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Allied Health Workforce and Services: Workshop Summary 1 Introduction In 1989 an Institute of Medicine (IOM) committee released its report Allied Health Services: Avoiding Crises (IOM, 1989). Many of the issues discussed in that report remain relevant today, but the environment is very different. The demand for health care is growing as the nation ages and seeks to provide coverage for the millions of Americans who lack health insurance. At the same time, escalating costs have led to a variety of initiatives to make the delivery of health care more effective and efficient. The allied health workforce is critical to the success of these efforts. Given the importance of allied health in health care reform, the Health Resources and Services Administration sponsored the IOM to hold a workshop in Washington, DC, on May 9-10, 2011, to examine the current allied health care workforce and consider how that workforce can contribute to improving health care access, quality, and effectiveness. Organizing questions for the workshop were as follows: • What is allied health, and who is part of that workforce? • What workforce strategies hold promise to improve access to selected allied health services across the continuum of provider professions? • How can policy makers, state and federal government, and allied health care providers improve the regulations and structure of allied health care delivery to increase access to care? Additional questions explored by presenters at the workshop included What is the demand for various allied health workforce professionals, and
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Allied Health Workforce and Services: Workshop Summary how will demand change in the future? What are the most effective forms of training and education for allied health workers? What is the relationship between allied health workers and other health professionals? What is the effect of allied health workers on health outcomes? How do regulations governing allied health workers vary from jurisdiction to jurisdiction, and what are the consequences of these variations? DEFINITIONS The allied health workforce includes hundreds of professionals employed in different professions with different job duties and different levels of preparation, but there is no single definition of allied health or list of allied health occupations. All formulations exclude physicians and dentists, and most exclude nurses. Others exclude pharmacists, physician assistants, and more. According to Title 42 of the U.S. Code,1 an allied health professional is a health professional (other than a registered nurse or physician assistant) who has a certificate, associate’s degree, bachelor’s degree, master’s degree, doctoral degree, or postbaccalaureate training in a science relating to health care and who shares in the responsibility for the delivery of health care services or related services, including • services related to the identification, evaluation, and prevention of diseases and disorders; • dietary and nutrition services; • health promotion services; • rehabilitation services; or • health system management services. The definition excludes those with a degree in medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatric medicine, pharmacy, public health, chiropractic, health administration, clinical psychology, social work, or counseling. Many of the presenters at the workshop used definitions of allied health that conflicted with this federal definition. Moreover, the definitions used by different speakers differed from each other. Presenters at the workshop also did not draw rigid distinctions between the terms profession, occupation, or field, and this summary does not attempt to regularize the usage of either allied health or profession. In its 1989 report, the IOM’s Committee to Study the Role of Allied Health Personnel stated 2 42 U.S.C. §295p(5)
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Allied Health Workforce and Services: Workshop Summary The committee chose not to join in the search for a definition [of allied health]. The benefits of making the term more precise are less clear than the benefits of continued evolution. The changing nature of health care makes some practices and practitioners obsolete at the same time it opens up opportunities for the formation of new groups. It is more important that pragmatism continue to prevail and that old and new groups draw what benefits they can from belonging to “allied health” than that a description of common characteristics defines the group. (IOM, 1989) Presenters at the workshop opted for a similar approach. ORGANIZATION OF THE REPORT In this summary, the presentations at the workshop have been organized into eight chapters. Following this introduction, Chapter 2 considers several broad changes under way in the health care system and some of the implications of these changes for allied health. Chapter 3 provides a broad overview of several prominent issues in allied health, including the definition of allied health and the accreditation of educational programs. Chapter 4 looks at the supply of and demand for allied health workers, as well as examining the data needed to make useful projections of future supply and demand. Chapter 5 explores several new issues that have arisen as a result of health care reform. Chapter 6 turns to educational issues, considering accreditation, community colleges in rural areas, and career advancement. Chapter 7 examines the future of team-based care in a changing health care environment. Chapter 8 presents perspectives from the representatives of several stakeholder organizations. Finally, Chapter 9 provides observations made during panel discussions at the end of each day’s presentations along with observations from other speakers and workshop participants. The ongoing changes in health care have presented the allied health professions with a major opportunity. These professions have always been a critical component of the health care workforce, and their importance will grow as policy makers emphasize the need for efficient and effective health care services. The IOM workshop explored many of the ways in which the allied health workforce will influence the health care that all Americans will receive in the future.
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