similar activities provide a creative skill which assists the patients
in restoring their lost ability4.
In addition, Occupational therapist can also be considered one of several Home
care specialists because they may make home visits and plan educational, recreational, and
social activities to aid the patients regain their bodily functions6. The optimum goal of
occupational therapist is to have their patients become independent even with their
handicaps. The goals of occupational therapists are similar to rehabilitation counselor,
which is for optimum health and well being in addition to the patient being independent.
Occupational therapists must have a bachelor’s degree and afterwards they take an
examination to be certified for their state of residence, where the state regulates the
practices of therapist5.
Physical therapists work with a broad range of individuals; they work with patients
recovering from accidents to Olympic atlethes5. They use methods such as exercise,
massage, ultrasound, electricity, heat, cold, and water to increase the mobility of patients,
relieve pain, and improve muscle and skin condition5, 6. Physical therapists have a detailed
job in evaluating patients such as providing the family with proper training instructions to
assist in the care of the patient. Along with a extensive skills involved in treating a patient
a physical therapist does not need to only work in a hospital, they are employed in many
other areas, such as sports facilities, health care centers, and nursing homes. There is a
great need for physical therapists that provide home health care. Attending therapy session
is a task for the patient and their family. This entails the family taking time out of their
schedule to take the patient to the hospital to provide therapy; however, with the ease of
having a therapist do home-visits is easier for the family and patient. Moreover, life
expectancy is very high for Americans today, so there are a growing number of elderly
individuals (baby boom) that require physical therapy after a surgery. Equally important is
our love of sports in the US, we have many athletes that push their limits daily, however,
in doing so they have an increased number of injuries which leads to surgery afterward
receiving physical therapy.
Physical therapists have a bachelor’s degree in physical therapy and attain a
certification by the state which gives them the license to practice.
These are only a few of licensed professionals that are important in the functions of the
health care system. We’ve noticed that simple surgery is not enough to retain a good
quality of life, therefore having counselors and therapist is very important in patient care.
Healthcare Managers
So far we’ve discussed health care professionals that provide care of some sort,
with primary or secondary care. However, coordinators within a hospital do not provide
care, but services. A Healthcare manager can have one task or many such as planning,
engineering, administration, application, and policy5. Planning refers to strategic efforts
engineering is designing modes and the flow of the department, administration is handling
various information and organizing it, application is analyzing and using the data for
attaining information, and policy is implementing confidentiality, integrity and other
standards within the hospital5.
Most healthcare managers have tasks based on the work environment so there are
no specific duties that are assigned on a daily basis, however the main skill the manager
should have and implement is to run the health care system as smoothly as possible. Being
the bridge between doctors and drug, insurance, or other companies is a difficult task for
an individual to handle. So the employees work as a team to function as a good system.
Another responsibility the health manager faces is the serving as an information service;
such as clinical quality assessment so the data is used properly and effectively5.
The Health and Human Services Department is an example of a large administrator
employee. Within the federal government it resides over 12 major divisions like the
Administration for Children and Families with provides services to encourage the proper
and healthy development of children7. Programs such as this allow the assistance
programs to run properly and with managers with skills to run a healthcare system the
entire organizations are able to assist children and families.
For more information on Healthcare Manager see chapter three.
Lastly, there has been controversy between the roles of physicians, physicians
assistant, and nurse practitioners. Nurse Practitioners are RNs who have received
specialized training who work under a physician similarly to a physician assistant. A
physicians assistant is fully capable of practicing medicine but under the supervision of a
physician5. Nurse practitioners practice mainly primary care and which is well received by
patients. However, individual states have authority to allow NPs to practice independently,
but the majority of states require the supervision of physicians1. All three are able to
prescribe medications. Nevertheless, physicians have more training which means that PA
and NPs will always have to report to physicians. Moreover, if all doctors, assistants, and
nurses work together with separate duties will allow for better and effective patient care.
The medical field requires an individual to be extremely disciplined and devoted to
their career. Doctors are extremely respected for their knowledge, devotion and hard work
that made them a doctor. The healthcare system may or may not always acknowledge the
difficulty of their careers, but hopefully this chapter has made readers more aware of some
different professions and importance of each profession. Doctors and nurses are
backbones of the medical field but it takes more than a backbone for a human to function.
There are many more professions that were not mentioned in the chapter that contribute a
great deal to the healthcare system. With some introductory knowledge an individual may
want to explore other options and hopefully want to pursue a career in the medial area.
References
1. “Medicine”. Microsoft® Encarta® Online Encyclopedia 2001.
http://encarta.msn.com
2. Howell, Joel. Osteopathy vs. Traditional Doctor. N England J Med. 1999;
341:1426-1431, 1465-1467.
3. Miller M. Health Care Choices for Today, a Consumers Guide to Quality and
Cost. New York: John Wiley and Sons, Inc., 1997.
4. Selden, A. Handbook of Health Care Careers. Lincolnwood: VGM Career
Horizons, 1994.
5. Health Professions Career and Education Directory. American Medical
Association, 2000.
6. Cardoza, A. Homecare Services Careers. Lincolnwood: VGM Career
Horizons, 1993.
7. “Health and Human Services”. Microsoft® Encarta® Online Encyclopedia
2001. http://encarta.msn.com
8. Belshaw, Chris. Osteopathy Is it for you? Element Books limited, 1987.
9. Fabb, W., Fry, J. Principles of practice management in Primary care.
Lancaster: MTP Press, 1984.
10. Stephen, William. An analysis of primary medical care: an international study.
Cambridge: Cambridge University Press, 1979.