Law 803 Health Care Malpractice
Professor Vernellia Randall
The University of Dayton School of Law

Alphabet Soup


01: Introduction
02: Sickness and Quality
03: Medical Error
04: Provider Obligation
05: Hospital Obligation
06: Contractual Relationship
Lesson Schedule

Unit01: Introduction
Unit02: Professional Liability
Unit03: Institutional Liability
Unit04: Tort Reform
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American Health Care Law

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Mary Anne Dunkin

excerpted from: Mary Anne Dunkin, From D.O. to P.T.: what do all those letters mean? Finally - an explanation of those initials you see after your health-care provider's name, 7 Arthritis Today 46-49 (Sept-Oct, 1993).

Finally -- an explanation of those initials you see after your health-care provider's name.

Looking over a list of doctors specializing in arthritis, you notice a few have the initials D.O. after their names. You schedule an appointment to see your family physician, but when you get to her office, a P.A. examines you and asks about your latest symptoms. When you describe the problems you've had keeping up with your job and household chores, he refers you to an O.T.

D.O., P.A., O.T. -- it may sound like a secret code, but actually these initials can tell us a great deal about the people who handle and manage our care for arthritis and other medical problems. There are dozens of professional degrees and designations conferred upon health-care providers -- many of them are probably familiar by now; some of them may not be. But even if you know what the initials stand for, you may still have questions: What's the difference between a D.O. and and M.D.? Is a P.A. qualified to treat arthritis? What does an O.T. do?

Following is some basic information about the duties and qualifications of health-care professionals you're likely to encounter. . . .

 D.O. - doctor of osteopathic medicine

Like medical doctors (M.D.s), D.O.s (or osteopathic physicians) are complete physicians, which means they are fully trained and licensed to perform surgery and prescribe medication. The primary difference between M.D.s and D.O.s is that D.O.s focus on the body as a whole and how different organ systems function together, rather than on specific disease symptoms. Teaching prevention by promoting healthy lifestyle changes is also an important role of the osteopathic physician.

D.O.s practice in all branches of medicine and surgery, but the majority are family-oriented primary-care physicians, Many D.O.s practice in small towns and rural areas.

Like M.D.s practice in small towns and rural areas.

Like M.D.s, osteopathic physicians attend a four-year medical school and complete an approved 12-month intership after graduation. Many then choose to take a residency program in a specialty area, requiring two to six years of additional training. To practice, D.O.s must be licensed by tests and procedures determined by their state. Some states administer the same tests for M.D.s and D.O.s, while other states adminster separate licensing exams.


* O.D. - doctor of optometry. 

Not to be confused with D.O.s, O.D.s (or optometrists) diagnose, manage and treat conditions and diseases of the eye and visual system. Among the services they render are prescription of glasses and contact lenses, rehabilitation of the visually handicapped and, in most states, treatment of diseases of the eye.

Unlike ophthalmologists (M.D.s who treat problems of the eye and visual system), optometrists do not perform surgery. In most states, however, they can be licensed to prescribe medication.

Most optomertrists complete undergraduate degrees before entering the required four-year accredited degree program at a school or college of optometry. After completing optometry school, they must pass a clinical and written examination administered by the National Board of Examiners in Optometry.


* D.P.M. - doctor of podiatric medicine. 

A doctor of podiatric medicine, or podiatric, is concerned with the diagnosis and treatment of conditions affecting the human foot and ankle. Podiatrists may perform foot surgery and prescribe medication. Podiatrists may have solo or group private practices or they may be affiliated with hospitals, teaching institutions, managed care or other health-delivery systems and health departments.

D.P.M. degrees are awarded to graduates of the seven four-year colleges of podiatric medicine in the United States. Most podiatric physicians complete hospital-based residency programs in specialty areas such as foot and ankle surgery, orthopaedics and primary podiatric medicine. To practice, podiatrists must pass licensing tests adminstered by their states.


* D.C. - doctor of chiropractic. 

Doctors of chiropractic, or chiropractors, consider the human body as a total functioning unit and seek to relieve pain, illness and disability by utilizing skillful manipulations and adjustments of the vertebrae and other joints. Chiropractors are concerned in particular about the spine's relationship to the nervous system, which controls important body functions. Chiropractors do not prescribe medicine or perform surgery; they refer patients needing those services to M.D.s or D.O.s.

Educational requirements for doctors of chirpractic are at least two years of undergraduate study followed by a four-year chiropractic college. To practice, chiropractors must pass state licensing tests. Also, most states require national board exams.


* P.A. - physician assistant. 

Physician assistants practice medicine with the supervision of licensed physicians. They are qualified to perform approximately 80 percent of the duties most commonly done by physicians. They may perform physical examinations, diagnose illnesses, determine treatment plans, order and interpret lab tests, suture wounds, set fractures and assist in surgical operations. In most states, P.A.s may also write prescriptions.

If you live in a rural area where physicians are in short supply, a P.A. may be your primary provider of health care.

Physician assistants are educated in one of 57 specially designed programs located at medical colleges and universities, teaching hospitals and through the armed forces. P.A. programs generally require applicants to have prior healthcare experience and a minimum of two years of college education. Programs usually last 24 months and consist of both classroom training and patient contact.


* P.T. - physical therapist. 

The role of the physical therapist is to relieve pain and increase function in people who have suffered illness or injury, helping these patients reenter the community, home and work environment with as much independence as possible.

Physical therapists use therapeutic exercise to improve patients' muscle strength, joint mobility and cardiovascular function. They may also use heat, cold, electrical stimulation and hydrotherapy to bring temporary relief of pain and reduce muscle spasms. P.T.s teach people to do activities safely and efficiently and may recommend a program of pain management and exercise to perform at home.

Physical therapists are educated in accredited programs offered at many colleges and universities and must pass a licensing exam administered by their state. P.T.s practice in a variety of settings, including hospitals, outpatient clinics, rehabilitation centers, nursing homes, schools and home health-care agencies. In some states, a physician referral is required for treatment by a physical therapist.


* O.T. - occupational therapist. 

The occupational therapist's role is to improve a person's functional ability to perform daily living tasks. They help patients adapt to disruptions is lifestyle and prevent loss of function. O.T.s teach energy conservation and joint protection as well as stress management. They also recommend adaptive equipment and teach patients how to use it to perform tasks related to self-care, job or school, housework or leisure activities.

Registered O.T.s have completed either an undergraduate or master's degree program as well as a period of supervisedc clinical experience. To be registered (often designated as O.T.R.), occupational therapists must complete a national certification exam. Many states require occupational therapists to be regulated before they can practice. A physician referral is sometimes necessary for evaluation and treatment by an O.T.


* B.S.W., M.S.W. - bachelor of science in social work, master of science in social work. 

The role of the social worker is to assess the capacities of individuals, families and communities to cope with diseases. Social workers offer a broad range of services from emotional support to referrals for community resources that can assist patients and their families in accepting acute and and chronic health conditions.

Social workers may be affiliated with hospitals, rehabilitation facilities, outpatient clinics, community mental health centers, schools, family and community service agencies and private practices.

To practice, a social worker must have at least an undergraduate degree, and most states require social workers to pass to licensing exam.


* R.N., L.V.N., L.P.N., N.P. - registered nurse, licensed vocational nurse, licensed practical nurse, nurse practitioner . 

Nurses can assume a broad range of responsibilities including the following: evaluation of physical, emotional, psychological and social needs; diagnosis; treatment; coordination of care given by other health-care providers; teaching; counseling; collaboration with other health-care providers; and case management. As the largest group of health-care professionals, nurses work in a variety of settings including hospitals, nursing homes, community health centers, home health agencies and outpatient clinics.

To practice, nurses must be licensed by their state. The difference between types of licensure is the degree of responsibility based on the nurse's level of education. Education for R.N. licensure consists of either a degree from a two-year college, a hospital school diploma, or an undergraduate degree. For L.P.N. or L.V.N. licensure a 12- to 18-month course is required.

Advanced practice nurses are registered nurses who have graduate-level education, typically a master's degree. Advanced practice nurses include nurse practioners (N.P.s), who are qualified to provide 80 percent of health-care services commonly provided by a family physician. N.P.s conduct physical exams, take medical histories, diagnose and treat common acute minor illness or injuries, order and interpret lab tests and X-rays, and counsel and educteate patients. In at least 43 states, N.P.s can prescribe medications. These are but a few of the many initials that identify health-care professionals. There are dozens more. A complete list would more than fill this magazine's pages.

As you try to make sense of this alphabet soup, remember some, such as R.N., stand for the person's license; some, such as B.S.N. (bachelor of science in nursing), stand for the academic degree the person holds. Still others stand for professional organizations of which the person is a member, such as F.A.C.P. (fellow of the American College of Physicians). . . .



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Home ] 01: Intro to Medical Malpractice ] 02: Defining Sickness and Quality ] 03: Medical Error ] 04: Obligation to Provide Care ] 05: Hospital Obligation ] 06: Contractual Relationship ]
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Professor Vernellia R. Randall
Institute on Race, Health Care and the Law
The University of Dayton School of Law
300 College Park 
Dayton, OH 45469-2772

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