Chapter 2 Health Care Settings and the Health

Chapter 2 Health Care Settings and the Health Care Team © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

Ambulatory Health Care Settings (Slide 1 of 6) • Sole Proprietorships - Solo practice - Exclusive rights to all aspects of the practice - Sees and treats all patients • Partnerships - Two or more providers - Liable for own actions • Professional Corporations - Shareholders are considered employees © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2

Ambulatory Health Care Settings (Slide 2 of 6) • Group Practices - Two or more providers share costs - Providers consult each other - Patients may request same provider for all appointments - Ensures there is always provider on call - Groups of three or four providers - HMO (health maintenance organization): serve as Primary Care Providers (PCP) • Allows providers and the medical assistant more time for patient care © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 3

Ambulatory Health Care Settings (Slide 3 of 6) • Urgent Care Centers - Usually private, for-profit centers - Provide services for primary care, routine injuries and illnesses, and minor surgery - Providers often salaried employees - Certain retail chain stores (CVS, Target, Walmart) have entered this market - See higher volume of patients, usually for lower cost than hospital emergency room - Increased in popularity © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 4

Ambulatory Health Care Settings (Slide 4 of 6) • Managed Care Operations - Health maintenance organizations (HMOs) provide full range of services under one roof - HMOs without walls is network of participating providers within defined geographic area - Preferred provider organization (PPO) is a physician’s network - Independent physician association (IPA) treats patients for agreed-upon fee © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 5

Ambulatory Health Care Settings (Slide 5 of 6) • “Boutique” or “Concierge” Medical Practices - Sought by patients discouraged with insurance reimbursement - Provides immediate access to provider 24/7 - Convenient, unhurried same-day appointments, monthly or annual fee - Unlimited email, fax, phone consultations - Home/work visits as needed - Coordination of specialist referrals - Two types: retainer-based and direct primary care © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 6

Ambulatory Health Care Settings (Slide 6 of 6) • Patient-Centered Medical Home (PCHM) - Listens to what patients want and seeks to provide better quality experience and cost - More than 15% of PCP’s practices are recognized as PCMH by the National Committee for Quality Assurance (NCQA)After hours and online access to providers - Patients are active in their own health care • Accountable Care Organization - Network of providers and hospitals that agree to manage all health care needs © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 7

The Health Care Team • Primary care provider • Specialists • Allied health professionals • Complementary and/or alternative medical (CAM) care © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 8

The Title Doctor • Physicians have earned a Doctor of Medicine degree (MD) • Other medical degrees - Doctor of Osteopathy (DO) - Doctor of Dental Surgery (DDS) - Doctor of Optometry (OD) - Doctor of Podiatric Medicine (DPM) - Doctor of Chiropractic (DC) - Doctor of Naturopathy (ND) • Nonmedical discipline doctors: education (Ed. D), philosophy (Ph. D), and psychology (PSYD) © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 9

Health Care Professionals and Their Roles • Doctor of Medicine (MD) - Four years of medical school after bachelor’s Three to seven years of residency training - State license/continuing medical education (CME) • Doctors of Osteopathy (DO) - Four years of medical school after bachelor’s Can work in specialty area with 2– 6 years additional training - State license/continuing medical education (CME) - Can incorporate osteopathic manipulative treatment (OMT) © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 10

Integrative Medicine and Alternative Health Care Practitioners • Many carry title doctor • Training highly specialized and specific • When licensed, allowed to diagnose and treat medical conditions • Examples include - Chiropractic medicine: Physiologic and biochemical aspect of the body - Naturopathic medicine: Natural healing processes to fight disease - Oriental Medicine/Acupuncture: Comprehensive system of health care based on energetic model © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 11

The Role of the Medical Assistant (Slide 1 of 2) • Administrative functions - Receptionist, secretary, office manager, bookkeeper, patient educator, insurance coder and biller, transcriptionist, patient educator, clinical assistant • Clinical functions - Administer injections, perform venipuncture, prepare patients for examinations, assist with examinations and special procedures, and perform electrocardiography and various laboratory tests © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 12

The Role of the Medical Assistant (Slide 2 of 2) • Perform only within scope of training and personal capabilities • Function within ethical and legal boundaries and state statutes • Positive attitude/excellent communicators • Project professional image of themselves and their employer © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 13

Selected Allied Health Professions • Health Unit Coordinator • Medical laboratory Technologist • Registered Dieticians • Pharmacist/Pharmacy Technician • Phlebotomist • Physical Therapist/Physical Therapy Assistant • Registered Nurse, Licensed Practical Nurse, Nurse Practitioner • Physician Assistant © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 14

The Value of the Medical Assistant to the Health Care Team • Acts as communicator and liaison between provider and hospital staff, and provider and allied and other health professionals • First to come in contact with patient • Directs, informs, and guides patient care © 2018 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 15