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Introduction to Medical Careers
Welcome to Introduction to Medical Careers
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CHAPTER 1 HEALTH CARE OF THE PAST, PRESENT, AND FUTURE
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Vocabulary Accreditation Health Insurance Licensure Litigation
Pandemic Paraprofessional Profession Quackery Registration
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Health Care of the Past Egyptians, Greeks, and Chinese
Ancient treatments Witch doctors Herbalists Use of herbs and plants for medication Hippocrates (460–377 B.C.) Father of modern medicine First to make distinction between medicine and other fields (Theurgy, philosophy) Plagues caused millions of deaths
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Box 1-2 Hippocratic Oath
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Hippocratic Oath, Modern
I swear to fulfill, to the best of my ability and judgment, this covenant:...I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. Above all, I must not play at God. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. I will prevent disease whenever I can but I will always look for a path to a cure for all diseases. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help. Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.
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Health Care of the Present
• Focus of health care has shifted from contagious diseases to lifestyle changes Cancer Drug abuse Heart disease Acquired immunodeficiency syndrome Tuberculosis
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Health Care of the Present (Continued)
Primary concerns Emergency response and preparedness services Some communicable diseases still a focus AIDS 1.2 million people in the United States were living with HIV at the end of 2013 (1 in 8 did not know they had it) Tuberculosis 9,557 cases in 2015
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Table 1-2 Pandemics and Pandemic Scares in the United States
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Table 1-3 Agency Health Care Providers
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Federal Agencies That Oversee Nation’s Health Care
Public Health Service Part of the Department of Health and Human Services (HHS) Established in 1798 Department of Labor Regulates some health concerns through the Occupational Safety and Health Administration (OSHA)
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Health Care in the United States
One of the largest industries in the United States Supply of workers is less than demand Job opportunities and job security in many areas Cost of health care continues to increase as a result of: Technological developments Malpractice litigation Increase in longevity Disaster relief expenses
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Health Insurance United States only industrialized nation that does not guarantee health care to all citizens Insurance company third party payer assumes most health care costs Medicare and Medicaid were established to provide health care benefits for special needs groups and the elderly
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Medicare Federal health care program for:
Individuals age 65 years and older Certain younger people with disabilities People with end-stage renal disease (ESRD) DRGs (Diagnosis-related groupings) Reimbursement based on diagnosis rather than services – limits time allowed for treatment
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Medicaid Provides health care coverage for people with low income and limited resources Joint program between federal and state governments Programs vary from state to state
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Health Insurance Options
Managed care insurance plans HMO: Health Maintenance Organizations PPO: Preferred Provider Organizations POS: Point-of-Service Indemnity (fee-for-service) Disability income insurance Long-term care insurance plan Medical Savings Account (MSA)
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Figure 1-2 Health Care Insurance Model
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Table 1-4 Sample Insurance Cost Comparison
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Health Insurance Portability and Accountability Act (HIPAA)
Allows employed individuals to maintain insurance coverage if they lose or change jobs Limits exclusion of coverage because of preexisting conditions Prohibits denial of coverage because of prior illness Guarantees right to purchase insurance if unemployed Mandates the format for electronic data interchange (EDI) of information Protects the privacy of medical records
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Factors in Choosing a Career in Health Care
Economic security Nature of the duties Good working environment Opportunities for advancement New challenges Respect
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Table 1-5 Career Ladder in Health Care
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The “Patient” of Today Takes on more responsibility for his or her own care Obtains second opinions Shops for the lowest health care costs Seeks alternative and complementary providers
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Patient and Resident Rights
American Hospital Association “Patient’s Bill of Rights” – rights of the client to participate in the system of care Nursing Home Reform Law Enacted by Congress in 1987 to protect nursing home residents Places strong emphasis on individual dignity and self-determination
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Agencies of Accreditation
Training programs must meet acceptable standards Most agencies of accreditation are provided by the professional association of the health care occupation
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Credentialing Health care workers may require:
Licensure: controlled by the state and is usually based on successful completion of an examination Certification: given by an agency or a training program; indicates successful completion of a particular course Registration: earned through the state or an agency
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Health Care of the Future
Wellness services To include nutritional advice, stress reduction counseling, habit cessation management, and exercise instruction Focus on care of the elderly Alternative medicine Technology
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Health Care Workers of the Future
Multicompetent Trained for a broad range of skills Able to adapt to new technologies Highly regulated to ensure quality of care
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Figure 1-4 National Health Care Skill Standards Model
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Who is involved in Athletic Medicine?
Umbrella Policy Who is involved in Athletic Medicine? Nutritionist Physician Physical Therapist Strength & Conditioning Specialist Massage Therapist Athletic Trainer Coach Sports Psychologist Dentist
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