Health Care Career Field Structure
Health care workers work in a variety of settings, including private offices, hospitals, clinics, managed-care facilities, nursing homes, and private homes.
The single most familiar element of the medical industry is the physician. For many years, the main health consultant was the family physician. General practitioners still serve the role of the family doctor to many families in the United States, but the role and the method of medical care delivery by the family doctor has changed.
According to the U.S. Department of Labor, approximately 28 percent of the physicians in the United States are general or family practitioners. General practitioners handle most medical problems, but when an emergency or problem arises that the family doctor may not have the equipment or capability to handle, the patient is referred to a specialist. The patient may rely on his or her generalist to recommend a specialist, or the patient may be able to determine which type of specialist is needed. For skin problems, for example, most patients would go to a dermatologist.
Internists frequently work as general practitioners. They are capable of handling most medical concerns that are presented to them by their patients and make referrals to specialists as needed. There are at least 40 different specialties for the physician to choose from while in medical school. They range from anesthesiology to urology. The rest work in one specific area of the body, one specific element of treatment, or with one specific clientele. For example, pediatricians work with children; neurologists work with problems of the nervous system; and anesthesiologists handle anesthetization during surgical procedures.
The largest group of workers in the health field are those in the nursing occupations: physician assistants, registered nurses, licensed practical nurses, nursing aides, orderlies, and nurse assistants. Depending on training and work setting, the nurse’s job may include a wide range of duties related to caring for the sick or educating those who are well.
In hospitals and other inpatient institutions, such as nursing homes, staff nurses frequently work with patients who are grouped together on the basis of some common characteristic, for example, pediatric patients or patients undergoing surgery. Nurses in some specialties, such as those working in intensive care units, are required to complete extra courses in addition to their basic education. Many nursing schools now provide training in certain specialties as part of their regular curriculum, for example, preparing students to work with elderly patients.
Registered nurses (RNs) may work in other settings besides hospitals. Private-duty nurses are RNs who are hired directly by patients and work in a variety of settings, including hospitals and nursing homes. Occupational health nurses oversee the health needs of business and government employees in their workplaces. Public health nurses specialize in promoting good health practices to prevent illness and restore health; they may provide care and counseling in schools, clinics, or other settings. Office nurses generally assist physicians, surgeons, and sometimes dentists in private practice or in clinics, often performing routine office and laboratory work in addition to nursing services. Other registered nurses teach, staff nursing organizations, act as administrators, or are engaged in research.
Advanced practice nurses are a broad category of registered nurses who have completed advanced clinical nurses’ educational practice requirements beyond the two to four years of basic nursing education required for all RNs. Under the advanced practice nursing designation fall four categories of nursing specialties: clinical nurse specialists, nurse practitioners, nurse-midwives, and nurse anesthetists.
Licensed practical nurses (LPNs) observe and record information about patients, including temperature, blood pressure, and respiration rates. They assist patients with their personal hygiene and prepare them for medical examinations. In addition, they give injections, change surgical dressings, and administer prescribed medicines.
Most nursing aides, orderlies, and attendants work in hospitals, but substantial numbers also are employed in nursing homes and other extended-care facilities.
One of the most distinctive features of modern medicine is its increasing reliance on new and sophisticated pieces of medical machinery. New technology aids in making diagnoses, providing effective treatments, and taking over body functions when organs fail or patients undergo surgery. Because these new machines require special skills from the people who attend them, they provide opportunities for many new jobs.
One of the areas in which technology has made particularly dramatic breakthroughs is in the area of heart disease. Numerous tests aid the discovery of heart disease. These include tests that pick up heart sounds and murmurs (phonocardiology), tests that record the heart’s electrical activity (vector cardiography), stress testing, ultrasound testing (echocardiography), as well as more complicated testing procedures in which medical technicians assist a physician in performing cardiac catheterization (inserting a tube through veins into a patient’s heart).
People working in therapy or rehabilitation help injured, disabled, or emotionally disturbed people regain their strength to the fullest extent possible. There are many different kinds of therapists, each with special knowledge and special skills. Some therapists, for instance, use dance, art, and music to help resolve patients’ physical, emotional, and social problems.
Research is one of the most important areas of medical work. Medical researchers look for cures to diseases, study drugs for treatment, and work on preventive measures for disease and disabilities. Biomedical researchers concentrate on eliminating specific diseases and health hazards, such as cancer, heart disease, and radiation contamination, and studying other environmental hazards that are damaging to human health. Nobel prizes are awarded to researchers for their work. Research is also one of the most frustrating and difficult aspects of medicine because one may work for years on a disease and never find a cure or treatment.
Biomedical research is funded by a variety of institutions, including manufacturers of pharmaceutical, electronic, chemical, and medical supply products; private health agencies, such as the American Cancer Society and the American Heart Association; endowments from philanthropic organizations; federal, state, and local governments; and hospitals, universities, and research organizations.
Medical research offers employment opportunities to individuals with varying amounts of training, ranging from the researcher who possesses an advanced degree to the technicians and assistants who have high school or community college diplomas or a certificate from a laboratory technical school.
Many health care professionals perform research work in pathology laboratories or other types of laboratories. Health care professionals also work with architects, city planners, government officials, law enforcement officers, and highway engineers to solve such health-related problems as traffic safety, drug abuse, rodent control, and the design of appropriate and adequate community health facilities.
Other health care professionals research the problems concerned with the delivery of medical care services. They investigate such problems as why infant mortality and the incidence of tuberculosis is greater among some segments of the population than others. They search for ways to establish cooperative arrangements among various hospitals so that duplicate facilities for certain types of treatment do not exist where the area patient load requires only one facility. They work out the logistics of an efficient system of evening and weekend medical coverage for a community and design effective emergency teams trained in the latest methods of cardiopulmonary resuscitation.
Many research positions in health care are associated with teaching responsibilities, but opportunities for teaching exist at all levels in the health care professions. Opportunities exist in professional schools of medicine, nursing, dentistry, and veterinary medicine, and in the allied medical professions, including therapy occupations and medical technology.
In the 20th century, advances in Western medicine overshadowed other ways of practicing medicine that many considered primitive and unscientific. In the last three decades, however, there has been an increasing interest in alternative medicine, a term used to refer to such practices as massage therapy, herbal remedies, homeopathy, acupuncture, reflexology, meditation, and many other treatment options. Although once frowned upon by the traditional medical community, more and more physicians and hospitals are embracing alternative medicine and finding new ways to combine old and new approaches to healing.
Overall, the structure of the health care industry is enormously varied. There are many different jobs to choose from and many different facilities in which to work, once the job is chosen. Preventing, curing, and treating the diseases and injuries that affect the population is a major undertaking, requiring skill and training on every level.