Difference between revisions of "Health professional" - New World Encyclopedia

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'''''Currently working on — Jennifer Tanabe, April 5, 2020'''''
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[[File:Health professional consults with patient.jpg|thumb|250px|A health professional discusses medical information at the bedside of a [[chemotherapy]] patient]]
 
[[File:Health professional consults with patient.jpg|thumb|250px|A health professional discusses medical information at the bedside of a [[chemotherapy]] patient]]
 
'''Health professionals''' (or '''healthcare professionals''') provide [[health care]] treatment and advice based on formal training and experience. They study, diagnose, treat, and prevent human illness and injury. The field includes those who work as a [[physician]], [[surgeon]], [[Nursing|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.
 
'''Health professionals''' (or '''healthcare professionals''') provide [[health care]] treatment and advice based on formal training and experience. They study, diagnose, treat, and prevent human illness and injury. The field includes those who work as a [[physician]], [[surgeon]], [[Nursing|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.
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Health care is a vital aspect of human society and a noble profession. Health care professionals in all fields are trained to serve the population as a whole while tending to each patient on an individual basis to achieve the best possible health outcome. In cases where they treat individuals with communicable diseases or experience physical and emotional stress while treating patients, health professionals do more than put the patient's well being ahead of their own, they risk their own health and safety for the sake of others.
  
 
== Practitioners and professionals ==
 
== Practitioners and professionals ==
 
The [[Health human resources|healthcare workforce]] comprises a wide variety of professions and occupations who provide some type of healthcare service, including such direct care practitioners as [[physician]]s, [[respiratory therapist]]s, [[nurse]]s, [[surgeon]]s, [[dentist]]s, [[Physical therapy|physical]] and [[Behavior therapy|behavior therapists]], as well as [[Allied health professions|allied health professionals]] such as [[Phlebotomy|phlebotomist]]s, [[medical laboratory scientist]]s, [[dietician]]s, and [[social work]]ers. They often work in hospitals, healthcare centers 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 worker]]s who work outside formal healthcare institutions. [[Health administration|Managers of healthcare services]], [[Health information management|health information technicians]], and other [[unlicensed assistive personnel|assistive personnel]] and support workers are also considered a vital part of health care teams.
 
The [[Health human resources|healthcare workforce]] comprises a wide variety of professions and occupations who provide some type of healthcare service, including such direct care practitioners as [[physician]]s, [[respiratory therapist]]s, [[nurse]]s, [[surgeon]]s, [[dentist]]s, [[Physical therapy|physical]] and [[Behavior therapy|behavior therapists]], as well as [[Allied health professions|allied health professionals]] such as [[Phlebotomy|phlebotomist]]s, [[medical laboratory scientist]]s, [[dietician]]s, and [[social work]]ers. They often work in hospitals, healthcare centers 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 worker]]s who work outside formal healthcare institutions. [[Health administration|Managers of healthcare services]], [[Health information management|health information technicians]], and other [[unlicensed assistive personnel|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.<ref> [https://www.who.int/hrh/statistics/Health_workers_classification.pdf Classifying health workers] World Health Organization, Geneva. Retrieved May 8, 2020.</ref> 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.
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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.<ref> [https://www.who.int/hrh/statistics/Health_workers_classification.pdf Classifying health workers] World Health Organization, Geneva. Retrieved June 17, 2020.</ref> 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.
  
 
Healthcare practitioners may also be categorized 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.
 
Healthcare practitioners may also be categorized 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.
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{{Main|Ophthalmology|Optometry}}
 
{{Main|Ophthalmology|Optometry}}
 
[[File:Navy optometrist gives eye exams during Greater Chenango Cares IRT 160720-A-AF888-356.jpg|thumb|250px|A Navy optometrist gives a young boy an eye exam]]
 
[[File:Navy optometrist gives eye exams during Greater Chenango Cares IRT 160720-A-AF888-356.jpg|thumb|250px|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.
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Care and treatment for the eye are delivered by [[ophthalmologists]], medical specialists who deal with the diagnosis and treatment of eye disorders, or [[optometrists]], health care professionals specialize in examining the eyes and applicable visual systems for defects or abnormalities as well as the correction of refractive error with glasses or contact lenses.
  
 
=== Foot care practitioners ===
 
=== Foot care practitioners ===
Care and treatment for the foot, ankle, and lower leg may be delivered by [[podiatry|podiatrists]], [[chiropody|chiropodists]], [[pedorthist]]s, [[foot health practitioner]]s, podiatric medical assistants, podiatric nurse and others.
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Care and treatment for the foot, ankle, and lower leg may be delivered by [[podiatry|podiatrists]], [[chiropody|chiropodists]], [[pedorthist]]s, [[foot health practitioner]]s, podiatric medical assistants, podiatric nurses, and others.
  
 
=== Geriatric care practitioners ===
 
=== Geriatric care practitioners ===
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=== Maternal and newborn health practitioners ===
 
=== Maternal and newborn health practitioners ===
 
{{Main|Obstetrics|Midwifery|Birth attendant}}
 
{{Main|Obstetrics|Midwifery|Birth attendant}}
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 [[Obstetrics|obstetricians]], [[midwifery|midwives]], [[Obstetrical nursing|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.<ref>N. Gupta et al., [https://human-resources-health.biomedcentral.com/articles/10.1186/1478-4491-9-16 Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes] ''Human Resources for Health'' 9(16) (June 24, 2011). Retrieved May 8, 2020.</ref>
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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 [[Obstetrics|obstetricians]], [[midwifery|midwives]], [[Obstetrical nursing|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.<ref name=Gupta>N. Gupta et al., [https://human-resources-health.biomedcentral.com/articles/10.1186/1478-4491-9-16 Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes] ''Human Resources for Health'' 9(16) (June 24, 2011). Retrieved June 17, 2020.</ref>
  
 
=== Medical diagnosis providers ===
 
=== Medical diagnosis providers ===
 
{{Main|Medical diagnosis}}
 
{{Main|Medical diagnosis}}
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 [[radiographer]]s, [[radiologist]]s, [[Sonographer]]s, [[medical laboratory scientist]]s, [[pathologist]]s, and related professionals.
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Medical diagnosis providers are health workers responsible for the process of determining which disease or condition explains a person's symptoms and signs. This usually involves a team of healthcare providers in various diagnostic units, including [[radiographer]]s, [[radiologist]]s, [[Sonographer]]s, [[medical laboratory scientist]]s, [[pathologist]]s, and related professionals.
  
 
=== Mental health practitioners ===
 
=== Mental health practitioners ===
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=== Public health practitioners ===
 
=== Public health practitioners ===
A [[public health|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 nursing|public health nurses]], [[clinical nurse specialist]]s, [[dietitian]]s, [[environmental health officer]]s, [[paramedics]], [[Epidemiology|epidemiologists]], [[health inspector]]s, and others.
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A [[public health|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 nursing|public health nurses]], [[clinical nurse specialist]]s, [[dietitian]]s, [[environmental health officer]]s, [[paramedics]], [[Epidemiology|epidemiologists]], [[health inspector]]s, and others.
  
 
=== Rehabilitation care practitioners ===
 
=== 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 [[Physical disability|disabilities]]. These include [[Physical medicine and rehabilitation|physiatrists]], [[rehabilitation nurse]]s, [[clinical nurse specialist]]s, [[nurse practitioner]]s, [[Physical therapy|physiotherapists]], [[Orthotics|orthotists]], [[prosthetist]]s, [[occupational therapist]]s, [[recreational therapist]]s, [[Audiology|audiologists]], [[Speech and language pathology|speech and language pathologists]], [[Respiratory Therapy|respiratory therapists]], [[rehabilitation counseling|rehabilitation counsellors]], [[physical rehabilitation therapist]]s, [[athletic trainer]]s, physiotherapy technicians, orthotic technicians, prosthetic technicians, [[personal care assistant]]s, and others.<ref>Gupta N et al. [http://www.biomedcentral.com/1472-6963/11/276 "Health-related rehabilitation services: assessing the global supply of and need for human resources."] {{webarchive|url=https://web.archive.org/web/20120720185509/http://www.biomedcentral.com/1472-6963/11/276 |date=2012-07-20 }} ''BMC Health Services Research'', 2011, 11:276. Published 17 October 2011. Retrieved 20 October 2011.</ref>
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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 [[Physical disability|disabilities]]. These include [[Physical medicine and rehabilitation|physiatrists]], [[rehabilitation nurse]]s, [[clinical nurse specialist]]s, [[nurse practitioner]]s, [[Physical therapy|physiotherapists]], [[Orthotics|orthotists]], [[prosthetist]]s, [[occupational therapist]]s, [[recreational therapist]]s, [[Audiology|audiologists]], [[Speech and language pathology|speech and language pathologists]], [[Respiratory Therapy|respiratory therapists]], [[rehabilitation counseling|rehabilitation counsellors]], [[physical rehabilitation therapist]]s, [[athletic trainer]]s, physiotherapy technicians, orthotic technicians, prosthetic technicians, [[personal care assistant]]s, and others.<ref>N. Gupta et al., [https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-11-276 Health-related rehabilitation services: assessing the global supply of and need for human resources] ''BMC Health Services Research'' 11 (2011): 276. Retrieved June 17, 2020.</ref>
  
 
=== Surgical practitioners ===
 
=== Surgical practitioners ===
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=== Alternative medicine practitioners ===
 
=== Alternative medicine practitioners ===
In addition to these recognized health care fields, 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]], [[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 [[Doctor of Osteopathic Medicine|doctors of osteopathic medicine]] in the [[United States]]) are considered alternative medicine practitioners.
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In addition to these recognized health care fields, practitioners of [[alternative medicine]] provide possibly healing treatments to those who seek medical help that may be outside the formal health care system. These include practitioners in [[acupuncture]], [[Ayurveda]], [[herbalism]], [[homeopathy]], [[naturopathy]], [[Reiki]], [[Siddha medicine]], [[traditional Chinese medicine]], [[traditional Korean medicine]], [[Unani]], and [[Yoga]]. In some countries, [[Chiropractic|chiropractors]] (may be called [[osteopaths]] outside the United States) are considered alternative medicine practitioners.
  
== Regulations and Practice conditions ==
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== Regulation and registration of professionals ==
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Health professionals must satisfy certain standards in order to practice. These include [[licensure]], [[Professional certification|certification]], and proof of minimum [[training]] for regulated health professions.<ref>M.R. Dal Poz, N. Gupta, E. Quain, and A.L.B. Soucat, ''Handbook on Monitoring and Evaluation of Human Resources for Health'' (Geneva, World Health Organization, 2009, ISBN 978-9241547703).</ref> 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.
  
=== Regulation and registration of professionals ===
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Most countries have credentialing staff in regulatory boards or [[health department]]s 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. Practicing health care without the appropriate license is generally a crime.
  
[[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, [[Healthcare provider requisites|requisites for individuals to receive professional licensure]], and nature of sanctions that can be imposed for failure to comply vary across jurisdictions.
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===Medical practice requisites===
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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,<ref>[https://wfme.org/standards/bme/ Basic Medical Education WFME Global Standards for Quality Improvement] ''World Federation for Medical Education''. Retrieved June 17, 2020.</ref> as requisite to obtain professional certification for practice as a [[physician]] or [[physician assistant]].
  
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.<ref>wiki.bmezine.com —> Practicing Medicine. In turn citing [[Michigan laws]]</ref>{{unreliable source?|date=November 2014}} In Florida, practicing medicine without the appropriate license is a crime classified as a third degree felony,<ref name=flrules>[http://laws.flrules.org/files/Ch_2004-256.pdf CHAPTER 2004-256 Committee Substitute for Senate Bill No. 1118] {{webarchive|url=https://web.archive.org/web/20110723141631/http://laws.flrules.org/files/Ch_2004-256.pdf |date=2011-07-23 }} State of Florida, Department of State.</ref> 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,<ref name=flrules/> providing up to 15 years' imprisonment.
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===Nursing requisites===
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[[Registered nurse]]s and [[licensed practical nurse]]s (or the equivalent national titles, such as enrolled nurses) must typically complete [[nursing school]] and pass a national examination in order to obtain their license.  
  
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.
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The legal requisites as well as [[scope of practice]] for nurses (and also midwives and [[Nurse midwife|nurse midwives]]) vary across countries. For instance, in some countries nurses are trained and authorized to provide emergency [[childbirth]] care, including administration of [[oxytocin]]s and newborn resuscitation, whereas in other countries these clinical functions are only authorized for physicians.<ref name=Gupta/>
  
'''Health professional requisites''' refer to the regulations used by countries to control the quality of [[health professionals|health workers]] practicing in their jurisdictions and to control the size of the health [[labour economics|labour market]]. They include [[licensure]], [[Professional certification|certification]] and proof of minimum [[training]] for regulated health professions.<ref>Tulenko et al., Framework and measurement issues for monitoring entry into the health workforce. ''Handbook on monitoring and evaluation of human resources for health''. Geneva, World Health Organization, 2009.</ref>
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===Respiratory Therapy requisites===
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[[Respiratory Therapist]]s 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 license to practice, and a fee must be paid every two years to the NBRC to maintain that credential.
  
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.
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===Other professional requisites===
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[[Dentistry|Dentist]]s 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 technician]]s.
  
Most countries have credentialing staff in regulatory boards or [[health department]]s 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.<ref>Schuwirth L, The need for national licensing examinations. ''Medical Education'', 2007, 41(11):1022–1023.</ref> 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.
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Requisites and regulations for other professions, such as [[paramedic]]s, [[clinical officer]]s, [[dietitian]]s, and [[homeopathy|homeopaths]], vary across countries. They may also vary over time within countries.
  
====Medical practice requisites====
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=== Practicing without a license ===
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,<ref>[http://www.iaomc.org/wfme.htm World Federation of Medical Education]</ref> as requisite to obtain professional certification for practice as a [[physician]] or physician assistant.
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[[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, once obtaining the appropriate medical degree, physicians can apply to attain licensure via [[Board certification]].
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== Occupational hazards ==
 
 
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]].<ref>[http://ccimindia.org/index.html Central Council of Indian Medicine] {{webarchive|url=https://web.archive.org/web/20110226063741/http://ccimindia.org/index.html |date=2011-02-26 }}</ref>
 
 
 
====Nursing requisites====
 
[[Registered nurse]]s and [[licensed practical nurse]]s (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 [[NCLEX|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 in Nursing|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.<ref name="Uganda">Uganda Legal Information Institute. [http://www.ulii.org/ug/legis/consol_act/nama1996223/ ''Nurses and Midwives Act 1996 (Ch 274)''] {{Webarchive|url=https://web.archive.org/web/20111005211537/http://www.ulii.org/ug/legis/consol_act/nama1996223/ |date=2011-10-05 }}, accessed 18 April 2011.</ref>
 
 
 
The legal requisites as well as [[scope of practice]] for nurses (and also midwives and [[Nurse midwife|nurse midwives]]) vary across countries. For instance, in some countries nurses are trained and authorized to provide emergency [[childbirth]] care, including administration of [[oxytocin]]s and newborn resuscitation, whereas in other countries these clinical functions are only authorized for physicians.<ref>Gupta N et al. [http://www.human-resources-health.com/content/9/1/16/abstract 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 {{doi|10.1186/1478-4491-9-16}}</ref>
 
 
 
====Respiratory Therapy requisites====
 
[[Respiratory Therapist]]s 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 technician]]s.
 
 
 
Requisites and regulations for other professions, such as [[paramedic]]s, [[clinical officer]]s, [[dietitian]]s, and [[Regulation and prevalence of homeopathy|homeopaths]], vary across countries. They may also vary over time within countries. For example, previously no academic qualifications were needed to work as a [[Registered Dental Nurse|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.<ref>wiki.bmezine.com —> Practicing Medicine. In turn citing [[Michigan laws]]</ref>
 
 
 
 
 
In Florida, such crime is classified as a third degree felony,<ref name=flrules>[http://laws.flrules.org/files/Ch_2004-256.pdf CHAPTER 2004-256 Committee Substitute for Senate Bill No. 1118] State of Florida, Department of State.</ref> which may give imprisonment up to five years.<ref name=flpenalties>[http://www.sodomy.org/laws/florida/penalties.html 775.082. Penalties] {{Webarchive|url=https://web.archive.org/web/20110612030616/http://www.sodomy.org/laws/florida/penalties.html |date=2011-06-12 }} United States Sodomy Laws. compilation v1.0 (January 28, 1998)</ref>  Practicing a health care profession without a license which results in serious bodily injury classifies as a second degree felony,<ref name=flrules/> providing up to 15 years' imprisonment.<ref name=flpenalties/>
 
 
 
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.<ref>[http://www.hpc-uk.org/ Health Professions Council of the United Kingdom]</ref>
 
 
 
Similarly, in South Africa, at least 12 professional titles are protected by law, subject to regulation by the Health Profession Council of South Africa.<ref>[http://www.hpcsa.co.za Health Professions Council of South Africa]</ref>
 
 
 
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.<ref name="Uganda"/>
 
 
 
 
 
 
 
=== Occupational hazards ===
 
{{see also|Occupational hazards in dentistry|Nursing#Occupational hazards}}
 
 
[[File:NIOSH Aerosol Sampler (8743397933).jpg|thumb|right|A healthcare professional wears an air sampling device to investigate exposure to airborne influenza]]
 
[[File:NIOSH Aerosol Sampler (8743397933).jpg|thumb|right|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.<ref name="cdc.gov">{{Cite web|url=https://www.cdc.gov/nora/councils/hcsa/agenda.html|title=National Occupational Research Agenda for Healthcare and Social Assistance {{!}} NIOSH {{!}} CDC|date=2019-02-15|website=www.cdc.gov|language=en-us|access-date=2019-03-14}}</ref><ref name="cdc.gov"/>
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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.<ref>[https://www.cdc.gov/nora/councils/hcsa/agenda.html National Occupational Research Agenda for Healthcare and Social Assistance] ''CDC''. Retrieved June 17, 2020.</ref>
[[Occupational stress]] and [[occupational burnout]] are highly prevalent among health professionals.<ref>{{Cite journal|last=Ruotsalainen|first=Jani H.|last2=Verbeek|first2=Jos H.|last3=Mariné|first3=Albert|last4=Serra|first4=Consol|date=2015-04-07|title=Preventing occupational stress in healthcare workers|journal=The Cochrane Database of Systematic Reviews|issue=4|pages=CD002892|doi=10.1002/14651858.CD002892.pub5|issn=1469-493X|pmid=25847433|pmc=6718215}}</ref> Some studies suggest that workplace stress is pervasive in the health care industry because of [[Health Human Resources|inadequate staffing levels]], [[working time|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 (psychology)|burnout]], [[absenteeism]] and diagnostic errors, and reduced rates of [[patient]] satisfaction.<ref>{{cite journal |url = https://www.cdc.gov/niosh/docs/2008-136/default.html |issue = July 2008 |title = Exposure to Stress: Occupational Hazards in Hospitals |journal = NIOSH Publication No. 2008–136 |date = 2 December 2008 |url-status = live |archiveurl = https://web.archive.org/web/20081212130033/http://www.cdc.gov/niosh/docs/2008-136/default.html |archivedate = 12 December 2008 |doi = 10.26616/NIOSHPUB2008136 }}</ref> In Canada, a national report ([[Canada's Health Care providers, 2007|''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.<ref>Canadian Institute for Health Information. [https://secure.cihi.ca/estore/productSeries.htm?pc=PCC56 ''Canada's Health Care Providers, 2007''] {{webarchive|url=https://web.archive.org/web/20110927225856/https://secure.cihi.ca/estore/productSeries.htm?pc=PCC56 |date=2011-09-27 }} Ottawa, 2007.</ref> There is some evidence that [[cognitive-behavioral therapy]], [[Relaxation technique|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.<ref>{{cite journal|last1=Ruotsalainen|first1=JH|last2=Verbeek|first2=JH|last3=Mariné|first3=A|last4=Serra|first4=C|title=Preventing occupational stress in healthcare workers.|journal=The Cochrane Database of Systematic Reviews|date=7 April 2015|issue=4|pages=CD002892|doi=10.1002/14651858.CD002892.pub5|pmid=25847433}}</ref>
+
Workplace stress is pervasive in the health care industry because of such factors as [[Health Human Resources|inadequate staffing levels]], [[working time|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 (psychology)|burnout]], [[absenteeism]], diagnostic errors, and reduced rates of [[patient]] satisfaction.<ref>[https://www.cdc.gov/niosh/docs/2008-136/default.html Exposure to Stress: Occupational Hazards in Hospitals]  ''NIOSH Publication No. 2008–136'', July 2008. Retrieved June 17, 2020.</ref> There is some evidence that [[cognitive-behavioral therapy]], [[Relaxation technique|relaxation]] training and therapy (including [[meditation]] and [[massage]]), and modifying schedules can reduce stress and burnout among multiple sectors of health care providers.<ref>J.H. Ruotsalainen, J.H. Verbeek, A. Mariné, and C. Serra, [https://www.ncbi.nlm.nih.gov/pubmed/25847433 Preventing occupational stress in healthcare workers] ''The Cochrane Database of Systematic Reviews'' 4 (April 7, 2015). Retrieved June 17, 2020. </ref>
 
 
Exposure to respiratory infectious diseases like [[tuberculosis]] (caused by ''[[Mycobacterium tuberculosis]]'') and [[influenza]] can be reduced with the use of [[respirator]]s; this exposure is a significant occupational hazard for health care professionals.<ref>{{cite web |url = http://blogs.cdc.gov/niosh-science-blog/2013/07/25/headforms/ |title = Advanced Headforms for Evaluating Respirator Fit |date = 25 July 2013 |first1 = Michael |last1 = Bergman |first2 = Ziqing |last2 = Zhuang |first3 = Ronald E. |last3 = Shaffer |publisher = National Institute for Occupational Safety and Health |accessdate = 18 January 2015 |url-status = live |archiveurl = https://web.archive.org/web/20150116154510/http://blogs.cdc.gov/niosh-science-blog/2013/07/25/headforms/ |archivedate = 16 January 2015 }}</ref> Exposure to dangerous chemicals, including [[chemotherapy]] drugs, is another potential occupational risk. These drugs can cause cancer and other health conditions.<ref>{{cite web|url = http://www.medscape.com/viewarticle/738076|title = Hazardous Drugs in Healthcare|date = March 7, 2011|website = NIOSH: Workplace Safety and Health|publisher = Medscape and NIOSH|last = Connor|first = Thomas H.|url-status = live|archiveurl = https://web.archive.org/web/20120307030022/http://www.medscape.com/viewarticle/738076|archivedate = March 7, 2012}}</ref> Healthcare workers are also at risk for diseases that are contracted through extended contact with a patient, including [[scabies]].<ref>{{Cite journal|title = Interventions for preventing the spread of infestation in close contacts of people with scabies|journal = The Cochrane Database of Systematic Reviews|date = 2014|issn = 1469-493X|pmid = 24566946|pages = CD009943|volume = 2|issue = 2|doi = 10.1002/14651858.CD009943.pub2|first = Deirdre|last = FitzGerald|first2 = Rachel J.|last2 = Grainger|first3 = Alex|last3 = Reid}}</ref> Health professionals are also at risk for contracting blood-borne diseases like [[hepatitis B]], [[hepatitis C]], and [[HIV/AIDS]] through [[needlestick injury|needlestick injuries]] or contact with bodily fluids.<ref>{{cite web|url=http://blogs.cdc.gov/niosh-science-blog/2013/05/17/hepatitis-safety-culture/|title=Does your workplace culture help protect you from hepatitis?|last2=Burnett|first2=Garrett|date=17 May 2013|publisher=National Institute for Occupational Safety and Health|first1=Thomas|last1=Cunningham|accessdate=18 January 2015|url-status=live|archiveurl=https://web.archive.org/web/20150118200537/http://blogs.cdc.gov/niosh-science-blog/2013/05/17/hepatitis-safety-culture/|archivedate=18 January 2015}}</ref><ref name=":0">{{Cite journal|last=Lavoie|first=Marie-Claude|last2=Verbeek|first2=Jos H.|last3=Pahwa|first3=Manisha|date=2014|title=Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel|journal=The Cochrane Database of Systematic Reviews|volume=3|issue=3|pages=CD009740|doi=10.1002/14651858.CD009740.pub2|issn=1469-493X|pmid=24610008}}</ref> This risk can be mitigated with vaccination when there is a vaccine available, like with hepatitis B.<ref name=":0" /> In epidemic situations, such as the 2014-2016 [[West African Ebola virus epidemic]] or the [[Timeline of the SARS outbreak|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.<ref>{{Cite journal|title=Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff|language=en|doi=10.1002/14651858.cd011621.pub2|issn=1465-1858|journal=Reviews|pmid=27093058|volume=4|vauthors=Verbeek JH, Ijaz S, Mischke C, Ruotsalainen JH, Mäkelä E, Neuvonen K, Edmond MB, Sauni R, Kilinc Balci FS, Mihalache RC|page=CD011621|year=2016}}</ref>{{Update inline|reason=Updated version https://www.ncbi.nlm.nih.gov/pubmed/31259389|date = September 2019}}
 
 
 
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 [[Miscarriage|spontaneous abortion]] and [[congenital disorder|congenital malformations]]. In some contexts, female health workers are also subject to gender-based violence from coworkers and patients.<ref>World Health Organization. [http://whqlibdoc.who.int/publications/2009/9789241563857_eng.pdf ''Women and health: today's evidence, tomorrow's agenda''.] {{webarchive|url=https://web.archive.org/web/20121225003343/http://whqlibdoc.who.int/publications/2009/9789241563857_eng.pdf |date=2012-12-25 }} Geneva, 2009. Retrieved on March 9, 2011.</ref><ref>{{cite web |url = http://blogs.cdc.gov/niosh-science-blog/2013/05/13/womens-health-at-work/ |title = Women's Health at Work |publisher = National Institute for Occupational Safety and Health |accessdate = 21 January 2015 |date = 13 May 2013 |first1 = Naomi |last1 = Swanson |first2 = Julie |last2 = Tisdale-Pardi |first3 = Leslie |last3 = MacDonald |first4 = Hope M. |last4 = Tiesman |url-status = live |archiveurl = https://web.archive.org/web/20150118223513/http://blogs.cdc.gov/niosh-science-blog/2013/05/13/womens-health-at-work/ |archivedate = 18 January 2015 }}</ref>
 
 
 
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.<ref name="Hartley" /> Violent incidents typically occur during one-on-one care; being alone with patients increases healthcare workers' risk of assault.<ref name=":2" /> In the United States, healthcare workers suffer ⅔ of nonfatal workplace violence incidents.<ref name=Hartley>{{cite web |url = http://blogs.cdc.gov/niosh-science-blog/2013/08/12/hcwviolence-prevention/ |title = Free On-line Violence Prevention Training for Nurses |date = 12 August 2013 |first1 = Dan |last1 = Hartley |first2 = Marilyn |last2 = Ridenour |accessdate = 15 January 2015 |publisher = National Institute for Occupational Safety and Health |url-status = live |archiveurl = https://web.archive.org/web/20150116120810/http://blogs.cdc.gov/niosh-science-blog/2013/08/12/hcwviolence-prevention/ |archivedate = 16 January 2015 }}</ref> 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.<ref name=":2">{{cite web|url = http://www.medscape.com/viewarticle/749441|title = Workplace Violence in the Healthcare Setting|date = September 13, 2011|website = NIOSH: Workplace Safety and Health|publisher = Medscape and NIOSH|last = Hartley|first = Dan|last2 = Ridenour|first2 = Marilyn|url-status = live|archiveurl = https://web.archive.org/web/20140208224755/http://www.medscape.com/viewarticle/749441|archivedate = February 8, 2014}}</ref>
 
  
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 [[strain (injury)|strain]]s 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.<ref name=":1" />
+
Exposure to respiratory infectious diseases like [[tuberculosis]] (caused by ''[[Mycobacterium tuberculosis]]'') and [[influenza]] is a significant occupational hazard for health care professionals. Healthcare workers are also at risk for diseases that are contracted through extended contact with a patient, such as [[scabies]]. Health professionals are also at risk for contracting blood-borne diseases like [[hepatitis B]], [[hepatitis C]], and [[HIV/AIDS]] through [[needlestick injury|needle stick injuries]] (the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue, or other body fluids before the exposure) or other contact with bodily fluids.<ref>Thomas Cunningham and Garrett Burnett, [https://blogs.cdc.gov/niosh-science-blog/2013/05/17/hepatitis-safety-culture/ Does your workplace culture help protect you from hepatitis?] ''National Institute for Occupational Safety and Health Science Blog'', May 17, 2013. Retrieved June 17, 2020.</ref> This risk can be mitigated with [[vaccination]] when there is a vaccine available, such as with hepatitis B.
 +
[[File:Paramedic wearing PPE mask, eye protection, and gown in Ireland 2020.jpg|thumb|225px|Paramedic wearing PPE mask, eye protection, and gown during the [[COVID-19 pandemic]]]]
 +
In epidemic situations, such as the 2014-2016 [[West African Ebola virus epidemic]], the [[Timeline of the SARS outbreak|2003 SARS outbreak]], and the [[COVID-19 pandemic]], healthcare workers are at even greater risk, and are disproportionately affected in such 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 necessarily 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.  
  
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.<ref>{{cite web|url = http://www.medscape.com/viewarticle/768414|title = Running on Empty: Fatigue and Healthcare Professionals|date = August 2, 2012|website = NIOSH: Workplace Safety and Health|publisher = Medscape and NIOSH|last = Caruso|first = Claire C.|url-status = live|archiveurl = https://web.archive.org/web/20130511070909/http://www.medscape.com/viewarticle/768414|archivedate = May 11, 2013}}</ref>
+
Female health care workers may face specific types of workplace-related health conditions and stress. According to the [[World Health Organization]], women 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 [[Miscarriage|spontaneous abortion]] and [[congenital disorder|congenital malformations]].  
  
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.<ref>{{Cite journal|last=Masterson|first=Elizabeth A.|last2=Themann|first2=Christa L.|last3=Calvert|first3=Geoffrey M.|date=2018-04-15|title=Prevalence of Hearing Loss Among Noise-Exposed Workers Within the Health Care and Social Assistance Sector, 2003 to 2012|journal=Journal of Occupational and Environmental Medicine|language=en|volume=60|issue=4|pages=350–356|doi=10.1097/JOM.0000000000001214|pmid=29111986|issn=1076-2752}}</ref>
+
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. Violent incidents typically occur during one-on-one care; being alone with patients increases healthcare workers' risk of assault. Workplace violence can also cause psychological trauma.<ref>Dan Hartley and Marilyn Ridenour, [https://www.medscape.com/viewarticle/749441 Workplace Violence in the Healthcare Setting] ''Medscape'', September 13, 2011. Retrieved June 17, 2020.</ref>
  
=== Shortages of health professionals ===
+
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]]. Sleep deprivation also predisposes healthcare professionals to make mistakes that may potentially endanger a patient.<ref>Claire C. Caruso, [https://www.medscape.com/viewarticle/768414 Running on Empty: Fatigue and Healthcare Professionals] ''Medscape'', August 2, 2012. Retrieved June 17, 2020.</ref>
{{See also|Health workforce|Doctor shortage|Nursing shortage}}
 
Many jurisdictions report shortfalls in the number of trained [[Health Human Resources|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 United States federal budget|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 school]]s to increase the number of nurses. It will also allow states to increase access to [[oral health care]] through dental workforce development [[Grant (money)|grant]]s. The Budget's new resources will sustain the expansion of the health care workforce funded in the [[Recovery Act]].<ref>{{cite web |url=http://www.whitehouse.gov/omb/assets/fy2010_new_era/A_New_Era_of_Responsibility2.pdf |title=Archived copy |accessdate=2009-03-06 |url-status=live |archiveurl=https://web.archive.org/web/20090306211818/https://www.whitehouse.gov/omb/assets/fy2010_new_era/A_New_Era_of_Responsibility2.pdf |archivedate=2009-03-06 }}</ref> There were 15.7 million health care professionals in the US as of 2011.<ref name=":1">{{cite web|url = http://www.medscape.com/viewarticle/765348|title = Slipping, Tripping, and Falling at Work|date = June 11, 2012|website = NIOSH: Workplace Safety and Health|publisher = Medscape and NIOSH|last = Collins|first = James W.|last2 = Bell|first2 = Jennifer L.|url-status = live|archiveurl = https://web.archive.org/web/20121203232137/http://www.medscape.com/viewarticle/765348|archivedate = December 3, 2012}}</ref>
 
  
In Canada, the 2011 federal budget announced a [[Student loans in Canada|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.<ref>Government of Canada. 2011. [https://web.archive.org/web/20120117182452/http://www.actionplan.gc.ca/eng/media.asp?id=4122 ''Canada's Economic Action Plan'']: ''Forgiving Loans for New Doctors and Nurses in Under-Served Rural and Remote Areas''. Ottawa, 22 March 2011. Retrieved 23 March 2011.</ref>
+
== Shortage of health professionals ==
 +
Many jurisdictions report shortfalls in the number of trained [[Health Human Resources|health human resources]] to meet population health needs and/or service delivery targets, especially in medically under-served areas.  
  
In Uganda, the [[Ministry of Health (Uganda)|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.<ref>Rockers P et al. [http://www.capacityplus.org/determining-priority-retention-packages ''Determining Priority Retention Packages to Attract and Retain Health Workers in Rural and Remote Areas in Uganda''.] {{webarchive|url=https://web.archive.org/web/20110523201744/http://www.capacityplus.org/determining-priority-retention-packages |date=2011-05-23 }} CapacityPlus Project. February 2011.</ref>
+
At the international level, in 2013 the [[World Health Organization]] reported a 7.2 million shortage of doctors, midwives, nurses, and support workers worldwide. They estimated that by 2035 there would be a shortage of almost 12.9 million, which would serious implications for the health of billions of people across all regions of the world.
 +
The report, entitled "A universal truth: No health without a workforce," identified several key causes of the shortage:
  
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.<ref>{{cite web |publisher=World Health Organization |date=2006 |title=The World Health Report 2006 - Working together for health |location=Geneva: WHO |url=http://www.who.int/whr/2006/en/index.html |url-status=live |archiveurl=https://web.archive.org/web/20110228033008/http://www.who.int/whr/2006/en/index.html |archivedate=2011-02-28 }}</ref> The shortage is reported most severe in 57 of the poorest countries, especially in sub-Saharan Africa.
+
#An ageing health workforce with staff retiring or leaving for better paid jobs without being replaced, while inversely, not enough young people are entering the profession or being adequately trained.
 +
#Increasing demands put on the sector from a growing world population with increased risks of noncommunicable diseases (for example, cancer, heart disease, stroke).
 +
#Internal and international migration of health workers exacerbates regional imbalances.<ref>[https://www.who.int/mediacentre/news/releases/2013/health-workforce-shortage/en/ Global health workforce shortage to reach 12.9 million in coming decades] ''World Health Organization'', November 11, 2013. Retrieved June 17, 2020.</ref>
  
 
==Notes==
 
==Notes==
Line 139: Line 110:
  
 
== References ==
 
== References ==
 +
*Dal Poz, M.R., N. Gupta, E. Quain, and A.L.B. Soucat. ''Handbook on Monitoring and Evaluation of Human Resources for Health''. Geneva, World Health Organization, 2009. ISBN 978-9241547703
 
* Makely, Sherry, Shirley A. Badasch, and Doreen S. Chesebro. ''Becoming a Health Care Professional''. Pearson, 2013. ISBN 978-0132843232
 
* 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
 
* Porche, Demetrius J. ''Health Policy: Application for Nurses and Other Health Care Professionals''. Jones & Bartlett Learning, 2018. ISBN 978-1284130386
Line 144: Line 116:
  
 
== External links ==
 
== External links ==
All links retrieved  
+
All links retrieved June 4, 2020.
 
*[http://www.who.int/hrh/en/ Health workforce] ''World Health Organization''.
 
*[http://www.who.int/hrh/en/ Health workforce] ''World Health Organization''.
 
*[https://medlineplus.gov/ency/article/001933.htm Types of health care providers] ''Medline Plus''.
 
*[https://medlineplus.gov/ency/article/001933.htm Types of health care providers] ''Medline Plus''.
 +
*[https://human-resources-health.biomedcentral.com/ Human Resources for Health]
 +
*[https://www.edumed.org/resources/adapting-to-a-crisis-as-a-healthcare-worker/ Adapting to a Public Health Crisis]
  
 
{{Health care}}
 
{{Health care}}

Latest revision as of 17:08, 17 June 2020


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

Health professionals (or healthcare professionals) provide health care treatment and advice based on formal training and experience. They study, diagnose, treat, and prevent human illness and injury. 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.

Health care is a vital aspect of human society and a noble profession. Health care professionals in all fields are trained to serve the population as a whole while tending to each patient on an individual basis to achieve the best possible health outcome. In cases where they treat individuals with communicable diseases or experience physical and emotional stress while treating patients, health professionals do more than put the patient's well being ahead of their own, they risk their own health and safety for the sake of others.

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 centers 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.[1] 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.

Healthcare practitioners may also be categorized 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.

Eye care practitioners

A Navy optometrist gives a young boy an eye exam

Care and treatment for the eye are delivered by ophthalmologists, medical specialists who deal with the diagnosis and treatment of eye disorders, or optometrists, health care professionals specialize in examining the eyes and applicable visual systems for defects or abnormalities as well as the correction of refractive error with glasses or contact lenses.

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 nurses, and others.

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 physical and psychological care needs of older adults.

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.[2]

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. This usually involves a team of healthcare providers in various diagnostic units, including radiographers, radiologists, Sonographers, medical laboratory scientists, pathologists, and related professionals.

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. They 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. The most significant difference across categories of mental health practitioners is education and training.

All mental health professionals exist to improve the mental health of individuals, couples, families, and the community-at-large. These health care providers often deal with the same illnesses, disorders, conditions, and issues; however, their scope of practice often differs. Some professionals may enhance relationships while others treat specific mental disorders and illness; still others work on population-based health promotion or prevention activities.

A dentist and dental assistant perform surgery on a patient.

Oral care practitioners

Main article: Dentistry

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.

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.

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.[3]

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 anesthetic, 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, anesthetic technicians, perioperative nursing, surgical technologists, and others.

Alternative medicine practitioners

In addition to these recognized health care fields, practitioners of alternative medicine provide possibly healing treatments to those who seek medical help that may be outside the formal health care system. These include practitioners in acupuncture, Ayurveda, herbalism, homeopathy, naturopathy, Reiki, Siddha medicine, traditional Chinese medicine, traditional Korean medicine, Unani, and Yoga. In some countries, chiropractors (may be called osteopaths outside the United States) are considered alternative medicine practitioners.

Regulation and registration of professionals

Health professionals must satisfy certain standards in order to practice. These include licensure, certification, and proof of minimum training for regulated health professions.[4] 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. 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,[5] as requisite to obtain professional certification for practice as a physician or physician assistant.

Nursing requisites

Registered nurses and licensed practical nurses (or the equivalent national titles, such as enrolled nurses) must typically complete nursing school and pass a national examination in order to obtain their license.

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.[2]

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 license 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.

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 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.

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.[6] Workplace stress is pervasive in the health care industry because of such factors as 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, diagnostic errors, and reduced rates of patient satisfaction.[7] 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.[8]

Exposure to respiratory infectious diseases like tuberculosis (caused by Mycobacterium tuberculosis) and influenza is a significant occupational hazard for health care professionals. Healthcare workers are also at risk for diseases that are contracted through extended contact with a patient, such as scabies. Health professionals are also at risk for contracting blood-borne diseases like hepatitis B, hepatitis C, and HIV/AIDS through needle stick injuries (the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue, or other body fluids before the exposure) or other contact with bodily fluids.[9] This risk can be mitigated with vaccination when there is a vaccine available, such as with hepatitis B.

Paramedic wearing PPE mask, eye protection, and gown during the COVID-19 pandemic

In epidemic situations, such as the 2014-2016 West African Ebola virus epidemic, the 2003 SARS outbreak, and the COVID-19 pandemic, healthcare workers are at even greater risk, and are disproportionately affected in such 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 necessarily 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.

Female health care workers may face specific types of workplace-related health conditions and stress. According to the World Health Organization, women 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.

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. Violent incidents typically occur during one-on-one care; being alone with patients increases healthcare workers' risk of assault. Workplace violence can also cause psychological trauma.[10]

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. Sleep deprivation also predisposes healthcare professionals to make mistakes that may potentially endanger a patient.[11]

Shortage 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 under-served areas.

At the international level, in 2013 the World Health Organization reported a 7.2 million shortage of doctors, midwives, nurses, and support workers worldwide. They estimated that by 2035 there would be a shortage of almost 12.9 million, which would serious implications for the health of billions of people across all regions of the world. The report, entitled "A universal truth: No health without a workforce," identified several key causes of the shortage:

  1. An ageing health workforce with staff retiring or leaving for better paid jobs without being replaced, while inversely, not enough young people are entering the profession or being adequately trained.
  2. Increasing demands put on the sector from a growing world population with increased risks of noncommunicable diseases (for example, cancer, heart disease, stroke).
  3. Internal and international migration of health workers exacerbates regional imbalances.[12]

Notes

  1. Classifying health workers World Health Organization, Geneva. Retrieved June 17, 2020.
  2. 2.0 2.1 N. Gupta et al., Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes Human Resources for Health 9(16) (June 24, 2011). Retrieved June 17, 2020.
  3. N. Gupta et al., Health-related rehabilitation services: assessing the global supply of and need for human resources BMC Health Services Research 11 (2011): 276. Retrieved June 17, 2020.
  4. M.R. Dal Poz, N. Gupta, E. Quain, and A.L.B. Soucat, Handbook on Monitoring and Evaluation of Human Resources for Health (Geneva, World Health Organization, 2009, ISBN 978-9241547703).
  5. Basic Medical Education WFME Global Standards for Quality Improvement World Federation for Medical Education. Retrieved June 17, 2020.
  6. National Occupational Research Agenda for Healthcare and Social Assistance CDC. Retrieved June 17, 2020.
  7. Exposure to Stress: Occupational Hazards in Hospitals NIOSH Publication No. 2008–136, July 2008. Retrieved June 17, 2020.
  8. J.H. Ruotsalainen, J.H. Verbeek, A. Mariné, and C. Serra, Preventing occupational stress in healthcare workers The Cochrane Database of Systematic Reviews 4 (April 7, 2015). Retrieved June 17, 2020.
  9. Thomas Cunningham and Garrett Burnett, Does your workplace culture help protect you from hepatitis? National Institute for Occupational Safety and Health Science Blog, May 17, 2013. Retrieved June 17, 2020.
  10. Dan Hartley and Marilyn Ridenour, Workplace Violence in the Healthcare Setting Medscape, September 13, 2011. Retrieved June 17, 2020.
  11. Claire C. Caruso, Running on Empty: Fatigue and Healthcare Professionals Medscape, August 2, 2012. Retrieved June 17, 2020.
  12. Global health workforce shortage to reach 12.9 million in coming decades World Health Organization, November 11, 2013. Retrieved June 17, 2020.

References
ISBN links support NWE through referral fees

  • Dal Poz, M.R., N. Gupta, E. Quain, and A.L.B. Soucat. Handbook on Monitoring and Evaluation of Human Resources for Health. Geneva, World Health Organization, 2009. ISBN 978-9241547703
  • 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 June 4, 2020.

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