Direct access, primary care, and autonomous practice Flashcards

1
Q

definition: The provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing within the context of family and community.

A

primary care

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2
Q

definition: The process of weighing the probability of one disease versus that of other diseases possibly accounting for a patient’s illness/injury.

A

differential Dx

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3
Q

(true/false) The role of primary care practitioner is consistent with the expectations of education and practice as stated in the official documents of the APTA and CAPTE

A

true

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4
Q

What primary care models have successfully paved the way for direct access?

A

Military
kaiser permanente (Large HMO structure)
VA (large hospital system)
Mercy health system (community hospital setting)

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5
Q

90% of family physician training is in what setting? How long must they be in a musculoskeletal training?

A

outpatient ( >1 month of MSK experience)

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6
Q

(true/false) family physicians do not have a heavy psychosocial focus.

A

false

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7
Q

General internists have an emphasis of caring for what type of patients? How long of MSK training do they need? Do they have outpatient training/practice experience)

A

hospitalized patients (no MSK requirements and no outpatient practice)

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8
Q

Nurse practitioners are grads of what training program? Who are typically their instructors?

A

RN; instructors are typically nurses, not MDs

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9
Q

(true/false) nurse practitioners have prescriptive authority in all states

A

true

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10
Q

(true/false) nurse practitioners can function independently

A

true (they are the closest to being a provider)

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11
Q

RNs require a _____ degree.

A

bachelors

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12
Q

LPNs require a ___ degree

A

associates

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13
Q

Nurse practitioners require a ___ degree.

A

masters

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14
Q

Physician assistants receive a _____ or ___ degree after graduate school.

A

bachelors or masters

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15
Q

Who are the typical instructors for physician assistant students?

A

PAs (some MDs)

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16
Q

(true/false) PAs have prescription authority in all states.

A

false (most states)

17
Q

(true/false) PAs can function independently.

A

False (only functions under the supervision of an MD)

18
Q

Who has more autonomy, NPs or PAs?

A

NPs

19
Q

How many years after undergraduate phase does a NP need in graduate school?

A

2 years

(undergrad 2-4 years)

20
Q

How many years after graduate school does an MD need to be in a fellowship?

A

3-5 years

21
Q

While in casualty situations, PTs manage patients in the ___ category.

A

minimal (“walking wounded”)

22
Q

Who augments the otho dept in mass casualty situations? Why?

A

a. PTs –> considered as a tactical admin

b. frees up surgeons and expedites access for patients with MSK/neuro MSK conditions

23
Q

How many PTs are in the army?

A

300+

24
Q

How many PTS are in the air force?

A

150

25
Q

How many PTs are in the navy?

A

90

26
Q

How many PTs are in the marine corps?

A

0

27
Q

With Kaiser permanente, PTs are part of the _______ care team.

A

primary

28
Q

In kaiser permanente model, PTs were recognized as experts in ___ conditions.

A

MSK

29
Q

__-__% of patient visits to adult primary care were MSK related

A

20-25%

30
Q

What are the 4 methods to see a PT in the kaiser permanente model?

A
  • physician referral
  • joint consult with PT and MD
  • triaged to PT with calling or walk-in to a medical station
  • triaged after calling a medical advice line
31
Q

What are PT patient requirements for the kaiser permanente model?

A
  • 18 to 65 y/o
  • non-industrial injury/ non-3rd party liability
  • afebrile
  • no chest or abdominal pain
  • not seeking medical intervention
  • willing to see a PT instead of an MD or NP
32
Q

What are the PT adult primary care staff guidelines in the kaiser permanente model?

A
  • minimum of 4-6 years of OP ortho experience
  • demonstrate continued education in ortho
  • team communication skills
33
Q

What is the largest health system in the US?

A

VA

34
Q

What is the typical patient population for the VA?

A

older population with complex, multiple, medical problems

35
Q

What are the 3 methods to see a PT in the VA model?

A
  • ED
  • primary care clinics
  • telephone triage systems
36
Q

What preparations do PTs need for the VA?

A

> 4 months experience in a primary care internship program

37
Q

What primary care model developed a model of education for physicians by PTs during clinical care of patients with NM conditions?

A

mercy health system

38
Q

What are the characteristics of autonomy?

A
  • Independent, self determined judgment
  • Responsibility and acceptance of risk
  • Ability to refer and collaborate
  • Recognition of need for consult
  • Clinical decision making independent of financial considerations
  • PT governance and control of PT practice
39
Q

(true/false) Acute care in indiana is highly regulated

A

true –> 1 of 2 states that have no form of direct access