Y khoa - Dược - Chapter 2: Types of medical practice

2Types of Medical Practice2-*2.1 Describe medical specialties and specialists.2.2 Explain the purpose of the American Board of Medical Specialties.2.3 Describe the duties of several types of allied health professionals with whom medical assistants may work.2.4 Name professional associations that may help advance a medical assistant’s career.Learning Outcomes2-*IntroductionMedical assistants are an integral part of the health-care teamA working knowledge of specialties and allied health professionals enables the MA to function better as a member of the health-care team 2-*Medical Specialties Approximately 22 major medical specialties existSpecialized medical care is driven by advances in diagnosing and treating various diseasesCardiologyPediatricsAdultNote: Cardiology = specialty Pediatrics and Adult = subspecialty2-*Physician Education and LicensureBachelor’s DegreeGraduate from an Accredited Medical SchoolPass the U.S. Medical Licensing ExamComplete 2–6 Years of Residency2-*Medical SpecialistsSpecialistFunctionsFamily PracticeMedical doctors that treat all conditions and age groupsAlso called general practitioners or primary care physicians by insurance companiesRefers patients to specialists for specific diseases requiring specialized careAllergistDiagnoses and treats people with hypersensitivity to substances such as drugs, chemicals, and elements in nature2-*Medical Specialists (cont.)SpecialistFunctionsAnesthesiologistAdministers medications that alter sensation and feelings during surgeryBariatricsMedical and surgical treatment of obesityCardiologistDiagnoses and treats diseases of the heart and blood vesselsDermatologistDiagnoses and treats diseases of the skin, hair, and nails2-*Medical Specialists (cont.)SpecialistFunctionsDoctor of OsteopathyUses eyes and hands to identify structural problems and promote natural healingUses osteopathic manipulative medicine (OMM) techniquesEmergency Medicine PhysicianWorks in hospital emergency roomsDiagnoses and treats medical crises and accidentsEndocrinologistDiagnoses and treats disorders of the endocrine system, which regulates many body functions2-*Medical Specialists (cont.)SpecialistFunctionsGastroenterologistDiagnoses and treats disorders related to the stomach, intestines, and other organsGerontologistDiagnoses and treats problems and diseases affecting older adultsGynecologistDiagnoses and treats diseases of the female reproductive systemInternistDiagnoses and treats problems related to internal organs2-*Medical Specialists (cont.)SpecialistFunctionsNephrologistStudies, manages, and diagnoses diseases of the kidneyNeurologistDiagnoses and treats disorders and diseases of the nervous systemObstetricianStudies pregnancy, labor and delivery, and postpartumOncologist Identifies and treats patients with cancer2-*Medical Specialists (cont.)SpecialistFunctionOphthalmologistDiagnoses and treats diseases and disorders of the eyeOrthopedistDiagnoses and treats diseases and disorders of muscles and bonesOtorhinolaryngologistDiagnoses and treats ear, nose, and throat disordersPathologistStudies bodily changes produced by disease processesPediatrician/Adolescent MedicineDiagnoses and treats childhood diseases2-*Medical Specialists (cont.)SpecialistFunctionPhysiatristDiagnoses and treats diseases and disorders with physical therapyPodiatristTreats disorders of the footPlastic SurgeonPerforms reconstruction, correction, and improvement of body structuresProctologistTreats disorders of the anus, rectum, and intestinesRadiologist/Nuclear MedicineUses x-rays and radioactive substances to diagnose and treat diseases 2-*Medical Specialists (cont.)SpecialistFunctionSports MedicineSubspecialty of medicine dealing with treatment and preventative care of athletes SurgeonUses hands and instruments to diagnose, correct, and treat injuries, diseases, and deformitiesUrologistDiagnoses and treats diseases of the kidneys, bladder, and urinary system2-*Apply Your Knowledge Name the medical specialists who would be involved in the care of a 6-month-old infant with massive burns over 90% of the body and indicate how each specialist would contribute to the care for this situation.ANSWER: The following specialists would be involved in the care of this patient: Pediatrician because of the age of the infant Plastic surgeon to perform skin grafting Dermatologist for skin, hair, and nail repair Emergency medicine for treatment during medical crisisCorrect!2-*PATIENTMedical AssistantsDoctorsSpecialistsNursesHealth-Care TeamKnowing the duties of other health-care team members will help you be a more effective team member.2-*Allied Health Professionals DisciplineFunctionAcupuncturist Treats pain or discomfort by inserting thin, hollow needles under the skin to balance the opposing forces of yin and yang Based on Chinese beliefs 2-*Allied Health Professionals (cont.)DisciplineFunctionChiropractorTreats disorders without drugs or surgery by making adjustments to realign the vertebrae in the spineIs an independent practitionerElectroencephalographic (EEG) Technologist / TechnicianElectroencephalography is the study and recording of the brain’s electrical activityEEG technicians work in hospitals, physicians’ offices, and clinics2-*Allied Health Professionals (cont.)DisciplineFunctionElectrocardiograph (ECG) TechnicianECG technicians operate electrocardiograph machines that record the heart’s electrical impulsesECG technicians work in hospitals2-*Allied Health Professionals (cont.)DisciplineFunctionMassage TherapistPromotes muscle and full body relaxation; increases circulation and lymph flow One of the oldest methods to promote healingMedical Administrative Assistant Provides administrative support to medical, professional, and technical personnelTranscribing dictationComposing correspondenceWorks in hospitals, clinics, etc.2-*Allied Health Professionals (cont.)DisciplineFunctionMedical Billing and CodingExtraction and coding of medical information from patient records Preparation of insurance claims to maximize reimbursement and ensure ethical standards in the professionMedical Records TechnologistOrganizes, analyzes, and evaluates medical records Compiles administrative and health statistics, code symptoms, and inputs and retrieves computerized health dataRegistered Health Information Administrator (RHIA) and Accredited Health Information Technician (RHIT)CPTICD-9HCPCS2-*Allied Health Professionals (cont.)DisciplineFunctionMedical Office Administrator / ManagerManages the practice of a physician or a group practiceCoordinates records and filingOversees office staffMay also greet patients, make appointments, and perform general secretarial tasksRequires knowledge of Computer application softwareAdvanced document processing skillsAccounting 2-*Allied Health Professionals (cont.)DisciplineFunctionMedical Technology – includes: Clinical Laboratory Technician (CLT)Performs lab tests under supervision of physicians or medical technologists1- or 2-year degreeWorks in hospital labs, clinics, etc.Medical TechnologistPerforms lab tests and procedures such as examining body fluids and tissuesHas a 4-year degreeWorks in clinics, industry, hospitals, research, etc. 2-*Allied Health Professionals (cont.)DisciplineFunctionMedical TranscriptionistTranslates a physician’s dictation into comprehensive, typed recordsWorks in attorney offices, insurance companies, hospitals, physician offices, clinics, and laboratoriesMental Health Technician (Psychiatric Aide or Counselor)Participates in supervising group therapy and counseling sessions Works with emotionally disturbed and mentally challenged patients Work settings include psychiatric clinics, crisis centers and shelters, hospital psychiatric units, and specialized nursing home settings2-*Allied Health Professionals (cont.)DisciplineFunctionNuclear Medicine TechnologistCompletes either a 2-year or 4-year programWorks in hospitals, physician offices, or public health institutionsDuties include:Overseeing quality controlPreparing and administering radioactive drugsOperating radiation detection instrumentsPositioning patientsPerforming imaging procedures2-*Allied Health Professionals (cont.)DisciplineFunctionOccupational TherapistHelps patients attain maximum physical and mental health through the use of educational, vocational, and rehabilitation activitiesHas a 4-year degree plus 9- to 12-month internship at an accredited hospitalWork settings include:HospitalGovernment agencyRehabilitation hospital2-*Allied Health Professionals (cont.)DisciplineFunctionPharmacistDispenses medications and health supplies Employment in hospitals, clinics, nursing homes, pharmaceutical companies, or private or chain pharmacies Three levels of educational training for pharmacy careersPharmacist Technician (CPhT) – 2-year programs Registered Pharmacist (RPh) – 5 years of college Doctor of Pharmacy (PharmD) – 6 to 7 years of college with residency2-*Allied Health Professionals (cont.)DisciplineFunctionPhlebotomistDraws blood for diagnostic laboratory testingReceives advanced phlebotomy training that allows him/her to draw blood under difficult circumstances Most states require phlebotomists to be certified by the National Phlebotomy Association or registered by the American Society of Clinical Pathologists2-*Allied Health Professionals (cont.)DisciplineFunctionPhysical Therapist (PT)Has a bachelor’s degree in physical therapy and must pass a state board examinationMay work in hospitals, rehabilitation centers, outpatient clinics, private practice, or sports medicine centerImproves patient functioning by using:Electricity, heat, and cold Ultrasound and massageExercise2-*Allied Health Professionals (cont.)DisciplineFunctionPhysician Assistant (PA)Provides direct patient care under the supervision of a licensed physicianTraining requirements vary; many states require certification and registration with the state medical boardWorks in a variety of settings: private practice, nursing homes, hospitals, etc.Some states allow PAs to write prescriptions2-*Allied Health Professionals (cont.)DisciplineFunctionRadiographer (X-ray Technician)Assists a radiologist in taking x-ray films May be employed in hospitals, physicians’ offices, clinics, government agencies, etc.Radiographic TechnologistTrained in x-ray theory and practical applications as well as radioactive materials May specialize in radiation therapy, radiography, or nuclear medicineWorks in hospitals, clinics, medical laboratories, and medical practices2-*Allied Health Professionals (cont.)DisciplineFunctionRegistered DietitianAlso called nutritionistAssists patients and family with nutrition planningMay prepare and serve food to groupsWork settings include: Community health agencies HospitalsClinics Private practices Teaching and consulting2-*Allied Health Professionals (cont.)DisciplineFunctionRespiratory TherapistWorks under the supervision of a physicianWorks in hospitals, physicians’ offices, nursing homes, and commercial companiesEvaluates, treats, and cares for patients with respiratory problems such as:AsthmaEmphysemaPneumoniaBronchitis2-*Nursing CareersTrainingSample DutiesNursing Aide/Assistant1 week to 3 monthsMakes bedsChecks vital signsBathes patientsPractical/Vocational Nurse (LPN, LVN)1 yearChecks vital signsAdministers medicationsChanges dressingsAssists registered nurses and physicians2-*Registered Nurse (RN)Educational PreparationLength of ProgramAssociate Degree RN (ADN)2 yearsDiploma RN3 yearsBaccalaureate RN (BSN)4 years2-*Nursing Careers (cont.)TitleFunctionRegistered Nurse (RN)RN designation once state boards are passedResponsible for planning, providing, and supervising bedside care of patientsWork settings includeHospitals, nursing homes, and physicians’ officesPublic health agencies and government agenciesEducational settings2-*Nursing Careers (cont.)TitleFunctionNurse Practitioner (NP)An RN that functions in an expanded roleRequires a minimum of a Master’s degree and 4 to 12 months of formal training or an apprenticeshipDuties include:Physical examinationsTreating common illnesses and injuriesMany states allow NPs to write prescriptionsPatient education2-*Apply Your KnowledgeIf you had to choose other health-care team members to plan the care for a 68-year-old patient recently diagnosed with a stroke, who has a history of seizure disorders, which would you choose, and why? ANSWER: The health-care team members that might participate in this patient’s care are: Physical therapist for decreased mobility due to strokePharmacist to review medicationsNutritionist for dietary evaluation and possible modificationsEEG technician to perform EEG for brain electrical activityNursing staff (RN, LPN, CNA)Other health-care professionals will also be part of the team!Good Job!2-*Specialty Career Options for MAsRequire additional education or trainingMany options available – check:Local and medical college librariesState employment agenciesHealth career opportunities in local newspapersDirectly with companies where you might seek employment2-*Specialty Career Options (cont.)SpecialtyFunctionAnesthetist’s AssistantProvides anesthetic care under direct supervision of the anesthetistWorks in hospitals and high-technology surgical centersAssists in evaluating patient mental and physical statusCertified Laboratory AssistantPerforms lab procedures such as bacteriology, chemistry, hematology, parasitology, serology, and urinalysis Supervised by medical technologists or hospital pathologistsWorks in labs, clinics, physicians’ offices, etc.2-*Specialty Career Options (cont.)SpecialtyFunctionDental AssistantCan practice without formal education or trainingPerforms both administrative and lab functionsWorks in private practice, clinics, schools, local health agencies, and for insurance companiesEmergency Medical Technician / ParamedicReferred to as an EMTTrained to triage patients and follow instructions from a physicianWorks for an ambulance service or in fire department, hospital emergency room, or private industry2-*Specialty Career Options (cont.)SpecialtyFunctionOccupational Therapist AssistantSupervised by occupational therapistsTeaches fine motor skills, occupations, and the arts to patients with mental and physical disabilitiesEarns a 2-year degreeOphthalmic AssistantAssists ophthalmologistsPerforms simple vision testing and other proceduresThree ophthalmic career levels:TechnologistTechnicianAssistant2-*Specialty Career Options (cont.)SpecialtyFunctionPathologist AssistantSupervised by a pathologistSome work with forensic and/or anatomic pathologistsPerforms laboratory duties and some administrative functionsPediatric Medical AssistantAssists the pediatrician with administrative and clinical dutiesWorks in private practice, hospitals, and clinics2-*Specialty Career Options (cont.)SpecialtyFunctionPharmacy TechnicianPerforms routine tasks related to recordkeeping and preparing and dispensing medicationsWorks in hospitals, pharmaceutical firms, and wholesale pharmaciesPhysical Therapy AssistantWorks directly under the physical therapistPerforms tests and treatment proceduresObserves and documents patient responses to therapyWorks in hospitals, rehabilitation centers, nursing homes, etc.2-*Specialty Career Options (cont.)SpecialtyFunctionRadiation Therapy TechnologistAssists the radiologistMaintains radiation treatment equipmentCompletes a 2- or 4-year education programWorks in hospitals, labs, clinics, and physicians’ officesRespiratory Therapy TechnicianWorks under supervision of physician and respiratory therapistPerforms artificial ventilation and maintains respiratory equipmentWorks in hospitals, physician offices, nursing homes, etc.2-*Specialty Career Options (cont.)SpecialtyFunctionSpeech / Language PathologistEvaluates, diagnoses, and counsels patients with communication problems like stutteringUsually has a Master’s degreeWorks in schools, hospitals, research settings, or private practiceSurgical TechnicianCompletes a 2- or 4-year degreeProvides patient services under direct supervision of a surgeonPerforms diagnostic and therapeutic proceduresWorks primarily in hospitals2-*Professional AssociationsInvolvement in issues and activities relevant to your professionOpportunities for continuingeducation2-*Professional Associations (cont.)American Association of Medical Assistants (AAMA)The Association for Healthcare Documentation Integrity (AHDI)American College of Physicians (ACP)American Hospital Association (AHA)2-*Professional Associations (cont.)American Medical Technologist (AMT)American Pharmacists AssociationAmerican Society of Phlebotomy Technicians (ASPI)American Medical Association (AMA)2-*TJCFormerly The Joint Commission on Accreditation of Healthcare OrganizationsNon-profit organizationGoal is to maintain and elevate the standards of health-care delivery by health-care organizationsEvaluation AccreditationAccreditation is significant factor in gaining reimbursement from Medicare and managed care organizations2-*Council of Ethical and Judicial Affairs (CEJA)Develops policy for the AMAAddresses timely ethical issuesMaintains and updates the AMA Code of EthicsComprehensive ethics guide for physicians2-*Apply Your KnowledgeWhich of the professional organizations listed below are primarily for the role(s) of medical assistants?AMAAAMAAHAAMTASCPAAMTACPAPhARight Answer!xxxANSWER: 2-*In Summary2.1 Today there are approximately 22 major medical specialties. As new medical advances occur, the demand for more specialty areas will emerge.2.2 The American Board of Medical Specialties is an organization of many different medical specialty boards. Its primary purpose is to maintain and improve the quality of medical care and to certify doctors in various specialties.2-*In Summary (cont.)2.3 Medical assistants are members of a health-care team that includes doctors, nurses, physical therapists, other allied health professionals, and patients. Understanding other health-care professionals’ duties will assist the medical assistant as a professional. 2.4 Membership in professional associations enables medical assistants to become involved in activities relevant to their field. The American Association of Medical Assistants is a key professional organization for medical assistants.2-*They go the extra mile. They give their hearts, and lead with great minds.—Sharon HudacekFrom A Daybook for Nurses: Making a Difference Each DayEnd of Chapter 2