4. Who Delivers Care Flashcards
Rank the number of dentists, physicians, NPs, RNs, and pharmacists in descending order.
RNs, physicians, NPs, Pharmacists, Dentists
What’s the ratio of PCPs/Non-PCPs in US?
1/2 to 2/3
Who licenses MDs, and what’s required?
STATES. Passing grade on national licensing exams, cert of graduation from med school, and usually completion of at least 1 year of residency
How did medical school start off as?
Small establishment profiting their physician owner (rather than as a university-centered academic institution)
2 key events that ushered modern medicine?
1) Establishment of Johns Hopkins U»_space; beginning of what looked like a legit med school 2) Flexner Report - indicted most other shit med schools, which subsequently closed and surviving schools became much more stringent with education.
How does the state treat MDs v. DOs?
Most state licensing boards grant docs with MD and DO degrees EQUIVALENT scopes of practice
What program accredits allopathic residency training programs? What about board certifications or specialties after residency?
ACGME (Accreditation Council for Graduate Medical Education), and American Board of Medical Specialties
Approx 25% more physicians enter ACGME residency programs than the number of students graduating from US allopathic med schools. How?
1) Half of DO grads enter allopathic residencies 2) Remained is filled by physicians who graduated from medical schools outside the US
What happens to international medical graduates who wanna train in US?
They receive a temporary educational visa and usually go back to their country. Sometimes there are visa-waiver programs which allow the docs to stay in some physician-shortage area of the US.
How does the govt factor in financing medical education?
State tax revenues help subsidize public school medication. Federal govt doesn’t do too much with med student education but is a major source of funds for residency training (MCARE and MCAID allocates “graduate medical education” funding to hospitals that sponsor residency programs)
What’s the advantage for hospitals to train residents?
They add new residency positions in non-PCP fields cuz residents are low-cost labor to staff hospital-based specialty services (more than assessment of regional physician workforce needs)
What’s the point of a PA?
Physician Assistant….developed to fill the nice of a broadly skilled clinician who could be trained without the many years of medical school and residency education required to produce a physician, who would work closely with docs to augment medical workforce, especially in primary care fields and under-served communities. Originally vets who are being retrained for civilian settings.
Explain PA education.
condensed version of medical school, average of 27 months. Most award a master’s degree, half a based at health centers that are directly affiliated with med schools.
Where do RNS work?
Most work full time, in hospitals
Where do RNs get trained?
1/5 in diploma programs (in hospitals), almost half in associate degree programs, and a third in baccalaureate degree programs (4 year). Push for baccalaureate programs cuz of better health outcomes.
International nurses?
Unlike docs, they don’t need additional training…just pass the SU RN licensing exam and apply for an occupational visa. Shitloads of nurses come in this way due to hospital demand.
NP Education?
2 year masters after a baccalaureate in nursing…emphasizes primary care, prevention, and health promotion. Up to 60% NPs work in primary care
Licensing NPs?
Less uniform regulations…usually master’s degree, and licensing by specialty-specific organizations. Can range from completely independent to working closely with a doc.
Why need NPs? (2)
1) Originally to fix the physician shortage, but as that problem waned and the issue of cost-containment arrived, 2) now you wanna find less expensive type of clinician to substitute for docs.
How do docs and NPs work together in multidisciplinary teams?
NPS often provide care management, health promotion, and instruction in self-care, while docs focus more on med management and treatment of acute complications
Pharmacist training? Where do they practice?
Baccalaureate degree program plus 1-2 years training for a Doctorate of Pharmacy degree. Mostly practice in retail pharmacy, second is hospitals.
What are social workers trained in?
Assessments, diagnostic impressions, psychosocial support, navigation of health/social service systems (like transitions and such), helping with neglect/abuse, and counseling pts on healthy behavior change
What are the requirements for a social worker?
Bachelor’s degree, most positions require a social work in masters plus state licensure, plus academic/practical experience
Explain growth of docs since 1965.
Generalists stay around the same, specialists are generally increasing in number.
