Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 1 CHAPTER 25 MEDICAL CAREERS

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 2 Chapter 25 Learning Objectives  Define at least 10 terms relating to careers in medicine and related fields.  Specify the role of selected medical care providers, including personal qualities, levels of education, and credentialing requirements.  Define visual acuity and describe at least two methods used to determine it.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 3 Chapter 25 Learning Objectives  Describe two types of electrocardiography used by medical personnel.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 4 Careers in Medicine Function of medical care providers Function of medical care providers  To promote optimal health and provide care during illness

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 5 Medical Careers

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 6 Medical Career Educational Costs and Earnings

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 7 Physicians  Two types of medical doctors  Doctor of medicine (MD) Largest group Largest group  Doctor of Osteopathic Medicine (DO)  Education for MD  4 years of medical school after completion of a college or university degree  1-year internship for specialization  Residency

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 8 Physicians  Areas of specialization  Anesthesiology  Surgery  Pediatrics  Obstetrics  Urology  Psychiatry  Ophthalmology  Podiatry

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 9 Physicians  Ophthalmologists are MDs who diagnose and treat diseases of and injuries to the eyes.  May prescribe medication  May perform surgery  Write prescriptions for glasses  Give instruction for corrective eye exercise  Education Medical degree and license Medical degree and license Specialty education and experience Specialty education and experience

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 10 Physicians  Osteopathic physicians  In addition to using the modern tools of medicine, osteopaths are trained to perform manipulation.  Education Similar in length to the MD Similar in length to the MD Completion of an accredited program and national examination Completion of an accredited program and national examination Completion of 150 hours of continuing education every 3 years in some states Completion of 150 hours of continuing education every 3 years in some states

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 11 Other Medical Care Providers  Podiatrist  Doctor of Podiatric Medicine (DPM)  Treat common foot disorders by using Corrective devices Corrective devices Orthopedic shoes Orthopedic shoes Surgery Surgery Medication Medication  Education 2 years of college 2 years of college 4 years of classroom and clinical instruction 4 years of classroom and clinical instruction Must be licensed by the state Must be licensed by the state

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 12 Other Medical Care Providers  Physician assistant (PA)  Works under the direction of a physician and performs about 70% of the duties of the doctor Taking patient history Taking patient history Conducting physical examinations Conducting physical examinations Performing minor surgical procedures Performing minor surgical procedures Ordering diagnostic tests Ordering diagnostic tests In some states, may write prescriptions In some states, may write prescriptions  Education 2 years of college and prior health care experience 2 years of college and prior health care experience 2 years of classroom and clinical training 2 years of classroom and clinical training Must be registered or licensed by the state and recertified through completion of at least 100 hours of continuing education Must be registered or licensed by the state and recertified through completion of at least 100 hours of continuing education

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 13 Other Medical Care Providers  Orthoptist  Eye muscle specialist who works under the direction of an ophthalmologist  Education 2 years of college 2 years of college 24 months of specialized training 24 months of specialized training Certification is recommended Certification is recommended

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 14 Other Medical Care Providers  Optician  Designs, fits, and adapts lenses and frames  Training On the job On the job Vocational school and 2-year college programs Vocational school and 2-year college programs Licensing is required in 26 states Licensing is required in 26 states

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 15 Other Medical Care Providers  Optometrist  Examines and tests eyes to evaluate vision  Uses lenses or therapy to improve vision  Education 2 years of college 2 years of college 4 years of professional study at an accredited optometric school 4 years of professional study at an accredited optometric school  Degree earned is Doctor of Optometry (OD) Licensure Licensure

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 16 Support Personnel  Surgical technologist (ST)  Helps prepare the operating room and the patient for surgery Assembles and sterilizes the instruments, drapes, and solutions Assembles and sterilizes the instruments, drapes, and solutions Prepares the patient by shaving and cleaning the incision site Prepares the patient by shaving and cleaning the incision site Assists the rest of the team to put on sterile gowns and gloves Assists the rest of the team to put on sterile gowns and gloves  Education Training programs in vocational school, community college, and the military (9 to 24 months long) Training programs in vocational school, community college, and the military (9 to 24 months long) Voluntary certification Voluntary certification

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 17 Support Personnel  Medical assistant (MA)  Performs clerical or clinical functions, or both, under the supervision of a physician  Education 1 to 2 years of vocational school or community college programs or on-the-job training 1 to 2 years of vocational school or community college programs or on-the-job training Certification for Registered Medical Assistant (RMA) Certification for Registered Medical Assistant (RMA)  Completed 5 years of service and an approved course

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 18 Types of Physical Examinations

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 19 Opening a Sterile Package FIGURE 25-3 Opening a sterile package.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 20 Opening a Sterile Package FIGURE 25-3 Opening a sterile package.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 21 Opening a Sterile Package FIGURE 25-3 Opening a sterile package.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 22 Opening a Sterile Package FIGURE 25-3 Opening a sterile package.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 23 Support Personnel  Podiatric assistant  Assists podiatrist with Patient preparation Patient preparation Equipment sterilization Equipment sterilization Development of radiographs Development of radiographs  Education On-the-job training On-the-job training Vocational school program Vocational school program

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 24 Support Personnel  Ophthalmic assistant/technician  Measures vision  Changes dressings  Administers eye and oral medication  Applies contact lenses  Assists with specialized ocular tests  Education On-the-job On-the-job Home study course through the American Academy of Ophthalmology (AAO) Home study course through the American Academy of Ophthalmology (AAO) Ophthalmic technician requires completion of a 2- year certificate program Ophthalmic technician requires completion of a 2- year certificate program

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 25 Support Personnel  Paraoptometric personnel work under the supervision of a doctor of optometry.  Optometric technicians Perform vision screening, measure pressure on the cornea, and record patient history Perform vision screening, measure pressure on the cornea, and record patient history Determine the power of existing lenses Determine the power of existing lenses Instruct patients on the contact lens care Instruct patients on the contact lens care Education: 2-year degree Education: 2-year degree  Optometric assistants On-the-job or 1-year program On-the-job or 1-year program

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 26 Vision  Vision  Visual acuity Ophthalmoscope used to view interior of eye Ophthalmoscope used to view interior of eye Field of vision test Field of vision test  Comprehensive eye examination Visual acuity testing for distant and near objects Visual acuity testing for distant and near objects Measures focusing, tracking, and fixation skills Measures focusing, tracking, and fixation skills

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 27 Snellen Chart FIGURE 25-8 Snellen and Jaeger charts are used to measure visual acuity.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 28 Electrocardiogram  Electrocardiogram  Measures electrical currents in the heart 3 to 12 leads (or more) attached to the person being treated 3 to 12 leads (or more) attached to the person being treated  Electrocardiogram is a strip of graph paper that records the heart’s electrical activity.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 29 Performance Instruction  Physical examination  Preparation of the examination room  Taking vital signs  Providing patient privacy  Assisting the physician in positioning and giving treatment to the patient  Labeling specimens

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 30 Performance Instruction  Vision assessment  Snellen chart Measures the ability to see symbols from a specified distance of 20 feet Measures the ability to see symbols from a specified distance of 20 feet Height of the characters on the chart that the patient can see is used to describe the patient’s vision. Height of the characters on the chart that the patient can see is used to describe the patient’s vision.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 31 Performance Instruction  Electrocardiogram (ECG)  Measures the electrical activity of the heart  Changes in the ECG may be used to locate the damaged area of the heart  Supine position is usually used for taking an ECG

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 32 Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. A, Modified semi-Fowler’s position.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 33 Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. B, Sitting position.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 34 Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. C,Horizontal or supine position.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 35 Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. D, Left Sims’ position.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 36 Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. E, Prone position.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 37 Summary  The role of medical care providers is to promote optimal health and provide care during illness.  Necessary personal qualities include leadership skills, ability to work under pressure, and self-motivation.

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 38 Summary  Visual acuity is the ability to differentiate shape and color and to interpret their meaning. Two assessment methods include using a Snellen chart and a field vision test to determine the width of the field vision.  Electrocardiography may be completed by using 3 or 12 electrodes.