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Types and Roles of Healthcare Providers

The healthcare workforce is composed of a vast number of various medical professionals and the field of healthcare is one of the largest and most complex industries in the US. The following section will list some of the main categories and roles of healthcare providers.

Physicians

The role of the physician has changed over time. There are numerous driving forces behind these changes, including the accumulation of scientific knowledge, development of medical technologies, changes in health insurance and healthcare reform practices, as well as the increasing demand for qualified and ethical practitioners. Various changes include:

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  • Private practices are becoming less common while corporate group practices are proliferating

  • General practitioners are declining in number as more specialists and subspecialists emerge

  • The relationship between doctors and their patients is evolving as healthcare becomes more patient centered (involving patients in decisions and their treatment)

  • Preventative medicine is becoming the forefront of care as opposed to treatment of acute illness after the fact

  • Physicians must complete a lengthy and rigorous graduate medical education, complete an ACGME accredited residency program, become certified and licensed, attend continuing education, and so on (as opposed to the more lax requirements of the more distant past)

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There are different types of physicians including:

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  • MD (Medical Doctorate)

    • Most practice in specialty care​

    • The most common doctorate degree

    • Focuses on allopathic care

  • DO (Doctorate of Osteopathy)

    • Most practice in primary care​

    • Focuses on a "whole person" approach to treatment

    • Utilizes osteopathic manipulative treatment

  • DPM (Doctor of Podiatric Medicine)

    • Treats diseases and injuries of the lower leg and foot​

Nurses

  • LPN

    • Provides basic nursing care to patients

  • RN

    • Provides care and treatment to patients

    • Educates patients about their health conditions

  • CNS 

    • Can perform managerial duties or direct other nurses

    • Can provide educational teaching or perform research

    • Often focuses in a defined field (perinatal, infectious disease, etc.)

  • NP

    • Can act as a PCP

    • Can own their own practice

    • Educates, diagnoses, and treats patients

Technicians and Technologists

  • Clinical lab technicians and technologists

    • Examine body fluids, tissues, and other samples to aid in diagnosis

  • Radiologic and MRI technologists

    • Perform diagnostic imaging procedures such as X-rays, MRIs, PETs, and ultrasounds

  • Nuclear Medicine Technologists

    • Prepare and administer radioactive drugs to patients for imaging purposes

Therapeutic Services

  • Occupational therapists

    • Treat patients who have injuries, illnesses, or disabilities to help them perform everyday activities or work tasks

    • Can also work with patients who have mental disorders or permanent disabilities

  • Physical therapists

    • Treat patients who have injuries or illnesses to improve their range of movement and reduce pain levels

Support Services

  • Health information administrators

    • Work with medical records at various facilities

    • Help maintain patient confidentiality

    • Often head the records department

  • Medical assistant

    • Completes administrative and clinical tasks such as entering patient information or taking patient vital signs

Behavioral Services

  • Social workers

    • Counsel patients and families to assist them in addressing the personal, economic, and social problems associated with illness and disability (Sultz & Young, 2018)

  • Rehabilitation counselors

    • Provide support and counseling to people with physical or emotional disabilities

 How Will Technology Change the Roles of Healthcare Providers?

The advancement of medical and non-medical technologies will continue to have a significant impact on roles of healthcare providers. Those working in all areas of healthcare will need to acquire technological skills to succeed in their chosen field. Advances in imaging, new pharmaceuticals, and health information and communications technologies have the potential to both increase and decrease the demand for various kinds of personnel (Sultz & Young, 2018). In addition, telehealth and remote patient monitoring solutions will change how healthcare is delivered. Technology will lead to breakthroughs in data collection, research and treatments to allow medical providers to use new tools and find fresh and innovative ways to practice medicine into the future. (University of Illinois at Chicago, n.d.).

Projected Growth of Healthcare Professions

The growth of various healthcare professions is overall
increasing faster than most other industries. Thus, it is
important to recognize some major determinants of the
size and nature of the healthcare employment sector
(Sultz & Young, 2018). These determinants include:

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  • Technological improvements (both medical and
    non-medical)

  • Shift of care from hospitals to home or long-term
    care settings

  • Decrease of private practices and increase of group
    practices

  • Increased prevalence of people with disabilities or
    chronic illness

  • Advancements in medical treatments

  • Aging of the total population

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There seems to be two contradicting opinions about the projected growth of nurses in relation to their demand in the future. Several nursing organizations project that there will be a significant national nursing shortage in the next decade. In contrast, the BLS and HRSA claim there will be a total national surplus of nurses but that certain states will experience nurse staffing shortages. According to HRSA’s 2014 report, “at the national level, the projected growth in RN supply (39 percent growth) is expected to exceed growth in demand (28 percent growth) resulting in a projected excess of about 293,800 RNs in 2030.” There are several factors behind this predicted surplus including later retirement for current nurses and an increasing rate of nursing graduates in the US. Though at the national level there is predicted to be a surplus, some states will have an excess number of nurses while other states will have rather substantial shortages. States with shortages will include New Jersey, South Dakota, Georgia, South Carolina, Texas, Alaska, and California.

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The growth of technicians and technologists is expected to continue to increase over the next few decades. This includes technicians and technologists working in nuclear medicine, radiology, and the laboratory. One reason for this growth is due to the population aging as a whole which will require more people capable of performing medical testing and imaging to help provide diagnoses. The development of new laboratory tests is also a factor.

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Various fields in therapeutic science are expected to experience significant growth. This includes both occupational and physical therapies which are predicted to have a 27 percent and 34 percent increase over the following decade. In addition, speech-language pathologists are expected to have a 21 percent increase throughout the next decade because the aging of the population will lead to an increase in hearing loss and strokes (Sultz & Young, 2018).

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The implementation of the Affordable Care Act coupled with the aging population will also cause a significant demand for physician assistants and medical assistants. Healthcare professions that will also experience a (less sizable) growth include social workers, rehabilitation therapists, podiatrists, chiropractors, and optometrists.

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One area of healthcare that is expected to experience rather slow (or even negative) growth is that of pharmacists. The projected growth in this field is expected to be just 3% in the following decade and this is due to a recent increase in the number of pharmacy schools and thus the level of competition for available jobs (Sultz & Young, 2018). In addition, the number of jobs in retail pharmacies is also declining due to an increasing number of people using mail order pharmacies.

Average Annual Job Openings 2016-2026.pn

Changes in Regulation of Healthcare Providers

There are a number of regulations for medical professionals including accreditation, licensure, and certification. These regulations are in place to protect the public from incompetent and unethical practitioners and states have taken steps to revise their credentialing systems to provide greater flexibility and responsiveness to fast-changing healthcare technology (Sultz & Young, 2018).

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Accreditation is a form of regulation often applied to residencies to establish educational standards. The ACGME specifies the curriculum, teaching methods, trainee assessment, program evaluation, faculty requirements for each residency and fellowship in detail (Sultz & Young, 2018). As of 2019, there are upcoming changes proposed to the ACGME accreditation requirements, including “the program must provide instruction and experience in pain management if applicable for the specialty, including recognition of the signs of addiction” and “language that stresses that programs and institutions must engage in recruitment and retention practices of a diverse workforce of residents/fellows and faculty,” among others.

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Licensure is a method of regulation aimed at educational and testing requirements; it also prevents people from practicing in fields without the required qualifications and titles. It is operated on a state level, therefore each state has its own requirements for licensure that are changed periodically. Most medical professionals must also attain certification to confirm they possess the knowledge, training, and performance abilities required for their field. One recent change regarding certification has been the implementation of MOC (maintenance of certification) programs. MOC programs require certain healthcare occupations to complete a specified number of continuing education hours, pass a medical knowledge self-assessment modules produced by the ABIM, and perform practice-improvement activities on a specified timeline (Sultz & Young, 2018). MOC has garnered critics as providers claim it too burdensome in terms of time and expense. Seven states (Georgia, Maryland, Missouri, North Carolina, Oklahoma, Tennessee, and Texas) have passed laws preventing the requirement of MOC participation and a number of other states are beginning to introduce anti-MOC legislation (Sullivan 2018).

References

Sullivan, T. (2018, May 4). Anti-MOC laws picking up steam across the US. Retrieved from https://www.policymed.com/2017/06/anti-moc-laws-picking-up-steam-across-the-united-states.html

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Partners Healthcare. (2018, November 13). 2019 changes to the ACGME CPR for residencies and fellowships. Retrieved from https://www.partners.org/Graduate-Medical-Education/GME-At-Partners/Newsletter-Stories/2019-ACGME-CPR-changes.aspx

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University of Chicago at Illinois. (n.d.). 3 ways technology has changed healthcare. Retrieved from https://healthinformatics.uic.edu/blog/3-ways-technology-has-changed-healthcare/

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U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. (2017). National and regional supply and demand projections of the nursing workforce: 2014-2030. Retrieved from https://bhw.hrsa.gov/sites/default/files/bhw/nchwa/projections/NCHWA_HRSA_Nursing_Report.pdf

 

U.S. Department of Labor, Bureau of Labor Statistics. (2019). Healthcare occupations. Retrieved from https://www.bls.gov/ooh/healthcare/home.htm

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Sultz, H. A., & Young, K. M. (2018). Health care USA: Understanding its organization and delivery. Burlington, MA: Jones & Bartlett Learning.

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