Allied Health Services Avoiding Crises (1989) / Chapter Skim
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1 What Does “Allied Health” Mean?
1 What Does “Allied Health” Mean?
Pages 15-43
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From page 15... ...
The individual fields that normally fall under the heading of allied health fared only somewhat better. Physical therapists were mentioned in 21 articles, occupational therapists in 8, dental hygienists in 7, and medical technologists in 3.
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performed functions that required little or no formal training in health care subject matter. Thus, in addition-to physicians, nurses, dentists, optometrists, podiatrists, pharmacists, veterinarians, and other independent health practitioners, the authors of the report excluded · professional public health personnel; · biomedical research personnel; · natural and social scientists working in the health field;
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The federal programs that supported allied health education provided the impetus for the aggregation of such groups as occupational therapists, clinical laboratory technologists, and dental hygienists. The groups coalesced in three major spheres: (1)
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Rather than rely on a single definition or scheme throughout the study, the committee preferred to emphasize the following characteristics of allied health fields. Each paragraph highlights important policyrelated characteristics and helps to explain how the fields are affected in different ways by changes in the health care environment.
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The fields the committee chose to focus on are clinical laboratory technology, dental hygiene, dietetic services, emergency medical services, medical record services, occupational therapy, physical therapy, radiologic technology, respiratory therapy, and speech-language pathology and audiology. The final chapter of this report includes an examination of the role of nursing aides in long-term care.
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This chapter briefly introduces each of the 10 allied health fields covered in the report and outlines their evolution.* It also traces the development of two fields perfusion and cardiovascular technology to see whether developing fields tend to follow the same general pathways as the established occupations.
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Associate degree-prepared technicians may discriminate between similar items, correct errors by using preset strategies, and monitor quality control programs within predetermined parameters. The first clinical laboratory in the United States was established in 1875 at the University of Michigan hospital.
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Of the group of 4-year college graduates, 37 percent are under 35 years old; 53 percent of the 2-year college graduate group fall into that age bracket (Bureau of Health Professions, 19841. DENTAL HYGIENISTS Dental hygienists, working under the supervision of dentists, remove stains and deposits from patients' teeth, take and develop x-ray films, apply
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From page 23... ...
Subsequently, the American Dental Association endorsed dental hygiene legislation, and by 1951 hygienists were licensed throughout the United States. It was not until 1947 that the American Dental Association and the American Dental Hygienists' Association developed the approved requirements for accreditation of dental hygiene programs.
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In 1984 only 13 percent earned more than $25,000 per year (American Dental Hygienists' Association, 19871. DIETETIC SERVICES According to the ADA's 1972 study commission, a dietician is a "translator of the science of nutrition into the skill of furnishing optimal nutrition to people." Although all dietitians share a common interest in the science of food and its effect on the body, they work in many different roles as administrators, educators, researchers, and clinicians.
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According to the Commission, slightly more than 63 percent of ADA members were under 40 years old, 99 percent had a bachelor's degree, 97 percent were women, and 87 percent were white (American Dietetic Association, 1985~. Little has changed since then.
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established an emergency medical services program. The program was moved to the Department of Transportation (DOT)
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MEDICAL RECORD SERVICES Medical record personnel develop, implement, and manage medical information systems. They are responsible for keeping track of the records
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The first medical record administrator, Grace Whiting Meyers, was appointed by Massachusetts General Hospital in 1897 to organize the patient care records that had been accumulating for 80 years. Other hospitals in the Boston area and elsewhere soon followed suit, hiring medical record personnel or librarians, as they came to be called.
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From page 29... ...
Because registration in this field is voluntary and because medical record departments use on-thejob trained personnel for some lower level jobs, it is hard to determine the size and composition of the current medical record work force. In 1987 AMRA reported 8,240 registered medical record administrators and 14,690 accredited record technicians.
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Licensure also requires a degree or certificate from an accredited educational program. Although the roots of occupational and physical therapy are similar, autonomy for occupational therapists has been slower to develop than autonomy for physical therapists.
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PHYSICAL THERAPY Physical therapists plan and administer treatment to relieve pain, improve functional mobility, maintain cardiopulmonary functioning, and limit the disability of people suffering from a disabling injury or disease. Therapeutic activities include exercises for improving endurance, strength, coordination, and range of motion; electrical stimulation to activate paralyzed muscles; instruction in the use of aids such as crutches or canes; and massage and electrotherapy to alleviate pain and promote healing in soft tissues.
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Reconstruction aides were considered charter members; membership requirements for others seeking to join the association included graduation from "recognized schools of massage and therapeutic exercise with some knowledge of either electrotherapy or hydrotherapy." By the end of 1921, the new association had 245 members. It became the current American Physical Therapy Association (APTA)
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Physical therapists have more autonomy than most allied health practitioners. Many are in private practice, and some states allow patients direct access to physical therapy services, which eases the way into independent practice for therapists.
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New applications of radioactive tracers led to the birth of nuclear medicine technology; the · ~ r .1 _ ~ _ Invention ot therapeutic x-ray equipment for treating cancer resulted in the field of radiation therapy technology; and the development of ultrasound imaging systems has created a new category of radiologic personnel, the diagnostic medical sonographer. Radiologic technologists and technicians (including radiographers, radiation therapy technologists, nuclear medicine technologists, and diagnostic medical sonographers)
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The Bureau of Health Professions estimates that there were 143,000 radiologic health service workers in 1986, of which approximately two-thirds were women and half were under 30 years of age (Bureau of Health Professions, 1988~. RESPIRATORY THERAPY Respiratory therapists provide an array of services that ranges from emergency care for stroke, drowning, heart failure, and shock to providing temporary relief to patients with emphysema or asthma.
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From page 36... ...
These first respiratory therapists, although usually employees of nursing departments, frequently developed direct relationships with physicians and often came to know more about gas therapy than their immediate supervisors. The field's first professional organization, the Inhalational Therapy Association, was formed in Chicago in 1946.
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Hospitals, nursing homes, speech-language and hearing centers, and private physicians provided most of the remaining jobs. Unlike most other allied health professions, the speech-language-hearing profession does not function exclusively or even principally in the medical world.
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The speech-language pathology work force is overwhelmingly white and female (approximately 95 percent and 89 percent, respectively, in 19881. NEW ALLIED HEALTH FIELDS The committee recognizes that the 10 fields selected for this study represent established, traditional allied health professions.
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The committee looked briefly at two fields perfusion and cardiovascular technology that recently have come to be recognized as allied health occupations to see if developing fields tend to follow the same general pathways as those of the established occupations. These two fields developed from core elements they once shared with respiratory therapy.
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The demand for these technicians is high, and their salaries are rising. They are often drawn from other disciplines, including nursing, physical therapy, and respiratory therapy; few trainees are without a medical background.
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Ultrasound techniques are used in these studies, and, as in the case of echocardiography, substantial training is required for technicians; in addition, like echocardiographers, noninvasive peripheral vascular technologists who conduct ultrasound tests also face competition from radiologic technologists. Equipment manufacturers have been the primary source of training; they have established educational programs in their own facilities as well as providing onsite, in-service training.
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American Dietetic Association, Chicago. AOTA (American Occupational Therapy Association)
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1987. Allied health professions in the United States: A summary of the origins, development, and potential futures of a selected sample of allied health fields.
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