1. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 2 Health Care Settings and the Health Care Team

2. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Ambulatory Health Care Settings Individual and group medical practices –Individual practices Also called solo practice or sole proprietorship One primary provider sees and treats patients One provider responsible for all costs

3. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Ambulatory Health Care Settings Individual and group medical practices –Group practices or Partnerships 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 –Corporations Providers are shareholders HMO is an example –Figure 2-1, p. 25

4. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

5. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Ambulatory Health Care Settings Managed care operations –Goal is to offer quality care while containing costs –Health maintenance organizations (HMOs) provide full range of services under one roof –HMOs without walls is network of participating providers within a defined geographic area –Preferred provider organization (PPO) is a physician’s network –Independent physician association (IPA) treats patients for agreed-upon fee

6. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

7. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Health Care Team Primary care provider Specialists: the “ologists” –Ophthalmologist: eye specialist –Cardiologist: heart specialist Allied health professionals Complementary and/or alternative medical (CAM) care

8. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Title “Doctor” Physicians have earned a Doctor of Medicine degree (MD) Other medical degrees –Doctor of Osteopathy (DO) –Doctor of Dentistry (DDS) –Doctor of Optometry (OD) –Doctor of Podiatric Medicine (DPM) –Doctor of Chiropractic (DC) –Doctor of Naturopathy (ND)

9. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Title “Doctor” Nonmedical disciplines –Doctor of Education (EdD) –Doctor of Philosophy (PhD) –Doctor of Psychology (PsyD)

10. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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) –4 years of medical school after bachelor’s degree –Can work in specialty area with 2–6 years additional training –Must have state license –Maintain currency in education MD and DO generally seen as equivalent

11. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 practices are increasingly seen as a complement to traditional medicine

12. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

13. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

14. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

15. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

16. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Role of the Medical Assistant Positive attitude is a must Healthy communication skills are a must Always project professional image of yourself and your employer Varies with setting and needs of the place of employment

17. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Role of the Medical Assistant Perform only within scope of training and personal capabilities Function within ethical and legal boundaries and state statutes In other words, MA’s never interpret diagnostic information, provide diagnoses or prescribe medications/treatments

18. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Other Allied Health Professionals Health unit coordinator (HUC) Medical laboratory technologist (MLT) MLT performing blood analysis >>

19. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Other Allied Health Professionals Registered dietitian (RD) Pharmacist (RPh) Pharmacy technician Pharm tech working with the pharmacist >>

20. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Other Allied Health Professionals Phlebotomist Physical therapist (PT) Physical therapy assistant (PTA) Nurse PT working with a patient >>

21. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Nurse Practitioner Registered nurse with advanced education: Master’s or Doctorate In most states can function as a primary care provider –Provide diagnoses and prescribe –Scope of practice is different state to state Number of NP’s is expected to increase

22. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Physician Assistant Just like the NP, the PA provides 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

23. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Value of the Medical Assistant Please refer to the instructor video “Paying Attention to Patients” through the instructor companion site.

24. © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Value of the Medical Assistant Valued ambulatory health care team member Communicator and liaison between provider and hospital staff/other allied health care professionals First to come in contact with patient Directs, informs, and guides patient care