THE HEALTHCARE PROFESSIONAL
Healthcare professionals are central to the delivery of high-quality healthcare services.
Extensive training, education, and skills are essential to meet society’s needs for safe, competent healthcare.
The healthcare industry is labor intensive and distinguished from other service industries by the number of licensed and registered personnel in various healthcare fields.
Today, healthcare is commonly delivered by interprofessional teams with the physician at the helm, with a greater emphasis on patient- and family-centered care.
PROFESSIONALIZATION
Although the terms occupation and profession often are used interchangeably, they can be differentiated from each other.
An occupation is the principal activity that supports one’s livelihood. It is different from a profession in several ways.
An occupation typically does not require a high level of skill specialization.
An individual in an occupation is usually closely supervised, adheres to a defined work schedule, and earns an hourly wage.
PROFESSIONALIZATION
A profession requires specialized knowledge and training. Professional has more authority and responsibility and must adhere to a code of ethics.
A professional usually has considerable autonomy in determining the content of the service provided and in monitoring the workload.
A professional generally earns a salary, obtains higher education, and works with more independence and mobility than nonprofessionals do.
Healthcare organizations are finding fewer financial resources available because of consolidation, demands for efficiency, and ongoing changes in the mechanisms for delivery and payment of services. As a result, healthcare organizations face pressure to replace highly trained—and therefore more expensive— healthcare professionals with unlicensed support personnel. Those with advanced degrees are required to supervise more assistants who are functionally trained for specific roles.
Functional training produces personnel who can perform tasks but may not know the theory behind the practice.
Healthcare is the largest and most powerful industry in the United States. It constitutes more than 10 percent of the country’s total labor force (US Bureau of Labor Statistics [BLS] 2022b) and 19.7 percent of gross domestic product (Centers for Medicare & Medicaid Services [CMS] 2022).
Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence“
The nursing process has five components:
Assessment: Collecting and analyzing physical, psychological, sociocultural, spiritual, economic, and lifestyle factors about a patient
Diagnosis: The nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs
Outcomes/planning: Based on the assessment and diagnosis, involves writing an individualized care plan in the patient’s record so that nurses as well as other members of the interprofessional team have access to it
Implementation: Includes supervising or carrying out the treatment plan and documenting it in the patient’s record
Evaluation: Continuous assessment of the plan and modifications as needed
PHARMACISTS
A pharmacist, also known as a chemist in Commonwealth English, is a healthcare professional who is knowledgeable about preparation, mechanism of action, clinical usage and legislation of medications in order to dispense them safely to the public and to provide consultancy services. A pharmacist also often serves as a primary care provider in the community and offers services, such as health screenings and immunizations.
In 2021, pharmacists comprised more than 323,000 jobs within the healthcare workforce, and total employment of pharmacists in the United States was projected to increase 2 percent by 2031, with about 7,700 openings for pharmacists anticipated each year as a result of workers retiring or transferring to other occupations (BLS 2022e).
OTHER HEALTH PROFESSIONALS
A wide range of health professionals work collaboratively with physicians, nurses, and pharmacists, and these professionals are commonly categorized as allied health professionals. The United States Code defines an allied health professional as follows:
A health professional (other than a registered nurse or a physician assistant)—
(A) who has received a certificate, an associate’s degree, a bachelor’s degree, a master’s degree, a doctoral degree, or postbaccalaureate training, in a science related to health care;
(B) who shares in the responsibility for the delivery of health care services or related services, including—
(i) services relating to the identification, evaluation, and prevention of disease and disorders;
(ii) dietary and nutrition services;
(iii) health promotion services;
(iv) rehabilitation services; or
(v) health systems management services;
OTHER HEALTH PROFESSIONALS (continued)
(C) who has not received a degree of doctor of medicine, a degree of doctor of osteopathy, a degree of doctor of dentistry or an equivalent degree, a degree of doctor of veterinary medicine or an equivalent degree, a degree of doctor of optometry or an equivalent degree, a degree of doctor of podiatric medicine or an equivalent degree, a degree of bachelor of science in pharmacy or an equivalent degree, a degree of doctor of pharmacy or an equivalent degree, a graduate degree in public health or an equivalent degree, a degree of doctor of chiropractic or an equivalent degree, a graduate degree in health administration or an equivalent degree, a doctoral degree in clinical psychology or an equivalent degree, or a degree in social work or an equivalent degree or a degree in counseling or an equivalent degree.
There is no single, commonly defined list of allied health professions, they are generally divided into two categories:
therapists/technologists
technicians/ assistants (Shi and Singh 2022). In general, the therapist/technologist category represents those with higher-level professional training and often responsible for supervising those in the technician/assistant category.
Educational and training programs for these health professions are sponsored by a variety of organizations in an array of academic and clinical settings.
They range from degree offerings at colleges and universities to clinical programs in hospitals and other health facilities.
HEALTHCARE MANAGERS
Healthcare managers organize, coordinate, and oversee the delivery of health services; provide leadership; and guide the strategic direction of healthcare organizations.
Healthcare management is taught at the undergraduate and graduate levels in various settings, including schools of medicine, public health, business, and allied health professions. A bachelor’s degree in health administration allows individuals to pursue positions such as nursing home administrator, supervisor, or middle manager in healthcare organizations.
HealthCare Management
Nursing home administrator programs require students to pass a national examination administered by the National Association of Long-Term Care Administrator Boards (NAB).
Passing this examination is a standard requirement in all states, but the educational preparation needed to qualify for this exam varies among states.
CONSIDERATIONS FOR HUMAN RESOURCES MANAGEMENT
The role of HR management in healthcare organizations is to develop and implement systems according to regulatory guidelines and licensure laws for the selection, evaluation, and retention of healthcare professionals.
HR personnel should be aware that each healthcare profession, and often the subspecialties within the profession, will have specific requirements that allow an individual to qualify for a job in their chosen profession.
The requirements of national accrediting organizations (e.g., The Joint Commission), regulatory bodies (e.g., CMS), and licensure authorities (e.g., state licensure boards) should be considered in all aspects of HR management.
QUALIFICATIONS
In developing a comprehensive employee compensation program, HR personnel must include the specific skill and knowledge required for each job in the organization.
Those qualifications must be determined and stated in writing for each job. The job description usually contains the level of education, experience, judgment ability, accountability, physical skills, responsibilities, communication skills, and any special certification or licensure requirements.
QUALIFICATIONS
HR personnel need to be aware of all specifications for all job titles within the organization.
This knowledge of healthcare professionals is necessary to ensure that essential qualifications of individuals coincide with job specifications, and it is also necessary for determining wage and salary ranges.
LICENSURE AND CERTIFICATION
An HR department must have policies and procedures that describe how licensure is verified upon initial employment.
HR must have a system in place for tracking the expiration dates of licenses and for ensuring licensure renewal.
Certifications must be verified during the selection process, although certifications and licenses generally are not statutory requirements.
Many healthcare organizations accept a copy of a certification document as verification. If the certification is a job requirement, systems must be in place to track expiration dates and access new certification documents.
EDUCATIONAL SERVICES
Healthcare professionals require continuous, lifelong learning.
Healthcare organizations must have training and development plans to ensure that professionals achieve competency in new technologies, programs, and equipment and are aware of policy and procedure changes.
In addition to providing training programs, healthcare organizations should provide onboarding for all new employees, including interprofessional team training.
PRACTITIONER IMPAIRMENT
Healthcare professionals are accountable to the public for maintaining high professional standards.
By statute, the governing body of a healthcare organization is responsible for the quality of care rendered in the organization,
An impaired practitioner is a healthcare professional who is unable to carry out their professional duties with reasonable skill and safety because of a physical or mental illness, including deterioration through aging, loss of motor skill, or excessive use of drugs and alcohol.
Hospitals, usually have a process in place for the governing board to review provider credentials and performance and to oversee any employment actions.
THE CHANGING NATURE OF THE HEALTHCARE PROFESSIONS
Changes in the organization and financing of healthcare services have shifted delivery from hospitals to outpatient facilities, the home, long-term care facilities, and the community. This trend is largely the result of three major forces:
(1) A shift in reimbursement to outpatient settings and a focus on cost containment
(2) Technological advances, such as telehealth and electronic health records
(3) Medical innovation—the science of medicine has progressed to the point that complicated procedures that once required several nights of stay in a hospital can now be treated with a simple procedure or even solely with medication.
SUPPLY AND DEMAND
These shifts in healthcare settings and arrangements have changed the roles, functions, and expectations of the healthcare workforce and have led to the emergence of the issues of supply and demand; complementary, alternative, and integrative therapies; nonphysician licensed independent practitioners; emerging and evolving roles; and innovation and entrepreneurship.
Labor markets for various health professions have cycled through periods of shortages and surpluses. Indicators of demand include numbers of vacancies, turnover rates, and increases in salaries.
Healthcare organizations are developing innovative ways to recruit and retain health professionals.
NONPHYSICIAN LICENSED INDEPENDENT PRACTITIONERS
As a result of the Affordable Care Act, healthcare organizations are relying more on nonphysician licensed independent practitioners (LIPs).
Collaborative practice models that include nurse practitioners, physician assistants, pharmacists, and other therapists are appropriate in both acute and long-term healthcare delivery.
Advances have been made in the direct reimbursement for some LIP services, which is an impetus for further collaboration in practice.
EMERGING AND EVOLVING ROLES
Critical roles within the healthcare workforce continue to emerge and evolve because of multiple factors, including the continued shift toward outpatient care, the increasing emphasis on population health management, the growth of healthcare consumerism, the increased prevalence of chronic disease, the proliferation of technology, and the expansion of value-based care models
We see the emergence of positions focused on such areas as patient experience, clinical informatics, diversity, and innovation (Rohan and Brandt 2016). Including
Care
Community health workers
INNOVATION AND ENTREPRENEURSHIP
Entrepreneurship is another aspect of the changing nature of the healthcare professions.
Given the bureaucratic nature of organizations, the regulation of the healthcare industry, and additional constraints imposed by payers and managed care, many healthcare professionals are choosing to pursue opportunities on their own.
The service economy, coupled with knowledge-based professions, may encourage the pursuit of new and different ventures for individuals who have the personality, skills, and tenacity to go into business for themselves.
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