Communicating the Value of Long Term Follow Ups

Communicating the Value of Long Term Follow Ups

* Maintaining the corrected tooth alignment achieved during braces.

Okay, so you've just gotten your child's braces off. Hooray! All that metal, all those appointments, finally done. You're probably thinking, "We're good, right? Perfect smile, time to move on." Orthodontic treatment can help improve your child's smile Pediatric orthodontic care health. And honestly, that's a totally normal feeling. But here's the thing: getting those teeth straight is only half the battle. The real win comes with keeping them that way.


Think of it like building a really cool sandcastle. You spend hours carefully shaping the towers, smoothing out the walls, making it just right. But without taking steps to protect it – maybe building a small barrier against the tide – all that hard work gets washed away pretty quickly.


Orthodontic treatment is the same. Those teeth have been moved into new positions, and they have a natural tendency to want to drift back. That's where long-term follow-ups come in. They're not just about the orthodontist wanting to see your kid's sparkling smile (though we do love that!). They're about making sure that investment of time, money, and effort actually sticks.


These follow-ups, even just a quick check-up here and there, allow us to catch any early signs of relapse – things shifting back slightly. We can then make small adjustments, usually with retainers, to keep everything in place. It's much easier (and cheaper!) to make a minor tweak than to have to go through a whole new round of treatment later on.


So, yeah, long-term stability might not sound as exciting as finally getting those braces off. But it's the key to a truly successful outcome. It's about ensuring your child's beautiful, healthy smile lasts a lifetime. And isn't that what we all want in the end?

Communicating the Value of Long Term Follow Ups: Addressing Parental Concerns About Relapse and the Need for Follow-Up


Look, I get it. As parents, we're wired to want to fix things, see immediate results, and then move on. When our child is struggling, especially with something like addiction or a serious mental health issue, we pour our hearts and souls into getting them the help they need. And when they start showing improvement, it's natural to feel a huge wave of relief. You think, "Okay, we're through the worst of it. We can relax now."


But that's precisely where the long-term follow-up comes in. It's not about suggesting we don't believe in our kids, or that we expect them to fail. Quite the opposite, actually. It's about acknowledging the reality that recovery, true recovery, is a marathon, not a sprint. It's about providing ongoing support and a safety net, just in case things get tough again.


I know what's buzzing in your head: "Relapse. That word scares me to death." Believe me, it scares all of us. Nobody wants to think about their child potentially slipping back. But pretending relapse isn't a possibility doesn't make it go away. It just leaves us unprepared. Long term follow-up isn't about dwelling on the negative; it's about proactively building resilience. It's about equipping your child with the tools and strategies they need to navigate triggers, cravings, and difficult emotions that might arise down the road.


Think of it like this: you wouldn't stop brushing your teeth just because you haven't had a cavity in a year, right? You keep brushing to prevent cavities. Long-term follow-up is the same principle. It's the ongoing maintenance that helps prevent a setback, or, if a setback does occur, allows us to catch it early and intervene before it spirals out of control.


The follow-up appointments, the check-ins, the support groups – they're not symbols of failure. They're signs of strength, of commitment, and of a proactive approach to long-term well-being. They tell your child, "We believe in you, and we're here for you, every step of the way, no matter what." And that message, that unwavering support, is often the most powerful tool in their recovery journey. So, let's not see follow-up as an option, but as an essential part of giving our kids the best chance at a healthy, fulfilling future.

Citations and other links

* Protecting the investment made in orthodontic treatment.

Okay, so you're trying to explain why those long-term checkups after orthodontic treatment are really important, right? And you want to get into the nitty-gritty of why teeth move, even after braces come off. Think about it like this: your teeth aren't just cemented in place. They're held in by this whole complex system of bone, ligaments, and soft tissue.


The thing that actually lets braces work in the first place is that bone around your teeth can be remodeled. When we apply force with braces, it stimulates cells called osteoblasts and osteoclasts. Osteoblasts build new bone on the side where the tooth is being pulled towards, and osteoclasts break down bone on the side the tooth is moving away from. It's this constant build-up and break-down that allows teeth to shift.


But here's the catch: that process doesn't just stop the second the braces are removed. The periodontal ligament, that stretchy tissue connecting the tooth to the bone, has "memory." It's been stretched and pulled into a new position, and it wants to go back. Plus, the surrounding bone hasn't fully solidified in its new configuration. It's like moving furniture around in a room – you might get it where you want it, but the carpet is still dented where the old furniture used to be.


Then there's the whole issue of natural growth and aging. Your jawbone continues to change over time. Your teeth are also constantly being subjected to forces from chewing, talking, and even subconscious habits like clenching or grinding. These forces can cause subtle shifts, especially if the teeth aren't supported by retainers while the bone is still solidifying.


So, those long-term follow-ups? They're not just about checking for cavities. They're about monitoring this ongoing biological process, making sure everything is stabilizing as expected, and catching any potential relapse before it becomes a major problem. It's about ensuring all that investment of time and money in orthodontic treatment doesn't slowly unravel because we ignored the natural, ongoing processes in your mouth. It's an investment in keeping that smile straight for the long haul, because teeth, like everything else in the body, are always changing.

* Protecting the investment made in orthodontic treatment.

* Ensuring the long-term stability of the bite and smile.

Okay, let's talk about why those long-term follow-up appointments are actually worth it. We're not just trying to fill appointment slots, promise! Think of them like this: early detection is the name of the game, and follow-ups are your secret weapon. Imagine you've just had a nagging cough checked out, and everything seems fine. Great! But a year from now, a tiny, easily treatable issue might start brewing, something that wouldn't be caught until it's much bigger and harder to deal with.


Those follow-up visits? They're your chance to catch those little whispers of trouble before they become shouts. It's like regularly checking the oil in your car; a small problem caught early prevents a major engine breakdown later. We aren't just looking for the obvious; we're looking for the subtle changes, the trends, the things that might indicate something's starting to shift.


And honestly, isn't peace of mind worth something? Knowing that you're actively staying on top of your health, that you're not letting anything sneak up on you, can be a huge weight off your shoulders. It's about being proactive, not reactive. It's about investing in your long-term well-being, and that investment could pay off big time by catching something early and keeping you healthier, longer. So, yeah, those follow-up appointments are more than just a formality; they're a vital part of staying one step ahead.

* Supporting proper jaw growth and development in younger children.

Let's talk about the nitty-gritty, the actual doing of long-term follow-ups. Because when we're trying to convince someone – a patient, a hospital administrator, even ourselves – that these follow-ups are worth the time and effort, we can't just wave our hands and say "it's important!" We need to show them what it looks like.


Think of it as building a case. You're not just stating a conclusion; you're presenting the evidence. So, what's the evidence in this case? It's the specific procedures, the careful assessments that make up a good follow-up plan.


For example, imagine a patient who's had a heart attack. Long-term follow-up isn't just a quick phone call asking, "You still alive?" It's a structured approach. It might involve regular blood pressure checks, not just at the doctor's office, but potentially with a home monitoring system. It includes lipid panels to keep an eye on cholesterol, and maybe even more advanced imaging like echocardiograms to assess heart function over time. We're talking about regular medication reviews, making sure the patient is still taking everything correctly and that there aren't any emerging side effects or interactions.


And it's not just about physical health. Mental well-being is crucial too. So, we might incorporate questionnaires to screen for depression or anxiety, common after such a traumatic event. We could offer referrals to support groups or counseling to help the patient cope with the emotional aftermath.


The same principle applies across different conditions. For someone with diabetes, it's regular A1c checks, foot exams to prevent complications, and eye exams to catch early signs of retinopathy. For cancer survivors, it's ongoing surveillance for recurrence, monitoring for late effects of treatment, and addressing any lingering fatigue or pain.


The key is to be specific. Instead of saying "we monitor for complications," say "we perform annual urine tests to screen for kidney damage, a potential complication of the treatment." Instead of "we provide support," say "we offer a monthly support group facilitated by a licensed therapist, where patients can share their experiences and learn coping strategies."


Detailing these procedures and assessments isn't just about being thorough; it's about building trust. It shows that you're not just paying lip service to long-term care, but that you have a concrete plan in place, a plan designed to actively improve the patient's health and well-being. And that, ultimately, is what makes the value of long-term follow-ups clear.

* Avoiding the need for future, potentially more extensive, orthodontic intervention.

Okay, so we've worked hard, right? Braces off, teeth are straight, smiles are gleaming. Everyone's happy. But here's the thing: teeth have a memory. They want to drift back to where they were. Think of it like a garden – you've finally trained that climbing rose bush to grow beautifully along the trellis, but if you just walk away and ignore it, it'll start to wander back to its wild, unruly state. That's where retainers come in.


And not just any retainer. We're talking about retainers that are crafted specifically for your mouth, your unique bite, your individual tooth alignment. Think about the difference between a generic, one-size-fits-all shoe and a custom-made boot. Which is going to support your foot better on a hike? The custom boot, of course. Same principle applies here. A customized retainer gently and consistently guides your teeth, preventing that subtle, almost imperceptible shift that can slowly undo all the hard work we've done.


Long-term follow-ups aren't just about making sure the retainer fits. They're about monitoring that stability, catching any little nudges back towards misalignment before they become bigger problems. It's like checking the rose bush regularly, snipping off any stray shoots before they become major branches pulling it off the trellis. We can adjust things, make minor tweaks to the retainer, and ensure your smile stays exactly where you want it. It's an investment in maintaining that beautiful, confident smile you earned. It's about making sure all that time, effort, and investment pays off for years to come. And honestly, isn't that worth it?

* Contributing to overall oral health by preventing crowding and misalignment.

Okay, so we're talking about long-term follow-ups and how to convince people they're actually worth the effort, right? Instead of just droning on about data and statistics, sometimes the most convincing thing you can do is tell a good story. And what's a better story than one where a little extra attention down the line actually saved someone from slipping back into old habits?


Think about it. Let's say we're dealing with addiction recovery. A person completes rehab, feels great, and goes back into the world. Six months in, they're doing okay, but the triggers are getting stronger. Maybe they're feeling isolated, or a stressful situation at work is pushing them to the edge. Now, imagine a long-term follow-up program is in place. A counselor calls, just checking in. They hear the subtle signs of struggle, the hesitation in the voice, the "I'm fine, really" that doesn't quite ring true. That counselor, because they're paying attention, can offer support, maybe suggest a support group meeting, or even just be a listening ear. That little intervention, that proactive reach-out, can be the difference between a near miss and a full-blown relapse. That's a powerful story.


Or consider chronic disease management. Maybe someone has diabetes and is doing well managing their blood sugar. But two years later, life gets complicated. A job loss, a family crisis, and suddenly they're skipping medication and eating poorly. A long-term follow-up appointment catches the rising A1C levels early. Instead of waiting for a serious medical event, the doctor can intervene, adjust the treatment plan, and provide much-needed support. Again, the follow-up isn't just about collecting data; it's about preventing a health crisis.


These aren't just hypotheticals. These are real-life scenarios playing out every day. And when you can showcase these success stories, when you can demonstrate how long-term follow-up actually prevents relapse, you're not just communicating the value; you're showing the human impact. You're proving that sometimes, a little extra care and attention over the long haul can make all the difference in someone's life. And that's a message that resonates.

Okay, so we're talking about getting people excited about sticking with their orthodontic check-ups, right? It's more than just straight teeth; it's about painting the bigger picture. Instead of just droning on about appointments, we need to talk about the investment they've already made. Think of it like this: they've already put in the time, the money, and maybe even a little discomfort to get that perfect smile started. We need to remind them that consistent follow-up is how they protect that investment and see the real return.


It's not just about the teeth looking good today; it's about the long haul. We're talking about preventing future problems, catching minor shifts before they become major regressions, and ensuring the bite stays healthy and happy for years to come. Frame it as proactive maintenance, like getting your car serviced regularly. You wouldn't skip oil changes, would you? Same deal here.


And the consistent follow-up part? That's crucial. It's not a "one and done" deal. It's about building a relationship, showing them we care, and being there to answer questions and adjust things as needed. It's about being a partner in their long-term oral health, not just a technician who bolted on some braces. Make it personal, make it about their specific needs and goals, and show them how those regular check-ups are the key to unlocking the full value of their orthodontic journey. It's not just about straight teeth; it's about a lifetime of confident smiles and healthy bites, and that's an investment worth protecting.

Human lower jaw viewed from the left

The jaws are a pair of opposable articulated structures at the entrance of the mouth, typically used for grasping and manipulating food. The term jaws is also broadly applied to the whole of the structures constituting the vault of the mouth and serving to open and close it and is part of the body plan of humans and most animals.

Arthropods

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The mandibles of a bull ant

In arthropods, the jaws are chitinous and oppose laterally, and may consist of mandibles or chelicerae. These jaws are often composed of numerous mouthparts. Their function is fundamentally for food acquisition, conveyance to the mouth, and/or initial processing (mastication or chewing). Many mouthparts and associate structures (such as pedipalps) are modified legs.

Vertebrates

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In most vertebrates, the jaws are bony or cartilaginous and oppose vertically, comprising an upper jaw and a lower jaw. The vertebrate jaw is derived from the most anterior two pharyngeal arches supporting the gills, and usually bears numerous teeth.

Jaws of a great white shark

Fish

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Moray eels have two sets of jaws: the oral jaws that capture prey and the pharyngeal jaws that advance into the mouth and move prey from the oral jaws to the esophagus for swallowing.

The vertebrate jaw probably originally evolved in the Silurian period and appeared in the Placoderm fish which further diversified in the Devonian. The two most anterior pharyngeal arches are thought to have become the jaw itself and the hyoid arch, respectively. The hyoid system suspends the jaw from the braincase of the skull, permitting great mobility of the jaws. While there is no fossil evidence directly to support this theory, it makes sense in light of the numbers of pharyngeal arches that are visible in extant jawed vertebrates (the Gnathostomes), which have seven arches, and primitive jawless vertebrates (the Agnatha), which have nine.

The original selective advantage offered by the jaw may not be related to feeding, but rather to increased respiration efficiency.[1] The jaws were used in the buccal pump (observable in modern fish and amphibians) that pumps water across the gills of fish or air into the lungs in the case of amphibians. Over evolutionary time the more familiar use of jaws (to humans), in feeding, was selected for and became a very important function in vertebrates. Many teleost fish have substantially modified jaws for suction feeding and jaw protrusion, resulting in highly complex jaws with dozens of bones involved.[2]

Amphibians, reptiles, and birds

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The jaw in tetrapods is substantially simplified compared to fish. Most of the upper jaw bones (premaxilla, maxilla, jugal, quadratojugal, and quadrate) have been fused to the braincase, while the lower jaw bones (dentary, splenial, angular, surangular, and articular) have been fused together into a unit called the mandible. The jaw articulates via a hinge joint between the quadrate and articular. The jaws of tetrapods exhibit varying degrees of mobility between jaw bones. Some species have jaw bones completely fused, while others may have joints allowing for mobility of the dentary, quadrate, or maxilla. The snake skull shows the greatest degree of cranial kinesis, which allows the snake to swallow large prey items.

Mammals

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In mammals, the jaws are made up of the mandible (lower jaw) and the maxilla (upper jaw). In the ape, there is a reinforcement to the lower jaw bone called the simian shelf. In the evolution of the mammalian jaw, two of the bones of the jaw structure (the articular bone of the lower jaw, and quadrate) were reduced in size and incorporated into the ear, while many others have been fused together.[3] As a result, mammals show little or no cranial kinesis, and the mandible is attached to the temporal bone by the temporomandibular joints. Temporomandibular joint dysfunction is a common disorder of these joints, characterized by pain, clicking and limitation of mandibular movement.[4] Especially in the therian mammal, the premaxilla that constituted the anterior tip of the upper jaw in reptiles has reduced in size; and most of the mesenchyme at the ancestral upper jaw tip has become a protruded mammalian nose.[5]

Sea urchins

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Sea urchins possess unique jaws which display five-part symmetry, termed the Aristotle's lantern. Each unit of the jaw holds a single, perpetually growing tooth composed of crystalline calcium carbonate.

See also

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  • Muscles of mastication
  • Otofacial syndrome
  • Predentary
  • Prognathism
  • Rostral bone

References

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  1. ^ Smith, M.M.; Coates, M.I. (2000). "10. Evolutionary origins of teeth and jaws: developmental models and phylogenetic patterns". In Teaford, Mark F.; Smith, Moya Meredith; Ferguson, Mark W.J. (eds.). Development, function and evolution of teeth. Cambridge: Cambridge University Press. p. 145. ISBN 978-0-521-57011-4.
  2. ^ Anderson, Philip S.L; Westneat, Mark (28 November 2006). "Feeding mechanics and bite force modelling of the skull of Dunkleosteus terrelli, an ancient apex predator". Biology Letters. pp. 77–80. doi:10.1098/rsbl.2006.0569. PMC 2373817. PMID 17443970. cite web: Missing or empty |url= (help)
  3. ^ Allin EF (December 1975). "Evolution of the mammalian middle ear". J. Morphol. 147 (4): 403–37. doi:10.1002/jmor.1051470404. PMID 1202224. S2CID 25886311.
  4. ^ Wright, Edward F. (2010). Manual of temporomandibular disorders (2nd ed.). Ames, Iowa: Wiley-Blackwell. ISBN 978-0-8138-1324-0.
  5. ^ Higashiyama, Hiroki; Koyabu, Daisuke; Hirasawa, Tatsuya; Werneburg, Ingmar; Kuratani, Shigeru; Kurihara, Hiroki (November 2, 2021). "Mammalian face as an evolutionary novelty". PNAS. 118 (44): e2111876118. Bibcode:2021PNAS..11811876H. doi:10.1073/pnas.2111876118. PMC 8673075. PMID 34716275.
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  • Media related to Jaw bones at Wikimedia Commons
  • Jaw at the U.S. National Library of Medicine Medical Subject Headings (MeSH)

 

A health professional, healthcare professional, or healthcare worker (sometimes abbreviated HCW)[1] is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician (such as family physician, internist, obstetrician, psychiatrist, radiologist, surgeon etc.), physician assistant, registered dietitian, veterinarian, veterinary technician, optometrist, pharmacist, pharmacy technician, medical assistant, physical therapist, occupational therapist, dentist, midwife, psychologist, audiologist, or healthcare scientist, or who perform services in allied health professions. Experts in public health and community health are also health professionals.

Fields

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NY College of Health Professions massage therapy class
US Navy doctors deliver a healthy baby
70% of global health and social care workers are women, 30% of leaders in the global health sector are women

The healthcare workforce comprises a wide variety of professions and occupations who provide some type of healthcare service, including such direct care practitioners as physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, dentists, pharmacists, speech-language pathologist, physical therapists, occupational therapists, physical and behavior therapists, as well as allied health professionals such as phlebotomists, medical laboratory scientists, dieticians, and social workers. They often work in hospitals, healthcare centers and other service delivery points, but also in academic training, research, and administration. Some provide care and treatment services for patients in private homes. Many countries have a large number of community health workers who work outside formal healthcare institutions. Managers of healthcare services, health information technicians, and other assistive personnel and support workers are also considered a vital part of health care teams.[2]

Healthcare practitioners are commonly grouped into health professions. Within each field of expertise, practitioners are often classified according to skill level and skill specialization. "Health professionals" are highly skilled workers, in professions that usually require extensive knowledge including university-level study leading to the award of a first degree or higher qualification.[3] This category includes physicians, physician assistants, registered nurses, veterinarians, veterinary technicians, veterinary assistants, dentists, midwives, radiographers, pharmacists, physiotherapists, optometrists, operating department practitioners and others. Allied health professionals, also referred to as "health associate professionals" in the International Standard Classification of Occupations, support implementation of health care, treatment and referral plans usually established by medical, nursing, respiratory care, and other health professionals, and usually require formal qualifications to practice their profession. In addition, unlicensed assistive personnel assist with providing health care services as permitted.[citation needed]

Another way to categorize healthcare practitioners is according to the sub-field in which they practice, such as mental health care, pregnancy and childbirth care, surgical care, rehabilitation care, or public health.[citation needed]

Mental health

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A mental health professional is a health worker who offers services to improve the mental health of individuals or treat mental illness. These include psychiatrists, psychiatry physician assistants, clinical, counseling, and school psychologists, occupational therapists, clinical social workers, psychiatric-mental health nurse practitioners, marriage and family therapists, mental health counselors, as well as other health professionals and allied health professions. These health care providers often deal with the same illnesses, disorders, conditions, and issues; however, their scope of practice often differs. The most significant difference across categories of mental health practitioners is education and training.[4] There are many damaging effects to the health care workers. Many have had diverse negative psychological symptoms ranging from emotional trauma to very severe anxiety. Health care workers have not been treated right and because of that their mental, physical, and emotional health has been affected by it. The SAGE author's said that there were 94% of nurses that had experienced at least one PTSD after the traumatic experience. Others have experienced nightmares, flashbacks, and short and long term emotional reactions.[5] The abuse is causing detrimental effects on these health care workers. Violence is causing health care workers to have a negative attitude toward work tasks and patients, and because of that they are "feeling pressured to accept the order, dispense a product, or administer a medication".[6] Sometimes it can range from verbal to sexual to physical harassment, whether the abuser is a patient, patient's families, physician, supervisors, or nurses.[citation needed]

Obstetrics

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A maternal and newborn health practitioner is a health care expert who deals with the care of women and their children before, during and after pregnancy and childbirth. Such health practitioners include obstetricians, physician assistants, midwives, obstetrical nurses and many others. One of the main differences between these professions is in the training and authority to provide surgical services and other life-saving interventions.[7] In some developing countries, traditional birth attendants, or traditional midwives, are the primary source of pregnancy and childbirth care for many women and families, although they are not certified or licensed. According to research, rates for unhappiness among obstetrician-gynecologists (Ob-Gyns) range somewhere between 40 and 75 percent.[8]

Geriatrics

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A geriatric care practitioner plans and coordinates the care of the elderly and/or disabled to promote their health, improve their quality of life, and maintain their independence for as long as possible.[9] They include geriatricians, occupational therapists, physician assistants, adult-gerontology nurse practitioners, clinical nurse specialists, geriatric clinical pharmacists, geriatric nurses, geriatric care managers, geriatric aides, nursing aides, caregivers and others who focus on the health and psychological care needs of older adults.[citation needed]

Surgery

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A surgical practitioner is a healthcare professional and expert who specializes in the planning and delivery of a patient's perioperative care, including during the anaesthetic, surgical and recovery stages. They may include general and specialist surgeons, physician assistants, assistant surgeons, surgical assistants, veterinary surgeons, veterinary technicians. anesthesiologists, anesthesiologist assistants, nurse anesthetists, surgical nurses, clinical officers, operating department practitioners, anaesthetic technicians, perioperative nurses, surgical technologists, and others.[citation needed]

Rehabilitation

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A rehabilitation care practitioner is a health worker who provides care and treatment which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. These include physiatrists, physician assistants, rehabilitation nurses, clinical nurse specialists, nurse practitioners, physiotherapists, chiropractors, orthotists, prosthetists, occupational therapists, recreational therapists, audiologists, speech and language pathologists, respiratory therapists, rehabilitation counsellors, physical rehabilitation therapists, athletic trainers, physiotherapy technicians, orthotic technicians, prosthetic technicians, personal care assistants, and others.[10]

Optometry

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Optometry is a field traditionally associated with the correction of refractive errors using glasses or contact lenses, and treating eye diseases. Optometrists also provide general eye care, including screening exams for glaucoma and diabetic retinopathy and management of routine or eye conditions. Optometrists may also undergo further training in order to specialize in various fields, including glaucoma, medical retina, low vision, or paediatrics. In some countries, such as the United Kingdom, United States, and Canada, Optometrists may also undergo further training in order to be able to perform some surgical procedures.

Diagnostics

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Medical diagnosis providers are health workers responsible for the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit. This usually involves a team of healthcare providers in various diagnostic units. These include radiographers, radiologists, Sonographers, medical laboratory scientists, pathologists, and related professionals.[citation needed]

Dentistry

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Dental assistant on the right supporting a dental operator on the left, during a procedure.

A dental care practitioner is a health worker and expert who provides care and treatment to promote and restore oral health. These include dentists and dental surgeons, dental assistants, dental auxiliaries, dental hygienists, dental nurses, dental technicians, dental therapists or oral health therapists, and related professionals.

Podiatry

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Care and treatment for the foot, ankle, and lower leg may be delivered by podiatrists, chiropodists, pedorthists, foot health practitioners, podiatric medical assistants, podiatric nurse and others.

Public health

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A public health practitioner focuses on improving health among individuals, families and communities through the prevention and treatment of diseases and injuries, surveillance of cases, and promotion of healthy behaviors. This category includes community and preventive medicine specialists, physician assistants, public health nurses, pharmacist, clinical nurse specialists, dietitians, environmental health officers (public health inspectors), paramedics, epidemiologists, public health dentists, and others.[citation needed]

Alternative medicine

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In many societies, practitioners of alternative medicine have contact with a significant number of people, either as integrated within or remaining outside the formal health care system. These include practitioners in acupuncture, Ayurveda, herbalism, homeopathy, naturopathy, Reiki, Shamballa Reiki energy healing Archived 2021-01-25 at the Wayback Machine, Siddha medicine, traditional Chinese medicine, traditional Korean medicine, Unani, and Yoga. In some countries such as Canada, chiropractors and osteopaths (not to be confused with doctors of osteopathic medicine in the United States) are considered alternative medicine practitioners.

Occupational hazards

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A healthcare professional wears an air sampling device to investigate exposure to airborne influenza
A video describing the Occupational Health and Safety Network, a tool for monitoring occupational hazards to health care workers

The healthcare workforce faces unique health and safety challenges and is recognized by the National Institute for Occupational Safety and Health (NIOSH) as a priority industry sector in the National Occupational Research Agenda (NORA) to identify and provide intervention strategies regarding occupational health and safety issues.[11]

Biological hazards

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Exposure to respiratory infectious diseases like tuberculosis (caused by Mycobacterium tuberculosis) and influenza can be reduced with the use of respirators; this exposure is a significant occupational hazard for health care professionals.[12] Healthcare workers are also at risk for diseases that are contracted through extended contact with a patient, including scabies.[13] Health professionals are also at risk for contracting blood-borne diseases like hepatitis B, hepatitis C, and HIV/AIDS through needlestick injuries or contact with bodily fluids.[14][15] This risk can be mitigated with vaccination when there is a vaccine available, like with hepatitis B.[15] In epidemic situations, such as the 2014-2016 West African Ebola virus epidemic or the 2003 SARS outbreak, healthcare workers are at even greater risk, and were disproportionately affected in both the Ebola and SARS outbreaks.[16]

In general, appropriate personal protective equipment (PPE) is the first-line mode of protection for healthcare workers from infectious diseases. For it to be effective against highly contagious diseases, personal protective equipment must be watertight and prevent the skin and mucous membranes from contacting infectious material. Different levels of personal protective equipment created to unique standards are used in situations where the risk of infection is different. Practices such as triple gloving and multiple respirators do not provide a higher level of protection and present a burden to the worker, who is additionally at increased risk of exposure when removing the PPE. Compliance with appropriate personal protective equipment rules may be difficult in certain situations, such as tropical environments or low-resource settings. A 2020 Cochrane systematic review found low-quality evidence that using more breathable fabric in PPE, double gloving, and active training reduce the risk of contamination but that more randomized controlled trials are needed for how best to train healthcare workers in proper PPE use.[16]

Tuberculosis screening, testing, and education

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Based on recommendations from The United States Center for Disease Control and Prevention (CDC) for TB screening and testing the following best practices should be followed when hiring and employing Health Care Personnel.[17]

When hiring Health Care Personnel, the applicant should complete the following:[18] a TB risk assessment,[19] a TB symptom evaluation for at least those listed on the Signs & Symptoms page,[20] a TB test in accordance with the guidelines for Testing for TB Infection,[21] and additional evaluation for TB disease as needed (e.g. chest x-ray for HCP with a positive TB test)[18] The CDC recommends either a blood test, also known as an interferon-gamma release assay (IGRA), or a skin test, also known as a Mantoux tuberculin skin test (TST).[21] A TB blood test for baseline testing does not require two-step testing. If the skin test method is used to test HCP upon hire, then two-step testing should be used. A one-step test is not recommended.[18]

The CDC has outlined further specifics on recommended testing for several scenarios.[22] In summary:

  1. Previous documented positive skin test (TST) then a further TST is not recommended
  2. Previous documented negative TST within 12 months before employment OR at least two documented negative TSTs ever then a single TST is recommended
  3. All other scenarios, with the exception of programs using blood tests, the recommended testing is a two-step TST

According to these recommended testing guidelines any two negative TST results within 12 months of each other constitute a two-step TST.

For annual screening, testing, and education, the only recurring requirement for all HCP is to receive TB education annually.[18] While the CDC offers education materials, there is not a well defined requirement as to what constitutes a satisfactory annual education. Annual TB testing is no longer recommended unless there is a known exposure or ongoing transmission at a healthcare facility. Should an HCP be considered at increased occupational risk for TB annual screening may be considered. For HCP with a documented history of a positive TB test result do not need to be re-tested but should instead complete a TB symptom evaluation. It is assumed that any HCP who has undergone a chest x-ray test has had a previous positive test result. When considering mental health you may see your doctor to be evaluated at your digression. It is recommended to see someone at least once a year in order to make sure that there has not been any sudden changes.[23]

Psychosocial hazards

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Occupational stress and occupational burnout are highly prevalent among health professionals.[24] Some studies suggest that workplace stress is pervasive in the health care industry because of inadequate staffing levels, long work hours, exposure to infectious diseases and hazardous substances leading to illness or death, and in some countries threat of malpractice litigation. Other stressors include the emotional labor of caring for ill people and high patient loads. The consequences of this stress can include substance abuse, suicide, major depressive disorder, and anxiety, all of which occur at higher rates in health professionals than the general working population. Elevated levels of stress are also linked to high rates of burnout, absenteeism and diagnostic errors, and reduced rates of patient satisfaction.[25] In Canada, a national report (Canada's Health Care Providers) also indicated higher rates of absenteeism due to illness or disability among health care workers compared to the rest of the working population, although those working in health care reported similar levels of good health and fewer reports of being injured at work.[26]

There is some evidence that cognitive-behavioral therapy, relaxation training and therapy (including meditation and massage), and modifying schedules can reduce stress and burnout among multiple sectors of health care providers. Research is ongoing in this area, especially with regards to physicians, whose occupational stress and burnout is less researched compared to other health professions.[27]

Healthcare workers are at higher risk of on-the-job injury due to violence. Drunk, confused, and hostile patients and visitors are a continual threat to providers attempting to treat patients. Frequently, assault and violence in a healthcare setting goes unreported and is wrongly assumed to be part of the job.[28] Violent incidents typically occur during one-on-one care; being alone with patients increases healthcare workers' risk of assault.[29] In the United States, healthcare workers experience 23 of nonfatal workplace violence incidents.[28] Psychiatric units represent the highest proportion of violent incidents, at 40%; they are followed by geriatric units (20%) and the emergency department (10%). Workplace violence can also cause psychological trauma.[29]

Health care professionals are also likely to experience sleep deprivation due to their jobs. Many health care professionals are on a shift work schedule, and therefore experience misalignment of their work schedule and their circadian rhythm. In 2007, 32% of healthcare workers were found to get fewer than 6 hours of sleep a night. Sleep deprivation also predisposes healthcare professionals to make mistakes that may potentially endanger a patient.[30]

COVID pandemic

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Especially in times like the present (2020), the hazards of health professional stem into the mental health. Research from the last few months highlights that COVID-19 has contributed greatly  to the degradation of mental health in healthcare providers. This includes, but is not limited to, anxiety, depression/burnout, and insomnia.[citation needed]

A study done by Di Mattei et al. (2020) revealed that 12.63% of COVID nurses and 16.28% of other COVID healthcare workers reported extremely severe anxiety symptoms at the peak of the pandemic.[31] In addition, another study was conducted on 1,448 full time employees in Japan. The participants were surveyed at baseline in March 2020 and then again in May 2020. The result of the study showed that psychological distress and anxiety had increased more among healthcare workers during the COVID-19 outbreak.[32]

Similarly, studies have also shown that following the pandemic, at least one in five healthcare professionals report symptoms of anxiety.[33] Specifically, the aspect of "anxiety was assessed in 12 studies, with a pooled prevalence of 23.2%" following COVID.[33] When considering all 1,448 participants that percentage makes up about 335 people.

Abuse by patients

[edit]
  • The patients are selecting victims who are more vulnerable. For example, Cho said that these would be the nurses that are lacking experience or trying to get used to their new roles at work.[34]
  • Others authors that agree with this are Vento, Cainelli, & Vallone and they said that, the reason patients have caused danger to health care workers is because of insufficient communication between them, long waiting lines, and overcrowding in waiting areas.[35] When patients are intrusive and/or violent toward the faculty, this makes the staff question what they should do about taking care of a patient.
  • There have been many incidents from patients that have really caused some health care workers to be traumatized and have so much self doubt. Goldblatt and other authors  said that there was a lady who was giving birth, her husband said, "Who is in charge around here"? "Who are these sluts you employ here".[5]  This was very avoidable to have been said to the people who are taking care of your wife and child.

Physical and chemical hazards

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Slips, trips, and falls are the second-most common cause of worker's compensation claims in the US and cause 21% of work absences due to injury. These injuries most commonly result in strains and sprains; women, those older than 45, and those who have been working less than a year in a healthcare setting are at the highest risk.[36]

An epidemiological study published in 2018 examined the hearing status of noise-exposed health care and social assistance (HSA) workers sector to estimate and compare the prevalence of hearing loss by subsector within the sector. Most of the HSA subsector prevalence estimates ranged from 14% to 18%, but the Medical and Diagnostic Laboratories subsector had 31% prevalence and the Offices of All Other Miscellaneous Health Practitioners had a 24% prevalence. The Child Day Care Services subsector also had a 52% higher risk than the reference industry.[37]

Exposure to hazardous drugs, including those for chemotherapy, is another potential occupational risk. These drugs can cause cancer and other health conditions.[38]

Gender factors

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Female health care workers may face specific types of workplace-related health conditions and stress. According to the World Health Organization, women predominate in the formal health workforce in many countries and are prone to musculoskeletal injury (caused by physically demanding job tasks such as lifting and moving patients) and burnout. Female health workers are exposed to hazardous drugs and chemicals in the workplace which may cause adverse reproductive outcomes such as spontaneous abortion and congenital malformations. In some contexts, female health workers are also subject to gender-based violence from coworkers and patients.[39][40]

 

Workforce shortages

[edit]

Many jurisdictions report shortfalls in the number of trained health human resources to meet population health needs and/or service delivery targets, especially in medically underserved areas. For example, in the United States, the 2010 federal budget invested $330 million to increase the number of physicians, physician assistants, nurse practitioners, nurses, and dentists practicing in areas of the country experiencing shortages of trained health professionals. The Budget expands loan repayment programs for physicians, nurses, and dentists who agree to practice in medically underserved areas. This funding will enhance the capacity of nursing schools to increase the number of nurses. It will also allow states to increase access to oral health care through dental workforce development grants. The Budget's new resources will sustain the expansion of the health care workforce funded in the Recovery Act.[41] There were 15.7 million health care professionals in the US as of 2011.[36]

In Canada, the 2011 federal budget announced a Canada Student Loan forgiveness program to encourage and support new family physicians, physician assistants, nurse practitioners and nurses to practice in underserved rural or remote communities of the country, including communities that provide health services to First Nations and Inuit populations.[42]

In Uganda, the Ministry of Health reports that as many as 50% of staffing positions for health workers in rural and underserved areas remain vacant. As of early 2011, the Ministry was conducting research and costing analyses to determine the most appropriate attraction and retention packages for medical officers, nursing officers, pharmacists, and laboratory technicians in the country's rural areas.[43]

At the international level, the World Health Organization estimates a shortage of almost 4.3 million doctors, midwives, nurses, and support workers worldwide to meet target coverage levels of essential primary health care interventions.[44] The shortage is reported most severe in 57 of the poorest countries, especially in sub-Saharan Africa.

Nurses are the most common type of medical field worker to face shortages around the world. There are numerous reasons that the nursing shortage occurs globally. Some include: inadequate pay, a large percentage of working nurses are over the age of 45 and are nearing retirement age, burnout, and lack of recognition.[45]

Incentive programs have been put in place to aid in the deficit of pharmacists and pharmacy students. The reason for the shortage of pharmacy students is unknown but one can infer that it is due to the level of difficulty in the program.[46]

Results of nursing staff shortages can cause unsafe staffing levels that lead to poor patient care. Five or more incidents that occur per day in a hospital setting as a result of nurses who do not receive adequate rest or meal breaks is a common issue.[47]

Regulation and registration

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Practicing without a license that is valid and current is typically illegal. In most jurisdictions, the provision of health care services is regulated by the government. Individuals found to be providing medical, nursing or other professional services without the appropriate certification or license may face sanctions and criminal charges leading to a prison term. The number of professions subject to regulation, requisites for individuals to receive professional licensure, and nature of sanctions that can be imposed for failure to comply vary across jurisdictions.

In the United States, under Michigan state laws, an individual is guilty of a felony if identified as practicing in the health profession without a valid personal license or registration. Health professionals can also be imprisoned if found guilty of practicing beyond the limits allowed by their licenses and registration. The state laws define the scope of practice for medicine, nursing, and a number of allied health professions.[48][unreliable source?] In Florida, practicing medicine without the appropriate license is a crime classified as a third degree felony,[49] which may give imprisonment up to five years. Practicing a health care profession without a license which results in serious bodily injury classifies as a second degree felony,[49] providing up to 15 years' imprisonment.

In the United Kingdom, healthcare professionals are regulated by the state; the UK Health and Care Professions Council (HCPC) protects the 'title' of each profession it regulates. For example, it is illegal for someone to call himself an Occupational Therapist or Radiographer if they are not on the register held by the HCPC.

See also

[edit]
  • List of healthcare occupations
  • Community health center
  • Chronic care management
  • Electronic superbill
  • Geriatric care management
  • Health human resources
  • Uniform Emergency Volunteer Health Practitioners Act

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[edit]
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[edit]
  • World Health Organization: Health workers