The duties of medical assistants vary from office to office, depending on the location and size of the practice and the specialty. Preparing for inspection visits by observers from regulatory bodies and submitting appropriate records and documentation can be time-consuming as well as technically demanding. Beginning salaries were slightly higher in selected areas where the prevailing local pay level was higher. They also work with family members to recognize and change behavior patterns that impede communication and treatment and show them communicationenhancing techniques to use at home. Accuracy, dependability, and the ability to work under pressure are important personal characteristics for clinical laboratory personnel. An individual seeking membership in the Association of Medical Illustrators must be a graduate of an accredited program or have at least eight years of experience in the profession. $36,168/yr. Public health services are provided by local and state governments. $61,600/yr. Employers who want certified dietetic assistants are often willing to pay all or a part of the student’s fees. While only 5 percent of the 65-plus population lived in nursing homes in 1994, the percentages increased dramatically with age, ranging from 1 percent of persons between 65 and 74 years of age, to 5 percent of persons between 75 and 84 years of age, and 25 percent of persons 85 years and older. This means your health team will get to know you as a person, before working with you to develop a personalized health plan based on your values, needs, and goals. The rest offered either a certificate, an associate degree, or a master’s degree. The starting salary for psychologists having a bachelor’s degree was about $21,900 in 2001; those with superior academic records could begin at 258 HEALTH PROFESSIONS INVOLVING PATIENT CARE $27,200. They provide emergency care, prepare accident reports, and arrange for further care if necessary. Hospitals, which face considerable pressure to keep 320 HEALTH PROFESSIONS INVOLVING PATIENT CARE costs under control, are trying to reduce the number of tests per patient and to discourage procedures that mean revenue losses. Mental impairment also affects how well the individual handles whatever physical problems there may be, and whether he or she can remain in the community or must be institutionalized. The more information you have, the easier your career decisions will be. Paraprofessional personnel such as psychiatric aides and mental health workers frequently encroach upon the duties of specialists in trying to broaden their own territories. Work Environment Dance therapists work in a variety of mental health settings, including psychiatric hospitals, clinics, developmental centers, correctional facilities, special schools, substance-abuse programs, and facilities for the aged. $38,470/yr. Although hospitals and physicians’ offices may come to mind as the most obvious settings for health care professionals, other employers abound, in both inpatient and outpatient facilities. L.P.N.’s must also be careful to avoid back injuries, shocks from electrical equipment, and the dangers associated with compressed gases such as those used for anesthesia. They are also employed in private and state schools, federal prisons, the Job Corps, and adult learning centers. Schools offer laboratory, clinical, and classroom instruction in subjects such as anatomy, physiology, chemistry, microbiology, pharmacology, nutrition, radiography, histology (the study of tissue structure), periodontology (the study of gum diseases), pathology, dental materials, clinical dental hygiene, and social and behavioral sciences. Employment Trends Employment of pharmacists is expected to grow slower than the average for all occupations through the year 2008, despite the increased pharmaceutical needs of a larger and older population, and greater use of medication. About one in five dietitians works part-time. • My formal training in marketing includes: B.A.—Idaho State University—major in Economics. Students learn to use and maintain care for common emergency equipment, such as backboards, suction devices, splints, oxygen delivery systems, and stretchers. Employment Trends Employment of physicians will grow faster than the average for all occupations through the year 2008 due to continued expansion of the health care industries. Overview. Among the conditions likely to require treatment by physical therapists are multiple sclerosis, cerebral palsy, nerve injuries, fractures, amputations, arthritis, and heart disease, with patients varying in age from the newborn to the elderly. Employers of Health Professionals and Health-Related Personnel The vast health care system offers employment in a wide variety of environments. Art Therapists Expressing ideas and feelings through art and achieving some sense of well-being as a result is a very old concept. Once the prescription is filled, technicians price and file the prescription, which must be checked by a pharmacist before it is given to a patient. Avoid: a. Manual arts therapists use industrial arts such as graphics or wood or metal working to rehabilitate their patients. 414 HEALTH-RELATED PROFESSIONS Requirements include a combination of education, experience, and passing scores on written examinations. The emphasis on technology has implications for the way physicians are trained and the way they practice medicine. The EMT-Intermediate (EMT-2 and EMT-3) has more advanced training that allows administration of intravenous fluids, use of manual defibrillators to give life-saving shocks to a stopped heart, and use of advanced airway techniques and equipment to assist patients experiencing respiratory emergencies. Industrial Health Care Employment. These state hospitals are run by state administrative agencies. Where once health care was considered an individual matter, it is now assumed that health care is a right to which everyone should have access. Consumers are increasingly complaining that their doctors are not in control of their care, and that companies are putting their bottom lines first. An individual who has a four-year degree in a related field, such as genetics or biology, and wants to become a physical therapist should enroll in a master’s-level physical therapy program. However, employers generally prefer applicants who are familiar with the trade, and an increasing number of trainees have some formal training in optical dispensing and fabricating. In those cases the health educator 422 HEALTH-RELATED PROFESSIONS can play an important role by helping other health personnel plan and deliver health care in ways that the community can and will use. Graduates receive associate’s degrees or certificates. They may on occasion accompany their clients to recreational activities and social gatherings. Educational and Legal Requirements Preparation for this field is offered at the postsecondary level in hospitals, medical centers, colleges and universities, trade schools, vocational-technical institutes, and the armed forces. Earnings According to the most recent information, median annual earnings for respiratory therapists were $37,680. Work Environment Hours and other working conditions vary according to the size and type of employment setting. Studies begin with classroom instruction and laboratory work in basic sciences, including anatomy, microbiology, biochemistry, and physiology. CRTs who meet education and experience requirements can take a separate examination, leading to the award of the RRT. Language : ISBN … They work with others to develop community resources within their area of expertise and attend various professional seminars, workshops, and conferences to keep abreast of the latest methods, techniques, and travel aids. Explain the differences between Medicare and Medicaid insurance. Individual size and working conditions vary greatly from library to library. Employment Opportunities The demand for paraoptometrics increases as the need for optometric services increases. The core curriculum of human services programs trains students to observe patients and record information, conduct patient 242 HEALTH PROFESSIONS INVOLVING PATIENT CARE interviews, implement treatment plans, employ problem-solving techniques, handle crisis intervention matters, and use proper case management and referral procedures. • National Association for Practical Nurse Education and Service, Inc., 1400 Spring St., Suite 330, Silver Spring, MD 20910. 10 THE HEALTH CARE SYSTEM IN THE UNITED STATES Optimal treatment for chronic illness requires health care that is long-term and continuous—at present, health care in the United States is primarily short-term and discontinuous. Educational and Legal Requirements All 50 states and the District of Columbia require dentists to be licensed. Washington, DC: Administration on Aging fact sheet. School health coordinators may work in a single school or in an entire school system; they furnish leadership in developing and maintaining an adequate, well-balanced health program and helping all groups interested in the health of school children work together effectively. Consequently, competition for jobs has increased, and individuals may now have to spend more time seeking employment than they did in the past. As a consequence, the majority of employment growth for physical therapists is expected to occur in the second half of the forecast period. Success in handling these inquiries depends largely on the librarian’s skill. Media portrayals through the years have contributed to a popular perception of doctors as public servants of rare intelligence, compassion, and skill; encounters with the medical system have left some consumers convinced that doctors have feet of clay that are shod in goldplated boots. Accelerating technological advances and changing societal factors have thrust hospitals into the grasp of big business. In addition, technologists in particular are expected to be good at problem solving and to have strong interpersonal communication skills. To accomplish these tasks, health information specialists must have working knowledge of almost every medium of communication. The words you use to describe your experience, activities, and so forth can convey the skills you have developed. Private practice, however, includes a wide variety of work settings and payment systems. Since the turn of the century, hospitals have gradually become the professional heart of all medical practice. Health Services Managers Work Description Health services manager is an inclusive term for individuals in many different positions who plan, organize, and coordinate the delivery of health care. Protection of the population from environmental hazards is a major concern of the small but significant number of veterinarians who specialize in toxicology or animal pathology. There are some winners in the job redistributions. 2. Certification and registration as a Registered Music Therapist (RMT) makes available many opportunities for employment. About one-third of PAs provide health care to communities having fewer than 50,000 residents and where physicians may be in limited supply. 2. Technicians may perform preliminary tests such as testing the ability of patients to see letters or numbers of various sizes at a specified distance. Because health care providers will have to address new health issues, policies, technologies, and practice guidelines over their careers, continuing education programs will need to be updated periodically (Healthy People 2010). Home health nurses provide periodic services, prescribed by a physician, to patients at home. Educational and Legal Requirements Of the states that regulate licensing (45 for speech-language pathologists and 47 for audiologists), almost all require a master’s degree or equivalent. For the first time in more than fifteen years AN INTRODUCTION TO ENGLISH GRAMMAR is available in a revised edition. This page intentionally left blank Chapter 6 }} Health Career Planning 82 THE HEALTH CARE SYSTEM IN THE UNITED STATES Key Terms Inpatient and outpatient facilities and services General hospital Specialty hospitals Industrial health care Career alteration due to new technology Expanded functions Rural and inner-city opportunities Maldistribution of health personnel Primary health care Primary care physicians Family practitioners Alternative choices of careers Licensure Professional certification Professional registration Objectives After studying this chapter the student should be able to: 1. Opportunities for social workers in hospitals and in many larger, long-term care facilities will increase in response to the need to ensure that the necessary medical and social services are in place when individuals leave the facility. Earnings Most recently, median annual earnings of dispensing opticians were $24,430. Chief administrators need leadership ability as well as technical skills to respond effectively to community requirements for health care while at the same time satisfying demand for financial viability, cost containment, and public and professional accountability. Some determine the effects of drug therapies, antibiotics, or new surgical techniques by testing them on animals. Human Service Workers and Assistants Work Description Human service workers and assistants is a generic term for people with various job titles, including social service assistant, case management aide, social work assistant, community support worker, alcohol or drug abuse counselor, mental health aide, community outreach worker, life skills counselor, and gerontology aide. Examples are microprocessing devices that permit individuals with paraplegia and quadriplegia to operate wheelchairs and switches for household resources such as telephones, television sets, and radios. Designated group members may form a credentials committee to screen prospective members, or a building committee may be established. Employment Opportunities Most recently, medical assistants held about 329,000 jobs. Facilities that emphasize primary care, such as HMOs and neighborhood health centers, will probably increase in number. Before a radiologic technologist can perform any examination or procedure on a patient, a physician must issue a requisition for the study or treatment. Hospital nurses usually are assigned to groups of patients who require similar nursing care. To this end, they work directly with individual clients and their families, as well as with other health professionals, to ensure that treatment and rehabilitation plans are carried out effectively. These services are provided in a variety of ways and settings. The government filled the gaps in the private insurance system and continued to accommodate physicians by not challenging their fee structures. Experience and good performance can lead to promotion to more responsible positions. Because they sell and service eye lenses, they deal with customers most of the time. As part of the management team, health administrators establish and implement policies, objectives, and procedures for their 382 HEALTH-RELATED PROFESSIONS department, evaluate personnel and work, develop reports and budgets, and coordinate activities with other managers and work closely with physicians. Technological advances, such as fiber optics and laser technology, will also permit new surgical procedures to be performed. Here resource teachers provide instruction in special skills, such as Braille or the use of recording devices. About 7 out of 10 were hospital jobs. This wide scope of training makes the primary care physician very knowledgeable in treating the whole patient preventively and in coordinating specialty care if necessary. Opportunities should be best for individuals with a bachelor’s degree in therapeutic recreation or in recreation with an option in therapeutic recreation. Treatment may include examining and cleaning the ear canal, fitting a hearing aid, auditory training, and instruction in speech or lip reading. Some also fix, adjust, and refit broken frames. New graduates are in great demand, and the number of people completing training programs is expected to fall short of that needed to fill the new job openings. A few colleges admit students directly from high school. Salaries for the highly specialized personnel who use the often costly equipment and interpret results can be overwhelming. Introduction to Health Care Management Edited by Sharon B. Buchbinder, RN, PhD Professor and Chair Department of Health Science Towson University Towson, MD Nancy H. Shanks, PhD Chair, Department of Health Professions Professor and Coordinator, Health Care Management Program Metropolitan State College of Denver Denver, CO About onehalf of all psychologists are self-employed. See Biological photographers Photomicrography, 462 Physical therapists description of work, 277–280, 336 earnings/salaries, 284 education and licensing requirements, 280–282 employment opportunities, 280 employment trends, 282–284 related occupations, 284 sources of information on, 284 work environment for, 280 Physical therapy, role of, 276 Physical therapy assistants and aides description of work and types of, 285 earnings/salaries, 287 education requirements, 286 employment trends, 287 525 related occupations, 288 sources of information on, 288 work environment for, 285–286 Physician assistants (PAs) description of work, 190–191 earnings/salaries, 194 education requirements, 192–194 employment opportunities, 191–192 employment trends, 194 related occupations, 195 sources of information on, 195 work environment for, 191 Physician Payment Review Commission, 37 Physicians description of work and types of, 105–109 earnings/salaries, 113–114 education and licensing requirements, 110–112 employment opportunities, 109–110 employment trends, 112–113 methods of reimbursing, 42– 43 public perceptions of, 104 related occupations, 114 sources of information on, 114 work environment for, 109 Physiological needs, women and, 73 Poison control centers, 85 Positron emission tomography (PET), 219 Practitioners’ offices, 86 Preferred provider organizations (PPOs), 20, 21, 46– 47 Prevention, 9 Preventive medicine, 108–109 Primary care centers, 60 526 Primary care (continued) employment opportunities in, 89–90 physicians, 105, 108 Private duty nurses, 133 Professional Association of Health Care Office Managers, 407 Professional associations, 86–87, 483 Professional certification, 96 Professional registration, 96 Professional Standards Review Organizations, 41 Proprietary nursing homes, 56 Prosthodontics, 116 Psychiatric aides description of work, 262 earnings/salaries, 263–264 education requirements, 262–263 employment trends, 263 related occupations, 264 sources of information on, 264 work environment for, 262 Psychiatric/mental health technicians description of work, 259–260 education and licensing requirements, 260–261 employment opportunities, 261 Psychiatrists, 106–107 Psychological treatment, 230 Psychologists description of work and types of, 248–252 earnings/salaries, 257–258 education and licensing requirements, 253–255 employment opportunities, 255–256 employment trends, 256–257 related occupations, 258 INDEX sources of information on, 258–259 work environment for, 253 Psychometric psychologists, 252 Public health defined, 25 services, 25–27 Public health dentistry, 116 Public health nurses, 133 Public Health Service (PHS), 17, 20, 26 employment opportunities in, 87 nurses, 59 Radiation therapy, 220 Radiographers, 219 Radiologic personnel description of work and types of, 219–222 earnings/salaries, 227 education and licensing requirements, 223–225 employment opportunities, 223 employment trends, 225–227 related occupations, 228 sources of information on, 228 work environment for, 222–223 Radiologic technologists, 219 Radiologists, 107, 219 Radionuclides, 314 Radiopharmacists, 148, 315 Recreational therapists description of work, 354–357 earnings/salaries, 361 education requirements, 358–359 employment opportunities, 358 employment trends, 359–361 related occupations, 361 sources of information on, 361 INDEX work environment for, 357 Registered Medical Assistants of American Medical Technologists, 331 Registered nurses (R.N.s) description of work and types of, 132–134 earnings/salaries, 138–139 education and licensing requirements, 135–137 employment opportunities, 135 employment trends, 137–138 related occupations, 139 sources of information on, 139–140 work environment for, 134 Registration, 96 Rehabilitation, 18 Rehabilitation psychologists, 252 Rehabilitation teachers description of work, 428– 429 education and licensing requirements, 429– 430 employment opportunities, 430 Reimbursement, methods of, 42– 43 Research dietitians, 164–165 Residencies, 111 Resignation, letter of, 500–501 Respiratory therapists and technicians description of work, 266–269 earnings/salaries, 273 education requirements, 269–272 employment opportunities, 269 employment trends, 272–273 related occupations, 273 sources of information on, 274 work environment for, 269 527 Résumés chronological, 494 functional, 495 how to write, 491– 493 on the Internet, 499–500 letter, 496 qualifications, 498 targeted, 497 Rights, of patients, 22–24 Rural areas, employment opportunities in, 89 Salaries. Human service workers and assistants with proven leadership ability, either from previous experience or as a volunteer in the field, often enjoy greater autonomy in their work. Students should evidence interest in various graphic art forms—still life drawing in particular—and maintain a portfolio demonstrating ability in several media. Their duties may include scheduling appointments, answering the telephone, restocking or ordering depleted supplies, and filling out insurance forms or other paperwork. Dietitians employed by magazines may determine the nutritional content of new recipes, analyze and report on the effectiveness of new diets, or report on important topics in nutrition such as the importance of dietary fiber or the value of vitamin supplements. See Technology Medical transcriptionists description of work, 388 earnings/salaries, 390 education requirements, 389–390 employment opportunities, 389 related occupations, 390 sources of information on, 391 work environment for, 388 Medical writers. Recognizing this, health officials are placing increasing emphasis on the psychological treatment as well as the clinical treatment of patients in health facilities. Deregulation is one instrument being used selectively to further goals of the federal government: The Unfunded Mandate Reform Act of 1995 limits federal power to adopt mandates for states, localities, and tribal governments without paying for them. However, employment in hospitals—where one-half of all psychiatric aides work—is likely to decline due to attempts to contain costs by limiting inpatient psychiatric treatment. Assistants must be a dentist’s “third hand,” and dentists therefore look for people who are reliable, can work well with others, and have manual dexterity. As the focus of social welfare policies shifts from benefit-based programs to work-based initiatives, there will be an increased demand for people to teach job skills to people who are new to or reentering the workforce. As professionals, community health educators use educational skills and a sound knowledge of public health to educate the public about health and disease and what can be done to maintain good health, prevent disease, or secure treatment. 7. Health care expenditures fall unevenly on the population. • Read each question carefully. Most states grant a license without reexamination to qualified pharmacists already licensed by another state. Educational and Legal Requirements All states, the District of Columbia, and the Commonwealth of Puerto Rico require a license to practice physical therapy. Most instructors work on a one-to-one basis and assist patients in making the maximum use of their remaining senses, primarily auditory (sound) and tactile (touch). The ability to put patients at ease is helpful; patients often are under stress. Health courses include the principles of mental health and good human FEDERAL AND STATE HEALTH REGULATORS 431 relations, as well as marriage and family life. Speech-language pathologists work with people who cannot make speech sounds or cannot make them clearly; those with 200 HEALTH PROFESSIONS INVOLVING PATIENT CARE speech rhythm and fluency problems, such as stuttering; people with voice quality problems, such as inappropriate pitch or harsh voice; those with problems understanding and producing language; and those with cognitive communication impairments, such as attention, memory, and problem-solving disorders. If no police are present, the help of bystanders may be enlisted. Athletic Trainers Work Description Athletic trainers are professionally trained medical technicians who work in conjunction with and under the supervision of a physician. 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