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hsa500_w8_c12.pptHealth Services Organization and Management
HSA 500
Health Care Professionals
Williams, S. J., & Torrens, P. R. (2008). Introduction to Health Services (7th ed.). New York: Cengage Delmar Learning.
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Welcome to Health Services Organization and Management.
In this lesson we will discuss Health Care Professionals.
Please go to the next slide.
Objectives
- Upon completion of this lesson, you will be able to:
- Explain the impact that policy, social and financial forces have on health care access and quality of care in the United States
- Explain the major components of the U.S. health care system, their functions, and the relationships among these components
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Upon completion of this lesson, you will be able to:
Explain the impact that policy, social and financial forces have on health care access and quality of care in the United States.
And explain the major components of the U.S. health care system, their functions, and the relationships among these components.
Please go to the next slide.
Employment Trends in the Health Care Sector
- Health care employees
- 624,000 in 1920
- 10 Million in 1998
- 400 different job titles
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There has been a dramatic growth in the number and types of personnel employed in the health care sector since the early part of the 20th century. The pool of employees grew from 624,000 in 1920 to almost 10 million in 1988.
There has also been the emergence of a wide variety of new categories of personnel. The Department of Labor now recognizes about 400 different job titles in the health care sector.
Please go to the next slide.
The Role of Osteopathic Medicine in the U.S.
- Emphasizes treatments that involve correction of the position of joints or tissues
- Licensed to practice medicine and perform surgery in all states
- More predominant in rural areas
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Osteopathy differs from allopathic medicine in that osteopaths traditionally emphasize treatments that involve correction of the position of joints or tissues, and they stress diet or environment as factors that might destroy natural resistance. Allopathic medicine views the physician as an active interventionist attempting to neutralize the effects of disease by using treatments that produce a counteracting effect.
Osteopaths are licensed to practice medicine and perform surgery in all states and are eligible for graduate medical education in either osteopathic or allopathic residencies
Eighty percent of all osteopaths were located in just 16 states, and proportionately five times more osteopathic physicians are in rural areas than there are in urban areas.
The Expanding Supply of Physicians
- Number of physicians increasing rapidly
- Two sources:
- U.S. Citizens Trained in U.S. Medical Schools
- People trained in Foreign Medical Schools
- Specialty distribution
- 37.3% of med. students go into primary care
- 7.5% go into other medical specialties
- 13.6% go into surgical specialties
- 41.6% go into all other specialties
- More physicians = better supply in rural areas
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The number of physicians has increased rapidly in the last four decades, with an estimated 846,684 active nonfederal physicians, including osteopath practicing in 2005.
This growth comes from two sources: U.S. citizens who are trained in U.S. medical schools and people who are trained in foreign medical schools.
With regard to trends in specialty distribution, one-third of medical school graduates go into primary care specialties, 6-10% go into other medical specialties, 25% go into surgical specialties, and slightly more than 25% go into all other specialties.
With regard to trends in the geographic distribution of physicians, there has been some evidence that the general increase in overall physician numbers has led to an improvement in physician supply in rural areas since 1970.
Please go to the next slide.
Trends in the Dental Profession
- Gap between dentists and need for services
- Two major types of auxiliaries:
- Dental hygienists
- Dental assistants
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In 1960 there were 90,120 active dentists; by 1997 there were 138,435, hardly any change at all. Since 1980, the total number of dental schools has dropped from 60 to 54 and the total number of first-year entering dental students dropped from 6,000 in 1980 to 4,347 in 1997.
There is also concern about the growing gap between availability of dentists and the need for services, especially since payment for dental services is on a much smaller scale than that for physician services.
There two major types of auxiliaries: dental hygienists and dental assistants. Dental hygienists are providing oral prophylaxis services and dental health education and constitute the only group of auxiliaries that is licensed. Dental assistants have generally supported the dentist at chair side and have had the opportunity in some states to perform expanded functions under a dentist’s supervision.
Please go to the next slide.
Check Your Understanding
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Public Health Profession
- General roles of public health
- Trends in the public health workforce
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In practice, public health roles have centered on, among others, administration of local, state, and national public health agencies; on planning, implementing, and evaluating prevention, screening, and health education programs; on surveillance and control of environmental hazards and pollutants; and on the epidemiological description and explanation for the incidence and prevalence of disease and trauma in populations.
The primary academic degree for public health is either the master of public health (MPH) or the master of science in public health (MSPH). Other common avenues for careers in public health include the study of medicine with emphasis on and board certification in preventive medicine, the study of public health nursing, dentistry, nutrition, industrial hygiene, and social work among others. Total enrollment in schools of public health has expanded rapidly over the period 1975-1976 to 2004-2005, growing from 6,461 to 19, 434 respectively, a 200 percent increase.
Please go to the next slide.
Trends in the Nursing Profession
- Many not working or inactive
- Most are women
- Three forms of training:
- 3 Year (Hospital Based)
- 2 Year (Associate Degree)
- 4 Year (Baccalaureate Program)
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Registered nurses are the largest group of licensed health professionals in the U.S.
A substantial number of nurses are not working in nursing or are inactive in the economic workforce.
Most nurses are women and approximately one-third of nurses work part time. The nurse workforce is not distributed evenly throughout the U.S.
Three forms of training lead to licensure as an RN: 3-year diploma programs that are hospital based, 2-year associate degree programs that are generally in community colleges, 4-year baccalaureate nursing programs in universities or 4-year colleges.
Please go to the next slide.
Trends in the Pharmacy Profession
- Changing role
- Employed in:
- Pharmacy chains
- Independent pharmacies
- Hospitals
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The major development has been the changing role of the pharmacist since the 1970s. Before 1980, pharmacists performed the traditional role of preparing drug products and filling prescriptions. In more recent years, pharmacists have expanded that role to include drug production education and acting as an expert for clients and patients about the effects of specific drugs, drug interactions, and generic drug substitutions for brand-name drugs.
There was a steady growth in the number of pharmacists during the first quarter of the 20th century, although the percentage of growth was not as great as in other health professions.
With regard to sites of work, in the 1990s, approximately 40% of all pharmacists were employed in chain drugstores, whereas about 40% worked in hospitals and independent pharmacies.
Please go to the next slide.
Trends with Physician Assistants and Nurse Practitioners
- Perceived shortage of physicians led to development of:
- Physician Assistants
- Perform many functions usually completed by physicians
- Nurse Practitioners
- Registered Nurses with expanded roles
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The perceived shortage of physicians in the mid-1960s led to the development of physician assistants (PAs) and nurse practitioners (NPs).
PAs are qualified by academic and practical training to provide patient services under the direct supervision of a licensed physician who is responsible for the performance of the PA. Laws in all states except Mississippi and D.C. authorize the use of PAs under physician supervision. More than 30 states allow a physician to authorize the PA to prescribe certain medications.
NPs are registered nurses who have completed formal programs of study preparing them for expanded roles and responsibilities. These roles include obtaining comprehensive health histories, assessing health status, performing physical exams, formulating and managing a care regimen for acute and chronically ill patients, teaching, and counseling.
PAs are viewed by the medical profession as extenders who can perform many of the usual functions completed by physicians. Nurses view NPs as registered nurses in an expanded role.
Please go to the next slide.
The Impact of Managed Care on the Health Professions
- Increasing number of professionals will deal with managed care
- May exacerbate provider surplus
- Unwillingness to finance education and training in hospitals
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More and more health professionals will have some sort of direct relationship with managed care.
Many observers believe that continued managed care growth will only magnify and exacerbate the problem of provider surplus, particularly among physicians; furthermore, there is worry that the historical imbalance between primary care and specialization will be worsened.
Many educational institutions will experience severe financial difficulties as managed care plans erode their financial bases. Managed care plans have historically not been willing to finance the education and training costs in hospitals, where much of the health force education and training takes place.
The education that health professionals receive will probably shift to the kind of clinical practice that health plans require, with emphasis on prevention, prudent use of resources, and evidence-based medicine.
Please go to the next slide.
Check Your Understanding
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Summary
- Employment trends in the Heath Care Sector
- Role of Osteopathic Medicine in the U.S.
- Expanding supply of physicians
- Professional trends
- Impact of managed care
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We have reached the end of this lesson. Let’s take a look at what we have covered.
We first looked at employment trends in the Health Care Sector and learned that there has been a dramatic growth in the number and types of personnel employed in the health care sector since the early part of the twentieth century.
Next we looked the Role of Osteopathic Medicine in the U.S. Osteopathy differs from allopathic medicine in that osteopaths traditionally emphasize treatments that involve correction of the position of joints or tissues, and they stress diet or environment as factors that might destroy natural resistance.
We then looked at the expanding supply of Physicians. The number of physicians has increased rapidly in the last four decades, with an estimated 846,684 active nonfederal physicians, including osteopath practicing in 2005.
We also looked at trends in the following professions:
Dental;
Public Health;
Nursing;
Pharmacy; and
Physician Assistants and Nurse Practitioners.
We concluded the lesson with a discussion of the impact of managed care on the Health Professions. Many observers believe that continued managed care growth will only magnify and exacerbate the problem of provider surplus, particularly among physicians; furthermore, there is worry that the historical imbalance between primary care and specialization will be worsened.
This concludes this lesson.
