HEALTH SERVICE PROFESSIONALS

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HEALTH SERVICE PROFESSIONALS

• PHYSICIANS

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• PHYSICIANS PLAY A CENTRAL ROLE IN EVALUATING A
  PATIENTS HEALTH CONDITION, DIAGNOSING
  ABNORMALITIES, AND PRESCRIBING TREATMENT.

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• SOME PHYSICIANS ARE ENGAGED IN MEDICAL EDUCATION
  AND RESEARCH TO FIND NEW AND BETTER WAYS TO
  CONTROL AND CURE HEALTH PROBLEMS.

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• A GROWING NUMBER ARE INVOLVED IN THE PREVENTION
  OF ILLNESS.

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• LICENSING
• ALL STATES REQUIRE PHYSICIANS TO BE LICENSED IN
  ORDER TO PRACTICE.

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• SUCCESSFUL COMPLETION OF A LICENSING EXAMINATION
  AND COMPLETION OF A SUPERVISED INTERNSHIP/RESIDENC
  Y PROGRAM.

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• REQUIREMENTS INCLUDE GRADUATION FROM AN
  ACCREDITED MEDICAL SCHOOL THAT AWARDS A DOCTOR OF
  MEDICINE (MD) OR DOCTOR OF OSTEOPATHIC MEDICINE
  (DO)

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• DOCTOR OF OSTEOPATHIC MEDICINE (DO)

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• OSTEOPATHIC MEDICINE EMPHASIZES THE
  MUSCULOSKETETAL SYSTEM OF THE BODY SUCH AS THE
  CORRECTION OF JOINTS OR TISSUES. THEY STRESS
  DIET AND THE ENVIRONMENT AS FACTORS WHICH MIGHT
  INFLUENCE NATURAL RESISTENCE.

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• DOCTOR OF MEDICINE (MD)

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• MEDICAL DOCTORS VIEW MEDICAL TREATMENT AS ACTIVE
  INTERVENTION TO PRODUCE A COUNTERACTING REACTION
  IN AN ATTEMPT TO NEUTRALIZE THE EFFECTS OF
  DISEASE.
• (MEDICAL MODEL)

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• PHYSICIANS TRAINED IN FAMILY MEDICINE/GENERAL
  PRACTICE, GENERAL INTERNAL MEDICINE, AND GENERAL
  PEDIATRICS ARE CONSIDERED PRIMARY CARE PHYSICIANS
  OR GENERALISTS.

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• PHYSICIANS IN NON-PRIMARY CARE SPECIALITIES ARE
  REFERRED TO AS SPECIALISTS.

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• SPECIALISTS MUST SEEK CERTIFICATION IN AN AREA OF
  MEDICAL SPECIALIZATION WHICH OFTEN REQUIRES
  ADDITIONAL YEARS OF ADVANCED RESIDENCY TRAINING
  FOLLOWED BY SEVERAL YEARS OF PRACTICE IN THE
  SPECIALITY.

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• PRIMARY AND SPECIALITY CARE

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• PRIMARY CARE IS FIRST-CONTACT CARE AND IS
  REGARDED AS THE PORTAL TO THE HEALTH CARE SYSTEM.
  SPECIALITY CARE, WHEN NEEDED, GENERALLY FOLLOWS
  PRIMARY CARE.

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• IN A MANAGED CARE ENVIRONMENT WHERE HEALTH
  SERVICES ARE INTEGRATED, PRIMARY CARE PHYSICIANS
  SERVE AS GATEKEEPERS.

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• GATEKEEPERS SERVE AN IMPORTANT ROLE IN
  CONTROLLING COST, UTILIZATION, AND THE RATIONAL
  ALLOCATION OF RESOURCES.

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• IN THE GATEKEEPING MODEL, SPECIALITY CARE
  REQUIRES A REFERRAL FROM A PRIMARY CARE
  PHYSICIAN.

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• PRIMARY CARE PROVIDERS FOLLOW THROUGH THE COURSE
  OF TREATMENT AND COORDINATE VARIOUS ACTIVITIES
  INCLUDING INITIAL DIAGNOSIS, TREATMENT, REFERRAL,
  CONSULTATION, MONITORING, AND FOLLOW-UP.

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• PRIMARY CARE FOCUSES ON THE PERSON AS A WHOLE,
  WHEREAS SPECIALTY CARE CENTERS ON PARTICULAR
  DISEASES OR ORGAN SYSTEMS OF THE BODY.

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• PRIMARY CARE STUDENTS SPEND A SIGNIFICANT AMOUNT
  IN AMBULATORY CARE SETTINGS, FAMILIARIZING
  THEMSELVES WITH A VARIETY OF PATIENT CONDITIONS
  AND PROBLEMS.

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• STUDENTS IN MEDICAL SUBSPECIALTIES SPEND
  SIGNIFICANT TIME IN INPATIENT HOSPITALS, WHERE
  THEY ARE EXPOSED TO STATE-OF-THE-ART MEDICAL
  TECHNOLOGY.

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• SOME KEY ISSUES IN MEDICAL PRACTICE

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• THE BALANCING ACT BETWEEN THE AVAILABILITY OF THE
  MOST ADVANCED TREATMENT PLANS, UNCERTAINTIES
  ABOUT THEIR POTENTIAL BENEFIT, AND WHETHER THE
  HIGHER COSTS OF TREATMENT ARE JUSTIFIED.

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• THE DEVELOPMENT OF MANAGED CARE IS LIKELY TO
  SUBJECT PHYSICIANS TO GREATER CONSTRAINTS IN
  EXERCISING THEIR PROFESSIONAL JUDGEMENT.

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• MANAGED CARE ARRANGEMENTS GENERALLY LIMIT
  PAYMENTS TO PARTICIPATING PHYSICIANS THROUGH
  CAPITATION OR DISCOUNTED FEES.

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• ACCESS TO SPECIALISTS IS CONTROLLED BY
  GENERALISTS GATEKEEPERS WHO ARE PROVIDED
  INCENTIVES TO REDUCE INPATIENT CARE, X-RAYS,
  LABORATORY SERVICES, AND SPECIALISTS
  CONSULTATIONS.

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• HOSPITAL BASED TRAINING HAS PRODUCED TOO MANY
  SPECIALISTS. MEDICARE SPENDS 7 BILLION A YEAR
  ON RESIDENCY TRAINING.

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• NIH HAS FUNDED RESEARCH THUS CREATING A LARGE
  POOL OF PHYSICIAN RESEARCERS.

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• THERE ARE TOO MANY PHYSICIANS IN THE WORK FORCE
  ILL-PREPARED TO PRACTICE IN THE WELL-NESS
  ORIENTED, AMBULATORY-BASED ENVIRONMENT.

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• IT HAS BEEN ESTIMATED THAT THE US NEEDS BETWEEN
  145 AND 185 PHYSICIANS PER 100,000 POPULATION.
  CURRENTLY THE SUPPLY IS ABOUT 200 PER 100,000.

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• A SURPLUS OF PHYSICIANS LEADS TO UNNECESSARY
  INCREASES IN HEALTH CARE EXPENDITURES. A
  SHORTAGE ADVERSELY AFFECTS THE DELIVERY OF HEALTH
  SERVICES.

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• THERE IS A SURPLUS AT THE AGGREGATE, HOWEVER,
  PHYSICIAN SHORTAGES STILL EXIST IN CERTAIN PARTS
  OF THE COUNTRY.

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• PHYSICIANS ARE MORE LIKELY TO CONCENTRATE IN
  METROPOLITAN AND SUBURBAN AREAS RATHER THAN IN
  RURAL AND INNER-CITY AREAS. THE CITY OFFERS
  GREATER PROSPECTS FOR HIGH INCOME, PROFESSIONAL
  INTERACTION, ACCESS TO MODERN FACILITIES AND
  TECHNOLOGY, CONTINUING EDUCATION, PROFESSIONAL
  GROWTH, HIGHER STANDARD OF LIVING, AND SOCIAL
  AMENITIES.

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• End of lecture for September 17th 2007, 6th
  Period
• Questions?
• Discussion?

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• NURSING

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• BIG RISE IN DEMAND FOR RNS FORECAST
• NEARLY 800,000 JOB OPENINGS FOR REGISTERED NURSES
  ARE EXPECTED IN THE U.S. BETWEEN 1998 AND 2008.

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• REFLECTS A 21.7 INCREASE OVER THE NUMBER OF RNS
  THE NATION EMPLOYS TODAY.

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• THIS PROJECTED HIRING NEED WILL HAVE A MAJOR
  IMPACT ON HOSPITALS, WHICH EMPLOY ABOUT
  TWO-THIRDS OF ALL REGISTERED NURSES.

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• THE AVERAGE RN IN 1998 WAS 42 YEARS OLD, AGING
  NEARLY 5 YEARS FROM AN AVERAGE OF 37 IN 1983.

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• THE AVERAGE RN IN 1998 WAS 42 YEARS OLD, AGING
  NEARLY 5 YEARS FROM AN AVERAGE OF 37 IN 1983.
• THE NUMBER OF RNS UNDER AGE 30 HAS DECLINED BY
  41.

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• THE PRIMARY CONTRIBUTOR APPEARS TO BE A
  TWO-DECADE DECLINE IN YOUNG WOMEN CHOOSING
  NURSING AS A CAREER.

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• IT IS PROJECTED THAT THE NUMBER OF RNS IN THE
  LABOR FORCE WILL PEAK IN 2007, THEN DECLINE
  THROUGH 2020 TO ABOUT THE SAME LEVEL AS TODAY
  (2.1 MILLION) AS OLDER RNS RETIRE.

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• HOSPITALS WILL HAVE TO REPLACE THESE RETIRING
  NURSES AS THE STAPLE OF NURSING STUDENTS DECLINES
  AND 78 MILLION BABY BOOMERS BEGIN TO ENTER THE
  MEDICARE SYSTEM.

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• THE SIZE OF RN GRADUATING CLASSES IS SHRINKING,
  IN SOME CASES TO HALF OF THEIR SIZE IN THE 1970S
  AND 1980S. THIS TREND IS EXPECTED TO CONTINUE
  INTO THE NEXT DECADE.

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• HOSPITALS ALREADY ARE REPORTING RN SHORTAGES,
  PARTICULARLY IN CRITICAL CARE, EMERGENCY
  SERVICES, MEDICAL-SURGICAL AND OPERATING ROOM
  CARE.

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• FUELING THE DEMAND FOR REGISTERED NURSES

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• U.S. HOSPITALS ARE EXPERIENCING INCREASING ACUITY
  OF ILLNESS, PARTICULARLY AMONG THE ELDERLY
  PATIENTS WHO REQUIRE MORE NURSING SERVICES.

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• PATIENTS, REFLECTING AGING OF THE POPULATION,
  NEED MORE INTENSIVE CARE.

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• HOSPITALS IN THE U.S. HAVE INCREASED THE NUMBER
  OF INTENSIVE CARE UNIT BEDS BY 17,000 SINCE 1980
  THESE REQUIRE FOUR TIMES AS MANY NURSES TO STAFF
  AS NON-INTENSIVE CARE UNITS OF THE SAME SIZE.

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• WHERE DO NURSES WORK?

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• HOSPITALS ARE THE MAJOR EMPLOYERS OF RNS, HIRING
  OVER 60 PERCENT OF THE RN SUPPLY.
• WITHIN THE HOSPITAL, 40 PERCENT OF THE PERSONNEL
  ARE FROM THE NURSING DEPARTMENT.

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• FACTORS AFFECTING THE SUPPLY OF NURSES

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• AN OVERALL DECLINE IN NURSING SCHOOL APPLICANTS,
  TURNOVER, PART-TIME WORKERS, AND DECLINING AGE
  AND ACTIVITY OF WORKING NURSES.

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• OTHER CAREER CHOICES FOR WOMEN.BOTH IN THE
  MEDICAL FIELD, BUSINESS, AND EDUCATION.

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• OVERALL FUNDING FROM THE FEDERAL GOVERNMENT TO
  SUPPORT NURSING EDUCATION HAS BEEN SHARPLY
  REDUCED.

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• A SHORTAGE OF NURSING SCHOOL FACULTY IS
  RESTRICTING NURSING PROGRAM ENROLLMENTS.

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• WITH FEWER NEW NURSES ENTERING THE PROFESSION,
  THE AVERAGE AGE OF THE RN IS CLIMBING.

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• TOTAL POPULATION OF REGISTERED NURSES IS GROWING
  AT THE SLOWEST RATE IN 20 YEARS.

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• JOB BURNOUT AND DISSATISFACTION ARE DRIVING
  NURSES TO LEAVE THE PROFESSION.

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• CHANGING DEMOGRAPHICS SIGNAL A NEED FOR MORE
  NURSES TO CARE FOR OUR AGING POPULATION.

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• THE NURSE PRACTITIONER

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• A NURSE PRACTITIONER IS A REGISTERED NURSE (RN)
  WHO HAS ADVANCED EDUCATION AND CLINICAL TRAINING
  IN A HEALTH CARE SPECIALITY AREA.

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• NURSE PRACTITIONERS WORK WITH PEOPLE OF ALL AGES
  AND THEIR FAMILIES PROVIDING INFORMATION PEOPLE
  NEED TO MAKE INFORMED DECISIONS ABOUT THEIR
  HEALTH CARE AND LIFESTYLE CHOICES.

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• NURSE PRACTITIONERS MAY BE FOUND IN ALL 50
  STATES. THEY
• OBTAIN MEDICAL HISTORIES AND PERFORM PHYSICAL
  EXAMINATIONS.
• DIAGNOSE AND TREATE ACUTE HEALTH PROBLEMS SUCH AS
  INFECTIONS AND INJURIES.

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• DIAGNOSE, TREAT, AND MONITOR CHRONIC DISEASES
  SUCH AS DIABETES AND HIGH BLOOD PRESSURE.
• ORDER X-RAYS, PRESCRIBE MEDICATIONS

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• END OF LECTURE FOR SEPTEMBER 19th 2007, 6th
  PERIOD.
• QUESTIONS?
• DISCUSSION?

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• DENTISTRY

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• DENTISTRY IS DEFINED AS THE EVALUATION,
  DIAGNOSIS, PREVENTION AND/OR TREATMENTS OF
  DISEASES, DISORDERS OF THE ORAL CAVITY,
  MAXILLOFACIAL AREA AND/OR THE ADJACENT AND
  ASSOCIATED STRUCTURES AND THEIR IMPACT ON THE
  HUMAN BODY.

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• THERE ARE MORE THAN 152,000 ACTIVE DENTISTS IN
  THE UNITED STATES.
• ABOUT 92 ARE IN PRIVATE PRACTICE.

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• A 1991 NATIONAL POLL REPORTED THAT 83 OF
  AMERICAN ADULTS WERE VERY SATISFIED WITH SERVICE
  RECEIVED FROM THEIR DENTIST.

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• IN 1995, THE AVERAGE NET INCOME OF GENERAL
  PRACTITIONERS WAS ABOUT 124,960. THE MEAN NET
  INCOME OF ALL DENTAL SPECIALISTS WAS
  APPROXIMATELY 196,670.

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• THE AVERAGE INCOME OF A DENTIST IN IN THE HIGHEST
  8 PERCENT OF U.S. FAMILY INCOME.

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• CURRENTLY, APPROXIMATELY 100 MILLION PEOPLE ARE
  COVERED UNDER DENTAL PLANS WHICH PAYS ALL OR PART
  OF THEIR DENTAL EXPENSES.

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• DENTAL SPECIALITIES
• DENTAL PUBLIC HEALTH
• ENDODONTICS
• ORAL AND MAXILLIOFACIAL PATHOLOGY

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• ORAL AND MAXILLOFACIAL RADIOLOGY
• ORAL AND MAXILLOFACIAL SURGERY
• ORTHODONTICS

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• PEDIATRIC DENTISTRY
• PERIODONTICS
• PROSTHODONTICS

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• THE FUTURE OF DENTISTRY
• THE DEMAND FOR DENTAL SERVICES WILL GROW. DUE TO
  THE SUCCESSES OF PREVENTATIVE DENTISTRY, PEOPLE
  WILL KEEP THEIR TEETH LONGER AND WILL SEEK
  REGULAR DENTAL CARE.

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• OTHER HEALTH CARE ROFESSIONALS

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• THE PHYSICIAN ASSISTANT

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• PHYSICIAN ASSISTANTS ARE HEALTH CARE
  PROFESSIONALS LICENSED TO PRACTICE MEDICINE WITH
  MEDICAL SUPERVISION.
• PAS CONDUCT PHYSICAL EXAMS, DIAGNOSE AND TREAT
  ILLNESS, ORDER AND INTERPRET TESTS, COUNSEL ON
  PREVENTATIVE HEALTH CARE, AND IN SOME STATES,
  WRITE PRESCRIPTIONS.

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• IN THE 1960S, IT WAS RECOGNIZED THAT THERE WAS A
  SHORTAGE AND AN UNEVEN DISTRIBUTION OF PRIMARY
  CARE PHYSICIANS.

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• DUKE UNIVERSITY CREATED A PROGRAM AND SELECTED
  RETURNING NAVY CORPSMAN WHO HAD SERVED IN
  VIETNAM.
• CURRICULUM WAS BASED ON THE FAST TRACK PROGRAM
  USED TO TRAIN DOCTORS IN WORLD WAR II.

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• PHYSICIAN ASSISTANTS ARE FOUND IN ALL AREAS OF
  MEDICINE.
• OVER 50 PRACTICE IN THE AREA OF PRIMARY CARE.
• 19 PRACTICE IN SURGICAL SPECIALITIES

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• STATE LAW DICTATES JUST WHAT A PHYSICIAN
  ASSISTANT MAY DO.
• IN GENERAL, PAS SEE MANY OF THE SAME TYPE OF
  CASES AS THE PHYSICIAN. CASES HANDLED BY THE
  PHYSICIAN ARE THE MORE COMPLICATED ONES.

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• IN 47 STATES PAS CAN PRESCRIBE MEDICATIONS.
• ARKANSAS AND ILLINOIS ARE CHANGING THEIR LAWS TO
  PERMIT PAS TO WRITE PRESCRIPTIONS.
• IN CALIFORNIA PAS WRITE WHAT IS CALLED
  TRANSMITTAL ORDER.

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• IT IS ESTIMATED THAT IN 2002, THERE ARE 42,000
  PAS IN CLINICAL PRACTICE.

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• THERE ARE 132 ACCREDITED EDUCATIONAL PROGRAMS IN
  THE UNITED STATES.

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• THE TYPICAL PA PROGRAM IS 24-25 MONTHS.
• THE MAJORITY OF THE STUDENTS HAVE A BA/BS DEGREE
  AND 45 MONTHS OF EXPERIENCE BEFORE ADMISSION.
• IN 2002, THERE WERE ABOUT 10,000 ENROLLED IN PA
  PROGRAMS.

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• THE UNITED STATES BUREAU OF LABOR STATISTICS
  PROJECTS THAT THE NUMBER OF PA JOBS WILL INCREASE
  BY 53 BETWEEN 2000 AND 2010.

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• THE PHYSICAL THERAPIST

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• DEFINITION
• THE PHYSICAL THERAPIST PROVIDES SERVICES AIMED AT
  PREVENTING THE ONSET AND/OR SLOWING THE
  PROGRESSION OF CONDITIONS RESULTING FROM INJURY,
  DISEASE AND OTHER CAUSES.

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• PROFESSION FINDS ITS ROOTS DURING WORLD WAR I
  WITH THE WORK DONE BY RESTORATIVE AIDES.

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• A PHYSICAL THERAPIST WILL EVALUATE AND TREAT
  THOSE WITH MUSCULOSKELETAL
• DISORDERS, NUEROLOGICAL DYSFUNCTIOINS AND THOSE
  WITH OTHER TYPES OF DISEASE, INJURY OR ILLNESS.

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• WHAT DO THEY EARN?
• THERE ARE MORE THAN 120,000 LICENSED PTS IN THE
  UNITED STATES. MEDIAN SALARY IS 52,000.

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• WHERE DO THEY PRACTICE?
• OUTPATIENT CLINICS OR OFFICES
• INPATIENT REHAB FACILITIES
• SKILLED NURSING, EXTENDED CARE OR SUBACUTE
  FACILITIES.

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• HOMES
• EDUCATION OR RESEARCH CENTERS
• SCHOOLS
• HOSPICES
• FITNESS CENTERS

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• PART OF THE MEDICAL TEAM
• REHABILITATION DONE IN COORDINATION WITH DOCTORS,
  NURSES, SOCIAL WORKERS, AND OCCUPATIONAL
  THERAPISTS.

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• OCCUPATIONAL THERAPISTS CONCENTRATE ON ACTIVITIES
  OF DAILY LIVING, THE ABILITY TO COOK, CLEAN AND
  MANAGE SAFELY IN A HOMR ENVIRONMENT.

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• PHYSICAL THERAPY WILL FOCUS ON BASIC GROSS
  MOBILITY SKILLS.
• BOTH PROFESSIONS AIM TO REDUCE PAIN, RESTORE
  FUNCTION, AND PROMOTE INDEPENDENCE.

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• EDUCATIONAL REQUIREMENTS PHYSICAL THERAPY
• MINIMUM POST-BACCALAUREATE DEGREE
• MASTERS OF PHYSICAL THERAPY
• DOCTOR OF PHYSICAL THERAPY

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• EDUCATIONAL REQUIREMENTS OCCUPATIONAL THERAPY
• MINIMUM POST-BACCALAUREATE DEGREE
• MASTERS OF OCCUPATIONAL THERAPY

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• LICENSURE REQUIREMENTS
• MUST PASS A STATE-ADMINISTERED TEST.
• EMPLOYMENT OPPORTUNITIES ARE NOW VERY GOOD

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• END OF LECTURE FOR SEPTEMBER 19th 2007
• 7TH PERIOD
• Questions?
• Discussion?