CHAPTER 25 MEDICAL CAREERS Acuity Allopathic Anesthesiology Biomechanics Internship Osteopathic Residency Vision Journal question: What personal qualities would make a student a good candidate for medical careers?

Chapter 25 Learning Objectives Define at least 10 terms relating to careers in medicine and related fields. Specify the role of selected medical care providers, including personal qualities, levels of education, and credentialing requirements. Define visual acuity and describe at least two methods used to determine it.

Chapter 25 Learning Objectives Describe two types of electrocardiography used by medical personnel.

Careers in Medicine • Function of medical care providers To promote optimal health and provide care during illness

Medical Careers

Medical Career Educational Costs and Earnings

Physicians Two types of medical doctors Education for MD Doctor of medicine (MD) Largest group Doctor of Osteopathic Medicine (DO) Education for MD 4 years of medical school after completion of a college or university degree 1-year internship for specialization Residency Discuss the differences between allopathic and osteopathic doctors.

Physicians Areas of specialization Anesthesiology Surgery Pediatrics Obstetrics Urology Psychiatry Ophthalmology Podiatry The American Board of Medical Specialists (ABMS) certifies doctors in more than 145 specialties and subspecialties.

Physicians Ophthalmologists are MDs who diagnose and treat diseases of and injuries to the eyes. May prescribe medication May perform surgery Write prescriptions for glasses Give instruction for corrective eye exercise Education Medical degree and license Specialty education and experience

Physicians Osteopathic physicians In addition to using the modern tools of medicine, osteopaths are trained to perform manipulation. Education Similar in length to the MD Completion of an accredited program and national examination Completion of 150 hours of continuing education every 3 years in some states Biomechanics is moving or manipulation of muscles and bones.

Other Medical Care Providers Podiatrist Doctor of Podiatric Medicine (DPM) Treat common foot disorders by using Corrective devices Orthopedic shoes Surgery Medication Education 2 years of college 4 years of classroom and clinical instruction Must be licensed by the state The professional care of feet was in existence in ancient Egypt. Bas-relief carvings were found at the entrance to Ankmahor's tomb dating from about 2400 BC and depicting work on hands and feet.

Other Medical Care Providers Physician assistant (PA) Works under the direction of a physician and performs about 70% of the duties of the doctor Taking patient history Conducting physical examinations Performing minor surgical procedures Ordering diagnostic tests In some states, may write prescriptions Education 2 years of college and prior health care experience 2 years of classroom and clinical training Must be registered or licensed by the state and recertified through completion of at least 100 hours of continuing education The PA may also be called a physician extender. Three PA programs train surgeon assistant.

Other Medical Care Providers Orthoptist Eye muscle specialist who works under the direction of an ophthalmologist Education 2 years of college 24 months of specialized training Certification is recommended Orthoptics is the clinical science of vision using both eyes (binocular).

Other Medical Care Providers Optician Designs, fits, and adapts lenses and frames Training On the job Vocational school and 2-year college programs Licensing is required in 26 states Opticians are also called ophthalmic dispensers. The first spectacles used quartz lenses (optical glass had not been developed). The lenses were set into bone, metal, and leather mountings.

Other Medical Care Providers Optometrist Examines and tests eyes to evaluate vision Uses lenses or therapy to improve vision Education 2 years of college 4 years of professional study at an accredited optometric school Degree earned is Doctor of Optometry (OD) Licensure Contact lenses were first used in the 1940s.

Support Personnel Surgical technologist (ST) Helps prepare the operating room and the patient for surgery Assembles and sterilizes the instruments, drapes, and solutions Prepares the patient by shaving and cleaning the incision site Assists the rest of the team to put on sterile gowns and gloves Education Training programs in vocational school, community college, and the military (9 to 24 months long) Voluntary certification Surgical technologists are also referred to as surgical and operating room technicians.

Support Personnel Medical assistant (MA) Performs clerical or clinical functions, or both, under the supervision of a physician Education 1 to 2 years of vocational school or community college programs or on-the-job training Certification for Registered Medical Assistant (RMA) Completed 5 years of service and an approved course Medical assistants who have a specialty may make casts or take radiographs and electrocardiographs.

Types of Physical Examinations

Opening a Sterile Package FIGURE 25-3 Opening a sterile package.

Opening a Sterile Package FIGURE 25-3 Opening a sterile package.

Opening a Sterile Package FIGURE 25-3 Opening a sterile package.

Opening a Sterile Package FIGURE 25-3 Opening a sterile package.

Support Personnel Podiatric assistant Assists podiatrist with Patient preparation Equipment sterilization Development of radiographs Education On-the-job training Vocational school program

Support Personnel Ophthalmic assistant/technician Measures vision Changes dressings Administers eye and oral medication Applies contact lenses Assists with specialized ocular tests Education On-the-job Home study course through the American Academy of Ophthalmology (AAO) Ophthalmic technician requires completion of a 2-year certificate program Ophthalmic technicians perform all of the items on this list and may be trained to prepare specimens for examination and to assist with ocular surgery.

Support Personnel Paraoptometric personnel work under the supervision of a doctor of optometry. Optometric technicians Perform vision screening, measure pressure on the cornea, and record patient history Determine the power of existing lenses Instruct patients on the contact lens care Education: 2-year degree Optometric assistants On-the-job or 1-year program

Vision Vision Visual acuity Comprehensive eye examination Ophthalmoscope used to view interior of eye Field of vision test Comprehensive eye examination Visual acuity testing for distant and near objects Measures focusing, tracking, and fixation skills Snellen charts are named after the Dutch ophthalmologist, Hermann Snellen, who developed the chart during 1862. The traditional Snellen chart is printed with 11 lines of block letters.

Snellen Chart FIGURE 25-8 Snellen and Jaeger charts are used to measure visual acuity.

Electrocardiogram Electrocardiogram Measures electrical currents in the heart 3 to 12 leads (or more) attached to the person being treated Electrocardiogram is a strip of graph paper that records the heart’s electrical activity. Alexander Muirhead is credited with recording the first human electrocardiogram in 1872 at St. Bartholomew’s hospital in Scotland.

Performance Instruction Physical examination Preparation of the examination room Taking vital signs Providing patient privacy Assisting the physician in positioning and giving treatment to the patient Labeling specimens

Performance Instruction Vision assessment Snellen chart Measures the ability to see symbols from a specified distance of 20 feet Height of the characters on the chart that the patient can see is used to describe the patient’s vision. A person who is said to have 20/20 vision can see characters that are 20 mm high when the person is 20 feet from the chart.

Performance Instruction Electrocardiogram (ECG) Measures the electrical activity of the heart Changes in the ECG may be used to locate the damaged area of the heart Supine position is usually used for taking an ECG

Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. A, Modified semi-Fowler’s position.

Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. B, Sitting position.

Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. C,Horizontal or supine position.

Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. D, Left Sims’ position.

Positions FIGURE 25-7 The best position is determined by the health care worker or ordered by the physician. E, Prone position.

Summary The role of medical care providers is to promote optimal health and provide care during illness. Necessary personal qualities include leadership skills, ability to work under pressure, and self-motivation.

Summary Visual acuity is the ability to differentiate shape and color and to interpret their meaning. Two assessment methods include using a Snellen chart and a field vision test to determine the width of the field vision. Electrocardiography may be completed by using 3 or 12 electrodes.

Review Surgical technologists: a. Design, fit, and adapt lenses and frames based on an optical prescription b. Assist during surgical procedures under the supervision of the surgeon and a registered nurse c. Examine and test eyes to evaluate vision and detect diseases of the eye for referral to a medical doctor d. Diagnose and treat diseases and injuries of the eye e. Working under the direction of a physician, perform about 70% of the duties of the medical doctor

Review Surgical technologists: a. Design, fit, and adapt lenses and frames based on an optical prescription b. Assist during surgical procedures under the supervision of the surgeon and a registered nurse c. Examine and test eyes to evaluate vision and detect diseases of the eye for referral to a medical doctor d. Diagnose and treat diseases and injuries of the eye e. Working under the direction of a physician, perform about 70% of the duties of the medical doctor

Review A normal vision reading is considered to be: a. 20/25 b. 20/30 c. 20/20 d. 20/35 e. 20/40

Review A normal vision reading is considered to be: a. 20/25 b. 20/30 c. 20/20 d. 20/35 e. 20/40