Health Service Professionals: Other Health Care Professionals

Learning Objectives Understand the role of non physician providers Identify allied health professionals and their roles Understand the functions and qualifications of health service administrators

Types of Health Care Personnel Dentists Dental Hygienists Dental Assistants Pharmacists Other Doctoral-Level Health Professionals Optometrists Psychologists Podiatrists Chiropractors Nurses Registered Nurses Licensed Practical Nurses Advanced Practice Nurses Non Physician Practitioners Physician Assistants Nurse Practitioners Certified Nurse Midwives AH Professionals (includes many health-related professionals) See Chart 4-2, page 144 Health Services Administrators

Dentists Major role: Must be licensed to practice Diagnose and treat dental problems related to teeth, gums and mouth Must be licensed to practice DDS – Doctor of Dental Surgery DDM – Doctor of Dental Medicine Eight specialties recognized by American Dentist Association Orthodontics – straighten teeth Oral/maxillofacial surgery – mouth and jaw Pediatric dentistry Periodontics – treat gums Prosthodontics – artificial teeth or dentures Endodontics – root canals Public health dentistry – community Oral pathology – disease of the mouth

Other Dental Professionals Dental hygienists Do preventative dental care Clean, educate Must be licensed Dental Assistants Help in the preparation, exam and treating of patients Do not need licensure

Pharmacists Role: Need license to practice $84,900 income in 2004 Dispense medicine prescribed by doctors, dentists, podiatrists, psychiatrists Consult on selected uses of medicine Need license to practice PharmD degree, 6 years of education $84,900 income in 2004

Other Doctoral-Level Health Professionals These are not M.D.s or D.O.s Optometrists Psychologists Podiatrists Chiropractors

Optometrists Role Need license Usually work in solo or group practices Provide vision care with: Exams, diagnostics, correction Need license Doctor of Optometry (OD) Usually work in solo or group practices

Psychologists Role Need license Provide patients with mental health care Need license Doctor of Philosophy (PhD) or Doctor of Psychology (PsyD)

Podiatrists Role Need a license Treat diseases or deformities of the feet Includes surgeries, medicine, corrective devises Need a license Doctor of Podiatric Medicine (DPM)

Chiropractors Role Need license to practice Treatment by hand manipulation, physiotherapy and dietary counseling Help patients with neurological, muscular, vascular problems Believe body is self-healing Do not prescribe medicine or do surgery Need license to practice Doctor of Chiropractic (DC), 4 years

Nurses The largest group of health care professionals Profession developed after World War I The major caregivers of sick and injured patients Address physical, mental and emotional needs Need to be licensed to practice 2 levels: Registered Nurses (RN) Licensed practical nurses (LPN)

Nurse Shortage As average length of stay decreased, demand for nursing fell, but patients are sicker and more nurses are needed work more intensive Shortfall of 110,000 nurses 120,000 are trained but not working In 2020, shortfall will be 340,000 RNs if current trends continue!

Reasons for Shortfall Reasons for shortfall: Sluggish wages Low job satisfaction Inadequate career mobility Falling nursing enrollments Demand from other alternative hospital sites

Nurse Reinvestment Act Nurse Reinvestment Act of 2002 Grants and scholarships to attract and keep in the field Most money goes to nursing schools, but hospitals will benefit Encouraging nurses to get: higher education training internships retention to enhance role of nurses

Advanced Practice Nurses Education and clinical experience is required for a Registered Nurse 4 Areas of Specialization: Clinical Nurse Specialist (CNS) – hospital Certified Registered Nurse Anesthetist (CRNA) Nurse Practitioners (NP) - primary care Certified Nurse Midwives (CNM)

Nonphysician Practioners (NPP) NPPs are: Clinical professionals who practice in many areas similar to a physician, but do not have a physician or DO degree “Delivery extenders”

Physician’s Assistants Role: Part of the health care team who works in a dependent relationship with a supervising physician to provide comprehensive care Licensed to do medical procedures under supervision of a physician supervision can be on or off-site Duties include: evaluation, monitor, diagnostics, therapy, counseling, referral Follows a medical model Focuses on disease

Nurse Practitioners Have completed study with competence of an RN in an expanded role Largest group of NPPs that has most growth, but may be declining Follow a nursing model with health promotion and education

Allied Health Professionals Includes many health-related areas Constitutes 60% of U.S. health care workforce 2 Broad Categories: Technicians/assistants Therapists/technologists Look at Exh 4-2, page 144

Health Service Administrators Employed at various levels of organizations Manage complex integrated delivery organizations Educational qualifications: MHA - Master in Health Administration MHSA - Master in Health Serv Admin MBA – Master in Business Administration MPH – Master in Public Health MPA - Master in Public Administration/Affairs

Administrative Challenges Challenges for health service administrators : Financing and payment structures Working with decreasing levels of reimbursement Pressure of uncompensated care High quality Community health service Demands by both public and private payers New policy developments Changing competitive environment Maintaining integrity

Summary Health care professions influenced by: Demographic trends Advances in research and technology Disease and illness trends Changing environment Click Topic 4 within Lesson 4 to continue.