Healthcare Professionals

Aisha Syed

Healthcare is comprised of many professions that work on different levels to care

for their patients. Some healthcare professionals have tasks that vary from complicated

surgical procedures, to changing a baby’s diaper. This chapter will discuss some of many

professions that make up the healthcare system. Nevertheless, when we think of healthcare

professions we assume that only nurses and physicians are involved. While physicians and

nurses are a vital part of the healthcare system there are many other professions that

makeup the healthcare field. This chapter will discuss the duties, skills, and educational

level of many healthcare professions.

The chapter which follows is divided into seven sections. The first of these

sections contains Healthcare Professionals, which will include medical doctors, doctors

of osteopathy, and nurses. The section will also discuss the differences between a medical

doctors and doctors of osteopathy. The second section describes the official medical

specialties. The next section is on Nursing, including different types and their duties,

skills, and educational background. The fifth section will discuss other licensed

professions like, Rehabilitation specialists, Occupational therapist, and Physical therapist.

The sixth section will cover Healthcare Managers. This refers to the people that are

providing services instead of care. The last section will discuss controversy between

physician, nurse practitioners, and physicians assistant.

Healthcare Professionals

There are hundreds of healthcare professions that array from medical doctor to

dietitian. Similarly, 11.6 million people work in healthcare in the US which includes

778,000 physicians where 5 percent are Doctors of Osteopathy2, 2.1 million registered

nurses, and 160,000 dentists1. The remaining are involved in research, care-giving,

teaching, or administration1.

Doctors prevent, treat, and advise patients to keep healthy. Nevertheless, doctors

can be categorized in two groups, medicine as practiced by MD’s, known as allopaths

(traditional) and Doctor of Osteopathy, DO2. The majority of doctors practice allopathy.

There are 15 accredited osteopathy schools compared to over 120 medical schools.

According to New England Journal of Medicine, osteopathic philosophy focuses on a

patient-centered approach, where it is based on prevention along with concentrating on the

patient as a whole, rather than individual parts of the body separetly2. In addition, the body

is used to assist in healing the body with the manipulation of bones, muscles, and tendons.

This technique used by DO’s is not practiced by most MD’s. An osteopath focuses on the

symptoms and its treatment rather than the disease only. Both forms of doctors use

medicines, surgery, and standard methods of treatment; however the approaches for the

doctors are slightly different1. Osteopaths have the same specialties as MD’s (see

Specialty section for further information).

MD’s and DO’s have the same level of education, training, and residency

programs, however there are many more MD’s then DO’s. In addition, MD’s and DO’s

attend separate and different schools that have variation in curriculum. Many more MD’s

enter into specialty where many DO’s enter in primary care. Whatever type of doctor a

patient chooses, they should realize that both physicians meet the same standards, but have

different approaches in treatment.

Those who desire to attend medical should pursue a pre-medical curriculum in

undergraduate and then apply to medical school or osteopathic school. Most medical

schools take four years to complete however, there are schools that allow for a completion

of both pre-medical and medical school in six to seven years4. Typically, in medical

school the first two years are spent in the classrooms and laboratories, the next two years

are spent in the hospital learning and training under supervision. After graduation medical

students enter a residency program, research programs, or may decide to teach.

The largest health professional group is nurses. There are different levels such as:

licensed practical nurse, nurse practitioner, registered nurse, and nurse midwife. These

topics will be discussed in detail later in the chapter.

Graduate Medical Education Year1 2 3 4 5 6-7

Family Practice

Pediatrics

Obstetrics

Internal Medicine

Neurosurgery

Subspecialties

Dermatology

Neurology

Ophthalmology

Psychiatry

Colon-Plastic-Thoracic

Orthopedic Surgery

Otorhinolaryngology

Urology

Surgery

Medical Specialties

Primary and specialty care received by a patient may include ambulatory care

(primary), secondary (specialty), and tertiary. Primary care refers to care received when

needed for example, you go to a primary care physician for a cough or cold in addition to

immunizations. Primary care aims for prevention and focuses on the maintenance of high

quality of life3. Some key points that primary care concentrates on include: disease

prevention, early detection of disease to eliminate further and or serious problems,

educates the patient, advises the patient for better health, and refers the patients to other

providers for the appropriate times3. Some examples of primary care physicians include

internist (internal medicine) and pediatricians. The primary care provider offers a wide

array of services to their patients such as: physical exams, health screenings, and

immunizations, infection assessment, advise on different conditions and many others

health-based advise3. Primary care providers are essential to the healthcare system;

however, they may be less paid then the other specialty doctors or surgeons. Primary care

physicians provide direct care to patients, which is the difference between secondary and

tertiary care.

Secondary care is often referred to as specialty care. Normally, a patient receives

care from their primary care giver; moreover if a specific problem arises the patient will be

referred to a specialist. Secondary care is often provided in hospitals and allows for long

term care3. Similar to primary care providers, specialists deal with diagnosis, prognosis,

and treatment3. In addition, secondary care concentrates on one specific part of the

patient’s body. There are several types of specialties (and there are subspecialties which

are not included for example cardiology):

SPECIALTY DESCRIPTIONAllergy and Immunology (formed in 1971) Study, diagnosis, and treatment of

disorders of the immune system, including

allergy, immune deficiency, and

autoimmune disease.

Anesthesiology (1938) Use of anesthetic agents to prevent pain

during surgical or other painful procedures

Colon and Rectal Surgery (1935) Surgical treatment of disorders of the anus,

rectum, and intestines

Dermatology (1932) Diagnosis and treatment of disorders and

diseases of the skin

Emergency Medicine (1979) Treatment of patients suffering from

sudden, life threatening injury and illness.

Family Practice (1969) Comprehensive care of individual of all

ages on a long-term basis.

Internal Medicine (1936) Non-surgical diagnosis and treatment of

disorders of the internal organs.

Medical Genetics Study, prevention, diagnosis, and treatment

of genetic disorders.

Neurological Surgery (1940) Surgical treatment of the nervous system,

including the nerves, brain, and spinal cord.

Nuclear Medicine (1971) Use of radioactive substances to diagnose

and treat disease.

Obstetrics and Gynecology (1930) Diagnosis and treatment of disorders of the

female reproductive system and

management of pregnancy, labor, and

childbirth.

Ophthalmology (1917) Diagnosis and treatment of disease and

disorders of the eyes.

Orthopedic Surgery (1934) Diagnosis and surgical treatment of

disorders of the bones, muscles, and

associated structures.

Otolaryngology (1924) Study, diagnosis, and treatment of disease

of the head and neck.

Pathology (1936) Study of the nature of disease and the

changes it causes in the body.

Pediatrics (1933) Study of the growth and development of

children, as well as diagnosis and treatment

of disease in children.

Physical Medicine and Rehabilitation (1947)

Treatment of disorders by physical means,

such as heat, cold, and radiation.

Plastic and Reconstructive Surgery (1939) Surgical treatment, to repair superficial

parts of the body.

Preventive Medicine (1948) Study and use various measures to prevent

disease by immunization and other

controls.

Psychiatry and Neurology (1934) Study of the mind and the treatment of its

disorders.

Radiology (1934) The use of x rays and other radiation to

treat disease.

Surgery (1937) Use of various procedures called operations

to treat and diagnosis disease and injury.

Thoracic Surgery (1948) Surgery of the chest, including surgery of

the heart, lungs, and chest wall.

Urology (1935) Diagnosis and treatment of diseases of the

urinary tract in female and the urogenital

tract in males.

Source: American Board of Medical Specialties, Encarta ® Online Encyclopedia 2001.

Primary care is synonymous with promoting health and prevention of disease,

secondary care specializes in certain areas such as dermatology or orthopedic surgery, and

tertiary care provides highly specialized care like intensive-care.

Alternative Healthcare

The definition of alternative medicine is not clear cut, but the previous written

chapter by Anna Rosenfeld discusses some of the professions that are considered as

alternative medicine today. Chapter three discusses chiropractors, acupuncture, Chinese

medicine, homeopathy, naturopathy, massage therapist, hypnosis, and biofeedback.

Nursing

Nurses are a vital part of the healthcare system. Next to doctors nurses are most

familiar with the patient’s cases. Nevertheless, there are several levels of nursing who

have different skills and qualifications. The two main categories of nurses are Licensed

practical nurses or LPNs and Registered nurses or RNs.

There are approximately 700,000 licensed practical nurses that provide different

types of care4. LPN’s provide for patients in hospital, nursing homes, and extended care

facilities4. LPNs do not have the same education and training as an RN; however provide

the physicians and other nurses assistance with patient care. Some of the duties that a LPN

performs include: record keeping of the patient, taking blood pressures, care of newborns,

administer medications, bathe patients, and other tasks that are needed by the physicians4.

LPNs work a 40 hour week, but not all nurses work the usual nine to five, most nurses

have to work odd hours because patients need 24 hour care. Most nurses are first to arrive

and assist a patient and if they seem necessary they will call a physician for duties they

cannot perform such as prescribing medication. Nurses also feel stressed and strained

similar to doctors because they have risks involved with their job. Some risks include

injuries, sleep deprivation, and emotional problems.

An LPN can receive their education through trade, technical, and vocational

schools4. The length of the program is one year in addition to a high school diploma.

After the completion of the program the nurses are certified by the state to practice.

Registered Nurses or RNs are extremely important in health care. They work hand

in hand with physicians and administering medications to patients4. Nurses are likely to

work on several different patients at one time in intensive care unit or a children’s ward.

Registered nurses can work in a variety of environments such as patient’s homes, schools,

public clinics and other community related areas4.

RNs differ from LPNs by the level of education and training received. RNs either

attend nursing school after graduating high school. RNs usually complete a four year

bachelor degree or receive an associate degree to be properly certified to practice nursing

where LPNs do not need a bachelor’s degree to practice. Indeed most RNs work part-time

with varying times in different areas of health care. Nevertheless, LPNs and RNs

educational background and duties vary so their tasks are different also but both nurses are

essential to doctors and their areas of work.

HEALTH CARE PROFESSIONALS DESCRIPTION

Anesthesiologist Assistant Assists the anesthesiologist in developing

and implementing the anesthesia care plan

Art Therapist Uses drawings and other art/media forms to

www.arttheerapy.org or www.atcb.org

assess, treat, rehabilitate patients with

mental, emotional, physical, and/or

developmental disorders

Athletic Trainer Are involved in prevention, recognition,

evaluation, management, treatment,

rehabilitation, organization, administration,

and education.

Audiologist and Speech-Language Pathologist

Audiologist determines what type of

hearing loss a person has and what can be

done to assist the person. A pathologist

evaluates speech, language, and swallowing

skills of people to determine any

communication problems and treats them.

Blood Bank Technology-Specialist Tests blood group for antigens, investigates

abnormalities, supports physicians in

transfusion, and performs blood collection

and processing.

Cardiovascular Technologist Reviews patient history and performs

cardiovascular and therapeutic services.

Clinical Laboratory Science/Medical Technologywww.aspc.org

Perform complex analyses, fine-line

discrimination, and error correction.

Counseling-related Professions

www.nbcc.org

Deal with human development concerns

through support, therapeutic approaches,

consultation, evaluation, teaching, and

research.

Cytotechnologist

Email:asc@cytopathology.org

Prepare cellular samples for study under

microscope and assist in diagnosis of

disease by examining the samples.

Dental-related Occupations

www.ada.org or www.aads.jhu.edu

Include Dental Assistant, Dental hygienist,

and Dental Laboratory Technician.

Diagnostic medical Sonographer Provides patient services in use and

interpretation of ultrasound procedures.

Dietitian

www.eatright.org/caade

Integrate and apply the principles derived

from the sciences of food, nutrition,

biochemistry, physiology, food

management, and behavior to achieve and

maintain the health status of the public.

Electroneurodiagnostic Technologist Taking and abstracting histories, applying

adequate recording electrodes and using

EEG, EP, and PSG techniques;

documenting the condition of the patients.

Emergency Medical Technician-Paramedic

Email: naemthq@aol.com

Practice out-of-hospital medicine in

conjunction with medical direction. The

asses and provide medical care, goal is to

prevent death due to injury or illness.

Genetic Counselor

www.fadeb.org/genetics

Consulting individuals with birth defects or

genetic disorder.

Health Information Management Related to the management of health

information and the systems used to collect,

store, process, retrieve, analyze,

disseminate, and communicate that info.

Kinesiotherapist Treats the effects of disease, injury, and

congenital disorders through the use of

therapeutic exercise and education.

Medical Assistant Work under the supervision of physicians

in their offices or other medical settings.

Medical Illustrator Create visual material designed to facilitate

the recording and dissemination of medical,

biological, and related knowledge.

Music Therapist Music is used within a therapeutic

www.musictherapy.org

relationship to address individuals’

physical, psychological, cognitive, and

social needs.

Nuclear Medicine Technologist Uses nuclear properties of radioactive and

stable nuclides to make diagnostic

evaluations and provide therapy.

Occupational Therapy Uses purposeful activity and interventions

to achieve functional outcomes to

maximize health of injured or ill.

Ophthalmic Dispensing Optician Fit corrective eyewear, including glasses

and contact lenses.

Ophthalmic Laboratory Technician Cut, grind, edge and finish lenses and

fabricate eyewear.

Ophthalmic Medical

Technician/Technologist

Assists ophthalmologists by administration

work and collection of data.

Orthoptist

www.orthoptics.org

Evaluation and treatment of disorders of

vision, eye movements, and eye alignment

in adults and children.

Orthotist and Prosthetist

www.oandp.com/academy or

www.oandp.org

Rehabilitation of the physically challenged.

Perfusionist

www.amsect.org

Conduct extracorporeal circulation and auto

transfusion equipment temporarily.

Physical Therapy

www.apta.org

Help improve patients’ strength and

mobility, relieve pain, and prevent

permanent physical damage.

Physician Assistant Prepared to practice medicine with the

supervision of a licensed doctor of

medicine or osteopathy.

Radiologic Technology Deliver prescribed doses of radiation to

patients for therapeutic purposes.

Rehabilitation Counselor Determines and coordinates services to

assist people with disabilities.

Respiratory Care Provides respiratory care.

Surgical Technologist Assist surgeons to provide surgical care.

Therapeutic Recreation Specialist

www.nrpa.org/branches/

Uses various interventions to treat physical,

cognitive, emotional, and social conditions

associated with illness, injury or

disabilities.

Health Professions Career and Education Directory. American Medical Association, 2000.

Other Licensed Professionals

Besides doctors, nurses, and administrators there are other professions that are

important to the health care system. Rehabilitation counselors, Occupational therapists,

and Physical therapist are some of the few licensed professionals that are not given very

much attention in the medical field. Each profession plays an important role to its patients

and with their specialized care they provide.

Rehabilitation counselors have various backgrounds which include public health

nursing, social work, and school counselining5. Rehabilitation counselors work with

persons who have a disability, where they encourage psychological, emotional, and

economic growth5. Furthermore, counselors aid patients who have other disabilities such

as mental and emotional along with physical. Some additional tasks of rehabilitation

counselors include: assist patients in locating and keeping employment, break down social

barriers that the society creates for disabled individuals, aid in the disabled to create a bond

between themselves and family and friends, they assist in training individuals so they are

more independent, and encourage good job performance and progress in daily living4,5.

There are a range of jobs and areas that a counselor may be employed however, they must

be certified through the Commission on Rehabilitation Counselor Certification (CRCC) in

addition to training programs that last up to two years. Approximately 43 million

Americans have some disability and having rehabilitation counselor’s assist with their

lives, jobs, and relationships the disabled will have better quality of life5.

Occupational therapists are similar to Rehabilitation counselors because they both

assist disabled individuals and aid them into a “normal” way of life. First, the patient is

evaluated to observe the type of therapy needed with tests which measure the skills of the

person. After the tests are interpreted the treatment or training begins with education,

consultation with the individual and or their family5. Victims of accidents which have left

them disabled are assisted with therapy by skills such as weaving, knitting, and other

intricate projects. Other similar activities provide a creative skill which assists the patients

in restoring their lost ability4.

In addition, Occupational therapist can also be considered one of several Home

care specialists because they may make home visits and plan educational, recreational, and

social activities to aid the patients regain their bodily functions6. The optimum goal of

occupational therapist is to have their patients become independent even with their

handicaps. The goals of occupational therapists are similar to rehabilitation counselor,

which is for optimum health and well being in addition to the patient being independent.

Occupational therapists must have a bachelor’s degree and afterwards they take an

examination to be certified for their state of residence, where the state regulates the

practices of therapist5.

Physical therapists work with a broad range of individuals; they work with patients

recovering from accidents to Olympic atlethes5. They use methods such as exercise,

massage, ultrasound, electricity, heat, cold, and water to increase the mobility of patients,

relieve pain, and improve muscle and skin condition5, 6. Physical therapists have a detailed

job in evaluating patients such as providing the family with proper training instructions to

assist in the care of the patient. Along with a extensive skills involved in treating a patient

a physical therapist does not need to only work in a hospital, they are employed in many

other areas, such as sports facilities, health care centers, and nursing homes. There is a

great need for physical therapists that provide home health care. Attending therapy session

is a task for the patient and their family. This entails the family taking time out of their

schedule to take the patient to the hospital to provide therapy; however, with the ease of

having a therapist do home-visits is easier for the family and patient. Moreover, life

expectancy is very high for Americans today, so there are a growing number of elderly

individuals (baby boom) that require physical therapy after a surgery. Equally important is

our love of sports in the US, we have many athletes that push their limits daily, however,

in doing so they have an increased number of injuries which leads to surgery afterward

receiving physical therapy.

Physical therapists have a bachelor’s degree in physical therapy and attain a

certification by the state which gives them the license to practice.

These are only a few of licensed professionals that are important in the functions of the

health care system. We’ve noticed that simple surgery is not enough to retain a good

quality of life, therefore having counselors and therapist is very important in patient care.

Healthcare Managers

So far we’ve discussed health care professionals that provide care of some sort,

with primary or secondary care. However, coordinators within a hospital do not provide

care, but services. A Healthcare manager can have one task or many such as planning,

engineering, administration, application, and policy5. Planning refers to strategic efforts

engineering is designing modes and the flow of the department, administration is handling

various information and organizing it, application is analyzing and using the data for

attaining information, and policy is implementing confidentiality, integrity and other

standards within the hospital5.

Most healthcare managers have tasks based on the work environment so there are

no specific duties that are assigned on a daily basis, however the main skill the manager

should have and implement is to run the health care system as smoothly as possible. Being

the bridge between doctors and drug, insurance, or other companies is a difficult task for

an individual to handle. So the employees work as a team to function as a good system.

Another responsibility the health manager faces is the serving as an information service;

such as clinical quality assessment so the data is used properly and effectively5.

The Health and Human Services Department is an example of a large administrator

employee. Within the federal government it resides over 12 major divisions like the

Administration for Children and Families with provides services to encourage the proper

and healthy development of children7. Programs such as this allow the assistance

programs to run properly and with managers with skills to run a healthcare system the

entire organizations are able to assist children and families.

For more information on Healthcare Manager see chapter three.

Lastly, there has been controversy between the roles of physicians, physicians

assistant, and nurse practitioners. Nurse Practitioners are RNs who have received

specialized training who work under a physician similarly to a physician assistant. A

physicians assistant is fully capable of practicing medicine but under the supervision of a

physician5. Nurse practitioners practice mainly primary care and which is well received by

patients. However, individual states have authority to allow NPs to practice independently,

but the majority of states require the supervision of physicians1. All three are able to

prescribe medications. Nevertheless, physicians have more training which means that PA

and NPs will always have to report to physicians. Moreover, if all doctors, assistants, and

nurses work together with separate duties will allow for better and effective patient care.

The medical field requires an individual to be extremely disciplined and devoted to

their career. Doctors are extremely respected for their knowledge, devotion and hard work

that made them a doctor. The healthcare system may or may not always acknowledge the

difficulty of their careers, but hopefully this chapter has made readers more aware of some

different professions and importance of each profession. Doctors and nurses are

backbones of the medical field but it takes more than a backbone for a human to function.

There are many more professions that were not mentioned in the chapter that contribute a

great deal to the healthcare system. With some introductory knowledge an individual may

want to explore other options and hopefully want to pursue a career in the medial area.

References

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http://encarta.msn.com

2. Howell, Joel. Osteopathy vs. Traditional Doctor. N England J Med. 1999;

341:1426-1431, 1465-1467.

3. Miller M. Health Care Choices for Today, a Consumers Guide to Quality and

Cost. New York: John Wiley and Sons, Inc., 1997.

4. Selden, A. Handbook of Health Care Careers. Lincolnwood: VGM Career

Horizons, 1994.

5. Health Professions Career and Education Directory . American Medical

Association, 2000.

6. Cardoza, A. Homecare Services Careers. Lincolnwood: VGM Career

Horizons, 1993.

7. “Health and Human Services”. Microsoft® Encarta® Online Encyclopedia

2001. http://encarta.msn.com

8. Belshaw, Chris. Osteopathy Is it for you? Element Books limited, 1987.

9. Fabb, W., Fry, J. Principles of practice management in Primary care.

Lancaster: MTP Press, 1984.

10. Stephen, William. An analysis of primary medical care: an international study.

Cambridge: Cambridge University Press, 1979.