INTRODUCTION to the HEALTH PROFESSIONS pdf

INTRODUCTION
to the
HEALTH
PROFESSIONS
stanfield_fm 2/14/02 7:09 AM Page i
stanfield_fm 2/14/02 7:09 AM Page ii
INTRODUCTION
to the
HEALTH
PROFESSIONS
Fourth Edition
Peggy S. Stanfield, MS, RD/LD, CNS
Dietetic Resources
Twin Falls, Idaho
Y. H. Hui, PhD
Science and Technology System
West Sacramento, California
}}}}}}}}}}}}}}}
}}}}}}}}}}}}}}}
stanfield_fm 2/14/02 7:09 AM Page iii
World Headquarters
Jones and Bartlett
Publishers
40 Tall Pine Drive
Sudbury, MA 01776
978-443-5000

www.jbpub.com
Jones and Bartlett
Publishers Canada

6339 Ormindale Way
Mississauga, ON L5V 1J2
CANADA
Jones and Bartlett
Publishers International
Barb House, Barb Mews
London W6 7PA
UK
Jones and Bartlett’s books and products are available through most bookstores and online
booksellers. To contact Jones and Bartlett Publishers directly, call 800-832-0034, fax 978-
443-8000, or visit our website at www.jbpub.com.
Substantial discounts on bulk quantities of Jones and Bartlett’s publications are
available to corporations, professional associations, and other qualified organizations.
For details and specific discount information, contact the special sales department at
Jones and Bartlett via the above contact information or send an email to

Copyright © 2002, 1998, 1995, 1990 by Jones and Bartlett Publishers, Inc.
All rights reserved. No part of the material protected by this copyright may be reproduced
or utilized in any form, electronic or mechanical, including photocopying, recording, or by
any information storage and retrieval system, without written permission from the copy-
right owner.
Acquisitions Editor: Kristin L. Ellis
Production Editor: Julie C. Bolduc
Editorial Assistant: Corinne G. Hudson
Manufacturing Buyer: Therese Connell
Typesetting: Northeast Compositors, Inc.
Cover Design: Kristin E. Ohlin
Printing and Binding: Malloy Lithographing, Inc.
Cover Printing: Malloy Lithographing, Inc.
Cover Credits:

(top) Thomas Brummett/PhotoDisc; (left) © Stockbyte/PictureQuest;
(middle) © Stockbyte/PictureQuest; (right) © Keith Brofsky/PhotoDisc/PictureQuest
Interior photo credits:
p. ii, Mark Richards/PhotoEdit; p. 2, Mark Richards/PhotoEdit; p. 98, Jonathan
Nourok/PhotoEdit; p. 362, Robert Brenner/PhotoEdit; p. 476, Robert Brenner/PhotoEdit
Library of Congress Cataloging-in-Publication Data
CIP data unavailable at time of printing.
ISBN-13: 978-0-7637-0049-2
ISBN-10: 0-7637-0049-5
8419
Printed in the United States of America
1009080706 1098765
00495_FMxx_stanfield.qxd 10/3/06 2:16 PM Page 1
This fourth edition of
Introduction to the Health Professions is dedicated
with appreciation and gratitude to many, but especially to:
The great teachers who channel their energies
into preparing students for health careers.
We salute you.
Those dedicated and caring students who
have chosen careers of service to humanity
and are sharing their talents with others.
We wish you great success.
Our dear friend, Jim Keating,
who many years ago started our writing careers,
and continues to support and encourage our endeavors.
Much love to you, Jim.
Colleagues who through the years
have given help and support in so many ways.
You are greatly valued.

stanfield_fm 2/14/02 7:09 AM Page v
This page intentionally left blank
Contents
Preface xiii
Acknowledgments xvii
PART ONE The Health Care System in the United States
1 U.S. Health Care, 1990–2001 5
A Look Back 7
A Look Forward 9
Summary 11
2 Categories of Health Services 15
Overview of the U.S. Health Care System 17
Health Care Facilities 19
Managed Care 20
The Consumer and Health Care 21
The Consumer’s Rights 22
Health Care Costs 24
Public Health Services 25
Hospitals: Development and Services 27
Ambulatory Health Care Services 29
Mental Health Services 30
Health Care in the Twenty-First Century 32
Summary 32
3 Paying for Health Services 35
Changing Objectives of National Health Insurance 39
Health Care Financing 41
Health Insurance Coverage in the United States 43
Implications of Devolution 47
Continuing Debate 49
Effect on Health Care Providers 50

stanfield_fm 2/14/02 7:09 AM Page vii
4 Long-Term Care 53
Nursing Homes 56
Community Services 58
Community Health Agencies 58
Personnel Needs 61
Demographic Trends and Projections 62
Potential Health Care Needs 64
Future Trends 68
Summary 68
5 Aging, Health, and Women’s Issues 71
Gender-Specific Roles in Health Care 73
Medicare for Older Women 74
Medicaid for Older Women 75
Women’s Issues and the Health Care System 76
Women as Care Givers 76
Conclusion 77
The Future of Health Care 77
Future Education for the Health Professions 78
6 Health Career Planning 81
Employers of Health Professionals and Health-Related
Personnel 83
Employment Opportunities 88
Health Careers: Something for Everyone 91
Exploring Health Careers 94
Selecting a School 95
Using This Book to Select and Plan a Health Career 96
PART TWO Health Professions Involving Patient Care
7 Medicine 103
Doctors: The Perceptions 104

Doctors: The Realities 105
8 Dentistry 115
Dentists 116
Dental Hygienists 122
Dental Assistants 126
viii CONTENTS
stanfield_fm 2/14/02 7:09 AM Page viii
9 Nursing 131
Registered Nurses 132
Licensed Practical Nurses 140
10 Pharmacists 145
Pharmaceutical Partners 146
Pharmacists 146
Pharmacy Technicians and Assistants 155
11 Dietetics 161
Dietitians 162
Dietetic Technicians 169
Dietetic Assistants 172
12 Optometry 175
Optometrists 176
Dispensing Opticians 181
Paraoptometrics 186
13 Physician Assistants 189
A Relatively New Profession 190
Physician Assistants 190
14 Communication Impairments 197
Speech, Language, and Hearing Impairments 198
Speech-Language Pathologists and Audiologists 199
15 Emergency Medical Services 207
High Drama in Health Care 208

EMT-Paramedics 208
16 Imaging Modalities 217
X Rays and Beyond 218
Radiologic Personnel 219
17 Social Workers 229
Social Workers 231
Human Service Workers and Assistants 239
CONTENTS ix
stanfield_fm 2/14/02 7:09 AM Page ix
18 Psychology 247
Psychologists 248
Psychiatric or Mental Health Technicians 259
Psychiatric Aides 262
19 Respiratory Care Practitioners 265
Maintaining the Breath of Life 266
Respiratory Therapists 266
20 Physical Therapy 275
Physical Therapists 277
Physical Therapy Assistants and Aides 285
21 Occupational Therapy 289
Occupational Therapists 290
Occupational Therapy Assistants and Aides 297
22 Additional Technologists, Technicians,
and Assistants 301
Electroneurodiagnostic Technologists 302
Cardiovascular Technologists and Technicians 309
Nuclear Medicine Technologists 314
Surgical Technologists 321
Medical Assistants 326
Athletic Trainers 331

23 Behavioral Therapists 335
Art Therapists 337
Corrective Therapists 339
Dance Therapists 342
Horticulture Therapists 346
Manual Arts Therapists 348
Music Therapists 351
Recreational Therapists 354
x CONTENTS
stanfield_fm 2/14/02 7:09 AM Page x
PART THREE Health-Related Professions
24 Clinical Laboratory Technology 367
The Laboratory Team 368
Clinical Laboratory (Medical) Technologists and Technicians 369
25 Health Information Personnel 379
Providing and Preserving Essential Information 380
Health Information Administrators 381
Health Information Technicians 383
Medical Transcriptionists 388
Medical Librarians 391
26 Health Services Administration 397
The Need for Professional Management 398
Health Services Managers 399
27 Federal and State Health Regulators 409
Government Health and Safety Officers 410
Environmental Health Technicians and Aides 416
28 Health Education 417
Community Health Educators 419
Educational Therapists 424
Orientation and Mobility Instructors for the Blind 426

Rehabilitation Teachers 428
School Health Educators 430
Teachers of the Visually Handicapped 432
Employment Trends in Health Education 433
29 Veterinary Medicine 437
Veterinarians 438
Animal Technicians 446
Veterinary Assistants and Nonfarm Animal Caretakers 450
CONTENTS xi
stanfield_fm 2/14/02 7:09 AM Page xi
30 Miscellaneous Health-Related Professions 459
Biological Photographers 461
Medical Illustrators 464
Writers: Medical, Science, and Technical 467
Medical Secretaries 472
A Salaries for Health Professions: A Comparison
Chart 475
B Sources of Career Information 479
C Résumés and Job Hunting 487
D References 503
Index 507
xii CONTENTS
stanfield_fm 2/14/02 7:09 AM Page xii
Preface
Thanks to you, the teachers, the number of students using this
book has continued to increase. We therefore have an obligation
to make sure that this fourth edition reflects the needs of your
courses and your students. The changes are divided into two cate-
gories.
The first category affects the chapters in Part One, The Health

Care System in the United States. They include the following:
1. An update on the continuing evolution of medicine, health
problems, and health care moving into the twenty-first cen-
tury.
• New technologies, which bring concomitant challenges
related to cost, availability, and lifespan
• Lifestyle changes in areas such as hygiene, exercise, and
drugs
• Improved nutrition and food safety
• Preventive measures and individual responsibility
• Socioeconomic factors
• Emerging and reemerging diseases
• The status of women’s health
2. Trends in financing of health care insurance coverage.
• Recent congressional budget agreements and the implica-
tions for future health care (Balanced Budget Amendment)
• Impact of deregulation
• Updates on managed care organizations
• Effect on hospitals and nonprofit institutions
• Effect of the Patient’s Bill of Rights
stanfield_fm 2/14/02 7:09 AM Page xiii
3. Updates on the status, job outlook, salaries, and future of
health care practitioners.
The second category of changes affects the remainder of the
book, reflecting the changes in each profession in the following
areas:
1. Work description
2. Work environment
3. Employment opportunities
4. Educational and legal requirements

5. Employment trends
6. Earnings
7. Communication (including new Web sites)
The wealth of up-to-date, practical information that is con-
tained in the four appendices is not available elsewhere:
• In Appendix A, the chart of the salary ranges for health profes-
sionals gives students a base for comparing current possibilities
and predicting salary changes.
• In addition to the sources of information listed in the chapters
in Parts Two and Three, Appendix B contains sources of career
information and places to begin collecting job information.
• Appendix C offers guidance in pursuing desired jobs, includ-
ing specific tips on locating jobs, being interviewed, and com-
posing a résumé.
• Appendix D lists the references for citations in the chapters as
well as additional suggested readings.
Our sources of information for each profession include the fol-
lowing:
• Occupational Outlook (2001–2002), published by the U.S.
Department of Labor. Just before press time, the 2002–2003
version was released. Because of time constraints we updated
only the salary ranges.
• Organizations representing each profession
xiv PREFACE
stanfield_fm 2/14/02 7:09 AM Page xiv
• Various documents obtained through the Internet
• Selected reports in current journals, magazines, and news-
papers
• Literature from college catalogs
• Other professional literature

We hope that the teachers and students will find this fourth
edition useful and that it will satisfy their needs for basic informa-
tion about various health professions in this country. Please let us
know your thoughts so we can serve you even better with a fifth
edition.
PREFACE xv
stanfield_fm 2/14/02 7:09 AM Page xv
This page intentionally left blank
Acknowledgments
Many people are instrumental in bringing a book to fruition—
every author is part of a well-organized team. We would like to
express our sincere appreciation to the team that assisted in the
preparation of this book, especially to the following members: Kris
Ellis, Julie Bolduc, and Corinne Hudson. The dedication and pro-
fessionalism you bring to your work are evident in the quality of
the product. Your contributions are highly valued.
The contents of this text were largely obtained from govern-
ment publications, most of which are authored anonymously.
Although all such writings are in the public domain and can be
reproduced as needed, we would like to thank all those workers
whose labors were so useful. This book would have been most dif-
ficult to complete without their contributions.
Steve Poppino, Reference Librarian at the College of Southern
Idaho in Twin Falls, lent his expert assistance to obtaining infor-
mation for this fourth edition. It is very much appreciated. Thank
you again, Steve.
We would especially like to thank Philip R. Lee and Carroll L.
Estes (The Nation’s Health, 6th ed., 2001, Jones and Bartlett
Publishers) and Charlene Harrington and Carroll L. Estes (Health
Policy: Crisis and Reform in the U.S. Health Care Delivery System,

3rd ed., 2001, Jones and Bartlett Publishers) for the use of their
excellent texts in guiding our writing of this book regarding the
salient points of current policies, factors affecting health care, and
projections for health care of North Americans.
We acknowledge with appreciation the contributions of myriad
groups of scientists, organizations, and others, whose combined
efforts produced national health objectives for the next 10 years
(Healthy People 2010, vol. 1 and 2, Understanding and Improving
Health; Department of Health and Human Services, November
stanfield_fm 2/14/02 7:09 AM Page xvii
2000). It reflects the scientific advances of the past 20 years and
provides insights into trends and opportunities for health improve-
ment as well as concerns that must be addressed in the twenty-first
century. The fact that this nation’s population is growing older
and more diverse demands that health care providers, working
with political bodies, address these issues in order to eliminate the
persistent disparities in health care.
xviii ACKNOWLEDGMENTS
stanfield_fm 2/14/02 7:09 AM Page xviii
INTRODUCTION
to the
HEALTH
PROFESSIONS
stanfield01 2/14/02 7:12 AM Page 1
stanfield01 2/14/02 7:12 AM Page 2
Part One
}}}}}}}}}}}}}}}}}
The Health Care System
in the United States
stanfield01 2/14/02 7:12 AM Page 3

This page intentionally left blank
Chapter 1
}}
U.S. Health Care,
1990–2001
stanfield01 2/14/02 7:12 AM Page 5
6 THE HEALTH CARE SYSTEM IN THE UNITED STATES
Key Terms
Acute infectious disease
World Health Organization
(WHO)
Socioeconomic status (SES)
Chronic illness
Prevention
Effects of expanded technology
Objectives
After studying this chapter the student should be able to:
1. Discuss the changes in health problems of the population dur-
ing this century.
2. Identify expected future changes in the health of the popula-
tion that will influence the health care professional.
3. Name five new technology advances in the United States.
4. Identify the role of the government in the expansion of health
care.
stanfield01 2/14/02 7:12 AM Page 6