Administrative medical assisting 5th by lindh chapter02

Chapter 2

Health Care Settings and
the Health Care Team

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or duplicated, or posted to a publicly accessible website, in whole or in part.


Ambulatory Health Care Settings
• Individual and group medical practices
– Individual practices
• Also called solo practice
• One primary provider sees and treats patients
• One provider responsible for all costs

© 2014 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
• Individual and group medical practices
– Group practices
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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
Most medical practices groups of three or four providers

© 2014 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
• 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 have entered this
market
– See higher volume of patients, usually for lower
cost than hospital emergency room

© 2014 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
• 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

© 2014 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
• Boutique or concierge medical practice
– Sought by patients discouraged with insurance
reimbursement
– Provides immediate access to provider 24/7
– Convenient, unhurried same-day appointments
– Unlimited email, fax, phone consultations
– Home/work visits as needed
– Coordination of specialist referrals
– Set monthly or yearly fee for exclusive service

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or duplicated, or posted to a publicly accessible website, in whole or in part.


The Health Care Team
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Primary care provider

Specialists
Allied health professionals
Complementary and/or alternative
medical (CAM) care

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or duplicated, or posted to a publicly accessible website, in whole or in part.


The Title “Doctor”
• Physicians have earned a Doctor of
Medicine degree (MD)
• Other medical degrees
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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)

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.

The Title “Doctor”
• Nonmedical disciplines
– Doctor of Education (EdD)
– Doctor of Philosophy (PhD)
– Doctor of Psychology (PsyD)

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Health Care Professionals
• Doctors of Medicine (MD)
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4 years of medical school after bachelor’s degree
3–7 years of residency training
Must have state license
Must receive continuing medical education (CME)

• Doctors of Osteopathy (DO)
– 4 years of medical school after bachelor’s degree
– Can work in specialty area with 2–6 years additional
training
– Must have state license
– Maintain currency in education
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied

or duplicated, or posted to a publicly accessible website, in whole or in part.


Alternative Health Care Practitioners
• Many carry title doctor
• Training highly specialized and specific
• When licensed, these professionals
allowed to diagnose and treat medical
conditions

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Alternative Health Care Practitioners
• Doctors of Chiropractic (DC)
– Complete 4–5 years of chiropractic college
– Special attention to physiological and biochemical
aspects of body structure
– Adjust and manipulate tissues of body, particularly
spinal column
– Nonsurgical science; does not include
pharmaceuticals or surgery
– Licensed in all 50 states

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Alternative Health Care Practitioners

• Doctors of Naturopathy (ND)
– Often referred to as “natural medicine”
– Remove underlying cause of disease and
stimulate natural healing process
– 2 years of science courses; 2 years of clinical
work at naturopathy college
– Licensed in 15 states, 4 Canadian provinces,
Puerto Rico, and Virgin Islands
– May practice independently and unlicensed, or
practice under direction of physician
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Alternative Health Care Practitioners
• Oriental medicine and acupuncture
– Acupuncture, Chinese herbology and bodywork,
dietary therapy, and exercise
– Attempts to restore the energy flow in body’s
meridians
– Minimum of 2-year undergraduate education and 3
years of specialty training
– Nearly all states regulate practice of acupuncture
and Oriental medicine

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or duplicated, or posted to a publicly accessible website, in whole or in part.


The Role of the Medical Assistant

• 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
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Role of the Medical Assistant
• Perform only within scope of training
and personal capabilities
• Function within ethical and legal
boundaries and state statutes
• Positive attitude important
• Excellent communicators
• Project professional image of
themselves and their employer
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or duplicated, or posted to a publicly accessible website, in whole or in part.


Other Allied Health Professionals
• Health unit

coordinator (HUC)
• Medical laboratory
technologist (MLT)

MLT performing blood
analysis >>

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or duplicated, or posted to a publicly accessible website, in whole or in part.


Other Allied Health Professionals
• Registered dietitian
(RD)
• Pharmacist (RPh)
• Pharmacy
technician

Pharm tech working with
the pharmacist >>

© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


Other Allied Health Professionals
• Phlebotomist
• Physical therapist
(PT)
• Physical therapy

assistant (PTA)
• Nurse
PT working with a patient
>>

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or duplicated, or posted to a publicly accessible website, in whole or in part.


Physician Assistant
• Provide diagnostic, therapeutic, and
preventive health care services delegated
by supervision of providers or surgeons
• May prescribe some medications; can
supervise technicians and medical
assistants
• Must complete accredited formal
education and pass Physician Assistant
National Certifying Examination
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.


The Value of the Medical Assistant
• Valued ambulatory health care team
member
• 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
© 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied
or duplicated, or posted to a publicly accessible website, in whole or in part.