Health Care Settings and the Health Care Team Chapter 2 Health Care Settings and the Health Care Team

Ambulatory Health Care Settings Individual and group medical practices Individual practices Also called solo practice One primary provider sees and treats patients One provider responsible for all costs

Ambulatory Health Care Settings Individual and group medical practices Group practices Two or more providers share costs Providers consult each other Patients may request same provider for all appointments Ensures there is always provider on call Most medical practices groups of three or four providers

Ambulatory Health Care Settings Urgent care centers Usually private, for-profit centers Provide services for primary care, routine injuries and illnesses, and minor surgery Providers often salaried employees Certain retail chain stores have entered this market See higher volume of patients, usually for lower cost than hospital emergency room

Ambulatory Health Care Settings Managed care operations Health maintenance organizations (HMOs) provide full range of services under one roof HMOs without walls is network of participating providers within defined geographic area Preferred provider organization (PPO) is a physician’s network Independent physician association (IPA) treats patients for agreed-upon fee

Ambulatory Health Care Settings Boutique or concierge medical practice Sought by patients discouraged with insurance reimbursement Provides immediate access to provider 24/7 Convenient, unhurried same-day appointments Unlimited email, fax, phone consultations Home/work visits as needed Coordination of specialist referrals Set monthly or yearly fee for exclusive service

The Health Care Team Primary care provider Specialists Allied health professionals Complementary and/or alternative medical (CAM) care

The Title “Doctor” Physicians have earned a Doctor of Medicine degree (MD) Other medical degrees Doctor of Osteopathy (DO) Doctor of Dental Surgery (DDS) Doctor of Optometry (OD) Doctor of Podiatric Medicine (DPM) Doctor of Chiropractic (DC) Doctor of Naturopathy (ND)

The Title “Doctor” Nonmedical disciplines Doctor of Education (EdD) Doctor of Philosophy (PhD) Doctor of Psychology (PsyD)

Health Care Professionals Doctors of Medicine (MD) 4 years of medical school after bachelor’s degree 3–7 years of residency training Must have state license Must receive continuing medical education (CME) Doctors of Osteopathy (DO) Can work in specialty area with 2–6 years additional training Maintain currency in education

Alternative Health Care Practitioners Many carry title doctor Training highly specialized and specific When licensed, these professionals allowed to diagnose and treat medical conditions

Alternative Health Care Practitioners Doctors of Chiropractic (DC) Complete 4–5 years of chiropractic college Special attention to physiological and biochemical aspects of body structure Adjust and manipulate tissues of body, particularly spinal column Nonsurgical science; does not include pharmaceuticals or surgery Licensed in all 50 states

Alternative Health Care Practitioners Doctors of Naturopathy (ND) Often referred to as “natural medicine” Remove underlying cause of disease and stimulate natural healing process 2 years of science courses; 2 years of clinical work at naturopathy college Licensed in 15 states, 4 Canadian provinces, Puerto Rico, and Virgin Islands May practice independently and unlicensed, or practice under direction of physician

Alternative Health Care Practitioners Oriental medicine and acupuncture Acupuncture, Chinese herbology and bodywork, dietary therapy, and exercise Attempts to restore the energy flow in body’s meridians Minimum of 2-year undergraduate education and 3 years of specialty training Nearly all states regulate practice of acupuncture and Oriental medicine

The Role of the Medical Assistant Administrative functions Receptionist, secretary, office manager, bookkeeper, patient educator, insurance coder and biller, transcriptionist, patient educator, clinical assistant Clinical functions Administer injections, perform venipuncture, prepare patients for examinations, assist with examinations and special procedures, and perform electrocardiography and various laboratory tests

The Role of the Medical Assistant Perform only within scope of training and personal capabilities Function within ethical and legal boundaries and state statutes Positive attitude important Excellent communicators Project professional image of themselves and their employer

Other Allied Health Professionals Health unit coordinator (HUC) Medical laboratory technologist (MLT) MLT performing blood analysis >> [FIGURE 2-2]

Other Allied Health Professionals Registered dietitian (RD) Pharmacist (RPh) Pharmacy technician Pharm tech working with the pharmacist >> [FIGURE 2-3]

Other Allied Health Professionals Phlebotomist Physical therapist (PT) Physical therapy assistant (PTA) Nurse PT working with a patient >> [FIGURE 2-4]

Physician Assistant Provide diagnostic, therapeutic, and preventive health care services delegated by supervision of providers or surgeons May prescribe some medications; can supervise technicians and medical assistants Must complete accredited formal education and pass Physician Assistant National Certifying Examination

The Value of the Medical Assistant Valued ambulatory health care team member As communicator and liaison between provider and hospital staff, and provider and allied and other health professionals First to come in contact with patient Directs, informs, and guides patient care