THE UNITED STATES HEALTH CARE SYSTEM Combining Business, Health, and Delivery CHAPTER Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Other Clinical and Non-Clinical Health Care Providers 6

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Objectives Identify the role of physician assistants, medical assistants, and surgical technologists in hospital and office visits. List the providers of diagnostic testing. Identify the providers of therapeutic services. Describe the role of health care professionals in emergency care situations.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Objectives (cont.) Identify the role of dentists, optometrists, chiropractors, podiatrists, and dietitians/nutritionists in the health care system. Define health administration. Identify the role of health information managers and technicians. Describe the role of professional billing and coding in the service delivery process.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Office or Hospital Visit Physician Assistants In 2009, there were approximately 74,800 practicing physician assistants (PAs).

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Office or Hospital Visit (cont.) Physician Assistants (cont.) Working under the supervision of a physician, the PA provides health care services to patients. –90% are in clinical practice –37% work in hospitals –35% work with group practice physicians –85% are employed full-time

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Office or Hospital Visit (cont.) Physician Assistants (cont.) PAs are allowed to prescribe medications. PAs must complete an accredited, formal education program. In 2008, there were 142 PA programs.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Office or Hospital Visit (cont.) Physician Assistants (cont.) All states require that PAs pass the Physician Assistants National Certifying Examination (PANCE). In 2009, median earnings for PAs was $93,500.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Office or Hospital Visit (cont.) Medical Assistant The medical assistant (MA) provides administrative, clerical, and limited clinical services to the physician. MAs complete college study resulting in a certificate or associate degree. In 2008, there were 483,600 MAs.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Office or Hospital Visit (cont.) Medical Assistant (cont.) 62% work in physicians’ offices 13% in hospitals 11% in other practitioners’ offices This is a fast growing occupation. In 2009, average earnings for a MA was $30,834.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Office or Hospital Visit (cont.) Surgical Technologists Surgical technologists assist the surgical team. In 2008, 71% of the 91,500 surgical technologists worked in hospital operating and delivery rooms. The annual median earnings was $38,740.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Providers of Diagnostic Testing Technologists and Technicians Technologists and technicians are found in hospitals, physicians’ offices, and diagnostic imaging centers. Growth is predicted in these fields because of the health care needs of an aging population.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Providers of Diagnostic Testing (cont.) Technologists Imaging technologists and technicians (diagnostic imaging technicians/ radiographers) take X-rays or other tests. –50% of the jobs are in the hospital

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Providers of Diagnostic Testing (cont.) Technologists (cont.) Nuclear medicine technologists administer the radiopharmaceuticals and operate the imaging equipment that traces a drug in the patient’s body. –66% of nuclear technologists work in hospitals

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Providers of Diagnostic Testing (cont.) Technologists and Technicians Cardiovascular technologists and technicians specialize in the heart and its peripheral blood vessels. –77% work in hospitals

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Providers of Diagnostic Testing (cont.) Technologists and Technicians (cont.) Diagnostic medical sonographers use ultrasound technology to generate an image to assess and diagnose various medical conditions. –59% of sonographers are employed by hospitals

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Providers of Diagnostic Testing (cont.) Medical Laboratory Specialists Medical laboratory specialists perform a variety of complex tests on the samples they receive. Histology technicians prepare tissue samples for pathologists. Phlebotomists collect blood samples.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Therapy Providers Physical Therapy Physical therapists (PTs) help patients restore mobility and manage pain by implementing a treatment plan that utilizes exercise, massage, and other therapies. 2/3s are employed by hospitals or in a PT practice, and 27% work part time. Nursing homes, rehabilitation centers, and home health agencies employ PTs.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Therapy Providers (cont.) Respiratory Therapy Respiratory therapists treat patients with breathing disorders. –80% work in hospitals in respiratory care, anesthesiology, or pulmonary medicine departments

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Therapy Providers (cont.) Occupational Therapy Occupational therapists (OTs) focus on improving patients’ ability to perform daily living and work skills. –They work in hospitals, schools, mental health centers, or rehabilitation centers

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Therapy Providers (cont.) Recreational Therapy Recreational therapy includes techniques such as arts and crafts, games, dance, drama, and music to improve the emotional and physical well-being of patients; they work in hospitals and long- term care facilities.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Therapy Providers (cont.) Speech-Language Therapy Speech-language pathologists diagnose and treat a range of problems: speech, language, cognitive, communication, voice, and swallowing.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Therapy Providers (cont.) Audiologists and Pharmacists Audiologists work with patients with hearing, balance, and related problems. Pharmacists dispense the drugs prescribed by the physician and provide information to patients about medications. –Retail pharmacies (65%) –Hospitals (22%)

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Therapy Providers (cont.) Pharmacy Technicians Pharmacy technicians count tablets, label bottles, verify information, prepare insurance forms, and stock inventory. 2/3s of technicians and 80% of aides work in retail pharmacies.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Emergency Care Providers The National Registry of Emergency Medical Technicians (NREMT) has four levels of service providers: –First responder –EMT-basic –EMT-intermediate (85 and 99) –EMT-paramedic.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Emergency Care Providers (cont.) First responders provide basic care. –EMT-basic personnel care for patients at the accident scene and transport by ambulance. –EMT-intermediate personnel can administer intravenous fluids, use defibrillators, and advanced airway techniques and equipment. –EMT-paramedics may also administer drugs, interpret EKGs, and use other complex equipment.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Emergency Care Providers (cont.) Paramedic and EMT In 2008, there were 210,700 paramedics. Annual median earnings was $28,200. Most work for hospitals and private ambulance services. Training and certification is required to become an EMT or paramedic.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Total Health Care Program Dental Care The dentist is the physician who provides oral health care. Like other physicians, dentists are licensed by the state and may prescribe medications for their patients. –75% are sole practitioners/private practice –15% work in a partnership –15% are specialists

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Total Health Care Program (cont.) Dental Care (cont.) Dental hygienists do the bulk of health assessment, X-rays, and teeth cleaning. Dental assistants perform a combination of patient care, office, and laboratory tasks. Dental laboratory technicians create all of the dental prosthetics such as crowns, bridges, and dentures.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Total Health Care Program (cont.) Eye Care More than half of all Americans need corrective eyewear. Ophthalmologists are physicians who treat diseases of the eye, perform eye surgery, and prescribe corrective lenses.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Total Health Care Program (cont.) Eye Care (cont.) Optometrists provide primary care. –40% work directly for the optometrists. –13% work for ophthalmologists. –33% work in retail optical stores. –Ophthalmic laboratory technicians make prescription eyeglasses.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Total Health Care Program (cont.) Chiropractic Care The chiropractor’s approach to healthcare is holistic, but the focus is on the spine. –A bachelor’s degree and a 4-year chiropractic college are required to obtain the doctor of chiropractic degree. –All states require licensure. –Most chiropractors (49,100) are in private, solo practice. –Median annual earnings are $66,490.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Total Health Care Program (cont.) Foot Care Podiatrists provide specialized care for the foot. 12,200; 1/2 in solo practice Average earnings are $113,560. A license is required to practice podiatric medicine.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Total Health Care Program (cont.) Diet and Nutrition Dietitians are the food and nutrition experts. They provide medical nutrition therapy. They are employed in hospitals, long-term care facilities, or in physicians’ clinics.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Total Health Care Program (cont.) Diet and Nutrition (cont.) In 2008, there were 60,300 dietitians with a median salary of $50,590. Most have a bachelor’s degree and many obtain a master’s degree.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Health Care Employment in Non-Clinical Positions Health Administrators and Managers Health administration is concerned with patient care, but also about profitability and other business issues. They are health administrators, health managers, or health executives.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Health Care Employment in Non-Clinical Positions (cont.) Health Administrators and Managers (cont.) In 2008, there were 284,000 positions with an average salary of $80,240. They have bachelor’s degree and master’s degrees.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Health Care Employment in Non-Clinical Positions (cont.) Information Technology Information technology positions include medical records management, privacy officer, risk management, medical coding, corporate compliance, and data analysis and reporting.

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Health Care Employment in Non-Clinical Positions (cont.) Coding Specialists Coding specialists assign codes, or numbers, to the diagnoses, services, and procedures, and must be familiar with CPT and ICD-9-CM codes. –In 2008, average salary was $30,600. –Other Support Staff: Transcriptionists and secretaries

Copyright ©2012 by Pearson Education, Inc. All rights reserved. The United States Health Care System: Combining Business, Health, and Delivery, Second Edition Anne Austin Victoria Wetle Cost-Effectiveness Issues It is more cost-effective to utilize lower level professionals because they are not paid as much. Some services and providers are reimbursed directly; others are not.