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Wednesday, December 7, 2022

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This Alphabet Soup Needs a Medical Dictionary


The United States provides some of the best and most advanced healthcare on the planet. However, the US healthcare delivery system can be overwhelming to navigate and comprehend. One factor contributing to the confusion is the myriad of personnel who provide care, what their credentials are, and what they can offer in terms of improving our health. 

Let’s begin by breaking down some basic definitions. Medical care, healthcare and wellness are not interchangeable definitions. For the most part, medical care is care provided by a physician in a medical facility. A physician can have the MD degree or the DO degree, both are used to designate that the public is dealing with a licensed physician. The education for DOs is somewhat more focused on holistic medicine and prevention, whereby MDs practice a more conventional form of medicine. To become a specialist, such as a cardiologist or orthopedist, MDs and DOs undergo additional training and residencies, followed by a board certification exam. 

Primary medical care can also be provided by a physician’s assistant (PA) or nurse practitioner (NP). Both are well trained to provide direct care, including examining patients, prescribing medication and ordering tests. Care rendered by NPs and PAs is generally under the supervision of a physician, in both the in-patient and out-patient setting. The supervising physician need not be physically present all the time. 

Nurses play a vital role in providing patient care. The RN can provide care in a hospital, nursing home or even the patient’s home. However, licensed practical nurses (LPN) typically have a more supportive role and are usually supervised by an RN. 

A Word About Naturopathic Physicians 

According to WebMD, naturopathic physicians attend a graduate level program, which includes many conventional medical courses, as well as courses in nutrition, herbal medicine and psychology. The goal of naturopathic physicians is to treat the whole person; mind, body and spirit. They may spend more time with their patients versus conventional physicians, getting to know them on a personal level. 

Naturopathic physicians may use manipulation, nutrition or herbal medicine as part of an overall treatment plan for their patients. However, NPs should not be used in an emergency, or to manage serious medical illnesses, such as cancer or heart disease. Conventional medicine and naturopathic medicine can both be utilized for the benefit of the patient— however, be aware that some herbal remedies can interfere with medically prescribed drugs (WebMD). Supporting the care rendered by physicians are a wide range of other professionals, including therapists, optometrists, psychologists, nutritionists, podiatrists and other specialists. 

Physicians often refer patients to physical therapy, occupational therapy, and speech therapy to assist in the recovery process after an injury. Social workers (MSW) play an important role in helping patients obtain benefits, get admitted to a rehab center or receive home care. Nutritionists contribute as specialists in diet, including assisting people with diabetes or a type of specific deficiency. 

Many of the above-mentioned healthcare professionals have assistants who are also licensed to provide care in the hospital or out-patient setting. There are physical therapy assistants (PTA) and occupational therapy assistants (OTA). Both PTAs and OTAs are supervised by a PT or OT. It’s perfectly fine to receive care by a PTA or OTA, but patients should be aware of who is treating them and what their qualifications are. You have the right to inquire. 

Contributing to the confusion is the use of the “Dr.” title. Typically, use of the Dr. title was reserved for physicians, but it is also used for podiatrists, dentists, audiologists, optometrists and psychologists. It’s perfectly fine as long as patients understand the roles of these professionals. 

A Word About Chiropractors 

Chiropractors (DC) generally practice in community based private practices, and do not have admitting privileges at hospitals. Chiropractors mainly focus on treating the spine using hands-on manipulation techniques. The theory behind chiropractic is that by performing “adjustments” of the spine, the body is placed in proper alignment and this assists with improving the patient’s symptoms, such as neck or back pain. Although chiropractors can read x-rays, it is usually preferable to be evaluated by a physician before being treated by a chiropractor to rule out a serious underlying medical condition. 

Recently, the educational training for physical therapists was changed to a doctorate degree. Therefore, physical therapists have the right to the “Dr” designation. However, PTs should never be confused with physicians as they still cannot diagnose a medical condition, prescribe medication, provide an injection or order tests. 

There are many healthcare and wellness professionals who can provide a service to the public. These include massage therapists (LMT), acupuncturists (L.Ac.), personal trainers and others. Acupuncture is based on East Asian medicine, requires advanced training and is quite popular with people seeking an alternative to conventional healthcare. Physicians and dentists can undergo additional training to become certified in acupuncture. Personal trainers can be found in fitness clubs, physical therapy practices and some market directly to the public. They are extremely valuable for designing individual fitness programs, including weight training, or preparing for a competitive event. 

While the benefits of massage are fairly well-documented, such as relieving muscle tension, the benefits of acupuncture, for example, are more subjective. All of these specialties must be licensed or certified in the state in which they practice. It is still prudent to see a physician prior to engaging with these other services, especially if you have an ongoing medical condition. Coverage for these services is not always guaranteed by medical insurance. 

Other wellness areas include yoga, Reiki and meditation. Experts who train and become certified in these specialties are not considered health professionals, but nonetheless can assist with wellness. The benefits of yoga are fairly well-accepted, as to managing stress while improving flexibility. Since we generally lose flexibility as we age, Yoga can be a worthwhile activity. Classes are designed from beginners to advanced. Reiki is considered a kind of energy healing. Proponents say that it works with the energy fields around the body and involves the transfer of energy from the practitioner’s palms to the client. 

According to www.medicalnewstoday.com, the clinical benefit of Reiki has not been established. However, many people who receive Reiki claim to experience positive outcomes. Meditation has been practiced for thousands of years. According to www.mayoclinic.org, the benefits of meditation, when performed correctly, can be inner peace, relaxation, stress reduction and emotional well-being. Meditation can be practiced individually, or with an instructor. Research has found that meditation may help reduce symptoms of anxiety and depression. When combined with conventional medicine, meditation may even improve such conditions as sleep disorder, high blood pressure and poor digestion. 

When receiving services from two or more health or wellness professionals, let each specialist know what you are doing, so that each practitioner is aware of your overall treatment plan. This is especially true when taking medication, herbal remedies, vitamins or CBD. 

One final note to consider. Long Island has many storefront businesses that advertise “bodywork.” The individuals who operate in these businesses may not be licensed massage therapists or licensed acupuncturists. Before undergoing this treatment, ask for the credentials of the person performing the care. A legitimate healthcare professional will always have their license someplace easily viewable by the public. 

Navigating our complex healthcare system can be quite challenging, especially when there are so many professionals and specialists with something to offer. Educational and licensing requirements are dynamic and evolving. When engaging with healthcare and wellness professionals, don’t be afraid to ask questions and inquire as to someone’s background and credentialing.