Module 1 - Health Care Systems/Settings Flashcards
Primary role of medical assistant
Work alongside a provider in outpatient or ambulatory setting. Might be cross-trained to perform administrative and clinical duties.
Role of medical doctors (MD)
“Allopathic” providers, most widely recognized type.
Diagnose illnesses, provide treatments, perform procedures such as surgical interventions, write prescriptions.
Role of osteopathic providers (DO)
Complete requirements similar to those of MDs
In addition to using modern medicine and surgical procedures, use osteopathic manipulative therapy (OMT) in treating their patients
Role of nurse practitioners
Provide basic patient care services including diagnosing and prescribing medications for common illnesses.
Require advanced academic training beyond the RN degree and have extensive amount of clinical experience.
Generally focus on preventive care and disease prevention
Role of physician assistants
Practice medicine under the direction and supervision of a licensed MD or DO.
Able to make clinical decisions are are responsible for a variety of services
Role of medical laboratory technicians
Perform diagnostic testing on blood, bodily fluids, and other specimens under the supervision of a medical technologist
Role of medical receptionist
Check patients in and out, answer phones, perform filing faxing, and other tasks
Role of occupational therapist
Assist patients who have developed conditions that disable them developmentally, emotionally, mentally, or physically
Role of pharmacy technician
Assist pharmacists with duties that do not require the expertise or judgement of a licensed pharmacist
Role of physical therapist
Assist patients in regaining their mobility and improving their strength and range of motion
Role of radiology technicians
Use various types of imaging equipment to assist the provider in diagnosing and treating certain diseases
Professionalism - appropriate dress
Good personal hygiene and appropriate work attire.
Avoid perfumes and colognes.
Conservative makeup and clean nails.
Professionalism - personal phone use
Take personal phone calls and text messages during scheduled work breaks or lunch hours.
If a phone must be carried, put on vibrate. Step into hall or break area if a call must be taken.
Professionalism - punctuality
Arrive to work in timely manner, perform all assigned duties each day.
Good time-management skills - prioritize tasks and arrange schedules to perform all necessary duties efficiently and effectively.
Professionalism - respect for boundaries
Respect personal space for patients and coworkers, provide effective communication when interrupting it
Professionalism - motivation
Intrinsic motivation comes from within and focuses on lifelong goals.
Extrinsic motivation is physical and driven by outside forces.
Extrinsic motivation is more short-lived and less fulfilling
Professionalism - work ethic
A set of values based on the moral virtues of hard work and diligence.
Always display initiative, be reliable, assist others, be present and ready to work.
Professionalism - integrity
The quality of being honest and having strong moral principles.
Honesty, truthfulness, equal treatment of all patients.
Professionalism - accountability
Being responsible for one’s own actions. Being able to explain and answer questions relating to their actions
Professionalism - flexibility
Being able to acclimate to a wide variety of situations. Staff must be flexible enough to adjust to schedule changes for all patients.
Staff members are willing to assist each other when workloads are uneven. Never say “that’s not my job”
Professionalism - open-mindedness
Willingness to try new things and be considerate of others ideas. Listens to opponents in a discussion
Scope of practice for medical assistants and variables
Must be trained or in some cases certified to perform certain duties. Cannot diagnose, treat, or instruct patients to take any course of action
Variables include regulations and policies issued by state medical boards, the specific organizational policies of the medical office
Licensure vs certification
Licensure is regulated by state, issued upon graduation. Mandatory for physicians and controlled by a state board of medical examiners. May be accomplished by examination, reciprocity, or endorsement
Certification is generally optional for medical assistants, but some states require official education and training to administer medication or perform phlebotomy procedures. Additionally the government may require certification in order to enter prescriptions into the computerized physician order entry CPOE program.
To keep certification a medical assistant must perform continuing education units
Delivery model - Accountable care organizations (ACOs)
Groups of physicians, hospitals, and other health care providers that coordinate care to Medicare patients.
Share savings it achieves for the Medicare program
Delivery model - Capitation (partial or full)
Patients are assigned a per-member, per-month payment based on age, race, sex, lifestyle, medical history, benefit design. Rates are tied to expected usage.
Providers have an incentive to help patients avoid high-cost procedures and tests to maximize their compensation
Delivery model - Global budget
Fixed total dollar amount paid annually for all care, providers determine how the money is spent.
Limits the level and rate of increase of health care cost.
Delivery model - Health maintenance organization (HMO)
Contracts with a medical center or group of providers to provide preventive and acute care for the insured person.
Generally require referrals to specialists, pre-certification and preauthorization for hospital admissions, outpatient procedures, and treatments
Delivery model - Patient-centered medical home (PCMH)
A primary care provider coordinates treatment to make sure patients receive the required care when and where they need it, and in a way they can understand
Delivery model - Pay for performance
Compensates providers only if they meet certain measures for quality and efficiency
Delivery model - Preferred provider organization (PPO)
More flexible than HMO, an insured person doesn’t need a PCP, can go to specialists without referrals. In-network providers usually cost less, although both are allowed
General practitioners (GPs)
Medical doctors who treat acute and chronic illnesses and provide preventive care and health education to patients. Often has holistic approach with consideration of biological, psychological, and social aspects relevant to the care of each patient’s illness
