Allied health personnel

Allied health professions are clinical health care professions distinct from medicine, dentistry, and nursing. One estimate reported allied health professionals make up 60 percent of the total health workforce. They work in health care teams to make the health care system function by providing a range of diagnostic, technical, therapeutic and direct patient care and support services that are critical to the other health professionals they work with and the patients they serve.

Professions
Definitions of allied health professions vary across countries and contexts, but generally indicate that they are health professions distinct from medicine, dentistry, and nursing. Some definitions only include health care providers that require registration by law to practice, but usually all allied health professions that require a post-secondary degree or higher qualification are included.

Depending on the country and local health care system, a limited subset of the following professions (professional areas) may be represented, and may be regulated:


 * Anesthesia technician
 * Athletic Trainer
 * Audiologist
 * Bioengineer
 * Biomedical scientist
 * Cardiographic technician
 * Environmental health officer
 * Cardiovascular technologist
 * Clinical laboratory scientist
 * Clinical officer
 * Clinical psychologist
 * Dental hygienist
 * Diagnostic medical sonographist
 * Dietitian / Nutritionist
 * Electrocardiogram technician
 * Epidemiologist/Biostatistician
 * Exercise physiologist
 * Health care administrator


 * Health coach
 * Health information technician
 * Health inspector
 * Kinesiotherapist
 * Licensed Practical Nurse
 * Massage therapist
 * Medical assistant
 * Medical coder
 * Neurophysiologist/END Technologist
 * Medical dosimetrist
 * Medical physicist
 * Medical laboratory technician
 * Medical radiation scientist
 * Music therapist
 * Nuclear medicine technologist
 * Occupational therapist
 * Optometrist
 * Orthotist / Prosthetist
 * Orthoptist


 * Paramedic
 * Pedorthist
 * Perfusionist
 * Personal trainer
 * Pharmacist
 * Pharmacy technician
 * Phlebotomist
 * Physiotherapy
 * Radiation therapist
 * Radiologic Technologist
 * Rehabilitation counsellor
 * Respiratory therapist
 * Speech and language pathologist
 * Surgical technologist
 * Recreational therapist
 * Ultrasound technologist

All professional areas ascribed before belong to the ever-growing group of allied health professionals and their subspecialties. The precise titles, roles, and requisites of the allied health professions may vary considerably from country to country. For example, the National Council for Homeopathy of Pakistan and the Central Council of Homeopathy of India recognize as allied health professionals those who qualify with a four-year university degree in the discipline, whereas in other countries the practice of homeopathy is not subject to professional regulation.

Allied health professions in Australia
In Australia, Allied Health typically includes all health professions other than medicine, dentistry and nursing that require a tertiary degree to practice, and who form part of the public health system. The proviso of forming part of the public health service excludes some registered professions, such as chiropractors in regions where they are not employed in government health facilities. Queensland Health employs more than 5000 allied health professionals across the following disciplines:


 * Audiology
 * Behavioral health (counseling, marriage and family therapy)
 * Clinical measurement science
 * Exercise physiology
 * Nuclear medicine technology
 * Dietetics
 * Music therapy
 * Occupational therapy
 * Optometry
 * Orthotics and prosthetics


 * Pharmacy
 * Podiatry
 * Psychology
 * Physiotherapy
 * Radiation therapy
 * Radiography / Medical imaging
 * Sonography
 * Social work
 * Speech pathology

Allied health professions in the UK
In the United Kingdom, allied health professions recognized by the National Health Service include:


 * Chiropody/Podiatry
 * Diagnostic radiography
 * Dietetics
 * Drama therapy
 * Music therapy
 * Orthoptics
 * Orthotics


 * Occupational therapy
 * Physiotheraphy
 * Paramedics
 * Prosthetics
 * Speech and language therapy
 * Therapeutic radiography

Allied health professions in South Africa
In South Africa, different professions are regulated by different boards. The Health Professions Council of South Africa regulates 26 different professional titles in medicine and dentistry plus the following areas:


 * Dental therapy & oral hygiene
 * Dietetics
 * Emergency care
 * Environmental health
 * Medical technology
 * Occupational therapy, medical orthotics / prosthetics & creative arts therapy


 * Optometry & dispensing opticians
 * Physiotherapy, podiatry & biokinetics
 * Psychology
 * Radiography & clinical technology
 * Speech, language & hearing professions

The Allied Health Professions Council of South Africa recognizes and regulates practitioners in the following professional areas:


 * Acupuncture
 * Ayurveda
 * Chinese Medicine
 * Chiropractic
 * Homeopathy
 * Naturopathy


 * Osteopathy
 * Phytotherapy
 * Therapeutic aromatherapy
 * Therapeutic massage therapy
 * Therapeutic reflexology
 * Unani-Tibb

Training and education
Some allied health professions are more specialized, and so must adhere to national training and education standards and their professional scope of practice. Often they must prove their skills through degrees, diplomas, certified credentials, and continuing education. Other allied health professions require no special training or credentials and are trained for their work by their employer through on-the-job training (which would then exclude them from consideration as an Allied Health Profession in a country like Australia). Many allied health jobs are considered career ladder jobs because of the opportunities for advancement within specific fields.

Allied health professions can include the use of many skills. Depending on the profession, these may include basic life support; medical terminology, acronyms and spelling; basics of medical law and ethics; understanding of human relations; interpersonal communication skills; counseling skills; computer literacy; ability to document healthcare information; interviewing skills; and proficiency in word processing; database management and electronic dictation.

History
The explosion of scientific knowledge that followed World War II brought increasingly sophisticated and complex medical diagnostic and treatment procedures. Increasing public demand for medical services combined with higher health care costs provoked a trend toward expansion of service delivery from treating patients in hospitals to widespread provision of care in physician's private and group practices, ambulatory medical and emergency clinics, and mobile clinics and community-based care. In the developing world, international development assistance led to numerous initiatives for strengthening health workforce capacity to deliver essential health care services. What followed has been an increase in the need for skilled health care delivery personnel worldwide.

Changes in the health industry and emphasis on cost-efficient solutions to health care delivery will continue to encourage expansion of the allied health workforce. The World Health Organization estimates there is currently a worldwide shortage of about 2 million allied health professionals (considering all health workers aside from medical and nursing personnel) needed in order to meet global health goals.

In recognition of the growth of the number and diversity of allied health professionals in recent years, the newly adopted 2008 version of the International Standard Classification of Occupations has increased the number of groups dedicated to allied health professions. Depending on the presumed skill level, they may either be identifed as “health professionals” or “health associate professionals”. For example, new categories have been created for delineating “paramedical practitioners” — grouping professions such as clinical officers, clinical associates, physician assistants, Feldshers, and assistant medical officers — as well as for community health workers; dietitians and nutritionists; audiologists and speech therapists; and others.

Allied health employment projections
Projections in the United States and many other countries have shown an expected long-term shortage of qualified workers to fill many allied health positions. This is primarily due to expansion of the health industry due to demographic changes (a growing and aging population), large numbers of health workers nearing retirement, the industry’s need to be cost efficient, and a lack of sufficient investment in training programs to keep pace with these trends.

Studies have also pointed to the need for increased diversity in the allied health workforce to realize a culturally competent health system in the United States and elsewhere.

Workforce and health care experts anticipate that health services will increasingly be delivered via ambulatory and nursing care settings rather than in hospitals. According to the North American Industry Classification System (NAICS), the health care industry consists of three main sub-sectors, divided by the types of services provided at each facility:
 * Hospitals: Primarily provides in-patient health services and may provide some out-patient services as a secondary activity.
 * Ambulatory health care settings (ambulatory): Primarily provides out-patient services at facilities such as doctors’ offices, out-patient clinics and clinical laboratories.
 * Nursing and residential care facilities (nursing care): Provides residential care, such as community care for the elderly or mental health and substance abuse facilities.

In the US, a larger proportion of the allied health care workforce is already employed in ambulatory settings. In California, nearly half (49.4 percent) of the allied health workforce is employed in ambulatory health care settings, compared with 28.7 percent and 21.9 percent employed in hospital and nursing care, respectively.

Advancements in medical technology also allow for more services that formerly required expensive hospital stays to be delivered via ambulatory care. For example, in California, research has predicted the total consumption of hospital days per person will decline from 4 days in 2010 to 3.2 days in 2020 to 2.5 days in 2030. In contrast, the number of ambulatory visits per person will increase from 3.2 visits per person in 2010 to 3.6 visits per person in 2020 to 4.2 visits in 2030.

In developing countries, many national human resources for health strategic plans and international development initiatives are focusing on scaling up training of allied health professions, such as HIV/AIDS counsellors, clinical officers and community health workers, in providing essential preventive and treatment services in ambulatory and community-based care settings.

With this growing demand for ambulatory health care, researchers expect to witness a heavier demand for professions that are employed within the ambulatory sector and other non-hospital settings — in other words, allied health.