Health care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities.
An individual health care provider (also known as a health worker) may be a health care professional within medicine, midwifery-obstetrics, nursing, pharmacy, or allied health professions. Health care providers may also be a public/community health professional. Institutions (also known as health facilities) include hospitals, clinics, primary care centres, and other service delivery points. The practice of health professionals and operation of health care institutions is typically regulated by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance. Together, they form part of an overall health care system.
- 1 Medical facility
- 2 Practitioners and professionals
- 2.1 Mental health practitioners
- 2.2 Maternal and newborn health practitioners
- 2.3 Geriatric care practitioners
- 2.4 Surgical practitioners
- 2.5 Rehabilitation care practitioners
- 2.6 Eye care practitioners
- 2.7 Oral health practitioners
- 2.8 Foot care practitioners
- 2.9 Public health practitioners
- 2.10 Traditional and complementary medicine practitioners
- 3 Practice conditions and regulations
- 4 Ratings
- 5 See also
- 6 References
- 7 External links
A medical facility is, in general, any location at which medicine is practiced regularly. Medical facilities range from small clinics and doctor's offices to urgent care centers and large hospitals with elaborate emergency rooms and trauma centers. The number and quality of medical facilities in a country or region is one common measure of that area's prosperity and quality of life. In many countries, medical facilities are regulated to some extent by law; licensing by a regulatory agency is often required before a facility may open for business. Medical facilities may be owned and operated by for-profit businesses, non-profit organizations, governments, and in some cases by individuals, with proportions varying by country.
Practitioners and professionals
Health care practitioners include physicians, dentists, pharmacists (including clinical pharmacists), physician assistants, nurses (including advanced practice registered nurses), midwives (obstetrics), dietitians, therapists, psychologists, chiropractors, clinical officers, social workers, phlebotomists, physical therapists, respiratory therapists, occupational therapists, audiologists, speech pathologists, optometrists, emergency medical technicians, paramedics, medical laboratory scientists, medical prosthetic technicians, radiographers and a wide variety of other human resources trained to provide some type of health care service. They often work in hospitals, health care centres, and other service delivery points, but also in academic training, research, and administration. Some provide care and treatment services for patients in private homes. Many countries have a large number of community health workers who work outside of formal health care institutions. Managers of health care services, health information technicians, and other assistive personnel and support workers are also considered a vital part of health care teams.
Health care practitioners are commonly grouped into four key fields:
- Medical (including generalist practitioners and specialists);
- Nursing (including various professional titles);
- Health Professions, including occupational therapy, pharmacy, physical therapy, paramedicine, respiratory therapy, radiographer and many others health specialists.
Within each field, practitioners are often classified according to skill level and skill specialization. “Health professionals” are highly skilled workers, in professions that usually require extensive knowledge including university-level study leading to the award of a first degree or higher qualification. This category includes physicians, physician assistants, dentists, registered nurses, pharmacists, physiotherapists, optometrists, and others. Allied health professionals, also referred to as "health associate professionals" in the International Standard Classification of Occupations, support implementation of health care, treatment and referral plans usually established by medical, nursing, and other health professionals, and usually require formal qualifications to practice their profession. In addition, unlicensed assistive personnel assist with providing health care services as permitted.
Another way to categorize health care practitioners is according to the sub-field in which they practice, such as mental health care, pregnancy and childbirth care, surgical care, rehabilitation care, or public health.
Mental health practitioners
A mental health practitioner is a health worker who offers services for the purpose of improving an individual's mental health or treating mental illness. These include psychiatrists, clinical psychologists, clinical social workers, psychiatric-mental health nurse practitioners, marriage and family therapists, as well as other health professionals and allied health professions. These health care providers often deal with the same illnesses, disorders, conditions, and issues; however their scope of practice often differs. The most significant difference across categories of mental health practitioners is education and training.
Maternal and newborn health practitioners
A maternal and newborn health practitioner is a health worker who deals with the care of women and their children before, during and after pregnancy and childbirth. These include obstetricians, midwives (obstetrics), obstetrical nurses, nurse practitioners, clinical nurse specialists, and others. One of the main differences across these professions is the training and authority to provide surgical services and other life-saving interventions. In some developing countries, traditional birth attendants, or traditional midwives, are the primary source of pregnancy and childbirth care for many women and families, although they are not certified or licensed.
Geriatric care practitioners
A geriatric care practitioner plans and coordinates the care of the elderly and/or disabled to promote their health, improve their quality of life, and maintain their independence for as long as possible. They include geriatricians, adult-gerontology nurse practitioners, clinical nurse specialists, geriatric clinical pharmacists, geriatric nurses, geriatric care managers, geriatric aides, and others who focus on the health and psychological care needs of older adults.
A surgical practitioner is a health worker who specializes in the planning and delivery of a patient's perioperative care, including during the anaesthetic, surgical and recovery stages. They may include general and specialist surgeons, anesthesiologists, nurse anesthetists, surgical nurses, clinical officers, operating department practitioners, anaesthetic technicians, surgical technologists, and others.
Rehabilitation care practitioners
A rehabilitation care practitioner is a health worker who provides care and treatment which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. These include physiatrists, rehabilitation nurses, clinical nurse specialists, nurse practitioners, physiotherapists, orthotists, prosthetists, occupational therapists, recreational therapists, audiologists, speech and language pathologists, respiratory therapists, rehabilitation counsellors, physiotherapy technicians, orthotic technicians, prosthetic technicians, personal care assistants, and others.
Eye care practitioners
Care and treatment for the eye and the adnexa may be delivered by ophthalmologists specializing in surgical/medical care, or optometrists specializing in refractive management and medical/therapeutic care.
Oral health practitioners
A dental care practitioner is a health worker who provides care and treatment to promote and restore oral health. These include dentists and dental surgeons, dental assistants, dental auxiliaries, dental hygienists, dental nurses, dental technicians, dental therapists, and related professional titles.
Foot care practitioners
Public health practitioners
A public health practitioner focuses on improving health among individuals, families and communities through the prevention and treatment of diseases and injuries, surveillance of cases, and promotion of healthy behaviors. This category includes community and preventive medicine specialists, public health nurses, clinical nurse specialists, dietitians, environmental health officers, paramedics, epidemiologists, health inspectors, and others.
Traditional and complementary medicine practitioners
In many societies, practitioners of traditional medicine or alternative medicine are an important primary health care provider, either as integrated within or remaining outside of the formal health care system. These include practitioners in acupuncture, Ayurveda, herbalism, homeopathy, naturopathy, Siddha medicine, traditional Chinese medicine, traditional Korean medicine, and Unani.
Practice conditions and regulations
Shortages of health professionals
Many jurisdictions report shortfalls in the number of trained health human resources to meet population health needs and/or service delivery targets, especially in medically underserved areas. For example, in the United States, the 2010 federal budget invested $330 million to increase the number of doctors, nurses, and dentists practicing in areas of the country experiencing shortages of health professionals. The Budget expands loan repayment programs for physicians, nurses, and dentists who agree to practice in medically underserved areas. This funding will enhance the capacity of nursing schools to increase the number of nurses. It will also allow states to increase access to oral health care through dental workforce development grants. The Budget’s new resources will sustain the expansion of the health care workforce funded in the Recovery Act.
In Canada, the 2011 federal budget announced a Canada Student Loan forgiveness programme to encourage and support new family physicians, nurse practitioners and nurses to practise in underserved rural or remote communities of the country, including communities that provide health services to First Nations and Inuit populations.
In Uganda, the Ministry of Health reports that as many as 50% of staffing positions for health workers in rural and underserved areas remain vacant. As of early 2011, the Ministry was conducting research and costing analyses to determine the most appropriate attraction and retention packages for medical officers, nursing officers, pharmacists, and laboratory technicians in the country’s rural areas.
At the international level, the World Health Organization estimates a shortage of almost 4.3 million doctors, midwives, nurses, and support workers worldwide to meet target coverage levels of essential primary health care interventions. The shortage is reported most severe in 57 of the poorest countries, especially in sub-Saharan Africa.
Health and stress among health care practitioners
Some studies suggest that workplace stress is pervasive in the health care industry because of inadequate staffing levels, long work hours, exposure to infectious diseases and hazardous substances leading to illness or death, and in some countries threat of malpractice litigation. According to a report from the United States' National Institute for Occupational Safety and Health, "health care workers have higher rates of substance abuse and suicide than other professions and elevated rates of depression and anxiety linked to job stress." Elevated levels of stress were also linked to high rates of burnout, absenteeism and diagnostic errors, and to reduced rates of patient satisfaction. In Canada, a national report Canada's Health Care Providers also indicated higher rates of absenteeism due to illness or disability among health care workers compared to the rest of the working population, although those working in health care reported similar levels of good health and fewer reports of being injured at work.
Female health care workers may face specific types of workplace-related health conditions and stress. According to the World Health Organization, women predominate in the formal health workforce in many countries, and are prone to musculoskeletal injury (caused by physically demanding job tasks such as lifting and moving patients) and burnout. Female health workers are exposed to hazardous drugs and chemicals in the workplace which may cause adverse reproductive outcomes such as spontaneous abortion and congenital malformations. In some contexts, female health workers are also subject to gender-based violence including from coworkers and patients.
Violence in the workplace subjects almost every healthcare worker to higher risk of on-the-job injury. Drunk, confused, and hostile patients and visitors are a continual threat to providers attempting to treat patients. Frequently, assault and violence in a healthcare setting goes unreported and is wrongly assumed to be part of the job.
In an ever changing work environment, health care providers face serious hazards on the job, including needlestick injuries, back injuries, violence, slips and falls, and stress. It is important for occupational health professionals within healthcare facilities to monitor occupational injuries and illnesses so that they can keep the workforce healthy. The Occupational Health Safety Network (OHSN) is a secure electronic surveillance system developed by the National Institute for Occupational Safety and Health (NIOSH) to address health and safety risks among health care providers. Hospitals and other healthcare facilities can upload the occupational injury data they already collect to the secure database for analysis and benchmarking with other de-identified facilities from throughout the U.S. NIOSH works with OHSN participants in identifying and implementing timely and targeted interventions. OHSN modules currently focus on three high risk and preventable events that can lead to injuries or musculoskeletal disorders among healthcare providers: musculoskeletal injuries from patient handling activities; slips, trips, and falls; and workplace violence. OHSN enrollment is open to all healthcare facilities.
Practicing without a license
Practicing without a license that is valid and current is typically illegal. In most jurisdictions, the provision of health care services is regulated by government, and individuals found to be providing medical, nursing or other professional services without the appropriate certification or licence may face sanctions including even criminal charges leading to prison. The number of professions subject to regulation, requisites for individuals to receive professional licensure, and nature of sanctions that can be imposed for failure to comply vary across jurisdictions.
For instance, in the United States, under Michigan state laws, an individual is guilty of a felony if found to be practicing a health profession subject to regulation without a valid license or registration of their own, or exceeding what a limited license or registration allows. The state laws define the scope of practice for medicine, nursing, and a number of allied health professions. In Florida, practicing medicine without the appropriate license is a crime classified as a third degree felony, which may give imprisonment up to five years. Practicing a health care profession without a license which results in serious bodily injury classifies as a second degree felony, providing up to 15 years' imprisonment.
In the United Kingdom, healthcare professionals are regulated by the state; the UK Health Professions Council (HPC) protects the 'title' of each profession it regulates. For example, it is illegal for someone to call themself an Occupational Therapist or Radiographer if they are not on the register held by the HPC.
Health care provider ratings are ratings or evaluations of health care providers used to evaluate process of care, healthcare structures and/or outcomes of a healthcare services. This information is translated into report cards that are generated by quality organizations, nonprofit,consumer groups and media. This evaluation of quality can be based on:
- Measures of Hospital quality
- Measures of Health Plan Quality
- Measures of Physician Quality
- Measures of Quality for Other Health Care Providers
- Measures of Patient Experience
- Chronic care management
- Electronic superbill
- Geriatric care management
- Health care
- Health human resources
- Health insurance
- Health insurance cooperative
- Health policy
- Health system
- United States Department of Health and Human Services
- Catholic Church and health care
- World Health Organization, 2003. Quality and accreditation in health care services. Geneva http://www.who.int/hrh/documents/en/quality_accreditation.pdf
- World Health Organization, 2006. World Health Report 2006: working together for health. Geneva: WHO.
- World Health Organization, 2010. Classifying health workers. Geneva http://www.who.int/hrh/statistics/Health_workers_classification.pdf
- About:Psychology. (2007). Difference Between Psychologists and Psychiatrists. Retrieved March 4, 2007, from http://psychology.about.com/od/psychotherapy/f/psychvspsych.htm
- Gupta N et al. “Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes. Human Resources for Health, 2011, 9(16). Accessed 20 October 2011.
- Gupta N et al. "Health-related rehabilitation services: assessing the global supply of and need for human resources." BMC Health Services Research, 2011, 11:276. Published 17 October 2011. Accessed 20 October 2011.
- Government of Canada. 2011. Canada's Economic Action Plan: Forgiving Loans for New Doctors and Nurses in Under-Served Rural and Remote Areas. Ottawa, 22 March 2011. Accessed 23 March 2011.
- Rockers P et al. Determining Priority Retention Packages to Attract and Retain Health Workers in Rural and Remote Areas in Uganda. CapacityPlus Project. February 2011.
- World Health Organization, 2006. The World Health Report 2006 - Working together for health. Geneva: WHO http://www.who.int/whr/2006/en/index.html
- National Institute for Occupational Safety and Health (NIOSH). Exposure to Stress: Occupational Hazards in Hospitals. NIOSH Publication No. 2008–136. Centers for Disease Control and Prevention, July 2008. Retrieved on December 2, 2008.
- Canadian Institute for Health Information. Canada's Health Care Providers, 2007. Ottawa, 2007.
- World Health Organization. Women and health: today's evidence, tomorrow's agenda. Geneva, 2009. Retrieved on March 9, 2011.
- wiki.bmezine.com --> Practicing Medicine. In turn citing Michigan laws
- CHAPTER 2004-256 Committee Substitute for Senate Bill No. 1118 State of Florida, Department of State.