copyright ©2012 delmar, cengage learning. all rights reserved. chapter 2 the health care team and...

Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Chapter 2

The Health Care Team and the Medical Environment,

Past and Present


Health Care Providers

• An individual who examines, diagnoses, and prescribes treatment to patients– Physicians are most common health care providers

• May also be an organization (hospital, clinic)


Physicians

• Education and training requirements– Undergraduate degree, 4 years– Medical school, 4 years– 3-8 years of internship and residency

• Licensure requirements– Established by each state– Complete education and training requirements– Moral and ethical requirements– State/national oral and written examinations


Physicians

• Endorsement – Passing the National Board of Medical Examiners’

examination• Reciprocity

– One state recognizes the licensing requirements of another state


Physicians

• Revocation of license– Temporary or permanent suspension of license

• Reasons for revocation– Conviction of a crime– Unprofessional conduct– Fraud– Incompetence


MD, DO, and PhD

• MD: Doctor of Medicine• DO: Doctor of Osteopathic Medicine

– Both are licensed physicians; have similar educational and licensing requirements

• PhD: Holds a doctorate degree in a particular discipline; completed highest level of study in that area


Physician Specialties

• General/family practitioners see all types of patients

• Specialty and subspecialty areas require additional years of study

• See Table 2-1 for areas in which a physician may specialize


Non-Physician Specialties

• Health specialists who are not physiciansSpecialist Degree Obtained

Chiropractor Doctor of Chiropractic (DC)

Dentist Doctor of Dental Surgery (DDS)

Optometrist Doctor of Optometry (OD)

Podiatrist Doctor of Podiatric Medicine (DPM)

Psychologist Doctor of Philosophy (PhD)


Midlevel Practitioners

• Nurse Practitioners (NP) and Physician’s Assistants (PA)

• Allowed to examine patients, order diagnostic testing, prescribe certain medications

• Activities may be directed by a supervising physician, or may work autonomously (per state law)


Nurses

• Registered Nurse (RN)– Must meet educational requirements, pass the

NCLEX-RN, licensed to practice by state• Nurse Anesthetist

– Certified to administer anesthesia• Nurse Midwife• Licensed Practical Nurse (LPN)

– Works under the supervision of RN or physician


Health Care Team MembersAudiologist Occupational Therapist

Dietician PhlebotomistEmergency Medical Technician Pharmacy Technician

Hospital Registrar Physical TherapistMedical Biller Radiology TechnicianMedical Coder Respiratory Therapist

Medical Office Manager SonographerLaboratory Technician Surgical Technologist

Nuclear Medicine Technologist


History: Ancient Times

• Primitive human beings– 80% of the population died by the age of 30

• Ancient civilizations– Disease was attributed to evil spirits and demons,

due to disobedience to the gods– Cures were rituals performed by priests


History: Egypt

• Developed medical practice ≈ 3000 BC


History: Egypt

• Physicians were priests who studied medicine and surgery

• Cures included:– Black magic, spells, concocted potions– 1/3 of medicinal plants that are still used today– Bloodletting and application of leeches


History: India

• The world’s first nurses and hospitals• Cures included:

– Extensive use of drugs, including anesthesia– Surgeries (used 120 surgical instruments!)– Cataract procedures and plastic surgery


History: China

• Highly developed center for medical learning• Cures/advancements included:

– Document, The Great Herbal, with over 1000 drugs

– Acupuncture


History: Greece

• Hippocrates, the founder of scientific medicine (460 – 379 BC)– Shifted medicine from priests to scientific study– Taught that illness was not punishment for sins– Listened to the chest (2000 years before the

stethoscope) to diagnose diseases– Code of behavior, the Hippocratic Oath


Oath of Hippocrates


History: Roman Empire

• Build an elaborate sanitation system– Saw the link between hygiene and disease

• Claudius Galen (121 – 199 AD)– Physician, surgeon, anatomist– Wrote over 500 anatomy books, based on

anatomy of animals– His viewpoints were accepted until the 16th

century


History: Medieval Times

• Little progress made between 5-16th centuries• The Arab Empire continued medical

knowledge– Had hospitals and four major teaching centers– Made contributions in pharmacology– Rhazes (860 – 932 AD)

• Wrote 150 books• Used animal gut sutures to sew wounds


History: The Great Diseases

• Leprosy• Bubonic plague, “Black Death”

– Caused by a bacillus that grew in fleas of infected black rats; fatal in 5 days

• Pneumonic plague– Affected the lungs; fatal in 3 days

• Septicemic plague


History: The Renaissance

• 17th century: Physicians, surgeon, and apothecaries practiced medicine

• Some of the contributors of this time:

Trotula Platearius Antony Van LeuwenhoekAmbroise Pare Gabriel FahrenheitAndreas Versalius Edward JennerWilliam Harvey Rene Laennec


Modern Medicine

• With the emphasis on scientific inquiry, medicine has changed rapidly

• Contributors in the 18th centuryWTG Morton Joseph ListerFlorence Nightingale Wilhelm von RoentgenClara Barton Elias MetchnikoffElizabeth Blackwell Walter ReedLouis Pasteur


Modern Medicine

• Medical pioneers in the 20th-21st centuries (cont.)Marie Curie Gerhard DomagkAlexis Carrel Dr. Jonas SalkElsie Strang L’Esperance Dr. A.B. SabinSir Alexander Fleming Dr. Michael DebakeyGeorge Papanicoulaou Dr. Willem J. KolffFrederic Banting Dr. Charles Hufnagel


Modern Medicine

Dr. C. Walton Lillehei Dr. Robert JarvickDr. Ake Senning Ray W. FullerFrank B. Colton Stanley Cohen & Herbert

Boyer

Dr. Peter Safar Nicolas Terrett & Peter Ellis (Pfizer)

Dr. Patrick Steptoe & Dr. Robert Edwards

AbioCor company


The Impact of Government on Health Care

• Has provided impetus and influence in the growth of health care

• Through grants, funding, and regulationsYear Agency1930 FDA1930 NIH1948 WHO1970 OSHA


The Impact of Government on Health Care

Year Legislation Year Legislation1946 Hill Burton Act 1970 Controlled

Substances Act1965 Medicaid 1996 HIPAA1966 Medicare 2006 Medicare Part D1967 CLIA 2010 Patient Protection

and Affordable Care Act

1968 Uniform Anatomical Gift Act


Alternatives to the Traditional Model

• Complimentary therapies– Supplement or add to conventional medicine– Massage, acupuncture, acupression, hypnosis

• Alternative therapies– Used instead of conventional medicine– No scientific evidence exists to validate

effectiveness


Alternatives to the Traditional Model

Acupuncture Homeopathy Hand reflexologyAromatherapy Humor NaturopathyAyurvedic medicine

Hypnosis Tai chi

Biofeedback Magnet therapy Visualization and guided imagery

Faith Massage Yoga

copyright ©2012 delmar, cengage learning. all rights reserved. chapter 2 the health care team and...

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