Topic 2: Health Service Professionals

Question 1

Distribution of labor force

Answer 1

• 40% ambulatory care services
• 25% employed by hospitals
• 15% by nursing and personal care facilities

Question 2

Health Personnel: Physicians

Answer 2

-state license require
- number increased but not enough (demand growing faster than supply)
- two types: MD- doctor of Medicine
DO- Doctor of Osteopathic Medicine (emphasizes prevention)
-> focused on primary care

Question 3

Primary care physicians

Answer 3

-family practice, internal medicine, pediatrics
-most ambulatory care visits
-gatekeeper role (meaning in some insurances plans patients need to see a primary care physician before they can see specialist)

Question 4

Specialists (4-7 residency)

Answer 4

-more years of advanced training
-patients may require referral from payer

Question 5

Issues in Medical Practices

Answer 5

Consequences of too many Specialists
- high volume of expenses, invasive procedures
- raises health care costs
- Surgeries grew at twice the rate of population growth

Question 6

Issues in Medical Practices pt 2

Answer 6

1. involvement in clinical practice guidelines
   -feels like a script for given complaint or diagnosis but is becoming increasingly used by insurance to measure cost effectiveness of physicians
2. threat of compromise
   -happens when there are a lot of physicians in one area and they do more to bring patients back or get more money from them.
   3.lopsided medical training
   -there’s more specialist training than primary care
   4.aggregate physician oversupply
   -
3. geographic maldistribution
   -
4. specialty maldistribution
5. International medical graduates
   need to redo residency so most go into primary care

Question 7

Types of healthcare personnel

Answer 7

-Dentists
-Pharmacists
-Optometrists
-Psychologists
-Podiatrist
-Chiropractors

Question 8

healthcare personnel: nurses

Answer 8

Nurses
-BSN
-registered nurses
- licensed practical nurses
- advanced practice nurses (=master’s)
Nurse Reinvestment Act of 2002
-to address shortage of nurses
- grants and scholarships to attract and keep nurses

Question 9

Physician Extenders

Answer 9

-PA’s
-Nurse Practitioners
-certified midwives

Allied Health Professionals
-therapists/technologists
-technicians/assistants

Question 10

How APN Laws Impact PCP Need

Answer 10

Restrictive advanced nurse laws
-laws are more restrictive in states where we need them to step up in care to help fill in the gap.

Question 11

Health Service Administrators

Answer 11

Challenges:
-financing and payment structures
-work with decreasing levels of reimbursement
-pressure of uncompensated care (needing to take care of someone without the means to pay for it)
-high quality
-community health service
-demands by both public and private payers
-new policy developments
-changing competitive environment
-mainting integrity