Download Chapter 02 - Types of Medical Practice

CHAPTER
2
Types of Medical
Practice
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
2-2
Learning Outcomes
2.1 Describe medical specialties and specialists.
2.2 Explain the purpose of the American Board of
Medical Specialties.
2.3 Describe the duties of several types of allied
health professionals with whom medical
assistants may work.
2.4 Name professional associations that may help
advance a medical assistant’s career.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
2-3
Introduction
• Medical assistants are an
integral part of the health-care
team
• A working knowledge of
specialties and allied health
professionals enables the MA
to function better as a member
of the health-care team
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
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Medical Specialties
• Approximately 22 major
medical specialties exist
• Specialized medical care
is driven by advances in
diagnosing and treating
various diseases
Cardiology
Pediatrics
Adult
Note: Cardiology = specialty
Pediatrics and Adult = subspecialty
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Physician Education and Licensure
Bachelor’s Degree
Graduate from an Accredited Medical School
Pass the U.S. Medical Licensing Exam
Complete 2–6 Years of Residency
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Medical Specialists
Specialist
Functions
Family Practice
 Medical doctors that treat all conditions and age
groups
 Also called general practitioners or primary care
physicians by insurance companies
 Refers patients to specialists for specific
diseases requiring specialized care
Allergist
 Diagnoses and treats people with
hypersensitivity to substances such as drugs,
chemicals, and elements in nature
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Medical Specialists (cont.)
Specialist
Functions
Anesthesiologist
 Administers medications that alter sensation and
feelings during surgery
Bariatrics
 Medical and surgical treatment of obesity
Cardiologist
 Diagnoses and treats diseases of the heart and
blood vessels
Dermatologist
 Diagnoses and treats diseases of the skin, hair,
and nails
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Medical Specialists (cont.)
Specialist
Functions
Doctor of
Osteopathy
 Uses eyes and hands to identify structural
problems and promote natural healing
 Uses osteopathic manipulative medicine (OMM)
techniques
Emergency
Medicine
Physician
 Works in hospital emergency rooms
 Diagnoses and treats medical crises and
accidents
Endocrinologist
 Diagnoses and treats disorders of the endocrine
system, which regulates many body functions
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Medical Specialists (cont.)
Specialist
Gastroenterologist
Gerontologist
Gynecologist
Internist
Functions
 Diagnoses and treats disorders related
to the stomach, intestines, and other
organs
 Diagnoses and treats problems and
diseases affecting older adults
 Diagnoses and treats diseases of the
female reproductive system
 Diagnoses and treats problems related
to internal organs
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Medical Specialists (cont.)
Specialist
Functions
Nephrologist
 Studies, manages, and diagnoses
diseases of the kidney
Neurologist
 Diagnoses and treats disorders and
diseases of the nervous system
Obstetrician
 Studies pregnancy, labor and delivery,
and postpartum
Oncologist
 Identifies and treats patients with
cancer
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Medical Specialists (cont.)
Specialist
Function
Ophthalmologist
 Diagnoses and treats diseases and
disorders of the eye
Orthopedist
 Diagnoses and treats diseases and
disorders of muscles and bones
Otorhinolaryngologist
 Diagnoses and treats ear, nose,
and throat disorders
Pathologist
 Studies bodily changes produced
by disease processes
Pediatrician/
Adolescent Medicine
 Diagnoses and treats childhood diseases
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Medical Specialists (cont.)
Specialist
Function
Physiatrist
 Diagnoses and treats diseases and disorders
with physical therapy
Podiatrist
 Treats disorders of the foot
Plastic Surgeon
 Performs reconstruction, correction, and
improvement of body structures
Proctologist
 Treats disorders of the anus, rectum, and
intestines
Radiologist/
Nuclear Medicine
 Uses x-rays and radioactive substances to
diagnose and treat diseases
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Medical Specialists (cont.)
Specialist
Function
Sports Medicine
 Subspecialty of medicine dealing with
treatment and preventative care of
athletes
Surgeon
 Uses hands and instruments to
diagnose, correct, and treat injuries,
diseases, and deformities
Urologist
 Diagnoses and treats diseases of the
kidneys, bladder, and urinary system
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
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Apply Your Knowledge
Name the medical specialists who would be
involved in the care of a 6-month-old infant with
massive burns over 90% of the body and
indicate how each specialist would contribute to
the care for this situation.
ANSWER: The following specialists would be involved in the care of this
patient:
• Pediatrician because of the age of the infant
• Plastic surgeon to perform skin grafting
Correct!
• Dermatologist for skin, hair, and nail repair
• Emergency medicine for treatment during medical crisis
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Health-Care Team
Doctors
Nurses
PATIENT
Medical Assistants
Specialists
Knowing the duties of other health-care team members will
help you be a more effective team member.
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Allied Health Professionals
Discipline
Acupuncturist
Function
 Treats pain or discomfort by
inserting thin, hollow needles
under the skin to balance the
opposing forces of yin and yang
 Based on Chinese beliefs
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Allied Health Professionals (cont.)
Discipline
Chiropractor
Function
 Treats disorders without drugs or
surgery by making adjustments to
realign the vertebrae in the spine
 Is an independent practitioner
Electroencephalographic  Electroencephalography is the study
and recording of the brain’s electrical
(EEG) Technologist /
activity
Technician
 EEG technicians work in hospitals,
physicians’ offices, and clinics
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Allied Health Professionals (cont.)
Discipline
Electrocardiograph
(ECG) Technician
Function
 ECG technicians operate
electrocardiograph machines that
record the heart’s electrical
impulses
 ECG technicians work in hospitals
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Allied Health Professionals (cont.)
Discipline
Function
Massage
Therapist
 Promotes muscle and full body
relaxation; increases circulation and
lymph flow
 One of the oldest methods to promote
healing
Medical
Administrative
Assistant
 Provides administrative support to
medical, professional, and technical
personnel
 Transcribing dictation
 Composing correspondence
 Works in hospitals, clinics, etc.
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Allied Health Professionals (cont.)
Discipline
Function
Medical Billing  Extraction and coding of medical information from
patient records
and Coding
 Preparation of insurance claims to maximize
reimbursement and ensure ethical standards in the
profession
Medical
Records
Technologist
 Organizes, analyzes, and evaluates medical
records
 Compiles administrative and health statistics, code
symptoms, and inputs and retrieves computerized
health data
 Registered Health Information Administrator (RHIA)
and Accredited Health Information Technician
(RHIT)
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Allied Health Professionals (cont.)
Discipline
Function
Medical Office  Manages the practice of a physician or a group
Administrator / practice
 Coordinates records and filing
Manager
 Oversees office staff
 May also greet patients, make appointments, and
perform general secretarial tasks
 Requires knowledge of
 Computer application software
 Advanced document processing skills
 Accounting
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Allied Health Professionals (cont.)
Discipline
Function
Medical Technology – includes:
 Performs lab tests under supervision of
Clinical
physicians or medical technologists
Laboratory
Technician (CLT)  1- or 2-year degree
 Works in hospital labs, clinics, etc.
Medical
Technologist
 Performs lab tests and procedures such as
examining body fluids and tissues
 Has a 4-year degree
 Works in clinics, industry, hospitals, research,
etc.
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Allied Health Professionals (cont.)
Discipline
Medical
Transcriptionist
Function
 Translates a physician’s dictation into
comprehensive, typed records
 Works in attorney offices, insurance companies,
hospitals, physician offices, clinics, and
laboratories
 Participates in supervising group therapy and
counseling sessions
(Psychiatric Aide or  Works with emotionally disturbed and mentally
challenged patients
Counselor)
 Work settings include psychiatric clinics, crisis
centers and shelters, hospital psychiatric units,
and specialized nursing home settings
Mental Health
Technician
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Allied Health Professionals (cont.)
Discipline
Nuclear
Medicine
Technologist
Function
 Completes either a 2-year or 4-year
program
 Works in hospitals, physician offices, or
public health institutions
 Duties include:
 Overseeing quality control
 Preparing and administering radioactive drugs
 Operating radiation detection instruments
 Positioning patients
 Performing imaging procedures
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Allied Health Professionals (cont.)
Discipline
Occupational
Therapist
Function
 Helps patients attain maximum physical
and mental health through the use of
educational, vocational, and rehabilitation
activities
 Has a 4-year degree plus 9- to 12-month
internship at an accredited hospital
 Work settings include:
 Hospital
 Government agency
 Rehabilitation hospital
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Allied Health Professionals (cont.)
Discipline
Pharmacist
Function
 Dispenses medications and health supplies
 Employment in hospitals, clinics, nursing homes,
pharmaceutical companies, or private or chain
pharmacies
 Three levels of educational training for pharmacy
careers
 Pharmacist Technician (CPhT) – 2-year
programs
 Registered Pharmacist (RPh) – 5 years of
college
 Doctor of Pharmacy (PharmD) – 6 to 7 years
of college with residency
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Allied Health Professionals (cont.)
Discipline
Phlebotomist
Function
 Draws blood for diagnostic laboratory
testing
 Receives advanced phlebotomy training
that allows him/her to draw blood under
difficult circumstances
 Most states require phlebotomists to be
certified by the National Phlebotomy
Association or registered by the American
Society of Clinical Pathologists
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Allied Health Professionals (cont.)
Discipline
Function
Physical
 Has a bachelor’s degree in physical
therapy and must pass a state board
Therapist (PT)
examination
 May work in hospitals, rehabilitation
centers, outpatient clinics, private
practice, or sports medicine center
 Improves patient functioning by using:
 Electricity, heat, and cold
 Ultrasound and massage
 Exercise
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
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Allied Health Professionals (cont.)
Discipline
Physician
Assistant (PA)
Function
 Provides direct patient care under the
supervision of a licensed physician
 Training requirements vary; many states
require certification and registration with
the state medical board
 Works in a variety of settings: private
practice, nursing homes, hospitals, etc.
 Some states allow PAs to write
prescriptions
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Allied Health Professionals (cont.)
Discipline
Function
 Assists a radiologist in taking x-ray films
(X-ray Technician)  May be employed in hospitals, physicians’ offices,
clinics, government agencies, etc.
Radiographer
Radiographic
Technologist
 Trained in x-ray theory and practical applications
as well as radioactive materials
 May specialize in radiation therapy, radiography, or
nuclear medicine
 Works in hospitals, clinics, medical laboratories,
and medical practices
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Allied Health Professionals (cont.)
Discipline
Registered
Dietitian
Function
 Also called nutritionist
 Assists patients and family with nutrition planning
 May prepare and serve food to groups
 Work settings include:





Community health agencies
Hospitals
Clinics
Private practices
Teaching and consulting
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Allied Health Professionals (cont.)
Discipline
Respiratory
Therapist
Function
 Works under the supervision of a
physician
 Works in hospitals, physicians’ offices,
nursing homes, and commercial
companies
 Evaluates, treats, and cares for patients
with respiratory problems such as:
 Asthma
 Emphysema
 Pneumonia
 Bronchitis
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Nursing Careers
Training
Nursing Aide/
Assistant
Practical/
Vocational
Nurse (LPN,
LVN)
Sample Duties
1 week to 3  Makes beds
months
 Checks vital signs
 Bathes patients
1 year




Checks vital signs
Administers medications
Changes dressings
Assists registered nurses and
physicians
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Registered Nurse (RN)
Educational Preparation
Length of
Program
Associate Degree RN (ADN)
2 years
Diploma RN
3 years
Baccalaureate RN (BSN)
4 years
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Nursing Careers (cont.)
Title
Registered
Nurse (RN)
Function
 RN designation once state boards are
passed
 Responsible for planning, providing, and
supervising bedside care of patients
 Work settings include



Hospitals, nursing homes, and physicians’
offices
Public health agencies and government
agencies
Educational settings
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Nursing Careers (cont.)
Title
Nurse
Practitioner
(NP)
Function
 An RN that functions in an expanded role
 Requires a minimum of a Master’s degree
and 4 to 12 months of formal training or
an apprenticeship
 Duties include:
 Physical examinations
 Treating common illnesses and injuries
 Many states allow NPs to write prescriptions
 Patient education
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2-37
Apply Your Knowledge
If you had to choose other health-care team members to
plan the care for a 68-year-old patient recently diagnosed
with a stroke, who has a history of seizure disorders, which
would you choose, and why?
ANSWER: The health-care team members that might participate in this
patient’s care are:
•Physical therapist for decreased mobility due to stroke
•Pharmacist to review medications
•Nutritionist for dietary evaluation and possible modifications
•EEG technician to perform EEG for brain electrical activity
Good
Job!
•Nursing staff (RN, LPN, CNA)
•Other health-care professionals will also be part of the team!
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Specialty Career Options for MAs
• Require additional education or training
• Many options available – check:
– Local and medical college libraries
– State employment agencies
– Health career opportunities in local
newspapers
– Directly with companies where you might
seek employment
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
2-39
Specialty Career Options (cont.)
Specialty
Function
Anesthetist’s
Assistant
 Provides anesthetic care under direct supervision
of the anesthetist
 Works in hospitals and high-technology surgical
centers
 Assists in evaluating patient mental and physical
status
Certified
Laboratory
Assistant
 Performs lab procedures such as bacteriology,
chemistry, hematology, parasitology, serology, and
urinalysis
 Supervised by medical technologists or hospital
pathologists
 Works in labs, clinics, physicians’ offices, etc.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
2-40
Specialty Career Options (cont.)
Specialty
Function
Dental
Assistant
 Can practice without formal education or training
 Performs both administrative and lab functions
 Works in private practice, clinics, schools, local
health agencies, and for insurance companies
Emergency
Medical
Technician /
Paramedic
 Referred to as an EMT
 Trained to triage patients and follow instructions
from a physician
 Works for an ambulance service or in fire
department, hospital emergency room, or private
industry
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2-41
Specialty Career Options (cont.)
Specialty
Function
Occupational
Therapist
Assistant
 Supervised by occupational therapists
 Teaches fine motor skills, occupations, and the
arts to patients with mental and physical
disabilities
 Earns a 2-year degree
Ophthalmic
Assistant
 Assists ophthalmologists
 Performs simple vision testing and other
procedures
 Three ophthalmic career levels:
 Technologist
 Technician
 Assistant
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Specialty Career Options (cont.)
Specialty
Pathologist
Assistant
Function
 Supervised by a pathologist
 Some work with forensic and/or anatomic
pathologists
 Performs laboratory duties and some
administrative functions
Pediatric Medical  Assists the pediatrician with administrative and
clinical duties
Assistant
 Works in private practice, hospitals, and clinics
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2-43
Specialty Career Options (cont.)
Specialty
Function
Pharmacy
Technician
 Performs routine tasks related to recordkeeping and
preparing and dispensing medications
 Works in hospitals, pharmaceutical firms, and
wholesale pharmacies
Physical
Therapy
Assistant
 Works directly under the physical therapist
 Performs tests and treatment procedures
 Observes and documents patient responses to
therapy
 Works in hospitals, rehabilitation centers, nursing
homes, etc.
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2-44
Specialty Career Options (cont.)
Specialty
Function
Radiation
Therapy
Technologist
 Assists the radiologist
 Maintains radiation treatment equipment
 Completes a 2- or 4-year education program
 Works in hospitals, labs, clinics, and physicians’
offices
Respiratory
Therapy
Technician
 Works under supervision of physician and
respiratory therapist
 Performs artificial ventilation and maintains
respiratory equipment
 Works in hospitals, physician offices, nursing
homes, etc.
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2-45
Specialty Career Options (cont.)
Specialty
Function
Speech /
Language
Pathologist
 Evaluates, diagnoses, and counsels patients with
communication problems like stuttering
 Usually has a Master’s degree
 Works in schools, hospitals, research settings, or
private practice
Surgical
Technician
 Completes a 2- or 4-year degree
 Provides patient services under direct supervision
of a surgeon
 Performs diagnostic and therapeutic procedures
 Works primarily in hospitals
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2-46
Professional Associations
• Involvement in issues and activities
relevant to your profession
• Opportunities for
continuing
education
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2-47
Professional Associations (cont.)
American Association of Medical Assistants (AAMA)
The Association for Healthcare
Documentation
Integrity (AHDI)
American College
of Physicians (ACP)
American Hospital Association (AHA)
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2-48
Professional Associations (cont.)
American Medical Association (AMA)
American Medical Technologists (AMT)
American Pharmacists Association
American Society of Phlebotomy Technicians (ASPI)
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TJC
• Formerly The Joint Commission on
Accreditation of Healthcare Organizations
• Non-profit organization
• Goal is to maintain and elevate the
standards of health-care delivery by
health-care organizations
– Evaluation
– Accreditation
• Accreditation is significant factor in gaining
reimbursement from Medicare and
managed care organizations
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Council of Ethical and Judicial Affairs (CEJA)
• Develops policy for the AMA
• Addresses timely ethical issues
• Maintains and updates the
AMA Code of Ethics
– Comprehensive ethics guide for physicians
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2-51
Apply Your Knowledge
Which of the professional organizations listed below are
primarily for the role(s) of medical assistants?
AMA
ANSWER:
x AAMA
AHA
x AMT
ASCP
x
AAMT
ACP
APhA
Right
Answer!
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In Summary
2.1 Today there are approximately 22 major medical
specialties. As new medical advances occur, the
demand for more specialty areas will emerge.
2.2 The American Board of Medical Specialties is an
organization of many different medical specialty boards.
Its primary purpose is to maintain and improve the
quality of medical care and to certify doctors in various
specialties.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
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In Summary (cont.)
2.3 Medical assistants are members of a health-care team
that includes doctors, nurses, physical therapists, other
allied health professionals, and patients.
Understanding other health-care professionals’ duties
will assist the medical assistant as a professional.
2.4 Membership in professional associations enables
medical assistants to become involved in activities
relevant to their field. The American Association of
Medical Assistants is a key professional organization
for medical assistants.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
2-54
End of Chapter 2
They go the extra mile.
They give their hearts,
and lead with great
minds.
—Sharon Hudacek
From A Daybook for Nurses:
Making a Difference Each Day
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.