Chapter 2

1. Chapter 2 The Health Care Environment: Past, Present, and Future

2. Objectives • Review the learning and performance objectives for this chapter • By the end of this chapter, demonstrate the procedures in the textbook and the job skills in the workbook

3. Heart of the Health Care Professional • Service • With cheerfulness and patience, you will be helping the medical practice and serving patients at the same time

4. History of Medicine • Medicine/Religion Connection • Ancient Egypt • First prescription • Discovered in tomb of Egyptian pharaoh • Imhotep • Known as God of healing • Physician to the pharaohs • First written medical record

5. History of Medicine • Ancient Greece • Hippocrates • “The father of medicine” • First to describe diseases • The Oath of Hippocrates

6. History of Medicine • Ancient Greece • Aesculapius • Greek legend • God of healing • Caduceus • Middle Ages • France and England began medical schools • See Table 2-1: Highlights of Medical History

7. Changes in Health Care • Physicians traded services for goods • Families paid for services monthly • Cost of medical education increased • Insurance companies emerge • Third-party reimbursement system

8. Changes in Health Care • Medicine advanced • Life expectancy rose • Lawsuits increased • Malpractice insurance soared • Healthcare facilities started competing • Baby Boomers aged

9. Today’s Health Care Delivery System • Utilization Review • Traditional Care • Choice of physician, specialist, and facility • Fee-for-service • Managed Care • Manage cost, quality, and delivery • Co-payments • Authorizations

10. Today’s Health Care Delivery System • Types of Managed Care Organizations • Health Maintenance Organization (HMO) • Preferred Provider Organization (PPO) • Independent Practice Association (IPA) • Exclusive Provider Organization (EPO) • Point-of-Service (POS) Plan • Concierge Medical Care

11. The Medical Practice Setting • Solo Physician Practice • Associate Practice • Group Practice • Partnership

12. The Medical Practice Setting Figure 2-4: Example of physician and staff interactions in a small medical group.

13. The Medical Practice Setting • Professional Corporation • Urgent Care Center • Clinic • In-Store Clinic

14. The Medical Practice Setting • Hospital • Categories • Government owned • Subsidized by federal, state, county, city • Example: Federal VA Hospital • Example: State facility for the developmentally disabled

15. The Medical Practice Setting • Hospital • Categories • Nongovernment owned • For-profit • Not-for-profit

16. The Medical Practice Setting • Hospital • Types • Acute care hospital • Specialty hospital • Mental health hospital • Substance abuse hospital • Convalescent hospital • Rehabilitation hospital

17. The Medical Practice Setting • Hospital • Administrative Departments (Figure 2-5A) • Adjunct Departments (Figure 2-5B) • Organization Chart (Figure 2-6)

18. The Medical Practice Setting • Medical Center • Hospital Owned Physician Practice • Specialized Care Center • Laboratory

19. The Medical Practice Setting • Managed Care Organization • Holistic Health Environment • Telemedicine • Patient-Centered Medical Home (PCMH) • Patient advocate • Promote and support patients’ interests

20. The Physician Specialist • See Table 2-3: Medical Specialists and Administrative Medical Assisting Job Requirements • Variety of: • Specialty practices • Patient types • Job responsibilities

21. The Physician Specialist • What practice would you choose? • What patients do you want to work with? • Which job responsibilities interest you?

22. The Physician Specialist • Nonphysician Providers (NPP) • Physician Assistant (PA) • Nurse Practitioner (NP) • Clinical Nurse Specialist (CNS) • Nurse Midwife (NMW)

23. Health CareProfessional Abbreviations • See Table 2-4: Abbreviations for Physician Specialists and Health Care Professionals • Be familiar with these abbreviations

24. Stop and ThinkCase Scenarios • Review the scenario “Traditional versus Managed Care” • What type of Medicare plan is Granny on? • What type of Medicare plan is Nana on? • What type of MCO does the physician belong to that enables him/her to see both of these types of patients in his/her office?

25. Stop and ThinkCase Scenarios • Review the five scenarios at the end of Chapter 2 “Types of Medical Practice Settings” • What type of practice setting will you look for? • Why would you make that choice?