Recruiting and Retaining Professionals

Looking at the shortage of Physicians and Nurses, how would you as a CEO, recruit, and retain your professionals for your facility?



Component 2, Unit 2: The Culture Of Health Care: Health Professionals-- The People in Health Care No audio. Recording preparation. Health IT Workforce Curriculum Version 4.0 1 The Culture of Health Care Health Professionals—The People in Health Care Lecture a This material (Comp2 Unit 2) was developed by Oregon Health & Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015. This material was updated in 2016 by Bellevue College under Award Number 90WT0002. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/. Welcome to The Culture of Health Care: Health Professionals—The People in Health Care. This is Lecture a. The component, The Culture of Health Care, addresses job expectations in health care settings, the organization of patient care within a practice setting, privacy laws, and professional and ethical issues encountered in the workplace. 2 Health Professionals—The People in Health Care Learning Objectives Define terms used in health care and in health professionals’ education and training, including clinician, patient/consumer, disease, and syndrome. (Lecture a) Describe the education, training, certification, licensure, and roles of physicians, including those in primary care and other specialties. (Lecture a) Describe the education, training, certification, licensure, and roles of nurses, advanced practice nurses, licensed practical nurses, medical assistants, and medication aides. (Lecture b) Describe the education, training, certification, licensure, and roles of physician assistants, pharmacists, therapists, and allied health professionals. (Lecture c) Describe the education, training, certification, licensure, and roles of paramedics, emergency medical technicians, dental professionals, mental health professionals, and social workers. (Lecture c) 3 The objectives for Health Professionals—The People in Health Care are to: Define terms used in health care and in health professionals’ education and training, including clinician, patient/consumer, disease, and syndrome. Describe the education, training, certification, licensure, and roles of physicians, including those in primary care and other specialties. Describe the education, training, certification, licensure, and roles of nurses, advanced practice nurses, licensed practical nurses, medical assistants, and medication aides. Describe the education, training, certification, licensure, and roles of physician assistants, pharmacists, therapists, and allied health professionals. Describe the education, training, certification, licensure, and roles of paramedics, emergency medical technicians, dental professionals, mental health professionals, and social workers. 3 Terminology (Merriam-Webster Medical Dictionary, Medline Plus, 2010) Health professional: Provides care to the sick and injured in pre-hospital, hospital, outpatient, home, extended-care facilities, and other settings Supports preventive care, wellness services, and patients’ self-managed care Patient/consumer: Anyone seeking preventive care services, wellness services, assistance with self-managed care, or medical services 4 This lecture introduces key terms used to describe health care professionals and their education, including education, training, certification, and licensure. Many health professionals provide care to the sick and injured in various settings. They deliver pre-hospital care, such as at accident scenes; inpatient care in hospitals and extended or long-term care facilities; outpatient or ambulatory care, such as in physician offices and clinics; home care; and more. Health professionals also support patients or consumers with preventive care, wellness services, and self-managed care. The emphasis of this unit is on the roles of various health professionals, but remember that most health care is delivered using a team approach. A patient or consumer is anyone who seeks preventive care, wellness care, self-managed care, or medical services. 4 Terminology Continued Clinician: An individual qualified in the clinical practice of medicine, psychiatry, or psychology as distinguished from one specializing in laboratory or research techniques or in theory 5 The term clinician separates those qualified to provide clinical care in medicine, psychiatry, or psychology from those specializing in laboratory research techniques or in theory. Clinician typically means a physician, but clinician may also be used to describe other licensed medical professionals, such as physician assistants, nurse practitioners, and nurses. Allied health professionals, such as radiology technicians, laboratory technicians, pharmacists, and medical assistants, also serve key roles in providing patient services. 5 Terminology Continued 2 Disease: An impairment of a specific structure or function of the body that produces symptoms and physical findings; usually attributable to a specific cause, such as a specific type of bacteria causing pneumonia Syndrome: A combination of symptoms and physical findings not easily attributable to a specific cause. An example is carpal tunnel syndrome, which is pain, burning, and numbness in the hand 6 A disease is an impairment of a specific structure or function of the body, which produces symptoms or physical findings. Symptoms are part of the story patients tell about their illness, including specific complaints such as the location of the pain, how often the pain occurs, and the duration of the pain. Physical findings are what the physician or other health professional determines by observation and physical examination. For example, a physician may observe swelling in the ankle and determine the area of most tenderness using maneuvers that increase or lessen the pain. Diseases usually have a specific cause. For example, bacterial pneumonia is caused by a specific type of bacteria. A syndrome is a combination of symptoms and physical findings not easily attributable to a specific cause. An example of a syndrome is carpal tunnel syndrome, which causes pain, burning, and numbness in the hand. 6 Terminology Continued 3 Education: Formal lecture and learning activities, including simulation and patient contact Depending on the health profession, may be on-the-job training, a certificate, associate’s degree, bachelor’s degree, master’s degree, or doctoral degree Training: Supervised clinical practice; often has increasing level of responsibility with time 7 Each lecture in Unit 2 describes the sequence that various health professionals go through to become educated, trained, and eligible to practice. Professional health education is a formal program that usually presents lectures and other learning activities, including simulation and patient contact. Depending on the health profession, it may be on-the-job training, a certificate, or an associate, bachelor’s, master’s, or doctoral degree. Health professions training is typically supervised clinical practice with an increasing level of responsibility over time. 7 Terminology Continued 4 Certification has several meanings: Education/training certificate program typically 1 year for medical assistants National health profession organization certification typically requires completion of an accredited program and an exam, such as with radiologic technologists Physician board certification in a specialty or subspecialty requires an approved residency/fellowship and a board exam State licensure is mandatory for many practicing professionals, such as physicians and nurses 8 Certification has several meanings. One definition is a short education or training program, usually lasting one year or less, such as a medical assistant certificate program. Certification by a national health profession organization usually requires completion of an accredited program and an exam. A radiologic [rey-dee-uh-loj-ihk] technologist, for example, is a certified health professional. Physicians may elect to obtain board certification in a medical specialty or subspecialty by completing an approved residency or fellowship and a board exam. In addition to certification, state licensure is required for many health professionals, including physicians, physician assistants, nurses, and pharmacists. State licensure is regulated by the state and may employ a variety of mechanisms for regulating clinical practice, one of which is certification. 8 Physician 2.1 Figure: Hickman, 2010. Retrieved from Author. Used with Permission. 9 Education for a physician typically includes four years of college and four years of medical school. The medical school can be either allopathic [al-uh-path-ik] (medical doctor) or osteopathic [os-tee-uh-path-ik] (doctor of osteopathy [os-tee-op-ath-ee]). After medical school, physicians typically pursue three to five years of training in a specialty. Fellowship training provides an additional one to three years of study to gain expertise in a subspecialty. 9 Physician Continued Certification Completion of an approved residency or fellowship program Must have a valid state medical licenses to practice Must complete a written and/or practical exam in that specialty or subspecialty Maintenance of certification State licensure Reciprocity among states 10 Physician specialty certification requires successful completion of an approved residency or fellowship program, a valid license to practice medicine, and completion of a written and/or practical exam that varies by specialty and subspecialty. Maintenance of certification is required in many specialties. It often includes specific continuing medical education requirements, quality improvement activities, patient surveys, and periodic specialty exams. In addition to certification, physicians are required to maintain an active state license in order to practice medicine. Some states allow reciprocity [res-uh-pros-ih-tee], which honors a valid license between states; however, there are usually minimal additional requirements to apply for a license in another state. 10 Steps of the USMLE Travis Nimmo CC-BY 11 Licensure is regulated by each state and requires successful completion of the United States Medical Licensing Examination or USMLE [U-S-M-L-E] (although exam requirements may vary from state to state). The USMLE is a nationally administered exam with three steps. Step one tests the application of basic science to clinical practice and typically is required at the end of the first two years of medical school. Step two is divided into two parts—a written test of clinical knowledge and a test of clinical skills using actors portraying patients. This test is usually required for graduation from medical school. Step three tests more applied clinical knowledge and is usually taken after the first year of residency. 11 Primary Care Roles Travis Nimmo CC-BY 12 Primary care includes specialties that provide routine care to a patient on a continuous basis; it includes acute care, health maintenance, wellness, preventative care, and management of chronic disease not requiring a specialist. The primary care physician also serves as the gatekeeper and coordinator of additional care when needed by a subspecialist. Primary care specialties are Family medicine, which provides care for the entire family, including infants, children, and adults. Some family medicine physicians also provide obstetrical care. Internal medicine, which provides care to adolescents and adults. Pediatrics, which provides care to infants, children and adolescents. Obstetrics [uhb-stet-triks] and gynecology [gahy-ni-kol-uh-jee], or OB/GYN [O-B-G-Y-N], which provides services to women, including during pregnancy and childbirth. OB/GYN specializes in the female reproductive system, but because many women obtain primary care services from their obstetrician [ob-sti-trish-uhn] or gynecologist [gahy-ni-kol-uh-jist], it’s often considered a primary care specialty. If a patient does not have a primary care physician, he or she may seek primary care in a hospital’s emergency facility, in a free-standing urgent care center, or from a specialist that the patient sees on a frequent basis. The decreasing number of primary care