Transcript wise_7e_powerpoint_chp_02

Chapter 2
The Health Care Team
and the Medical Environment,
Past and Present
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Health Care Providers
• An individual who examines, diagnoses, and
prescribes treatment to patients
– Physicians are most common health care
providers
• May also be an organization (hospital, clinic)
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Physicians
• Education and training requirements
– Undergraduate degree, 4 years
– Medical school, 4 years
– 3-8 years of internship and residency
• Licensure requirements
– Established by each state
– Complete education and training requirements
– Moral and ethical requirements
– State/national oral and written examinations
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Physicians
• Endorsement
– Passing the National Board of Medical Examiners’
examination
• Reciprocity
– One state recognizes the licensing requirements of
another state
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Physicians
• Revocation of license
– Temporary or permanent suspension of license
• Reasons for revocation
– Conviction of a crime
– Unprofessional conduct
– Fraud
– Incompetence
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
MD, DO, and PhD
• MD: Doctor of Medicine
• DO: Doctor of Osteopathic Medicine
– Both are licensed physicians; have similar
educational and licensing requirements
• PhD: Holds a doctorate degree in a particular
discipline; completed highest level of study in
that area
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Physician Specialties
• General/family practitioners see all types of
patients
• Specialty and subspecialty areas require
additional years of study
• See Table 2-1 for areas in which a physician
may specialize
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Non-Physician Specialties
• Health specialists who are not physicians
Specialist
Degree Obtained
Chiropractor
Doctor of Chiropractic (DC)
Dentist
Doctor of Dental Surgery (DDS)
Optometrist
Doctor of Optometry (OD)
Podiatrist
Doctor of Podiatric Medicine
(DPM)
Psychologist
Doctor of Philosophy (PhD)
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Midlevel Practitioners
• Nurse Practitioners (NP) and Physician’s
Assistants (PA)
• Allowed to examine patients, order diagnostic
testing, prescribe certain medications
• Activities may be directed by a supervising
physician, or may work autonomously (per
state law)
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Nurses
• Registered Nurse (RN)
– Must meet educational requirements, pass the
NCLEX-RN, licensed to practice by state
• Nurse Anesthetist
– Certified to administer anesthesia
• Nurse Midwife
• Licensed Practical Nurse (LPN)
– Works under the supervision of RN or physician
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Health Care Team Members
Audiologist
Occupational Therapist
Dietician
Emergency Medical Technician
Hospital Registrar
Medical Biller
Phlebotomist
Pharmacy Technician
Physical Therapist
Radiology Technician
Medical Coder
Medical Office Manager
Laboratory Technician
Respiratory Therapist
Sonographer
Surgical Technologist
Nuclear Medicine Technologist
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: Ancient Times
• Primitive human beings
– 80% of the population died by the age of 30
• Ancient civilizations
– Disease was attributed to evil spirits and demons,
due to disobedience to the gods
– Cures were rituals performed by priests
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: Egypt
• Developed medical practice ≈ 3000 BC
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: Egypt
• Physicians were priests who studied medicine
and surgery
• Cures included:
– Black magic, spells, concocted potions
– 1/3 of medicinal plants that are still used today
– Bloodletting and application of leeches
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: India
• The world’s first nurses and hospitals
• Cures included:
– Extensive use of drugs, including anesthesia
– Surgeries (used 120 surgical instruments!)
– Cataract procedures and plastic surgery
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: China
• Highly developed center for medical learning
• Cures/advancements included:
– Document, The Great Herbal, with over 1000
drugs
– Acupuncture
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: Greece
• Hippocrates, the founder of scientific
medicine (460 – 379 BC)
– Shifted medicine from priests to scientific study
– Taught that illness was not punishment for sins
– Listened to the chest (2000 years before the
stethoscope) to diagnose diseases
– Code of behavior, the Hippocratic Oath
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Oath of Hippocrates
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: Roman Empire
• Build an elaborate sanitation system
– Saw the link between hygiene and disease
• Claudius Galen (121 – 199 AD)
– Physician, surgeon, anatomist
– Wrote over 500 anatomy books, based on
anatomy of animals
– His viewpoints were accepted until the 16th
century
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: Medieval Times
• Little progress made between 5-16th centuries
• The Arab Empire continued medical
knowledge
– Had hospitals and four major teaching centers
– Made contributions in pharmacology
– Rhazes (860 – 932 AD)
• Wrote 150 books
• Used animal gut sutures to sew wounds
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: The Great Diseases
• Leprosy
• Bubonic plague, “Black Death”
– Caused by a bacillus that grew in fleas of infected
black rats; fatal in 5 days
• Pneumonic plague
– Affected the lungs; fatal in 3 days
• Septicemic plague
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
History: The Renaissance
• 17th century: Physicians, surgeon, and
apothecaries practiced medicine
• Some of the contributors of this time:
Trotula Platearius
Ambroise Pare
Andreas Versalius
William Harvey
Antony Van Leuwenhoek
Gabriel Fahrenheit
Edward Jenner
Rene Laennec
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Modern Medicine
• With the emphasis on scientific inquiry,
medicine has changed rapidly
• Contributors in the 18th century
WTG Morton
Florence Nightingale
Clara Barton
Elizabeth Blackwell
Louis Pasteur
Joseph Lister
Wilhelm von Roentgen
Elias Metchnikoff
Walter Reed
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Modern Medicine
• Medical pioneers in the 20th-21st centuries (cont.)
Marie Curie
Alexis Carrel
Elsie Strang L’Esperance
Sir Alexander Fleming
George Papanicoulaou
Frederic Banting
Gerhard Domagk
Dr. Jonas Salk
Dr. A.B. Sabin
Dr. Michael Debakey
Dr. Willem J. Kolff
Dr. Charles Hufnagel
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Modern Medicine
Dr. C. Walton Lillehei
Dr. Ake Senning
Frank B. Colton
Dr. Peter Safar
Dr. Patrick Steptoe &
Dr. Robert Edwards
Dr. Robert Jarvick
Ray W. Fuller
Stanley Cohen & Herbert
Boyer
Nicolas Terrett & Peter
Ellis (Pfizer)
AbioCor company
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
The Impact of Government
on Health Care
• Has provided impetus and influence in the
growth of health care
• Through grants, funding, and regulations
Year
1930
1930
1948
1970
Agency
FDA
NIH
WHO
OSHA
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
The Impact of Government
on Health Care
Year
1946
Legislation
Hill Burton Act
Year
1970
1965
1966
1967
1968
Medicaid
Medicare
CLIA
Uniform
Anatomical Gift
Act
1996
2006
2010
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Legislation
Controlled
Substances Act
HIPAA
Medicare Part D
Patient Protection
and Affordable
Care Act
Alternatives to the Traditional Model
• Complimentary therapies
– Supplement or add to conventional medicine
– Massage, acupuncture, acupression, hypnosis
• Alternative therapies
– Used instead of conventional medicine
– No scientific evidence exists to validate
effectiveness
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.
Alternatives to the Traditional Model
Acupuncture
Aromatherapy
Ayurvedic
medicine
Biofeedback
Homeopathy
Humor
Hypnosis
Hand reflexology
Naturopathy
Tai chi
Magnet therapy
Faith
Massage
Visualization and
guided imagery
Yoga
Copyright ©2012 Delmar, Cengage Learning.
All rights reserved.