Deciding what type of health care provider you want to become isn?t just about picking a role where the content of the care suits you. You also need to think about where you sit within the complex health care system. Do you want to be a professional to whom patients come as their first course of action when illness strikes? Or do you want to be brought in as a specialized professional by other health care providers once a patient is ?in the system?? Do you want to assist another health care professional who has more authority? Do you see yourself as someone?s associate, or as an independent practitioner? As the first line of defense or as a specialist seen on down the line?
Some of the allied health care professions covered in this book are what we call ?gateway providers,? or primary health care providers. These are professionals that a patient typically goes to see as a first step in seeking preventative or curative medical care: optometrists, paramedics (in an emergency), naturopaths (in the states where they are licensed), and nurse practitioners (who are licensed in most states to work almost the same as doctors). Add to that, of course, all the doctors, dentists and mental health providers (not ?allied health care? and, thus, not covered in this particular book).
Another set of allied health care professionals what we call ?specialty? providers ? someone a patient sees for a particular problem when it arises, and usually after having consulted with a gateway provider. These professionals rely on gateway providers recommending that their patients seek them out, or sometimes on insurers requiring an official referral to see them. Occupational therapists and physical therapists are typically called in for patient care by a physician, surgeon or mental health provider. Midwives are sought out by pregnant patients after seeing their primary care gynecologist for years. Chiropractors and Oriental medicine practitioners are sought after a patient figures out that their pain is neither a surgical case nor an indicator of some treatable illness. Dietitians address the nutritional needs of patients who are already being cared for by other health care professionals.
Now, this delineation of gateway versus specialty providers is not a black-and-white issue. Both chiropractors and Oriental medicine practitioners perform diagnostics, and, in fact, are licensed in a few states to be primary health care providers, above and beyond treating pain. The physical therapist role has been evolving over the years; in many states, a patient can call a PT and make an appointment for diagnosis and treatment without having identified a medical problem through his or her doctor first (and the PT licensure will be changing to require a three-year doctorate in the coming years to reflect this independent diagnostician role).
Finally, there are ?auxiliary? allied health care positions, where you work in close collaboration with or in an assistant role for another health care professional, usually under someone else?s supervision and insurance. These are crucial roles in the health care world, enabling physicians to treat more patients with better-quality care by virtue of outsourcing certain components of health care delivery away from the physician. Medical technologists run the labs that allow physicians to make diagnoses. Long ago, physicians used to diagnose, treat and dispense drugs, but, thankfully, there are professional pharmacists whose entire focus is on accurately dispensing medications. Dental hygienists take care of routine tooth cleanings so the dentist can use her valuable time to address tooth pathologies. Hospitals and clinics would grind to a halt if not for registered nurses and physician assistants.