Decades ago, doctors and nurses were the people who first came to mind when thinking of health care providers. Over time, health care became fragmented among countless specialties, and who was responsible for what health care issue became more complex and confusing. With each emerging class of medical professionals specific licensing requirements had to be established, and the appropriate treatment limits had to be defined. Furthermore, levels of responsibility had to be defined for the practitioner and supervisory and oversight management had to be put in place. And, along with the responsibility of a new practice comes the risk of negligence.

Health care is now more technical, specific, complex, and sophisticated than ever before. There are two types of medical doctors licensed in the U.S.:

• allopathic doctors who obtain the degree of Medical Doctor (MD) and;
• osteopathic physicians who obtain the degree of Doctor of Osteopathy (DO).

These physicians can obtain specialty certification in 24 fields at the present time, and that number is expected to grow as more subspecialties are defined. Other doctorate level health care degrees include: Doctor of Dental Science (DDS), Doctor of Medical Dentistry (DMD), Doctor of Podiatric Medicine (DPM), Doctor of Pharmacy (Pharm.D), Doctor of Optometry (OD), and Doctor of Chiropractic (DC). Physician Assistants (PA) are not doctors, but they often operate in a semi-autonomous fashion (in clinics and sometimes in hospitals) however, they are directly supervised by a medical doctor.

Nurses can now obtain licenses as Licensed Practical Nurses (LPN), Registered Nurses (RN), and Advanced Practical Nurses (APN). Registered Nurses can obtain certification (RN-C) in emergency medicine, pediatric medicine, critical care, flight emergency nursing, and neonatal nursing (and that list is not exhaustive). Advanced Practical Nursing encompasses multiple subspecialties, including Certified Registered Nurse Anesthetist (CRNA), Certified Nurse Midwives (CNM), Certified Nurse Practitioners (CNP) and nearly countless Clinical Nurse Specialists (CNS) including, perfusionists, oncology nurses, geriatric nurses, psychiatry nurses, and women’s health nurses (to name a few).

And last but not least, there are all the therapists, technicians, technologists, aides, and assistants (too numerous to mention) who provide health care in our country. The age of the orderly is forever gone.

If this is confusing to you, you are not alone. The overlapping territories and responsibilities of these specialties can be difficult for the average patient to discern. A critical piece of information, however, is that nearly everyone who provides for your care should be licensed by the state in which they practice, and if they are not doctorate level providers, they should be supervised by a physician. That means they carry insurance to cover negligence and malpractice, whether it is provided by a physician in charge, a clinic, a hospital, a nursing home, a rehabilitation facility, a pharmacy, a surgical center, a university, or individually. With privilege comes responsibility and accountability.

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