Health Service Professionals: Physicians

Learning Objectives Recognize the different types of health service professionals Differentiate between primary and specialty care, and the causes for imbalance between the two in the U.S.

Health Care Industry The US health care industry is the largest and most powerful employer 3% of the total labor force 16% of the Gross Domestic Product in 2005 Health professionals among most educated and diverse Look at Table 4-1, page 118 Health care will continue to grow due to: 1) growth in population 2) aging of the population

Health Services Professionals Types of professionals: Physicians Nurses Dentists Pharmacists Optometrists Psychologists Podiatrists Chiropractors Nonphysician practitioners Health administrators Allied health professionals Therapists Social Workers Educators

Work Places Work places Hospitals Managed Care Organizations Nursing Homes Mental health facilities Insurance firms Pharmaceutical Companies Outpatient Community Health Centers Mental Health Centers School Clinics Many others – you name a few

Employment Distribution 42.6% employed by hospitals 13% by nursing and personal care facilities 11.4% physician offices and clinics

Physicians Physicians Play a central role in evaluating the patient States require licensure Graduate from an accredited medical school Pass licensure Complete residency Paid graduate medical education 3-7 years Number of active physicians increased Look at Table 4-2, page 120

Types of Physicians Two types: MD - Doctor of Medicine View medical treatment as active intervention to counter reaction or neutralize the effects of disease Most are specialists DO – Doctor of Osteopathic Medicine Emphasize the musculoskeletal system of the body and correcting the misalignment of bones & joints Most are generalists

Differences Between Types MDs and DOs Both use accepted methods of treatment (i.e. drugs, surgery) They differ in their: Philosophies and approach to medicine

Osteopathic Medicine Osteopathic medicine Practiced by DO’s Stresses preventative medicine Diet, environment, other factors Takes a holistic approach Fewer than 6% of physicians are osteopaths although their numbers are increasing

Physicians: Generalists Primary Care Physicians (Primary Care Provider) / Generalists Train in family medicine, internal medicine, obstetrics/gynecology and pediatrics Provide preventative medicine Exams, immunizations, mammograms, pap smears) Patients problems less severe and occur less frequently General Practitioner/Family Practice accounts for greatest proportion of ambulatory care visits

Physicians: Specialists Physicians in nonprimary care specialties Must seek certification in a medical specialization Usually require more years of advanced residence training Specialists include: Cardiology, Radiology, Anesthesiology, Surgery, Pathology, Psychiatry Look at Exh 4-1, page 122 Look at Tbl 4-3, page 123

Primary Care Differs according to time, focus and scope of service to patients 5 Areas of Distinction: First contact to the health care system In managed care, primary care providers are “gate-keepers” Primary care is longitudinal, they follow up in treatment and coordinate care Serve as patient advisors and advocates Focus is on the whole person Holistic, integrates Spend much time in ambulatory care settings

Specialty Care 5 Areas of Distinction: Typically seen after patient has seen a General Practitioner Requires referral from a Primary Care Provider to see a patient Episodic, more focused and intense Limited to an illness episode Deal with specific disease or body organs Time spent in inpatient hospitals, using state-of art technology

Summary The U.S. health care industry is a large industry with a lot of power. There are many different types of health care workers and employers. A physician may be an M.D. or D.O. Physicians are generalists or specialists. Click Topic 3 within Lesson 4 to continue.