Types of Medical Practice

CHAPTER

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

2Types of Medical

Practice


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2.1 Describe medical specialties and specialists.

2.2 Explain the purpose of the American Board of Medical Specialties.

2.3 Describe the duties of several types of allied health professionals with whom medical assistants may work.

2.4 Name professional associations that may help advance a medical assistant’s career.

Learning Outcomes


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Introduction

• Medical assistants are an integral part of the health-care team

• A working knowledge of specialties and allied health professionals enables the MA to function better as a member of the health-care team


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Medical Specialties • Approximately 22 major

medical specialties exist

• Specialized medical care is driven by advances in diagnosing and treating various diseases

Cardiology

Pediatrics Adult

Note: Cardiology = specialty Pediatrics and Adult = subspecialty


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Physician Education and Licensure

Bachelor’s Degree

Graduate from an Accredited Medical School

Pass the U.S. Medical Licensing Exam

Complete 2–6 Years of Residency


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Medical Specialists

Specialist FunctionsFamily Practice Medical doctors that treat all conditions and age

groups Also called general practitioners or primary care

physicians by insurance companies Refers patients to specialists for specific

diseases requiring specialized care

Allergist Diagnoses and treats people with hypersensitivity to substances such as drugs, chemicals, and elements in nature


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Medical Specialists (cont.)

Specialist FunctionsAnesthesiologist Administers medications that alter sensation and

feelings during surgery

Bariatrics Medical and surgical treatment of obesity

Cardiologist Diagnoses and treats diseases of the heart and blood vessels

Dermatologist Diagnoses and treats diseases of the skin, hair, and nails


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Specialist Functions

Doctor of Osteopathy

Uses eyes and hands to identify structural problems and promote natural healing

Uses osteopathic manipulative medicine (OMM) techniques

Emergency Medicine Physician

Works in hospital emergency rooms Diagnoses and treats medical crises and

accidents

Endocrinologist Diagnoses and treats disorders of the endocrine system, which regulates many body functions


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Specialist FunctionsGastroenterologist Diagnoses and treats disorders related

to the stomach, intestines, and other organs

Gerontologist Diagnoses and treats problems and diseases affecting older adults

Gynecologist Diagnoses and treats diseases of the female reproductive system

Internist Diagnoses and treats problems related to internal organs


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Specialist FunctionsNephrologist Studies, manages, and diagnoses

diseases of the kidney

Neurologist Diagnoses and treats disorders and diseases of the nervous system

Obstetrician Studies pregnancy, labor and delivery, and postpartum

Oncologist Identifies and treats patients with cancer


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Specialist FunctionOphthalmologist Diagnoses and treats diseases and

disorders of the eye

Orthopedist Diagnoses and treats diseases and disorders of muscles and bones

Otorhinolaryngologist Diagnoses and treats ear, nose, and throat disorders

Pathologist Studies bodily changes produced by disease processes

Pediatrician/Adolescent Medicine

Diagnoses and treats childhood diseases


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Specialist FunctionPhysiatrist Diagnoses and treats diseases and disorders

with physical therapy

Podiatrist Treats disorders of the foot

Plastic Surgeon Performs reconstruction, correction, and improvement of body structures

Proctologist Treats disorders of the anus, rectum, and intestines

Radiologist/Nuclear Medicine

Uses x-rays and radioactive substances to diagnose and treat diseases


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Specialist FunctionSports Medicine Subspecialty of medicine dealing with

treatment and preventative care of athletes

Surgeon Uses hands and instruments to diagnose, correct, and treat injuries, diseases, and deformities

Urologist Diagnoses and treats diseases of the kidneys, bladder, and urinary system


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Apply Your KnowledgeName the medical specialists who would be involved in the care of a 6-month-old infant with massive burns over 90% of the body and indicate how each specialist would contribute to the care for this situation.

ANSWER: The following specialists would be involved in the care of this patient:

• Pediatrician because of the age of the infant

• Plastic surgeon to perform skin grafting

• Dermatologist for skin, hair, and nail repair

• Emergency medicine for treatment during medical crisis

Correct!


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PATIENT

Medical Assistants

Doctors

Specialists

Nurses

Health-Care Team

Knowing the duties of other health-care team members will help you be a more effective team member.


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Allied Health Professionals

Discipline Function

Acupuncturist Treats pain or discomfort by inserting thin, hollow needles under the skin to balance the opposing forces of yin and yang

Based on Chinese beliefs


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Allied Health Professionals (cont.)

Discipline FunctionChiropractor Treats disorders without drugs or

surgery by making adjustments to realign the vertebrae in the spine

Is an independent practitioner

Electroencephalographic (EEG) Technologist / Technician

Electroencephalography is the study and recording of the brain’s electrical activity

EEG technicians work in hospitals, physicians’ offices, and clinics


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Discipline Function

Electrocardiograph (ECG) Technician

ECG technicians operate electrocardiograph machines that record the heart’s electrical impulses

ECG technicians work in hospitals


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Discipline Function

Massage Therapist

Promotes muscle and full body relaxation; increases circulation and lymph flow

One of the oldest methods to promote healing

Medical Administrative Assistant

Provides administrative support to medical, professional, and technical personnel

Transcribing dictation Composing correspondence

Works in hospitals, clinics, etc.


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Discipline Function

Medical Billing and Coding

Extraction and coding of medical information from patient records

Preparation of insurance claims to maximize reimbursement and ensure ethical standards in the profession

Medical Records Technologist

Organizes, analyzes, and evaluates medical records

Compiles administrative and health statistics, code symptoms, and inputs and retrieves computerized health data

Registered Health Information Administrator (RHIA) and Accredited Health Information Technician (RHIT)


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Discipline Function

Medical Office Administrator / Manager

Manages the practice of a physician or a group practice

Coordinates records and filing Oversees office staff May also greet patients, make appointments, and

perform general secretarial tasks Requires knowledge of

Computer application software Advanced document processing skills Accounting


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Discipline FunctionMedical Technology – includes:

Clinical Laboratory Technician (CLT)

Performs lab tests under supervision of physicians or medical technologists

1- or 2-year degree Works in hospital labs, clinics, etc.

Medical Technologist

Performs lab tests and procedures such as examining body fluids and tissues

Has a 4-year degree Works in clinics, industry, hospitals, research,

etc.


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Discipline Function

Medical Transcriptionist

Translates a physician’s dictation into comprehensive, typed records

Works in attorney offices, insurance companies, hospitals, physician offices, clinics, and laboratories

Mental Health Technician (Psychiatric Aide or Counselor)

Participates in supervising group therapy and counseling sessions

Works with emotionally disturbed and mentally challenged patients

Work settings include psychiatric clinics, crisis centers and shelters, hospital psychiatric units, and specialized nursing home settings


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Discipline Function

Nuclear Medicine Technologist

Completes either a 2-year or 4-year program

Works in hospitals, physician offices, or public health institutions

Duties include: Overseeing quality control Preparing and administering radioactive drugs Operating radiation detection instruments Positioning patients Performing imaging procedures


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Discipline Function

Occupational Therapist

Helps patients attain maximum physical and mental health through the use of educational, vocational, and rehabilitation activities

Has a 4-year degree plus 9- to 12-month internship at an accredited hospital

Work settings include: Hospital Government agency Rehabilitation hospital


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Discipline Function

Pharmacist Dispenses medications and health supplies Employment in hospitals, clinics, nursing homes,

pharmaceutical companies, or private or chain pharmacies

Three levels of educational training for pharmacy careers

Pharmacist Technician (CPhT) – 2-year programs

Registered Pharmacist (RPh) – 5 years of college

Doctor of Pharmacy (PharmD) – 6 to 7 years of college with residency


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Discipline Function

Phlebotomist Draws blood for diagnostic laboratory testing

Receives advanced phlebotomy training that allows him/her to draw blood under difficult circumstances

Most states require phlebotomists to be certified by the National Phlebotomy Association or registered by the American Society of Clinical Pathologists


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Discipline Function

Physical Therapist (PT)

Has a bachelor’s degree in physical therapy and must pass a state board examination

May work in hospitals, rehabilitation centers, outpatient clinics, private practice, or sports medicine center

Improves patient functioning by using: Electricity, heat, and cold Ultrasound and massage Exercise


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Discipline Function

Physician Assistant (PA)

Provides direct patient care under the supervision of a licensed physician

Training requirements vary; many states require certification and registration with the state medical board

Works in a variety of settings: private practice, nursing homes, hospitals, etc.

Some states allow PAs to write prescriptions


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Discipline Function

Radiographer (X-ray Technician)

Assists a radiologist in taking x-ray films May be employed in hospitals, physicians’ offices,

clinics, government agencies, etc.

Radiographic Technologist

Trained in x-ray theory and practical applications as well as radioactive materials

May specialize in radiation therapy, radiography, or nuclear medicine

Works in hospitals, clinics, medical laboratories, and medical practices


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Discipline Function

Registered Dietitian

Also called nutritionist Assists patients and family with nutrition planning May prepare and serve food to groups Work settings include:

Community health agencies Hospitals Clinics Private practices Teaching and consulting


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Discipline Function

Respiratory Therapist

Works under the supervision of a physician

Works in hospitals, physicians’ offices, nursing homes, and commercial companies

Evaluates, treats, and cares for patients with respiratory problems such as:

Asthma Emphysema Pneumonia Bronchitis


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Nursing Careers

Training Sample Duties

Nursing Aide/

Assistant

1 week to 3 months

Makes beds Checks vital signs Bathes patients

Practical/

Vocational Nurse (LPN, LVN)

1 year Checks vital signs Administers medications Changes dressings Assists registered nurses and

physicians


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Registered Nurse (RN)

Educational Preparation Length of Program

Associate Degree RN (ADN) 2 years

Diploma RN 3 years

Baccalaureate RN (BSN) 4 years


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Nursing Careers (cont.)

Title Function

Registered Nurse (RN)

RN designation once state boards are passed

Responsible for planning, providing, and supervising bedside care of patients

Work settings include Hospitals, nursing homes, and physicians’

offices Public health agencies and government

agencies Educational settings


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Nursing Careers (cont.)

Title Function

Nurse Practitioner (NP)

An RN that functions in an expanded role Requires a minimum of a Master’s degree

and 4 to 12 months of formal training or an apprenticeship

Duties include: Physical examinations Treating common illnesses and injuries Many states allow NPs to write prescriptions Patient education


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Apply Your Knowledge

If you had to choose other health-care team members to plan the care for a 68-year-old patient recently diagnosed with a stroke, who has a history of seizure disorders, which would you choose, and why?

ANSWER: The health-care team members that might participate in this patient’s care are:

•Physical therapist for decreased mobility due to stroke

•Pharmacist to review medications

•Nutritionist for dietary evaluation and possible modifications

•EEG technician to perform EEG for brain electrical activity

•Nursing staff (RN, LPN, CNA)

•Other health-care professionals will also be part of the team!

Good Job!


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Specialty Career Options for MAs

• Require additional education or training

• Many options available – check:– Local and medical college libraries– State employment agencies– Health career opportunities in local

newspapers– Directly with companies where you might seek

employment


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Specialty Career Options (cont.)

Specialty FunctionAnesthetist’s Assistant

Provides anesthetic care under direct supervision of the anesthetist

Works in hospitals and high-technology surgical centers

Assists in evaluating patient mental and physical status

Certified Laboratory Assistant

Performs lab procedures such as bacteriology, chemistry, hematology, parasitology, serology, and urinalysis

Supervised by medical technologists or hospital pathologists

Works in labs, clinics, physicians’ offices, etc.


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Specialty FunctionDental Assistant

Can practice without formal education or training Performs both administrative and lab functions Works in private practice, clinics, schools, local

health agencies, and for insurance companies

Emergency Medical Technician / Paramedic

Referred to as an EMT Trained to triage patients and follow instructions

from a physician Works for an ambulance service or in fire

department, hospital emergency room, or private industry


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Specialty FunctionOccupational Therapist Assistant

Supervised by occupational therapists Teaches fine motor skills, occupations, and the

arts to patients with mental and physical disabilities

Earns a 2-year degree

Ophthalmic Assistant

Assists ophthalmologists Performs simple vision testing and other

procedures Three ophthalmic career levels:

Technologist Technician Assistant


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Specialty Function

Pathologist Assistant

Supervised by a pathologist Some work with forensic and/or anatomic

pathologists Performs laboratory duties and some

administrative functions

Pediatric Medical Assistant

Assists the pediatrician with administrative and clinical duties

Works in private practice, hospitals, and clinics


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Specialty Function

Pharmacy Technician

Performs routine tasks related to recordkeeping and preparing and dispensing medications

Works in hospitals, pharmaceutical firms, and wholesale pharmacies

Physical Therapy Assistant

Works directly under the physical therapist Performs tests and treatment procedures Observes and documents patient responses to

therapy Works in hospitals, rehabilitation centers, nursing

homes, etc.


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Specialty FunctionRadiation Therapy Technologist

Assists the radiologist Maintains radiation treatment equipment Completes a 2- or 4-year education program Works in hospitals, labs, clinics, and physicians’

offices

Respiratory Therapy Technician

Works under supervision of physician and respiratory therapist

Performs artificial ventilation and maintains respiratory equipment

Works in hospitals, physician offices, nursing homes, etc.


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Specialty Function

Speech / Language Pathologist

Evaluates, diagnoses, and counsels patients with communication problems like stuttering

Usually has a Master’s degree Works in schools, hospitals, research settings, or

private practice

Surgical Technician

Completes a 2- or 4-year degree Provides patient services under direct supervision

of a surgeon Performs diagnostic and therapeutic procedures Works primarily in hospitals


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Professional Associations

• Involvement in issues and activities relevant to your profession

• Opportunities for continuingeducation


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Professional Associations (cont.)

American Association of Medical Assistants (AAMA)

The Association for Healthcare Documentation Integrity (AHDI)

American College of Physicians (ACP)

American Hospital Association (AHA)


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Professional Associations (cont.)

American Medical Technologist (AMT)

American Pharmacists Association

American Society of Phlebotomy Technicians (ASPI)

American Medical Association (AMA)


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TJC

• Formerly The Joint Commission on Accreditation of Healthcare Organizations

• Non-profit organization• Goal is to maintain and elevate the

standards of health-care delivery by health-care organizations– Evaluation – Accreditation

• Accreditation is significant factor in gaining reimbursement from Medicare and managed care organizations


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Council of Ethical and Judicial Affairs (CEJA)

• Develops policy for the AMA

• Addresses timely ethical issues

• Maintains and updates the AMA Code of Ethics– Comprehensive ethics guide for physicians


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Apply Your Knowledge

Which of the professional organizations listed below are primarily for the role(s) of medical assistants?

AMA

AAMA

AHA

AMT

ASCP

AAMT

ACP

APhARight

Answer!

xx

xx

xxANSWER:


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In Summary

2.1 Today there are approximately 22 major medical specialties. As new medical advances occur, the demand for more specialty areas will emerge.

2.2 The American Board of Medical Specialties is an organization of many different medical specialty boards. Its primary purpose is to maintain and improve the quality of medical care and to certify doctors in various specialties.


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In Summary (cont.)

2.3 Medical assistants are members of a health-care team that includes doctors, nurses, physical therapists, other allied health professionals, and patients. Understanding other health-care professionals’ duties will assist the medical assistant as a professional.

2.4 Membership in professional associations enables medical assistants to become involved in activities relevant to their field. The American Association of Medical Assistants is a key professional organization for medical assistants.


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They go the extra mile. They give their hearts, and lead with great

minds.—Sharon Hudacek

From A Daybook for Nurses: Making a Difference Each Day

End of Chapter 2

Types of Medical Practice

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