A profession can be defined as a unified occupational group, with a standardized training, high social standing, acquisition of approved qualification, legal protection and political recognition. (Morrell, 2001) The professional standards mean that knowledge and skills acquired can be applied for the delivery of a quality service. Professionals, who work in the allied medical professions, play an important role in health care services. Most of allied medical professions involve a high level of technical skill and are well trained through specialized programs. They must be certified by a professional licensing board and continue their education to keep up with latest advances in technologies and techniques. (Turnbull, et al., 2009, p27)
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Definition of allied health professions include health professions that require registration by law to practice or licensure, or admission to a relevant professional body, and usually all allied health professions require a degree or higher qualification. They work in health care teams to make the healthcare 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. (Agency Health Professional Reference Group, 2003)
Allied health professionals are any medical professionals other than doctors and nurses, who are involved with the delivery of health services relating to the identification, evaluation, prevention and treatment of diseases and disorders; dietary and nutrition services; rehabilitation and health systems management, continuing patient-care and quality-of-life services to patients in collaboration with clinical departments. The precise titles and roles in the allied health professions may different from country to country.
In Australia, Allied Health Professions Australia (AHPA) is the national peak body for allied health professionals. AHPA defines that allied health professionals are required to complete recognized Bachelor of Science or Applied Science degrees. It enable them to obtain State/Territory registration, license or accreditation to practice, or eligible to join the relevant professional association, before being legally entitled to work. The members mainly include audiologists, chiropractors, dietitians, exercise physiologists, occupational therapists, orthoptists, orthotists and prosthetists, osteopaths, pharmacists, podiatrists, psychologists, radiographers, radiation therapists and sonographers, social workers and speech pathologists. They must often prove their skills through diplomas, certified credentials, and continuing education. Overall, allied health disciplines include clinical healthcare professions distinct from medicine, dentistry, nursing and medical scientists (Allied health professions Australia, 2008).
In 2006, Services for Australian Rural and Remote Allied Health (S.A.R.R.A.H) proposed some criteria for allied health professional workforce in order to fulfill health policy development. The health professionals must be graduated from an accredited degree course of recognized university. They can apply their skills and knowledge to assist patients to restore and maintain optimal physical, sensory, psychological, cognitive and social function. They should be recognized by State or Territory registration, licensure or accreditation to practice, or registration in the relevant professional association. Allied health professionals collaborate with other health professional workforce, community or work as part of a multidisciplinary team to achieve the best function of health system. (Lowe, Adams & O’Kane, 2007).
The Australian Institute of Medical Scientists (AIMS) is another professional association representing medical scientists. Professional membership of the association is recognized by employers as indicating professional status. AIMS conducts scientific meetings, conferences and seminars at national, state and local levels, all of these can keep the continued professional development of members of the profession. (Australian Institute of Medical Scientists, 2010)
However, in rural and remote areas, the cost of such continuing education is particularly high. The medical scientists in rural communities are faced with particular problems in attempting to upgrade their skills to keep pace with rapidly developing of new technologies. On the other hand, after graduation from a recognized university, the medical scientists need on-the-job training that may lead to differing standards of training depending on the competence laboratories or small laboratories in rural area. Under the limited resource in small laboratories, particularly in rural area, only part time medical scientists or technicians are employed. They are difficult to maintain and apply their skills to develop new technologies. By the way, allied health professions in Australia are not uniformly required to be registered to practice. Poor salaries and poor career path reflect low profession’s value and low professional status. (Australian Institute of Medical Scientists, n.d.)
In USA, the allied health professions are used to identify a cluster of health professions. There are over 6 million allied health care providers in the U.S. and over 200 allied health careers, who work in more than 80 different professions and represent approximately 60% of all health care providers. There are two types of allied health professionals: Technicians and Therapists. Technicians receive two years training and often need to report to Therapists or Technologists. Therapists/Technologists receive 4 to 6 years training and their minimum educational requirement is a bachelor’s degree or higher. According to the American Medical Association (AMA), medical scientists are within the range of allied health professions. (American medical association, 2010) The following are allied health categories defined by the U.S. Office of Education: (Douglas, 2004)
Diagnostic and Treatment Services
Medical Laboratory Technologies
Mental Health or Human Services
Miscellaneous Allied Health Services
Rehabilitation and Related Services
Allied Health, New Emerging Fields
In UK, Health Professions Council (HPC) is the regulator of 15 health professions: Arts therapists, biomedical scientists, chiropodists/ podiatrists, clinical scientists, dietitians, hearing aid dispensers, occupational therapists, operating department practitioners, orthoptists, paramedics, physiotherapists, practitioner psychologists, prosthetists/ orthotists, radiographers, speech and language therapists. (Health profession council, 2010)
HPC assess the professional standards of biomedical scientists or clinical scientists. Registration with the HPC is mandatory to be able to work for biomedical scientists or clinical scientists who have similar job nature to medical scientists. (Health profession council, 2010) A competence biomedical or clinical scientist applies scientific methods to maintain the efficacy, quality and safety in diagnosis and treatment. They perform research and develop new diagnosis method or treatment for patients. They can communicate good with patients or other health profession by providing professional scientific and clinical advices. They have clear mind for problem solving and management. (Badrick, 2007)
In Hong Kong
In Hong Kong, Hospital Authority (HA) has allied health division that includes several career opportunities: Assistant social worker officer, audiology technician, clinical psychologist, dental hygienists, department manager/ general manager (allied health), dietitian, dispenser, medical laboratory technologists, scientific officer(medical), mould laboratory technician, occupational therapist, optometrist, orthoptist, pharmacist, physicist, physiotherapist, podiatrist/ chiropodist, prosthetist-orthotist, radiographer, sonographer and speech therapist. (Hospital authority, 2010)
All allied health services departments under the division work as a team based on unity and mutual support to achieve its goals of doing the best possible quality patient care, complementing that provided by clinical departments. The continuous quality improvement with all departments can demonstrate commitment to quality patient services in accordance with the hospital’s mission of providing patient-centered quality service and encouraging patient’s participation in the treatment and rehabilitation process. All allied health services departments undergo reviews of work or care processes and make incremental improvements. To enhance allied health services staff’s professional expertise and academic qualification, exchange and training relationship with academic institutes has been established. In particular, Departments of Dietetics, Pharmacy, Physiotherapy, Biomedical Science and Podiatry are respectively the clinical education centres of Hong Kong University, Hong Kong Chinese University, Hong Kong Polytechnic University and California College of Podiatric Medicine (USA) respectively.
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Medical scientists in Hong Kong are also known as scientific officers who work in Allied Health Division of hospital laboratory, reference laboratory, private clinical laboratory or universities. They have at least 5 years working experience in hospital laboratories or clinical related field. Most of them are promoted from experienced medical laboratory technologist with Ph.D.- M.D. qualifications. They must be registered by Medical Laboratory Technologists Board under Supplementary Medical Professions Ordinance, which is responsible for promote adequate standards of professional practice and professional conduct among registered medical laboratory technologists. (The Supplementary Medical Professional Council, 2010)
Nature of work
In Great Britain, USA, Canada and most countries, medical scientists are considered as being allied health professionals who mainly work in hospital laboratories, private pathology laboratories and universities. They usually specialize in the professional disciplines such as clinical biochemistry, hematology, blood transfusion, immunology, histopathology, cytology, microbiology and virology. Medical scientists assist doctors in the diagnosis, treatment and prevention of disease. Medical scientists conduct research focused on advancing medical treatments and improving human healthcare in order to find out the causes of and the treatments for disease. They analyze data, write reports or articles to present their findings. Medical scientists may teach medical principles and lab procedures to staff, supervise the duties of clerical, statistical, or laboratory staff and can provide instruction and advice to other health professionals. They aim to develop policies to improve public health and oversee public health programs. (Australian visa bureau, 2010)
Training, qualifications, and advancement
Since medical scientists work in advanced scientific research and knowledge of human health, they should have advanced education in bachelor’s degree program in biological sciences and then enroll in a university Ph.D. program in the biological sciences or a joint Ph.D.-M.D. program at a medical college. Higher qualifications with on-job training can help improve employment prospects in the medical science field. (Bureau of Labor Statistics, 2010-2011)
By the way, the participation in ongoing Continuing Professional Development (CPD) is a responsibility of a medical scientist for advancement of knowledge and skills. Medical scientists should be able to work independently and communicate clearly. So, they may promote into managerial positions. (Bureau of Labor Statistics, 2010-2011)
Medical scientists need to interact medically with patients. So, they must be licensed and must graduate from an accredited medical school. (Bureau of Labor Statistics, 2010-2011) The professional associations and licensing bodies have a primary role in guaranteeing the quality of health care services. Licensure legislation ensures that laboratory personnel possess appropriate academic and clinical training, pass competency-base examinations and participate in continuing education programs. (American society of clinical pathology, 2005)
However, medical scientists in some states of Australia are not considered as allied health professionals. It is because variation in the inclusion or exclusion of professions under the umbrella term of allied health may fluctuate in relation to the goal of the collaborative exercise, political expediency, the clinical setting and the source or purpose of the identification level. (Struber, 2004)
Professional Status of Medical Scientists
Medical Scientists are prestige persons who do the research on diseases, develop vaccines and assist doctors to make diagnosis and treatments. Most of them are working in the hospital laboratory or private clinical laboratory under Medical Officer and Medical Consultant. A Ph.D. and M.D. in a biological science is the minimum education requirement for medical scientists. Moreover, Continuing Professional Development Scheme (CPD) is set up that recognizes continuing education, formal courses and a wide range of professional activities that can maintain the professional skills and professional growth. (Bureau of Labor Statistics, 2010-2011) Medical scientists must in compliance with the code of practice, good laboratory practice and good clinical practice. They need to register in accredited associations with license. (American Society for Clinical Laboratory Science, 2006)
According to the comparison of training, career structure and professional role, medical scientists are equal to or even better than other allied health professions. The job nature always lies between the diagnostic/technical domain in allied health and scientific domain in science. (Government of South Australia, 2008) From my point of views, medical scientists use scientific research, their knowledge and skills for the delivery health to the identification, evaluation and prevention of diseases and disorders. So, I think medical scientists should be included in the allied health professionals. Therefore, in Australia, improvement for public recognition and acceptance can improve the status of profession for medical scientists. Nobody knows who responsible for the research to find causes of and treatments for disease. (McGregor & Moriarty, 2003) Registration and licensure are needed. By the way, medical scientists must follow the instructions from the doctor and this may loss of respect from public. Medical scientists must increase autonomy although automation in laboratory has been developed.. They need to join some unity to gain strong identity and promote recognition of the group. Increase remuneration is equal to increase the status of medical scientists, recognition and respect because we have money to upgrade our skills with continuing education and high morale for a high quality health system.
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