Thanks to all of you who sent in your words of support (and your recipes) after the last issue of The Flame in which I shared my gluten-free solution to my cough.  I can't tell you how nice it is to be cough-free.   

In the last few weeks, we've had two cases of 'mistaken identity' where patients with whom we were working reported to us that their "doctor" had ordered something for them, a drug, a test, etc.  As we delved deeper into one case, the doctor was not a doctor, but a physician's assistant.  As a Seinfeld episode once joked, "Not that there's anything wrong with that," but in that one case, the physician's assistant's suggested treatment plan was surgery. The patient knew enough to want a second opinion and we got one--from a gynecologist.  As the case evolved, it turned out the patient didn't need surgery. 

As we head into the new school year, I thought it might be educational to share some simple ABCs about Who's Who on your clinical team.

Hope You Had a GREAT Summer!

Sharpen Your Pencils!

OK, Class, this  month's lesson will review some of the 'who's who' on the healthcare team so that you can become more familiar with whom you are interacting and who's taking care of you.  Don't worry, there will not be a pop quiz!

While alot of service industries often have multiple members of the service team (think hotels and restaurants), the healthcare industry is no different.  Depending on the setting (in-patient vs. out-patient, for instance), the clinical team can be comprised of multiple, diverse resources. Some of your interactions may be brief, some not so.  Regardless, you should know who's who. 

• Medical Doctor (MD): often, the top of the food chain. These doctors are often called "Attendings" in a hospital and are ultimately in charge of a patient's treatment. In hospitals that train Residents and Interns, Attendings make 'rounds' with the team, reviewing and adjusting each patient's care and treatment.   
• Doctor of Osteopathy (DO): a doctor who has trained at an osteopathic medical school.  Same amount of training and same route to Attending.   
• Fellow (MD or DO): a Fellow is not an English gentleman in this scenario.  Fellows are physicians who have completed their residency training but have decided to pursue additional training in a specific area.  Following the fellowship, they go on to work as an Attending. 
• Resident:  a graduate of medical school who is now putting all that education to use in a clinical setting.  Residents typically work in hospitals that are affiliated with training doctors. In hospitals that are not affiliated, your care is overseen by an attending doctor.  The term 'resident' came about because in the 'early days,' they lived at the hospital. 
• Intern: the low guy/gal on the doctor totem pole. This is a first year resident who often is going most of the interviews, assessments, and 'leg work' in an in-patient setting.  The Intern is overseen by the Resident, the Resident is overseen by the Attending.
• Medical Student: after two years of classroom education, med students do clinical rotations in their 3rd and 4th year. They are typically only observers in a clinical setting. 
• Nurse Practitioner (CRNP):  a nurse who has received additional training to function independently treating patients under the supervision of a physician. Nurse Practitioners practice in all healthcare settings, but often support primary care practices and urgent care clinics.   
• Registered Nurse (RN): OK, I admit, I'm biased, but the nurse is simply the backbone of the healthcare system.  Nurses function as bedside nurses on all units, as case managers, in the OR, in the cath lab, in physician's offices, in insurance companies, you name it...and there's likely to be a nurse!
• Social Worker (MSW, LCSW): depending on the venue, social workers will be your case manager, an insurance liaison, a mental health therapist or a discharge planner.   
• Licensed Practical Nurse (LPN): you may not meet an LPN in an acute-care setting as most hospitals have eliminated the LPN but you will meet them in a long-term care setting, aka, a nursing home.
• Physician's Assistant (PA): a relatively new position which grew out of the role of medics in the armed forces. PAs go to special schooling for their certification and pass a licensure exam. They typically work in physician or surgical practices and are supervised by those physicians and surgeons. 
• Nurse Anesthetist (CRNA): typically you'll only meet a Nurse Anesthetist if you're having a procedure that requires sedation or if you're heading to the OR for surgery. If they're doing their job right, you likely won't remember them!  CRNA's work with anesthesiologists (physicians) to deliver sedation and anesthesia.    
• Nurses' Aide (CNA): an Aide functions in a supportive role to the nursing team and provides much of the daily care for hospitalized or nursing home patients. 
• Medical Technologist (MT):  possibly seen more in an out-patient setting in a primary care physician's office, these might be the folks who get you settled in the room, take your blood pressure and give you a gown.