CH # 1: The Health Care System Flashcards
Medical care that is provided on a outpatient basis.
Ambulatory care
When the patient comes 2 the facility providing care and return home after having received services
Outpatient care
A set payment provided by managed care insurance per patient per month regardless of the amount of services received
Capitation
A treatment that cures disease
Curative treatment
Learned from observation or experiment
Empirical
A means of payment 4 health care in which the cost of each service provided is reimbursed in full or in part
Fee-4-service
A list of prescription drugs covered or preferred by a managed care insurance company
Formulary
The purchase of protection 4 covered services related 2 health care
Health insurance
Considering the whole person when providing health care; physical, mental and spiritual components
Holistic
A system that manages the delivery of health care w/the intention of controlling costs
Managed care
Therapy that reduces the effects of a disease or condition but does not remove the disease itself
Palliative treatment
A model of primary care that emphasizes patient-centered health care based on a personal relationship among a patient, a physician and the patient’s care team
Patient-centered medical home
PCMH
A program that provides training in a medical speciality 2 a physician who has finished medical school
Residency
Therapy 4 symptoms of a disease or condition that does not remove the disease itself
Symptomatic treatment
An assessment of medical services 2 determine whether they r appropriate, necessary and of high quality
Utilization review
An organization that defines health as being the absence of illness or disease and a state of being in which the individual feels well and is able 2 carry out daily functions of life w/no difficulties and no pain
World Health Organzation
WHO
A 4th century BCE Greek physician believed that disease was not punishment 4 transgressions against the gods but the result of physiologic and environmental factors that could b studied
He is considered 2 b the beginnings of Western medicine
Hippocrates
A government program that provides health care 2 low income people
Medicaid
A government program that initiated health insurance 4 the elderly, disabled and those w/end stage kidney disease
Medicare
An organization formed w/the belief that consistent, routine care would help prevent later expensive care
In the 1970’s, they pushed traditional health insurance companies 2 provide routine check ups
Health maintenance organizations
HMO’s
Became law in 2010
Expanded insurance coverage 4 an estimated 32 million Americans who were previously uninsured
Protected people w/preexisting health conditions from being excluded from getting health insurance
The Patient Protection and Affordable Care Act
“Obama Care”
Members include physicians, NP’s, MA’s, RN’s, a business manager, a receptionist, a medical secretary, file clerks and 1 or more insurance specialists
Health Care Team
2 types of occupations that assigns codes 2 patient charges and diagnoses 4 insurance billing
There r many coding certifications depending on knowledge and speciality
Certified Professional Coder
(CPC)
Certified Coding Associate
(CCA)
An occupation where the individual performs ultrasound scans in hospitals and ambulatory care facilities
Ultrasound uses high frequency sound waves 2 produce images
Diagnostic Medical Sonographer
DMS
An occupation where the individual provides emergency services and life support in the community
Several levels of emergency personal exist which depends and training and experience
Emergency Medical Technician Paramedic
EMT, paramedic
An occupation where the individual works w/the patients medical records
Records may provide assistance in planning, managing information, gathering data 4 medical research and policy making
Health Information Specialist
RHIA, RHIT
An occupation where the individual performs adminstrative and clinical tasks in ambulatory care
Medical Assistant
MA
An occupation where the individual performs laboratory tests in the clinical laboratory and may supervise laboratory operations or provide consulting services
Medical (Clinical) Technologist
MT, MLT
An occupation where the individual is a secretary who specializes in administrative procedures in a health care setting
Medical Secretary
CMS
An occupation where the individual operated devices that detect and map absorption of radioactive substances given by injection 2 create diagnostic images
Nuclear Medicine Technologist
CNMT
An occupation where the individual performs direct patient care and procedures
Nurse, Practical
LPN, LVN
An occupation where the individual specializes in a specific area of medicine
Manages routine patient care in ambulatory care settings
Nurse Practitioner
An occupation where the individual plans and provides nursing care in inpatient settings
Provides supervision 4 caregivers in both inpatient and outpatient settings
Nurse, Registered
RN
2 names 4 an occupation where the individual plans therapeutic activities 4 rehabilitation especially 4 daily living activities
Implements treatment plans
Occupational Therapist
(OT)
Occupational Therapist Assistant
(OTA)
2 names 4 an occupation where the individual plans exercises 4 large muscle groups 4 rehabilitation and implements treatment plans
Physical Therapist
(PT)
Physical Therapy Assistant
(PTA)
An occupation where the individual manages routine patient care under the supervision of a physician
Usually works in ambulatory care
Physician Assistant
PA
An occupation where the individual takes radiographs and assists w/special radio graphic examinations
Radiologic Technologist
RT
An occupation where the individual assists w/nutrition of patients in hospitals and ambulatory care
Performs nutrition screening and counseling
Coordinates all aspects of food service
Registered Dietician
RD
An occupation where the individual provides respiratory treatments and manages patients on ventilators
Respiratory Therapist
RRT
An occupation where the individual assists during surgery in hospitals and day surgery centers by setting up operating rooms, preparing instruments and equipment and passes instruments during surgery
Surgical Technologist
CST
All facilities include: reception and waiting room
examination rooms and laboratory
medical records storage and business offices
May include: pediatrics examination and treatment room
surgical procedures room
complex testing room
trauma room
Parts of the medical office
2 medical specialities that treats adults and/or children w/allergies or problems w/the immune system
They diagnose, manage and treat allergic diseases, immunodeficiency conditions and autoimmune diseases
Allergy and Immunology
A medical speciality that provides anesthesia during surgery and other procedures and medical care 2 patients b4, during and after surgery
Anesthesiology
A medical speciality that performs surgical treatment of the large intestine and the rectum
Specializes in diagnosis and treatment of diseases of the colon and the rectum
Performs diagnostic and screening procedures and preform surgery when necessary
Colon and Rectal Surgery
A medical speciality that specializes in conditions of the skin
They diagnose skin diseases and perform surgery on the skin
Dermatology
A medical speciality that treats patients 4 emergency conditions in a hosptial ER
They focus on treatment of acute illnesses and injuries that require immediate care
Emergency Medicine
A medical speciality that treats adults and children 4 routine care and complaints
They r often the primary care physician
Family Medicine
A medical speciality that provides medical treatment 4 conditions of various body systems
There r many different specialities in this area of medicine
Internal Medicine
A medical speciality that provides diagnostic procedures and treatments 4 individuals w/genetically linked diseases, genetic counseling and prenatal diagnosis
Medical Genetics
A medical speciality that performs prevention diagnosis, surgical and nonsurgical treatment and rehabilitation 4 conditions of the brain, spine and the nervous system
Also provides surgical and nonsurgical treatment 4 pain
Neurologic Surgery
A medical speciality that provides diagnosis and medical treatment of diseases of the peripheral and central nervous systems
Neurology
A medical speciality that specializes in the diagnosis using radionuclides; atoms that give off electromagnetic radiation
They diagnosis and give treatment recommendations of abnormalities detected through the various imaging modalities they use
Nuclear Medicine
2 names 4 a medical speciality that specializes in care during pregnancy and delivery, care and surgery of the female reproductive system, screening 4 diagnostic procedures and both medical and surgical treatments and frequently uses hormone-modulating treatments
Obstetrics and Gynecology
A medical speciality that specializes in care of the eye and manages diseases and conditions of the eye w/both medical and surgical treatment
Ophthalmology
A medical speciality that specializes in diagnosis and treatment of acute and traumatic injuries of the musculoskeletal system and diseases of the muscle are and skeletal systems
Orthopedic Surgery
A medical speciality that specializes in the care of the ear, nose, throat, head and neck
Provides diagnosis and surgical and nonsurgical treatment of a variety of disorders
Otolaryngonology
A medical speciality that examines cells, tissues and other specimens 2 determine whether their structure is normal or abnormal
They attempt 2 determine the nature or cause of a disease
Also perform autopsies
Pathology
A medical speciality that specializes in the care of children from birth through adolescence
In the USA they r usually the primary care physician 4 the child
Pediatrics
Medical speciality that specializes in the treatment and rehabilitation of patients w/disabling conditions
Physical Medicine and Rehabilitation
A medical speciality that specializes in the surgical and nonsurgical treatment of physical defects of various areas of the body
They cover Cosmetic Surgery involving enhancement or reconstruction of various body parts
Plastic Surgery
A medical speciality that includes aerospace medicine, occupational medicine and public health
They usually specialize in 1 area of the body
Preventative Medicine
A medical speciality that specializes in preventing, diagnosing and treating mental illiness
They have the same general training as any other physician and they r able 2 prescribe medications 4 mental illnesses and monitor their effects
Psychiatry
A medical speciality that specializes in use of x-ray and other ionizing radiation 4 diagnosis, treatment or medical physics
Radiology
A medical speciality that performs general surigical procedures
Surgery
A medical speciality that performs surgery of the chest including cardiac surgery
Thoracic Surgery
A medical speciality that specializes in the care and surgery of the urinary system in both males and females and the reproductive tract in males only
Urology
A medical speciality that performs surgeries of the arteries and veins EXCEPT 4 the blood vessels of the heart and the brain
Vascular Surgery
A medical speciality that is a mix of traditional scientific medicine and holistic medicine
They seek 2 balance the structure and function of the body through manipulation of muscles and joints
Osteopathy
A medical speciality that uses traditional medicine and surgical techniques but r limited in their practice 2 treatment of disorders of the feet and ankles
Podiatry
A medical speciality that utilizes the technique of spinal manipulation
They believe that vertebral subluxations cause nerve blockages which in turn lead 2 pain in the back, neck, shoulders and legs
Chiropractic
Is usually used 4 medical treatments that patients use in addition or an alternative 2 standard medical treatments
Complementary and Alternative Medicine
