An Interdisciplinary Approach To The Health Care Team

Updated August 19, 2021. The article was updated to correct minor grammatical errors and to update technical details.

Health care is an increasingly diverse field where many specialties interact to provide patient care, and the team approach to caring for patients includes many professionals performing a variety of specialized functions designed to meet the physical, emotional, and psychological needs of the patient. In the course of just one stay, a hospitalized patient may be cared for by an array of non-physician providers. For this collaborative approach to work, it is imperative that all health care professionals understand and respect the credentials, scope of practice, and function of each member of the health care team.

So who are these providers? This article will provide a brief introduction to the educational background and role of the different professionals a patient might typically encounter in a hospital. This list is by no means inclusive but is meant to be an overview of the major groups of professional practitioners currently found in large, comprehensive hospitals.

The Nurse Practitioner

Nurse practitioners (NP) are licensed registered nurses who have completed advanced academic and supervised clinical training beyond their registered nurse certification. Most have master’s degrees and many have doctoral degrees. Nurse practitioners provide a number of different health care services. They are trained to diagnose and treat a variety of conditions and can order and interpret diagnostic tests and procedures, perform health screenings, give immunizations, and may prescribe most medications. Nurse practitioners often focus on health promotion, disease prevention, and helping patients make healthy lifestyle choices. They treat patients in outpatient settings and in the hospital. Although most nurse practitioners focus on primary care, many train and practice in fields as diverse as OB/GYN, pediatrics, oncology, and dermatology. An NP-C is a nurse practitioner who has successfully completed a national certification exam for adult and family nurse practitioners. Scope of practice and autonomy for nurse practitioners varies state by state with most states requiring nurse practitioners to complete a collaborative care agreement with a physician who provides a specified level of supervision and oversight.

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The Doctor of Podiatric Medicine

Doctors of Podiatric Medicine (DPM’s) earn a bachelor’s degree and complete four years of podiatric medical school followed by a hospital-based residency. Podiatrists are represented in private practice, on hospital medical staffs, in health care administration, on medical school faculties, and in the armed forces. Doctors of Podiatric Medicine are experts at preventing, diagnosing, and treating diseases and disorders of the foot, ankle, and related structures. DPM scope of practice varies by state but is generally restricted to the foot, ankle, or sometimes other lower extremity structures. They provide medical, surgical, and pharmacological treatments for a variety of foot conditions including diabetic foot care, sports injuries, wound care, and congenital abnormalities. Most states allow DPMs to prescribe a full complement of medications used to treat conditions related to the foot and ankle.

The Clinical Nurse Specialist

Clinical nurse specialists are licensed registered nurses who have additional training in nursing at the masters or doctoral level. Clinical nurse specialists are experts in specialized areas of nursing practice such as geriatrics, wound care, or psychiatric care. Many also work as administrators, educators, consultants, or case managers. In addition to providing direct patient care, clinical nurse specialists may work to improve patient outcomes through research, training, and bringing about improvements in health care delivery.

The Certified Registered Nurse Anesthetist

Certified Registered Nurse Anesthetists (CRNAs) are registered nurses who have masters and advanced training in anesthesia. Their clinical and classroom training lasts for 24-36 months and all graduates must pass a national certification examination. CRNAs provide anesthetics to patients in every type of practice setting and are the main anesthesia providers in two-thirds of all rural hospitals. They provide anesthesia in collaboration with other health care professionals such as surgeons, dentists, podiatrists, and anesthesiologists. They utilize a variety of anesthesia techniques and procedures for all types of surgery and obstetrics. As with other nurse practitioners, requirements for physician supervision of CRNAs vary by state.

The Certified Nurse-Midwife

Certified nurse-midwives (CNMs) are registered nurses who have been trained in midwifery. All have at least a bachelor’s degree and over 70% hold a master’s degree or higher. They must pass a national certification exam in order to be licensed to practice. Certified nurse-midwives provide health care for women including prenatal care, labor and delivery, post-partum care, routine gynecological services, family planning, menopausal care, health promotion, and disease prevention. Most certified nurse-midwives work in group practices with physicians and deliver babies in birthing centers or hospitals. CNMs can order and interpret laboratory tests and are able to prescribe most medications.

The Registered Dietitian

Registered dietitians have earned a bachelor’s degree in dietetics or nutrition with coursework that meets the requirements set forth by the American Dietetic Association. Dietitians complete an approved practical education program and must pass a national examination. The dietitian is the food and nutrition expert on the health care team. Dietitians help design food plans and educate and counsel patients to help them manage disease states such as obesity, high cholesterol, or heart disease. Many dietitians specialize in areas such as pediatrics, geriatrics, renal disease, or diabetes education. Dietitians are also involved in hospital food service management and clinical research.

The Recreation Therapist

Recreation Therapists have at least a bachelor’s degree with coursework in the sciences and in recreation theory, have completed a formal internship, and must pass a national certification examination. Recreation Therapists provide a wide range of interventions and therapy designed to improve patients’ functioning and keep them as healthy, active, and independent as possible. Recreation therapists incorporate patients’ specific interests into therapeutic activities to help the patient develop and maintain skills for daily living and promote physical, emotional, and social well-being. Recreation therapists work with clients of all ages and disease states.

The Audiologist

Audiologists hold a master’s or doctoral degree from an accredited university-based graduate program. They can be found working in medical centers, hospitals, private practice, in schools, and in government health facilities. Audiologists are primary care providers for hearing health. They evaluate hearing and balance problems using a variety of specialized auditory and vestibular assessments. Based upon the diagnosis, the audiologist can offer a patient a variety of treatment options including hearing aids. Audiologists are trained to manage hearing health for newborns through elderly patients. When a patient’s hearing or balance problems require medical or surgical evaluation or treatment, audiologists are trained to make referrals to physicians for intervention.

The Physician Assistant

Physician Assistants (or simply “PAs”) are licensed health care providers who typically possess a bachelor’s degree and have completed a 24-26 month PA training program. They work alongside physicians to perform physical examinations, diagnose and treat illnesses, order and interpret diagnostic tests, prescribe medication, and assist in surgery. PAs are found in virtually all medical specialties, ranging from Family Medicine to each of the surgical sub-specialties.

The Pharmacist

Pharmacists earn the Doctor of Pharmacy (PharmD) degree after completing at least two years of undergraduate study and four years of pharmacy school. Pharmacists are medication experts, working with physicians (or PAs) to ensure new prescriptions do not interact with a patient’s current medications, that the right dosage for a particular medication has been prescribed, and to answer any questions patients may have. Pharmacists employed within the Department of Veterans Affairs (VA) have the authority to prescribe and change medications under collaborative care agreements with patients’ physicians. Pharmacist prescriptive authority is becoming more widespread as the benefits of having pharmacists involved in disease state management become more apparent. Additionally, pharmacists can complete postgraduate residency training to become Critical Care Pharmacists working in the ICU, Emergency Pharmacists in the Emergency Department, or a number of other possible specialties.

The Clinical Psychologist

Psychologists study the inner workings of the mind. A clinical psychologist’s aim is to reduce psychological and emotional distress and to promote emotional well-being. They often work in hospitals, clinics, or private practice settings. They work with individuals suffering from mental health problems, including anxiety, depression, adjustment to physical illness, neurological disorders, addictions, or behavioral disorders. Clinical psychologists complete four to five years of doctoral-level training and must complete a clinical internship prior to licensure.

The Speech and Language Pathologist

Speech and Language Pathologists evaluate, diagnose, and treat language, speech, or swallowing difficulties in patients in various settings. Education and licensure requirements vary by state, but virtually all Speech and Language Pathologists have completed a graduate degree and a clinical fellowship. They can be found in an array of settings, working with individuals suffering from mental impairments, recovering from strokes, or requiring rehabilitation therapy.

The Occupational Therapist

Occupational Therapists (OTs) work with individuals of all demographics to regain, master, or develop the everyday skills that enable them to lead fulfilling and independent lives. OTs possess a graduate-level degree in occupational therapy. They develop activities of daily living for individuals with mental or physical disabilities that inhibit their capacity to function independently. With time, routines may be developed which help equip these patients to pursue education and employment. OTs are most frequently found in the hospital or outpatient rehabilitation setting.

The Physical Therapist

Similar to OTs, a Physical Therapist (PT) works to treat individuals whose medical problems or other health-related conditions that impair their ability to move and perform activities of daily living. Treatment plans focus on preventing further disability, alleviating pain, and restoring function. Educational programs for PTs exist at both the masters and doctoral levels.

The Respiratory Therapist

Respiratory Therapists (RT) help evaluate and treat individuals suffering from respiratory ailments, injuries that involve the respiratory tract, need pulmonary rehabilitation, or require augmented or mechanical ventilation. They are all graduates of an approved college program in Respiratory Therapy, have completed their licensure requirements, and passed a nationally administered advanced practice examination. RT’s practice primarily in the hospital and long-term care settings, where they are an integral member of the patient care team.

The future of health care lies in successful collaboration among all of these disciplines. It is essential for medical and other health professional students to learn how to work with other clinicians in hospitals and other practice sites. Each of these professionals brings a unique skill set and viewpoint to the management of patient care. An environment of mutual respect and trust among health care providers will promote excellent care and improve patient outcomes.

28 thoughts on “An Interdisciplinary Approach To The Health Care Team”

  1. I just wanted to let you know that you left out an important and diverse field of medicine, dentistry.
    Any chance we could add a paragraph for the DMD and DDS of us out there?

  2. armorshell – absolutely. Let us do a little research and get back to you. Thanks for the suggestion.

  3. Hi Natty – the point of the article was to explain the role of the NON MD/DO providers. Clearly, MD/DOs are vital members of the team. Thanks for reading.

  4. Interesting that Optometry was also left out. Hopefully not because of medical politics. There are more and more ODs working in hospital settings due to their ability to handle most all non surgical medical eye care.
    4 years of undergrad plus 4 years of Optmetry school. Many like myself have a 5th year of specialization.

  5. Clearly, they are vital members of the team, but you wouldn’t believe how many times others on the team ask about our training (student vs resident vs fellow vs attending). It’d be nice to see a little blurb about that, but I guess that’s another article-understandable.

  6. indianaOD – I have nothing but respect for the training and qualifications of optometrists. The professions featured in this article were intended to cover the spectrum of care providers patients could expect to encounter during a hospital stay. I can’t find much information about optometrists practicing in hospitals (other than in hospital affiliated outpatient clinics) – can you point me in the direction of some information?

  7. NattyGann – I agree that might make a good article. I could see how an article explaining the role that a person in each level of MD/DO training (med student – intern – resident – fellow – attending) plays in the health care team would be helpful. SDN accepts article submissions from members if you are interested.

  8. Sure, Richard Hom is a common poster on the optometry forums. He works in a hospital setting. I rotated through a VA hospital during my externships.
    Clearly not as prevalent in a hospital as a NP or PA, but I think there is even more confusion about what an optometrist is than almost anything.

  9. Indiana – when I searched the internet for info about optometrists in hospitals, all I could find was links to stuff from the United Kingdom. Maybe I’m not looking in the right place? If you’d like to do a short write-up for me (include info about training and what ODs do in hospitals) I’ll be happy to insert it into the article and credit you. Be sure to cite your source. 🙂 I think it would make a great addition to the article.

  10. While it is nice to see what the non-MD/DO’s do not all MD’s and DO’s do the same thing for each patient. There are so many specialties that just syaing that a patient will encounter a physician is not enough. For example – the orthopaedic patient may have an orthopaedic surgeon, a hospitalist, a vascular surgeon, an interventional radiologist, a cardiologist, and more visit them if their complications dictate. I agree that more detail should be added to this list.
    And as a side note – DPM’s perform surgery to the foot and ankle for some aspects of treatment.
    Thanks for a good overview.

  11. What about medical technologists/clinical laboratory scientists? They may have limited direct contact with patients but they are very vital to the healthcare team–they perform virtually all of the diagnostic laboratory tests in a hospital and do assist in some patient-related procedures.

  12. “What about medical technologists/clinical laboratory scientists? They may have limited direct contact with patients but they are very vital to the healthcare team–they perform virtually all of the diagnostic laboratory tests in a hospital and do assist in some patient-related procedures.”
    For more info:

  13. anonymous – Some optometrists work for Walmart, some work in private practice, others work in different settings. Very much the same as pharmacists, who can also be found in different work places.
    I hope to have some new information about optometrists in the hospital setting to post soon.

  14. This article was poorly written. There are way too many variables missing. This article would be better written if you showed what allied health care workers a patent would MOST likely encounter depending on the reason for their stay.
    There are many fields missing in this article. It might be that the author feels these other fields don’t have as much respect or need, but I sure don’t like personal selection of choices for the allied health care workers selected in this article and the importance of all the other health care workers.
    Remember, those closent to the bottom are the ones that make the health care system function from day to day.

  15. Collegefootball,
    Believe it or not, the list actually had to be pared down a bit from its original form. This was not out of disrespect, but length constraints. The article was written to give a very brief overview of the educational backgrounds and general functions of non-physician health professionals. Much to our chagrin, we simply could not write an all-encompassing tome.
    If you’d like to see a more exhaustive article written, we do take suggestions in the Articles forum. Additionally, we’re always looking for writers!
    Thank you for your feedback!

  16. The doctor is not just a “valued member of the team”, but its natural leader, who ties together the strings and evaluates the evaluations. Or is that considered a politically incorrect statement these days?

  17. Actually I believe the majority of physician assistant programs today grant Master’s Degrees, not Bachelor’s Degrees, although some do exist (Certificates too).

  18. How about the hospital chaplain? Where I come from the employed staff hospital chaplain is part of the health care team. S/he plays an important role and is professionally trained to attend to the psycho-spiritual needs that either the patient or family may be experiencing. As well, the staff chaplain provides care and support for the staff as well.

  19. Also, like when in high school, The ACT, the only section, you had to know to do good was the math part. The other sections you couldn’t really study a lot for.
    same way, what courses should i put a lot of emphasis in so that i can do excellent on the MCAT?
    what courses do i have to have before taking it? hope someone can help.

  20. I think you two did a great job. I would actually slim down this list. There are a couple of professions that don’t need to be listed. Overall great synopsis.

  21. You did include the varied advance practice nurses (although PS, they all hold at least a Masters degree, and also coordinate with pharmacists) but I do find it funny that the registered nurse is not listed. The RN is the one who spends the most time with the hospitalized patient.
    I do think that it is excellent the student docs are addressing the concept of interprofessional collaboration!

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