Health professional

Currently working on — Jennifer Tanabe, April 5, 2020

A health professional discusses medical information at the bedside of a chemotherapy patient

A health professional (or healthcare professional) may provide health care treatment and advice based on formal training and experience. The field includes those who work as a physician, surgeon, nurse, physiotherapist, dentist, midwife, psychologist, psychiatrist, or pharmacist or who perform services in allied health professions. A health professional may also be a public health or community health practitioner.

Practitioners and professionals

The healthcare workforce comprises a wide variety of professions and occupations who provide some type of healthcare service, including such direct care practitioners as physicians, respiratory therapists,nurses, surgeons, dentists, physical and behavior therapists, as well as allied health professionals such as phlebotomists, medical laboratory scientists, dieticians, and social workers. They often work in hospitals, healthcare 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 formal healthcare institutions. Managers of healthcare services, health information technicians, and other assistive personnel and support workers are also considered a vital part of health care teams.

Healthcare practitioners are commonly grouped into health professions. Within each field of expertise, 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, midwives, radiographers, registered nurses, pharmacists, physiotherapists, optometrists, operating department practitioners 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, respiratory care, 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 healthcare 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 to improve the mental health of individuals or treat mental illness. These include psychiatrists, clinical psychologists, occupational therapists, clinical social workers, psychiatric-mental health nurse practitioners, marriage and family therapists, mental health counselors, 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. Such health practitioners include obstetricians, midwives, obstetrical nurses and many others. One of the main differences between these professions is in 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

Geriatric dental care

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, Nursing aides, Caregivers and others who focus on the health and psychological care needs of older adults.

Surgical practitioners

A surgical practitioner is a healthcare professional 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, surgical PAs, surgeon's assistant, assistant surgeon, surgical assistant, anesthesiologists, anesthesiologist assistant, nurse anesthetists, surgical nurses, clinical officers, operating department practitioners, anaesthetic technicians, perioperative nursing, 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, physical rehabilitation therapists, athletic trainers, physiotherapy technicians, orthotic technicians, prosthetic technicians, personal care assistants, and others.

Eye care practitioners

A Navy optometrist gives a young boy an eye exam

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.

Medical diagnosis providers

Medical diagnosis providers are health workers responsible for the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit. This usually involves a team of healthcare providers in various diagnostic units. These include radiographers, radiologists, Sonographers, medical laboratory scientists, pathologists, and related professionals.

A dentist and dental assistant perform surgery on a patient.

Oral care 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 or oral health therapists, and related professionals.

Foot care practitioners

Care and treatment for the foot, ankle, and lower leg may be delivered by podiatrists, chiropodists, pedorthists, foot health practitioners, podiatric medical assistants, podiatric nurse and others.

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.

Alternative medicine practitioners

In many societies, practitioners of alternative medicine have contact with a significant number of people, either as integrated within or remaining outside the formal health care system. These include practitioners in acupuncture, Ayurveda, herbalism, homeopathy, naturopathy, Reiki, Shamballa Reiki energy healing, Siddha medicine, traditional Chinese medicine, traditional Korean medicine, Unani, and Yoga. In some countries such as Canada, chiropractors and osteopaths (not to be confused with doctors of osteopathic medicine in the United States) are considered alternative medicine practitioners.

Regulations and Practice conditions

Regulation and registration of professionals

Practicing without a license that is valid and current is typically illegal. In most jurisdictions, the provision of health care services is regulated by the government. Individuals found to be providing medical, nursing or other professional services without the appropriate certification or license may face sanctions and criminal charges leading to a prison term. 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.

In the United States, under Michigan state laws, an individual is guilty of a felony if identified as practicing in the health profession without a valid personal license or registration. Health professionals can also be imprisoned if found guilty of practicing beyond the limits allowed by their licences and registration. The state laws define the scope of practice for medicine, nursing, and a number of allied health professions.Template:Unreliable source? 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 and Care Professions Council (HCPC) protects the 'title' of each profession it regulates. For example, it is illegal for someone to call himself an Occupational Therapist or Radiographer if they are not on the register held by the HCPC.

Health professional requisites refer to the regulations used by countries to control the quality of health workers practicing in their jurisdictions and to control the size of the health labour market. They include licensure, certification and proof of minimum training for regulated health professions.

In the health care system, a health professional who offers medical, nursing or other types of health care services is required to meet specific requisites put into effect by laws governing health care practices. The number of professions subject to regulation, the requisites for an individual to receive professional licensure or certification, the scope of practice that is permitted for the individual to perform, and the nature of sanctions that can be imposed for failure to comply vary across jurisdictions.

Most countries have credentialing staff in regulatory boards or health departments who document the certification or licensing of health workers and their work history. The processes for professional certification and licensure vary across professions and countries. Certification to practise a profession usually does not need to be renewed, while a licence usually needs to be periodically renewed based on certain criteria such as passing a renewal exam, demonstrating continuing learning, being employed in the field or simply paying a fee. Most health care industry employers publish the specific requisites for persons seeking employment by means of job boards, ads and solicitations for employment. Practicing health care without the appropriate license is generally a crime.

Medical practice requisites

Most countries require individuals to demonstrate proof of graduation from a recognized medical school, such as one meeting the quality assurance standards of the World Federation of Medical Education, as requisite to obtain professional certification for practice as a physician or physician assistant.

In the United States, once obtaining the appropriate medical degree, physicians can apply to attain licensure via Board certification.

In India, practitioners of both modern medicine and traditional medicine are subject to professional regulation. Doctors are regulated by the Medical Council of India, while practitioners of Ayurved, Siddha and Unani medicine are regulated by the Central Council of Indian Medicine.

Nursing requisites

Registered nurses and licensed practical nurses (or the equivalent national titles, e.g. enrolled nurses) must typically complete nursing school and pass a national examination in order to obtain their license. For example, in the United States, nurses must pass the National Council Licensure EXamination (NCLEX). They must then obtain a nursing license by applying to appropriate board of nursing. In Uganda, nurses must complete a Bachelor of Science or other diploma in nursing recognized by the Nurses and Midwives Council and pass national qualifying examinations; several years of work experience in a hospital or other health unit is further required in order to be eligible for a licence to engage in private practice.

The legal requisites as well as scope of practice for nurses (and also midwives and nurse midwives) vary across countries. For instance, in some countries nurses are trained and authorized to provide emergency childbirth care, including administration of oxytocins and newborn resuscitation, whereas in other countries these clinical functions are only authorized for physicians.

Respiratory Therapy requisites

Respiratory Therapists or Respiratory Care Practitioners in many countries are required to have graduated from an accredited and recognized college or university and additionally pass a registry exam prior to being eligible for licensure. In the United States, Respiratory Therapists are granted either Registry or Certificate credentials by the National Board for Respiratory Care (NBRC). The credential granted by the NBRC must be maintained to continue to hold a state licence to practice, and a fee must be paid every two years to the NBRC to maintain that credential.

Other professional requisites

Dentists and many other categories of allied health professions typically also require professional certification or licensure for legal practice. Training and knowledge in basic life support is required by regulation for certification for many practicing individuals, including emergency medical technicians.

Requisites and regulations for other professions, such as paramedics, clinical officers, dietitians, and homeopaths, vary across countries. They may also vary over time within countries. For example, previously no academic qualifications were needed to work as a Dental nurse in the United Kingdom; however now, hospitals, community dental services and other employers require all Dental nurses to have obtained recognized qualifications and be registered with the General Dental Council.

Practicing without a license

Practicing without a license is typically illegal. In most jurisdictions, 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 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 he practices or holds himself out as practicing a health profession subject to regulation without a license or registration or under a suspended, revoked, lapsed, void, or fraudulently obtained license or registration, or exceeding what a limited license or registration allows, or who uses the license or registration of another person as his own. The "practice of medicine" may be defined as any diagnosis, treatment, prevention, cure, or relieving of a human disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device, diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do, any of these acts.

In Florida, such crime is 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 Council for Healthcare Regulatory Excellence oversees the work of various regulatory bodies including the Nursing and Midwifery Council, the General Dental Council, and the Health Professions Council (HPC). Each Council 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.

Similarly, in South Africa, at least 12 professional titles are protected by law, subject to regulation by the Health Profession Council of South Africa.

In Uganda, a person who calls themself a "nurse" or "midwife" without having the appropriate licence from the Nurses and Midwives Council can be subject to a fine and/or up to three years of imprisonment.

Occupational hazards

A healthcare professional wears an air sampling device to investigate exposure to airborne influenza

The healthcare workforce faces unique health and safety challenges and is recognized by the National Institute for Occupational Safety and Health (NIOSH) as a priority industry sector in the National Occupational Research Agenda (NORA) to identify and provide intervention strategies regarding occupational health and safety issues. Occupational stress and occupational burnout are highly prevalent among health professionals. 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. Other stressors include the emotional labor of caring for ill people and high patient loads. The consequences of this stress can include substance abuse, suicide, major depressive disorder, and anxiety, all of which occur at higher rates in health professionals than the general working population. Elevated levels of stress are also linked to high rates of burnout, absenteeism and diagnostic errors, and 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. There is some evidence that cognitive-behavioral therapy, relaxation training and therapy (including meditation and massage), and modifying schedules can reduce stress and burnout among multiple sectors of health care providers. Research is ongoing in this area, especially with regards to physicians, whose occupational stress and burnout is less researched compared to other health professions.

Exposure to respiratory infectious diseases like tuberculosis (caused by Mycobacterium tuberculosis) and influenza can be reduced with the use of respirators; this exposure is a significant occupational hazard for health care professionals. Exposure to dangerous chemicals, including chemotherapy drugs, is another potential occupational risk. These drugs can cause cancer and other health conditions. Healthcare workers are also at risk for diseases that are contracted through extended contact with a patient, including scabies. Health professionals are also at risk for contracting blood-borne diseases like hepatitis B, hepatitis C, and HIV/AIDS through needlestick injuries or contact with bodily fluids. This risk can be mitigated with vaccination when there is a vaccine available, like with hepatitis B. In epidemic situations, such as the 2014-2016 West African Ebola virus epidemic or the 2003 SARS outbreak, healthcare workers are at even greater risk, and were disproportionately affected in both the Ebola and SARS outbreaks. In general, appropriate personal protective equipment (PPE) is the first-line mode of protection for healthcare workers from infectious diseases. For it to be effective against highly contagious diseases, personal protective equipment must be watertight and prevent the skin and mucous membranes from contacting infectious material. Different levels of personal protective equipment created to unique standards are used in situations where the risk of infection is different. Practices such as triple gloving and multiple respirators do not provide a higher level of protection and present a burden to the worker, who is additionally at increased risk of exposure when removing the PPE. Compliance with appropriate personal protective equipment rules may be difficult in certain situations, such as tropical environments or low-resource settings. A 2016 Cochrane systematic review found low-quality evidence that using more breathable fabric in PPE, double gloving, and active training reduce the risk of contamination.Template:Update inline

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 from coworkers and patients.

Healthcare workers are at higher risk of on-the-job injury due to violence. 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. Violent incidents typically occur during one-on-one care; being alone with patients increases healthcare workers' risk of assault. In the United States, healthcare workers suffer ⅔ of nonfatal workplace violence incidents. Psychiatric units represent the highest proportion of violent incidents, at 40%; they are followed by geriatric units (20%) and the emergency department (10%). Workplace violence can also cause psychological trauma.

Slips, trips, and falls are the second-most common cause of worker's compensation claims in the US and cause 21% of work absences due to injury. These injuries most commonly result in strains and sprains; women, those older than 45, and those who have been working less than a year in a healthcare setting are at the highest risk.

Health care professionals are also likely to experience sleep deprivation due to their jobs. Many health care professionals are on a shift work schedule, and therefore experience misalignment of their work schedule and their circadian rhythm. In 2007, 32% of healthcare workers were found to get fewer than 6 hours of sleep a night. Sleep deprivation also predisposes healthcare professionals to make mistakes that may potentially endanger a patient.

An epidemiological study published in 2018 examined the hearing status of noise-exposed health care and social assistance (HSA) workers sector to estimate and compare the prevalence of hearing loss by subsector within the sector. Most of the HSA subsector prevalence estimates ranged from 14% to 18%, but the Medical and Diagnostic Laboratories subsector had 31% prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24% prevalence. The Child Day Care Services subsector also had a 52% higher risk than the reference industry.

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 trained 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. There were 15.7 million health care professionals in the US as of 2011.

In Canada, the 2011 federal budget announced a Canada Student Loan forgiveness program to encourage and support new family physicians, nurse practitioners and nurses to practice 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.

References

ISBN links support NWE through referral fees

• Makely, Sherry, Shirley A. Badasch, and Doreen S. Chesebro. Becoming a Health Care Professional. Pearson, 2013. ISBN 978-0132843232
• Porche, Demetrius J. Health Policy: Application for Nurses and Other Health Care Professionals. Jones & Bartlett Learning, 2018. ISBN 978-1284130386
• Pozgar, George D. Legal and Ethical Issues for Health Professionals. Jones & Bartlett Learning, 2019. ISBN 978-1284144185

External links

All links retrieved

• Health workforce World Health Organization.
• Types of health care providers Medline Plus.

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