AMT Chapter 4 List of Medical Professionals1 Within the many different specialties of medical practice, there is still a wide variety of medical professionals who contribute to the care provided to individuals with special physical problems. While the PCP and family doctor attend to people’s basic healthcare needs, that is where the simplicity of the system ends; when a patient develops a health problem that goes beyond the scope of practice of the family physician, the problem may require the input and expertise of a number of different “specialists” and, in the course of resolving the problem, will most likely come into contact with many different medical professionals. Due to this complexity of the U.S. healthcare system, it is important for interpreters to be familiar with the names and descriptions of all types of medical professionals in case an LEP patient becomes confused by the title and qualifications of the healthcare provider. The following chart is useful to healthcare interpreters for that purpose, and deserves a careful review. PROVIDER (SPA translation in blue font) AB R. Chiropractor (Quiropráctico) DC Doctor (physician) (Doctor) MD Osteopath (Osteópata) DO 1 LOCATION OF WORK DESCRIPTION OF DUTIES Private practice, clinics, chiropractic hospitals All medical settings Use manipulation of the body, especially the spine, to improve health and relieve pain. May use X‐rays, water, heat, light, diet and exercise therapy in the treatment of patients. Evaluate and treat illness. Perform medical examinations, diagnose illnesses, and treat people who are suffering from injury or disease. Also advise patients on good health practices. Medical centers, private practice, osteopathic hospitals Osteopathic doctors emphasizes seeing the patient as a “totally integrated, whole person” and treats all aspects of the patient’s health needs. Osteopathic treatment also places special emphasis on the body’s musculoskeletal system. EDUCATIONAL BACKGROUND (AFTER HIGH SCHOOL) 2 years of undergraduate study + 4 years of chiropractic college; licensure required. 12‐20 years after high school. After completion of a bachelor’s degree and medical school, most states require students to enter a 1 or 2‐year internship/residency programs. Most MDs complete 3 or 4 years of residency. Physicians seeking certification in a field of specialty are required to spend from 3 to 6 years in advanced residency training followed by 2 or more years of practice in that specialty. Bachelor’s degree + 3‐4 years of study. Osteopaths are physicians who receive their training in osteopathic medical schools. About 75% of all Doctors of Osteopathy are general practitioners or primary care providers. This list was prepared by a LanguageLine Interpreter, Lorena Martin, for training purposes. 1 LanguageLine Solutions© 2013 Proprietary Information All Rights Reserved 2003-2013 Dentist (Dentista, Odontólogo) DDS Private practice, medical centers Evaluate and treat tooth and gum problems. Diagnose and treat ailments of the gums and teeth. Fill cavities, extract teeth and provide dentures. Areas of specialty include oral surgery and orthodontics. Orthodontist (Ortodoncista) DDS Private practice, medical centers Orthodontists are dentists who specialize in straightening teeth. They are involved in diagnosis, treatment and prevention, as well as in the design and use of corrective appliances, such as braces. Dental Assistant (Asistente dental) ‐ Assist dentist during a variety of procedures; make temporary crowns and X‐rays; take and develop dental X‐rays, sterilize instruments and equipment and take impressions of patients’ teeth. Dental Hygienist (Higienista dental) RDH Optometrist (Optometrista) OD Solo dental practices, group practices, specialty practices, public health dentistry, and hospital dental clinics. General dental practices, as well as in specialty practices such as periodontics or pediatric dentistry; also, hospitals, nursing homes and public health clinics Medical centers, private practice, clinics, hospitals, health maintenance organizations, and retail optical stores. Clean teeth and place fillings. Provide preventive dental care and encourage patients to develop good oral hygiene skills. Perform patient screening procedures, such as taking and developing X‐rays, assessment of oral health conditions, review of the health history, oral cancer screening, head and neck inspection, dental charting and taking blood pressure and pulse. Perform documentation and office management activities. Examine people’s eyes to diagnose vision problems and eye diseases. Use instruments and observation to examine eye health and to test patients’ visual acuity, depth and color perception, and their ability to focus and coordinate the eyes. Analyze test results and develop a treatment plan. Prescribe eyeglasses and contact lenses, and provide vision therapy and low‐vision rehabilitation. Administer drugs to patients to aid in the diagnosis of eye vision problems and prescribe drugs to treat some eye diseases. Often provide pre‐ and postoperative care to cataract, laser vision correction, and other eye surgery patients. Also, diagnose conditions due to systemic diseases, such as diabetes and high blood pressure. If evidence of eye disease is 8‐10 years after high school. Dental schools require a minimum of 3 to 4 years of college‐level pre‐dental education. Students then attend dental school for four years, with an additional two to four years for a specialty. Same initial requirements as dentists; currently, about 17 states require dentists to obtain a specialty license before practicing as a specialist. Requirements include 2 to 4 years of postgraduate education and, in some cases, completion of a special state examination. Most state licenses permit dentists to engage in both general and specialized practice. 0‐2 years. 3 years. Most programs require applicants to complete at least one year of undergraduate study while a number of dental hygiene schools require a minimum of two years of college. Licensure examination required. 3‐4 years of college. The Doctor of Optometry degree requires completion of a 4‐ year program at an accredited optometry school preceded by at least 3 years of pre‐ optometric study at an accredited college or university 2 LanguageLine Solutions© 2013 Proprietary Information All Rights Reserved 2003-2013 Ophthalmologist (Oftalmólogo) Dispensing Optician (Dispensario óptico, consultorio óptico) MD Hospitals, medical centers, and individual and group practice ‐ Medical offices, retail stores Podiatrist (Podiatra, Podólogo) DPM Most podiatrists are solo practitioners, although more are entering partnerships and multi‐specialty group practices. Others are employed in hospitals, nursing homes, and public health agencies. Social Worker (Trabajador(a) social) MSW Hospitals, psychiatric hospitals, mental health centers, community centers, rehabilitation centers, nursing homes, public present, the optometrist will normally refer the client to an ophthalmologist, a physician whose specialty is the eye. Ophthalmologists are physicians who specialize in diagnosing and treating diseases and injuries of the eye. Perform examinations of the internal and external structures of the eye, order laboratory tests, prescribe medications and treatments, evaluate vision and prescribe corrective lenses such as eyeglasses and contact lenses. Also perform eye surgery. Examine written prescriptions to determine lens specifications. Recommend eyeglass frames, lenses, and lens coatings, measure clients’ eyes, verify prescriptions with the examining optometrist or ophthalmologist, and prepare work orders for lenses and frames. Instruct clients about adapting to, wearing, or caring for eyeglasses. Some specialize in fitting contacts, artificial eyes, or cosmetic shells to cover blemished eyes. They also keep records on customer prescriptions, work orders and payments, track inventory and sales, and perform other administrative duties. Podiatrists are doctors who specialize in diagnosing and treating a variety of foot and lower leg disorders and injuries. They take X‐ rays, prescribe medication, perform surgery and admit patients to the hospital. They are trained to treat fractures and sprains as well as to provide routine foot care. They treat corns, calluses, ingrown toenails, bunions, heel spurs, and arch problems; ankle and foot injuries, deformities and infections; and foot complaints associated with diseases such as diabetes. They prescribe drugs, order physical therapy, set fractures, and perform surgery. They also fit corrective inserts called orthotics, design plaster casts and strappings to correct deformities, and design custom‐made shoes. Help patients access social services. Provide counseling services on marriage, family, and adoption matters, and help people through personal or community emergencies, such as dealing with loss or grief or arranging for disaster assistance. Help people locate basic benefits, such as income assistance, housing, and job training. Also offer counseling to those receiving therapy for addictive or physical disorders. Ophthalmologists must earn a bachelor’s degree and then a four‐year medical degree from an accredited medical school. A one‐year internship in medicine or surgery is followed by a three to four‐ year residency. They are then eligible to take an exam and be certified by the American Board of Ophthalmology. Specialization in an advanced area of ophthalmology may require one or more years of fellowship training beyond the residency. A 2‐year Associate’s Degree program, or 2‐ to 4‐year apprenticeships. There are also shorter programs of one year or less. A licensure exam is required. Bachelor’s degree + 4 years. The professional training is a four‐year program similar to medical school. Also, 1‐2 years of residency. Specialties include surgery, orthopedics, primary care, or public health. Besides these board‐certified specialties, podiatrists may practice a subspecialty such as sports medicine, pediatrics, dermatology, radiology, geriatrics, or diabetic foot care. 6 years. A master’s in social work (MSW) is necessary for positions in health and mental health settings and typically is required for certification for clinical work. Licensure is required by all states. 3 LanguageLine Solutions© 2013 Proprietary Information All Rights Reserved 2003-2013 Counselor (Consejero(a)) MA MSW health agencies, home health agencies, and private practice. Healthcare facilities, residential care facilities, drug and alcohol rehabilitation programs, government agencies, health maintenance organizations, insurance companies, group practice, and private practice Provide clinical or diagnostic testing services covering a wide range of personal disorders. Emphasize prevention and work with individuals and groups to promote optimum mental health. Help individuals deal with addictions and substance abuse, suicide, stress management, problems with self‐esteem, issues associated with aging, issues of mental and emotional health, and family, parenting and marital problems. Work closely with other mental health specialists, including psychiatrists, psychologists, clinical social workers, psychiatric nurses and school counselors. 6 years. Licensure required by some states; national certification is also available. Psychologist (Psicólogo) PhD, Psy. D. Hospitals, clinics, schools, correctional facilities, counseling centers, independent or group practices or private settings Help mentally and emotionally disturbed clients adjust to life and help medical and surgical patients deal with illnesses or injuries. Also help people deal with times of personal crisis, such as divorce or the death of a loved one. Interview patients, give diagnostic tests, provide individual, family, or group psychotherapy, and design and implement behavior modification programs. Sometimes collaborate with physicians and other specialists to develop and implement treatment and intervention programs. Psychiatrist (Psiquiatra) MD Community mental health centers, psychiatric hospitals, and private practice Psychiatrists are medical doctors who specialize in diagnosing, treating and preventing mental and emotional problems. As physicians, they can order tests and prescribe medications that can help patients. They often work as part of a treatment team, including nurses, social workers, psychologists, occupational therapists and when possible, the patient’s family. ARNP Hospitals, clinics Those of an ARNP working in family practice. 10 years. A doctoral degree is usually required for employment as a licensed clinical or counseling psychologist. They must meet certification or licensing requirements in all States and the District of Columbia. Clinical and counseling psychologists usually require a doctorate in psychology, completion of an approved internship, and 1 to 2 years of professional experience. Training as a psychiatrist comes after completion of a bachelor’s degree, a four‐year medical degree, and a four‐ year residency. Certification can then be sought from the American Board of Psychiatry and Neurology. State licensure is also required. Same as ARNP. ARNP Hospitals, clinics Those of an ARNP working in pediatrics. ARNP + 1‐year fellowship. Family Nurse Practitioner (Enfermera facultativa de familia) Pediatric Nurse Practitioner (Enfermera facultativa de pediatria) 4 LanguageLine Solutions© 2013 Proprietary Information All Rights Reserved 2003-2013 Certified Nurse Midwife (Partera certificada) Clinical Nurse Specialist (Enfermera clínica facultativa/ especializada) CNM Hospitals Similar to an ARNP for attending births. Specialize in delivering babies and in women’s health issues associated with obstetrics. RN/BSN + 2 years. CNS Medical centers Like NPs, can make diagnoses and, in most states, have prescription‐writing privileges. Licensed Practical Nurse (also known as licensed vocational nurses in California and Texas) (Enfermera practicante licensiada) LPN (or LVN) All medical settings, including hospitals, nursing homes, home healthcare services, medical centers, physicians’ offices, and outpatient clinics All medical settings, including clinics, surgical centers, emergency rooms, outpatient centers, home care, hospitals and HMOs. Also, in government and private agencies Private agencies or hospitals. Carry out basic bedside care such as taking temperatures, preparing and giving injections, and collecting blood and fluid samples. May also complete basic secretarial tasks, such as making appointments and keeping records. Work under the supervision of physicians or registered nurses. In most states are allowed to administer prescription medications. Most are trained in a specific area of expertise, such as oncology, pediatrics, or obstetrics, and become certified and work within that area. 1 ½ years + licensure. Registered Nurse (Enfermera diplomada /certificada) RN Home Healthcare Nurse (Enfermera de asistencia en el hogar) RN Certified Registered Nurse Anesthetist (Enfermera anestesista diplomada/ certificada) Certified Nursing Assistant (Asistente certificado(a) de geriatría) CRNA CAN A variety of health‐care settings, such as operating rooms, ambulances, and dentists’ offices Nursing home, hospitals, bedside care Like all nurses, staff nurses in hospitals assess their patients’ conditions, administer medications, interpret and carry out physicians’ orders, and make sure their patients are comfortable and being taken care of properly. 2, 3 or 4 years. Visit a patient’s home to assess his or her condition, and carry out instructions prescribed by the patient’s physician. After assessing patients’ home environments, they care for and instruct patients and their families. Home health nurses care for a broad range of patients, such as those recovering from illnesses and accidents, cancer and child birth. They must be able to work independently and may supervise home health aides. Deliver anesthetics to patients. Same as RN (2, 3 or 4 years). Work under the direction of other healthcare professionals. Duties include taking the blood pressure, temperature, and pulse of patients. Help patients get in and out of bed, take baths, and dress. Also serve meals and perform housekeeping chores like making beds and 1 year. Some hospitals offer on‐the‐job training. RN/BSN + 2 years. 5 LanguageLine Solutions© 2013 Proprietary Information All Rights Reserved 2003-2013 ‐ Hospitals, nursing homes, home‐ care settings, and psychiatric wards Medical Assistant (Asistente médico) MA Ambulatory settings such as medical offices and outpatient clinics, as well as hospitals, nursing homes, and other healthcare facilities Physician’s Assistant (Asistente de fisiatra) PA Any setting in which the physician renders care EMT Advanced life‐ support units and ambulance services MA, RD Medical centers, public health agencies, hospitals, nursing homes, home health agencies, and health maintenance organizations Private practice, hospitals, doctors’ offices, speech, language, and hearing centers, home health agencies, and schools Nurses’ Aide (Asistente de enfermeria) Emergency medical technician (paramedic) (Paramédico, Técnico de emergencias) Dietitian/ Nutritionist (Dietista o Especialista en nutricion) Audiologist (Audiólogo) MS cleaning rooms. Observe the patient’s physical, emotional, and mental status and report any changes to the medical or nursing staff. Help staff nurses in such tasks as bathing and feeding patients and taking temperatures. Function as members of the healthcare delivery team and perform administrative and clinical procedures. Medical assistants perform routine administrative and clinical tasks to keep the offices and clinics of physicians, podiatrists, chiropractors, and optometrists running smoothly. They should not be confused with physician assistants who examine, diagnose, and treat patients under the direct supervision of a physician. Care for patients and prescribes, under the supervision of a doctor of medicine or osteopathy, who is ultimately responsible for patient care. Functions include performing diagnostic, therapeutic, preventive, and health maintenance services, to allow for a more effective and focused application of the physician’s particular knowledge and skills. Work under the direction and supervision of a physician, often through radio communication. Recognize, assess, and manage medical emergencies of acutely ill or injured patients in pre‐hospital care settings. Training in high school or college. Programs are either 2 years (resulting in an associate degree), or 1 year in length (resulting in a certificate or diploma). BA/BS/experience + 2 years training. Instruction dealing specifically with emergency medical care requires anywhere from 600 to 1,000 hours of instruction. Requires a field internship. Develop medical nutrition therapy for special needs and counsels patients. Plan food and nutrition programs and supervise the preparation and serving of meals. Help prevent and treat illnesses by promoting healthy eating habits, scientifically evaluating clients’ diets, and suggesting diet modifications. 4 years + 1 year internship; some have 6 years. Measure hearing. Identify, assess, and manage auditory, balance, and other neural systems. Use audiometers, computers, and other testing devices to measure a person’s ability to distinguish between sounds, and the nature and extent of hearing loss. Interpret these results and coordinate them with medical, educational, and psychological information to make a diagnosis and determine a course of treatment. May also recommend, fit, and dispense personal or large area amplification systems, such as hearing aids and alerting devices. 6 years. Licensure requirements include a master’s degree or equivalent, 300 to 375 hours of supervised clinical experience, a passing score on a national examination, and 9 months of postgraduate professional clinical experience. 6 LanguageLine Solutions© 2013 Proprietary Information All Rights Reserved 2003-2013 Speech‐Language Pathologist (Patólogo(a) del habla / lenguaje) Occupational Therapist (Terapeuta Ocupacional) Physical Therapist (Terapeuta físico) MS Private practice, hospitals, doctors’ offices, speech, language, and hearing centers, home health agencies, and schools ‐ Hospitals, private practice, nursing homes, rehabilitation centers, and adult daycare centers PT (4), MSPT (6) Medical centers, nursing homes, hospitals, residential institutions, home care, public health agencies, and private practice Medical centers, oncology centers Radiation Therapist (Terapeuta de radiación) ‐ Registered Respiratory Therapist (Terapeuta respiratorio inscrito/registrado) Orthotist (Ortesista) RRT Prosthetist (Protesista) Doctor of Pharmacy (Doctor en Farmacología, farmacéutico) Pharmacist ‐ ‐ Pharm D. RPh Hospitals, home health agencies, respiratory therapy clinics, and nursing homes Hospitals, rehabilitation centers Hospitals, rehabilitation centers Work in hospital teams or in group practice with private physicians. Hospitals, Assess, treat, and help to prevent speech, language, cognitive, communication, voice, swallowing, fluency and other related disorders. Use written and oral tests, as well as special instruments, to diagnose the nature and extent of impairment and to record and analyze speech, language, and swallowing irregularities. Develop an individualized plan of care, tailored to each patient’s needs. Help patients develop or recover reliable communication skills. Also work with family members to recognize and change behavior patterns that impede communication and treatment and show them communication‐ enhancing techniques to use at home. Use purposeful activity and interventions to maximize the independence and health maintenance of any individual who is limited by a physical injury or illness, a cognitive impairment, psychosocial dysfunction, mental illness, developmental or learning disability, or an adverse environmental condition. Treat joint problems and disabilities through exercise and heat/cold. Plan individual programs for patients, using exercise, massage, heat, water, light and electrical treatments. Conduct diagnostic tests on muscle, nerve and joint functions. Educate patients in postural control and exercise that can be continued after hospital stays. 6 years. Licensure requirements include a master’s degree or equivalent, 300 to 375 hours of supervised clinical experience, a passing score on a national examination, and 9 months of postgraduate professional clinical experience. Programs at the baccalaureate level entail 4 years of college or university preparation. Postbaccalaureate programs leading to a certificate or master’s degree are generally 2 years in length. Also requires a national certification examination. 4‐6 years. Licensure is required. Administer radiation therapy services to patients. Provide appropriate patient care, exercise judgment in the administration of prescribed courses of treatment, tumor localization and dosimetry, and maintain pertinent records. Administer treatment for respiratory problems under the supervision of a physician. May be required to exercise considerable independent clinical judgment in the respiratory care of patients. Programs may be 1, 2, or 4 years in length, depending on program design, objectives, and the degree or certificate awarded. 2‐3 years + 1 year experience; programs are usually 2 years in length, leading to an associate degree or, in a few instances, to a baccalaureate degree. Design and fit devices, known as orthoses, or provide care to patients who have disabling conditions of the limbs and spine. Design and fit devices, known as prostheses, for patients who have a partial or total absence of a limb. Make recommendations to MDs on drug therapy, assist physicians in the prescription of drugs, and advise and educate patients in the proper use of drugs. 4 years of college; baccalaureate degree. Dispense medication under doctor’s orders and 5 years; most Colleges of 4 years of college; bachelor’s degree. 6 years. 7 LanguageLine Solutions© 2013 Proprietary Information All Rights Reserved 2003-2013 drugstores, and community pharmacies (Farmacéutico) counsel patients; provide information about drugs and drug treatments; dispense drugs prescribed by physicians, podiatrists, and dentists. Dispense medications, data entry, triage Pharmacy programs are 5 years and result in a Bachelor of Science degree in Pharmacy. 1 ½‐2 years. Pharmacy Assistant A (Asistente de farmacia tipo A) Pharmacy Assistant B (Asistente de farmacia tipo B) Diagnostic Medical Sonographer (Asistente de sonografia) ‐ Hospitals, drugstores, and community pharmacies ‐ Hospitals, drugstores, and community pharmacies Clerical work. None ‐ Medical centers, hospitals, physicians’ offices and clinics, and diagnostic imaging centers Provide patient services, using medical ultrasound under the supervision of a physician. Assist the physician in gathering sonographic data necessary to diagnose a variety of conditions and diseases. Sonographers explain the procedure, record additional medical history, select appropriate equipment settings and use various patient positions, as necessary. Phlebotomist (Flebotomista) ‐ Hospitals, medical laboratories, physicians’ offices and clinics, and blood banks Collect blood samples from patients for testing purposes. Usually work under the supervision of medical technologists or laboratory managers. Radiographer (Radiógrafo) ‐ Medical centers, hospitals, physicians’ offices and clinics, and diagnostic imaging centers Provide patient services using imaging equipment, as directed by physicians qualified to order and/or perform radiological procedures. Radiographers produce X‐ray films (radiographs) of parts of the human body for use in diagnosing medical problems. They prepare patients for radiological examinations and protect them from unnecessary radiation exposure. Experienced radiographers may perform more complex imaging tests, such as fluoroscopies, CT scans, or MRIs. Programs may be 1, 2, or 4 years in duration. Sonographers may specialize in neurosonography (the brain), vascular (blood flows), echocardiography (the heart), abdominal (the liver, kidneys, spleen, and pancreas), obstetrics/gynecology (the female reproductive system), and ophthalmology (the eye). 1 year phlebotomy programs are offered at vocational/technical schools awarding diplomas and 2 year phlebotomy programs are offered at community colleges awarding associate degrees. Programs are generally two to four years in length, depending on program design, objectives, and the degree or certificate awarded. 8 LanguageLine Solutions© 2013 Proprietary Information All Rights Reserved 2003-2013