Nurses Physicians Dentists and Other Health Care Practitioners - Allied Health Care Providers

Many health care services are provided by an interdisciplinary team of health professionals. The complete health care team may include physicians, nurses, mid-level practitioners, and dentists; physical and occupational therapists; audiologists and speech-language pathologists; licensed practical nurses, nurses' aides, and home health aides; and pharmacists, optometrists, podiatrists, dental hygienists, social workers, registered dieticians, and others. Table 2.7 describes some of these allied heath professions. Specific health care teams are assembled to meet the varying needs of patients. For example, the team involved in stroke rehabilitation might include a physician, nurse, physical and occupational therapists, a speech-language pathologist, and a social worker.

Physical and Occupational Therapists

Physical therapists (PTs) are licensed practitioners who work with patients to preserve and restore function, improve capabilities and mobility, and regain independence following illness or injury. They also aim to prevent or limit disability and slow the progress of debilitating diseases. Treatment involves exercise to improve range of motion, balance, coordination, flexibility, strength, and endurance. PTs may also use electrical stimulation to promote healing, hot and cold packs to relieve pain and inflammation (swelling), and therapeutic massage.

Note: In 1997 the National Health Interview Survey questionnaire was redesigned.
*Estimates are considered unreliable.
— Data not available.
1Estimates are age adjusted to the year 2000 standard using six age groups; 2–17 years, 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over.
2Estimates for the elderly are the percent of persons 65 years of age over with a dental visit in the past year. Data from the 1997–2001 National Health Interview Survey estimate that 28–30 percent of persons 65 years of age and over (elderly) were edentulous (having lost all their natural teeth). In 1997–2001 about 70 percent of elderly dentate persons compared with 17–20 percent of elderly edentate persons had a dental visit in the past year.
3Respondents were asked "About how long has it been since you last saw or talked to a dentist?"
4Includes all other races not shown separately and unknown poverty status.
5The race groups, white, black, American Indian and Alaska Native (AI/AN), Asian, Native Hawaiian and Other Pacific Islander, and 2 or more races, include persons of Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with data year 1999 race-specific estimates are tabulated according to 1997 Standards for Federal data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single race categories plus multiple race categories shown in the table conform to 1997 Standards. The 1999 race-specific estimates are for persons who reported only one racial group; the category "2 or more races" includes persons who reported more than on racial group. Prior to data year 1999, data were tabulated according to 1977 Standards with four racial groups and the category "Asian only" included Native Hawaiian and Other Pacific Islander. Estimates for single race categories prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. The effect of the 1997 Standard on the 1999 estimates can be seen by comparing 1999 data tabulated according to the two Standards: Age-adjusted estimates based on the 1977 Standard of the percent of persons with a recent dental visit are: 0.1 percentage points lower for white and black persons; identical for AI/AN persons; and 0.2 percentage points lower for Asian and Pacific Islander persons than estimates based on the 1997 Standards.
6Poor persons are defined as below the poverty threshold. Near poor persons have incomes of 100 percent to less than 200 percent of the poverty threshold. Nonpoor persons have incomes of 200 percent or greater than the poverty threshold. Poverty status was unknown for 20 percent of persons in the sample in 1997, 25 percent in 1998, 28 percent in 1999, 27 percent in 2000, and 28 percent in 2001.
7MSA is metropolitan statistical area.
SOURCE: "Table 78. Dental Visits in the Past Year according to Selected Characteristics: United States, Selected Years 1997–2001," in Health, United States, 2003, National Center for Health Statistics, 2003, http://www.cdc.gov/nchs/data/hus/tables/2003/03hus078.pdf (accessed June 2, 2004)
Geographic region
Northeast	69.6	70.9	72.2	77.5	78.5	79.6	69.6	71.5	72.2	55.5	54.3	59.6
Midwest	68.3	68.1	68.4	76.4	76.8	77.4	67.4	67.6	68.0	57.6	54.3	55.0
South	60.0	60.6	60.2	68.0	68.0	68.8	59.4	59.4	58.7	49.0	52.4	52.0
West	64.9	64.7	65.7	71.5	69.9	70.7	62.9	63.3	64.4	61.9	61.9	62.6
Location of residence
Within MSA7	66.5	67.1	67.0	73.6	73.1	73.9	65.7	66.8	66.0	57.6	58.1	59.1
Outside MSA7	59.1	58.3	60.3	69.3	70.7	70.7	58.0	56.2	59.1	46.1	45.0	47.2

According to the U.S. Bureau of Labor Statistics, PTs worked at 137,000 jobs in 2002, but one in four were part-time jobs and some PTs held two or more jobs at the same time. Two-thirds of practicing PTs worked in hospitals and the remaining PTs were employed in physicians'offices, outpatient rehabilitation clinics, nursing homes, and home health agencies. Though most work in rehabilitation, PTs may specialize in areas such as sports medicine, pediatrics, or neurology. PTs often work as members of a health care team and may supervise physical therapy assistants or aides. Physical therapists'median annual earnings were $57,330 in 2002.

Occupational therapists (OTs) focus on helping people relearn and improve their abilities to perform the "activities of daily living," the tasks they perform during the course of their work and home lives. Examples of activities of daily living that OTs help patients to regain are dressing, bathing themselves, and meal preparation. For persons with long-term or permanent disabilities, OTs may assist them to find new ways to accomplish their responsibilities on the job, sometimes using adaptive equipment or by asking employers to accommodate workers with special needs such as persons in wheelchairs. OTs use computer programs and simulations to help patients restore fine motor skills and practice reasoning, decision making, and problem solving.

The U.S. Bureau of Labor Statistics reported that OTs filled eighty-two thousand jobs in 2002 with one in six holding more than one job at a time. The demand for OTs and PTs is expected to exceed the available supply through 2010. In addition to hospital and rehabilitation center jobs, it is anticipated that PTs and OTs will increasingly be involved in school program efforts to meet the needs of disabled and special education students.

Today, a bachelor's degree in occupational therapy is the minimum educational requirement; beginning in 2007, however, a master's degree or higher will be required. Median annual earnings of occupational therapists were $51,990 in 2002.

Pharmacists Provide Valuable Patient Care Services

Today pharmacists are involved in many more aspects of patient care than simply compounding and dispensing medication from behind the drugstore counter. According to the American Pharmaceutical Association (APhA), its more than 50,000 members (including practicing pharmacists, pharmaceutical scientists, students, and technicians) provide pharmaceutical care that not only improves patient adherence to prescribed drug treatment but also reduces

TABLE 2.7

Allied health care providers
SOURCE: "Allied Health Care Providers," U.S. Department of Commerce, Washington, DC
Dental hygienists provide services for maintaining oral health. Their primary duty is to clean teeth.
Emergency Medical Technicians (EMTs) provide immediate care to critically ill or injured people in emergency situations.
Home health aides provide nursing, household, and personal care services to patients who are homebound or disabled.
Licensed practical nurses (LPNs) are trained and licensed to provide basic nursing care under the supervision of registered nurses and doctors.
Medical records personnel analyze patient records and keep them up-to-date, complete, accurate, and confidential.
Medical technologists perform laboratory tests to help diagnose diseases and to aid in identifying their causes and extent.
Nurses' Aides, Orderlies, and Attendants help nurses in hospitals, nursing homes and other facilities.
Occupational therapists help disabled persons adapt to their disabilities. This may include helping a patient relearn basic living skills or modifying the environment.
Optometrists measure vision for corrective lenses and prescribe glasses.
Pharmacists are trained and licensed to make up and dispense drugs in accordance with a physician's prescription.
Physician assistants (PAs) work under a doctor's supervision. Their duties include performing routine physical exams, prescribing certain drugs, and providing medical counseling.
Physical therapists work with disabled patients to help restore function, strength and mobility. PTs use exercise, heat, cold, water, and electricity to relieve pain and restore function.
Podiatrists diagnose and treat diseases, injuries, and abnormalities of the feet. They may use drugs and surgery to treat foot problems.
Psychologists are trained in human behavior and provide counseling and testing services related to mental health.
Radiation technicians take and develop x-ray photographs for medical purposes.
Registered dietitians (RDs) are licensed to use dietary principles to maintain health and treat disease.
Respiratory therapists treat breathing problems under a doctor's supervision and help in respiratory rehabilitation.
Social workers help patients to handle social problems such as finances, housing, and social and family problems that arise out of illness or disability.
Speech pathologists diagnose and treat disorders of speech and communication.

the frequency of drug therapy mishaps, which can have serious and even life-threatening consequences.

Studies citing the value of pharmacists in patient care describe pharmacists improving rates of immunization against disease (pharmacists can provide immunization in twenty-seven states), assisting patients to better control chronic diseases such as asthma and diabetes, reducing the frequency and severity of drug interactions and adverse reactions, and helping patients effectively manage pain and symptoms of disease, especially at the end of life. Pharmacists also offer public health education programs about prescription medication safety, prevention of poisoning, appropriate use of nonprescription (over-the-counter) drugs, and medical self-care.

The U.S. Bureau of Labor Statistics reported that pharmacists held about 230,000 jobs in 2002. More than 60% worked in community pharmacies—either independently owned or part of a drugstore chain, grocery store, department store, or mass merchandiser. Most full-time salaried pharmacists worked about forty hours a week; however, about 19% worked part time in 2002, and many self-employed pharmacists worked more than fifty hours a week. The median annual wage and salary earnings of pharmacists in 2002 was $77,050.