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Lesson5:U.S.HealthCareSystem

LearningObjectives
x Comparehospitalstructures(public,nonprofit,private)
x Describehowcancercaremaybestructuredanddelivered
x Compareinpatientandoutpatientcaredelivery
x Discusstypesofcareandtypesofhealthcareprofessionalsinvolvedindifferenttypesof
care
KeyTakeaways
x Cancercarecanbedeliveredinhospitalbasedprograms,academiccancercenters,
communitycancercentersandprivatepractices.
x Cancercaremaybedeliveredinpatientoroutpatient,althoughmostadultcancercare
isdeliveredoutpatient.
x Therearedifferenttypesofcare,suchasprimarycare,specialtycare,urgentcareand
hospicecare.
x Oncologyspecialistsincluderadiologists,pathologists,radiationoncologists,
hematologists/oncologistsandsurgeons.
x Cancercareisateameffortthatincludesmanydisciplines,suchasdoctors,nurses,
pharmacists,therapistsandpatientnavigators.

 

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LESSON
N5:U.S.HEAALTHCARESSYSTEM

CancerCareDelivery
Overvie
ewofHealthhCareSpeciaalists
Overvie
ewofOncolo ogySpecialissts
MentallHealthProffessionals
ResourcesforPatie
entNavigato ors

CancerC
CareDeliveryy

deliveredthrroughthefollowingwayys:
Cancercaarecanbed

x Hospitalbase
H edprogramss
Soomecare,likkesurgery,ccanbehospiitalbased.C
Childrenofteenreceivech
hemotherap pyin
ahospital,whhileadultsm
moreoftenreeceivechem moinanamb bulatorycareesetting,wh
hich
maybecalled
m dacancerce enter.

Hospitalsmay
H ybe:


Pu
ublic Nonproffit Private
Fundedan ndownedbyy Offtencommunnity Owneddbyinvestorrs,
local,stateorfederal ho
ospitals towho
omtheyare
governme ents Maaybelinkedwitha accoun
ntable
Receivem moneyfrom relligious
thegovernment de
enomination
Someareassociated
withmedicalschools


x Academiccan
A ncercenter
Academiccan
A ncercenterssaretiedtouniversitiesandfocussiignificantlyo
onbasicand
d
cllinicalcare,ccancerreseaarch,educattionandtrai ning.
x Communityccancercente er
Mostpatient
M s,however,receivecareeatcommunnitycancerccenters,whichfocusmo ostly
oncaredelive ery.
x Privatepractice
Patientsmaybetreatedb byprivateoncologists,aaswell,whoarenotpartofalarger
caancercenterrandofferfewerservice es.


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Patientsmayalsoexperiencedifferenttypesofcaresettings,suchas:

Primary Specialty Emergency

UrgentCare
Care Care Care

LongTerm Hospice Mental

Care Care HealthCare



Sources:PNTC;Simon.2002.

OverviewofHealthCareSpecialists

Cancercareisateameffort.Eachhealthcareproviderisamemberoftheteamwithaspecial
role.Someteammembersaredoctorsortechnicianswhohelpdiagnosedisease.Othersare
expertswhotreatdiseaseorcareforpatients'physicalandemotionalneeds.

Social
Workers
Physical
Cardiologists
Therapists

Gynecologists Surgeons

Palliative
Oncologists SPECIALISTS
Care

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AccordingtotheAssociationofAmericanMedicalColleges,thefollowingisalistofmedical
specialtiesthatmayalsobeinvolvedinapatientscare:

x AllergyandImmunology o Oncology
o Clinical&Laboratory o PulmonaryDisease
Immunology o PulmonaryDisease&Critical
x Anesthesiology CareMedicine
o CriticalCareMedicine o Rheumatology
o ObstetricAnesthesiology o SportsMedicine
o PainMedicine o TransplantHepatology
o PediatricAnesthesiology x InternalMedicinePediatrics
x ColonandRectalSurgery x MedicalGenetics
x Dermatology o BiochemicalGenetics
o Dermatopathology o MolecularGeneticPathology
o ProceduralDermatology x NeurologicalSurgery
x EmergencyMedicine o EndovascularSurgical
o MedicalToxicology Neuroradiology
o PediatricEmergency x Neurology
Medicine o ChildNeurology
o SportsMedicine o ClinicalNeurophysiology
x FamilyMedicine o EndovascularSurgical
o GeriatricMedicine Neuroradiology
o SportsMedicine o NeuromuscularMedicine
x FamilyPractice o PainMedicine
o GeriatricMedicine x NuclearMedicine
x InternalMedicine x ObstetricsandGynecology
o AdvancedHeartFailure& o FemalePelvicMedicine&
TransplantCardiology ReconstructiveSurgery
o CardiovascularDisease x Ophthalmology
o ClinicalCardiac o OphthalmicPlastic&
Electrophysiology ReconstructiveSurgery
o CriticalCareMedicine x OrthopaedicSurgery
o Endocrinology,Diabetes& o AdultReconstructive
Metabolism Orthopaedics
o Gastroenterology o Foot&AnkleOrthopaedics
o GeriatricMedicine o HandSurgery
o Hematology o MusculoskeletalOncology
o Hematology&Oncology o OrthopaedicSportsMedicine
o InfectiousDisease o OrthopaedicSurgeryofthe
o InterventionalCardiology Spine
o Nephrology o OrthopaedicTrauma

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o PediatricOrthopaedics o PainMedicine
x Otolaryngology o SpinalCordInjuryMedicine
o OtologyNeurotology o SportsMedicine
o PediatricOtolaryngology x PlasticSurgery
x PathologyAnatomicandClinical o CraniofacialSurgery
o BloodBankingTransfusion o HandSurgery
Medicine o PreventiveMedicine
o ChemicalPathology o MedicalToxicology
o Cytopathology x Psychiatry
o ForensicPathology o AddictionPsychiatry
o Hematology o Child&Adolescent
o MedicalMicrobiology Psychiatry
o Neuropathology o ForensicPsychiatry
o PediatricPathology o GeriatricPsychiatry
x Pediatrics x RadiationOncology
o AdolescentMedicine x RadiologyDiagnostic
o NeonatalPerinatal o AbdominalRadiology
Medicine o CardiothoracicRadiology
o PediatricCardiology o EndovascularSurgical
o PediatricCriticalCare Neuroradiology
Medicine o MuscoskeletalRadiology
o PediatricEmergency o Neuroradiology
Medicine o NuclearRadiology
o PediatricEndocrinology o PediatricRadiology
o PediatricGastroenterology o Vascular&Interventional
o PediatricHematology Radiology
Oncology x SleepMedicine
o PediatricInfectiousDiseases x SurgeryGeneral
o PediatricNephrology o HandSurgery
o PediatricPulmonology o PediatricSurgery
o PediatricRheumatology o SurgicalCriticalCare
o PediatricSportsMedicine o VascularSurgery
o PediatricTransplant x ThoracicSurgery
Hepatology o CongenitalCardiacSurgery
x PhysicalMedicineand o ThoracicSurgeryIntegrated
Rehabilitation x Urology
o NeuromuscularMedicine o PediatricUrology



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OverviewofOncologySpecialists

Withinoncologythereareseveraltypesofspecialties.Althoughsomeofthesemaysound
similar,specialistsinthesefieldsprovideverydifferentservices.

Radiologyisthemedicalfieldofimaging.Doctorstrainedinthisfieldarecall
radiologists.Radiologistsprovidediagnosticservicesforpatientsbytakingimagesofthe
body.Thisfieldisnotlimitedtocancer.Radiologistsarefocusedonthedetectionof
cancer.
Pathologyisthefieldfocusedondiagnosis.Doctorstrainedinthisfieldarecalled
pathologists.Theylookatbodyfluidslikebloodandurineaswellastissuestodiagnose
cancer.
Radiationoncologyisafieldfocusedonprovidingcancertreatmenttopatientsusing
radiation.Doctorstrainedinthisfieldarecalledradiationoncologists.
Hematology/oncologyisthespecialtythatprovideschemotherapytreatmenttocancer
patients.Doctorswhopracticeinthisfieldarecalledmedicaloncologistsorsimply
oncologists.
Surgeryisanotherspecialtythattreatscancerpatients.Doctorswhopracticesurgery
arecalledsurgeons.

MentalHealthProfessionals

Specialhealthcareprofessionalsarerequiredfortreatinganymentalhealthconditionsa
patientmayexperience.

Counselors Psychologists

Licensed
Psychiatrists ClinicalSocial
Mental Workers
Health
Professionals





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ResourcesforPatientNavigators

x PatientNavigationTrainingCollaborativesIntroductiontotheHealthcareSystem
Inthiscourseyouwilllearnaboutdifferenttypesofhealthcaresystems,hospitals,
clinics,communityhealthagenciesandtheroleofotherhealthcareteammembers.
Youwillalsolearnthebasicsofhealthinsuranceandimportantthingsyouneedtoknow
aboutlegalissuesrelatedtopatientnavigation.


 

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Module3,Lesson5:U.S.HealthCareSystem

References:Presentations

CentersforMedicare&MedicaidServices.EmergencyMedicalTreatment&LaborAct
(EMTALA).2012.Retrievedfrom:https://www.cms.gov/Regulationsand
Guidance/Legislation/EMTALA/index.html?redirect=/EMTALA/.
WeaverAJ.ClergyasHealthCareProviders.SouthMedJ.2005;98(12):1237.
PatientNavigatorTrainingCollaborative.n.d.Retrievedfrom:
http://patientnavigatortraining.org/.
PrattChapmanML,WillisLA,MasselinkL.CoreCompetenciesforNonClinicallyLicensed
PatientNavigators.TheGeorgeWashingtonUniversityCancerInstituteCenterforthe
AdvancementofCancerSurvivorship,NavigationandPolicy:WashingtonDC,2014.
SimoneJ.Understandingcancercenters.JClinOnco.2002;20(23):45034507.
References:BriefQuiz

AmericanHeritageMedicalDictionary.MidlevelProvider.2007.Retrievedfrom:http://medical
dictionary.thefreedictionary.com/midlevel+provider.
AmericanNursesAssociation.AdvancedPracticeNurses.2015.Retrievedfrom:
http://www.nursingworld.org/EspeciallyForYou/AdvancedPracticeNurses.
Cancer.Net.WhatisRadiationTherapy?2013.Retrievedfrom:
http://www.cancer.net/navigatingcancercare/howcancertreated/radiationtherapy/what
radiationtherapy.
CentersforMedicareandMedicaidServices.FindOutIfYoureanInpatientoranOutpatient
ItAffectsWhatYouPay.n.d.Retrievedfrom:http://www.medicare.gov/whatmedicare
covers/parta/inpatientoroutpatient.html.
HorowitzJ.Makingprofitsandprovidingcare:Comparingnonprofit,forprofit,andgovernment
hospitals.HealthAff.2005;24(3):790801.doi:10.1377/hlthaff.24.3.790.
ProvidenceHealth&Services.DifferenceBetweenEmergency,TraumaandUrgentCare.2015.
Retrievedfrom:http://california.providence.org/holycross/services/emergency/patient
familysupport/emergencytraumaurgentcare/.
SimoneJ.Understandingcancercenters.JClinOnco.2002;20(23):45034507.

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SloanF,PiconeG,TaylorD,ShinYiC.Hospitalownershipandcostandqualityofcare:Istherea
dimesworthofdifference?JournalofHealthEconomics.2001;20(1):121.doi:
10.3386/w6706.
WadleR.UrgentCareVs.PrimaryCarePhysicians:WhatstheDifference?2012.Retrieved
from:http://patch.com/michigan/birmingham/bpurgentcarevsprimarycarephysicians
whatsthedifference.

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