Chapter 4: Health Care Providers and Professionals

1. Chapter 4: Health Care Providers and Professionals Lecturer: Monika M. Wahi, MPH, CPH

2. Learning Objectives • Explain why health care professionals make up such a large proportion of the U.S. work force • Name three types of allied health professionals • Describe the role and value of non-physician practitioners • List two differences between primary and specialty care • Understand the role of dentists, pharmacists, and other doctoral-level health professionals At the end of this lecture, student should be able to:

3. Introduction

4. Introduction • U.S. health care industry is the largest employer in the U.S. – 13% of the U.S. labor force • Over the years, services offered and types of health care professionals available are closely linked • Remember Market Justice? • Likewise, the distribution of types of services and types of providers has evolved over time • Current imbalances • Too many specialists, not enough generalists • Maldistribution of practitioners – oversupply of the wrong type of physicians • Roles for NPPs, PA’s, and nurse midwives increasing

5. Health Services Professionals Pharmacists Allied Health Professionals Physicians Chiropractors NPPs Nurses Dentists Podiatrists Optometrists Health Service Administrators Psychologists

6. Allied Health Professionals

7. Colleges of Medicine Health Care Settings Laboratories Colleges of Allied Health Professions Migrant Health Centers Hospitals Community Health Centers Mental Health Centers MCOs Voluntary Health Agencies Research Institutions Nursing Care Facilities Insurance Firms Hospitals Pharmaceutical Companies Professional Health Associations Outpatient Facilities School Clinics Physicians’ Offices

8. Persons Employed at Health Service Sites From Table 4.1 (page 81)

9. Persons Employed at HealthService Sites From Table 4.1 (page 81)

10. Physicians

11. Active Physicians per 10,000 Population From Table 4.2 (page 83)

12. Type of Active Physicians From Table 4.2 (page 83)

13. MD’s and DO’s MD’S Do’s Osteopathic medicine More likely to be generalists (>1/2) Holistic approach • Allopathic medicine • Less likely to be generalists (1/3) • Non-holistic approach

14. Primary vs. Specialty Care

15. Aggregate Physician Oversupply Shortage? • Geographic maldistribution • Specialty maldistribution

16. Ambulatory Visits by Generalists and Specialists in the U.S., 2005

17. Dentists

18. Distribution of Specialties for Dentists, 2008

19. Pharmacists

20. Sites of Employment for Pharmacists, 2008

21. Other Doctoral-level Health Professionals

22. Employment Levels of Doctoral-level Health Professionals in the United States, 2008 From Table 4.5 (page 92)

23. Nurses

24. Nurses

25. Non-physician Practitioners NPP

26. Distribution of Most Common NPPs, 2008 Survey 50%/50% split between Primary and Specialty Care Work predominantly in Primary Care

27. Role and Value of NPPs

28. Allied Health Professionals

29. What is an Allied Health Professional?

30. Types of Allied Health Professionals

31. Public Health Professionals and Core Disciplines

32. Health Services Administrators MHA, MHSA, MBA, MPH, MPA BA, BS

33. Conclusion • As health care evolves, we are challenged with the maldistribution of physicians • NPPs are needed to help, but there are obstacles there as well • Strong role for nurses, and many career opportunities for nurses at different levels • Other health care professionals have various levels of training, dx/tx authority, and roles • Dentists, public health professionals, health service administrators, pharmaceuticals

34. Learning Objectives • Explain why health care professionals make up such a large proportion of the U.S. work force • Name three types of allied health professionals • Describe the role and value of non-physician practitioners • List two differences between primary and specialty care • Understand the role of dentists, pharmacists, and other doctoral-level health professionals At the end of this lecture, student should be able to: