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Dr. Pushpinder Singh SandhuSpecialist, General Surgery,ESIC Model Hospital, Ludhiana.

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Allied health professionsAllied health professions are health care professions distinct

from nursing , medicine , and pharmacy .

One estimate reported allied health professionals make up 60percent of the total health workforce .

They Provide a range of diagnostic, technical, therapeutic anddirect patient care and support services that are critical to theother health professionals they work with and the patients theyserve.

Sometimes the term Paramedical Staff may be used to describethem.

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The World Health Organization estimates there is currently aworldwide shortage of about 2 million allied health professionals(considering all health workers aside from medical and nursingpersonnel) needed in order to meet global health goals.

In recognition of the growth of the number and diversity of alliedhealth professionals in recent years, the newly adopted 2008

version of the International Standard Classification ofOccupations has increased the number of groups dedicated toallied health professions.

Depending on the presumed skill level, they may either be

identified as “health professionals” or “health associateprofessionals”.

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ProfessionsDefinitions of allied health professions vary acrosscountries, but generally indicate that they are healthprofessions distinct from medicine, pharmacy andnursing.

Some definitions only include health careproviders that require registration by law to practice,but usually all allied health professions that require apost-secondary degree or higher qualification areincluded.

Hence by this definition Nursing Orderlies may not beincluded in this category.

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

Anesthesia technician Animal-assisted therapist Aquatic therapist

Athletic Trainer Auto-transfusionist Audiologist Art therapist

Cardiographic technician Cardiovascular technologist Clinical laboratory scientist

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Clinical officer Clinical psychologist

Community Health WorkersDance/Movement Therapist Dental hygienist Diagnostic medical sonographist Dietitian / Nutritionist Electrocardiogram technician Emergency Medical Technician Environmental health officer Environmental Health Technician

Esthetician Exercise physiologist Expressive-Creative Arts Therapist Health care administrator

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Health information technician Horticultural therapist

Kinesiotherapist Licensed Practical Nurse Massage therapist Medical assistant Medical coder Neurophysiologist Medical dosimetrist Medical laboratory scientist Medical Laboratory Technician

Medical radiation scientist Medical transcriptionist Music therapist Nuclear medicine technologist

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Occupational therapist Orthotist / Prosthetist Orthoptist

Pedorthist Perfusionist Pharmacy technician Phlebotomist

Physical Therapist Radiation therapist Radiologic Technologist / Radiographer Recreational therapist Renal dialysis technologist Respiratory therapist Social Work Speech - Language Pathologist Surgical technologist

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All professional areas ascribed above belong to the ever-growinggroup of allied health professionals and their subspecialties.

The precise titles, roles, and requisites of the allied healthprofessions may vary considerably from country to country.

For example, the National Council for Homeopathy ofPakistan and the Central Council of Homeopathy ofIndia recognize as allied health professionals those who qualifywith a four-year university degree in the discipline, whereas inother countries the practice of homeopathy is not subjectto professional regulation .

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However, it is more and more recognized that other professionalshave a role to play in regard to healthcare.

These include professionals such as youth workers, socialworkers, sexual health workers and school nurses.

Not only do these practitioners have a key role to play due to theirinteraction with a wide range of the population but they may alsohave that opportunistic 'teachable' moment that allows them toimpart health advice in a non-threatening manner.

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Training and educationSome allied health professions are more specialized, and so must

adhere to national training and education standards and theirprofessional scope of practice.

Often they must prove their skills through degrees, diplomas ,certified credentials, and continuing education.

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 medicallaw and ethics ; understanding of human relations; interpersonal

communication skills; counseling skills; computer literacy;interviewing skills; and proficiency in wordprocessing ; database management and electronic dictation

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Allied health professions in ESIC Model Hospital, Ldh.

Audiology Technician Dental technician/ HygienistDietician ECG technician

Lab assistant/ technician or medical laboratory scientist (MLS)or clinical laboratory technologist.Occupational therapistOperation theatre technician and assistant-Physical therapy or physiotherapy

Radiographer or radiologic technologist or medical radiationtechnologistOptometrist.

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Audiology Technician

Audiology (from Latin audīre , "to hear"; and from Greek - λογία, -logia) is the branch of science that studies hearing, balance, andrelated disorders.

Its practitioners, who treat those with hearing loss and proactively

prevent related damage, are audiologists.

Employing various testing strategies (e.g. hearing tests ,otoacoustic emission measurements and electrophysiologic tests),audiology aims to determine whether someone can hear withinthe normal range, and if not, which portions of hearing (high,middle, or low frequencies ) are affected and to what degree.

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If an audiologist determines that a hearing loss or vestibularabnormality is present he or she will provide recommendations toa patient as to what options (e.g. hearing aid ,cochlearimplants , surgery , appropriate medical referrals) may be ofassistance.

In addition to testing hearing, audiologists can also work with awide range of clientele in rehabilitation (cochlear implants and/orhearing aids), pediatric populations and assessment of thevestibular system.

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DENTAL TECHNICIAN / HYGEINIST A dental technologist is a member of the dental team who, upon

prescription from a dental clinician, constructs custom maderestorative and dental appliances.

The dentist communicates with the dental technologist withprescriptions, drawings and measurements taken from the patient.

The most important aspect of this is a dental impression intowhich the technologist flows a gypsum dental stone to create areplica of the patient’s anatomy known as a dental model.

A technologist can then use this model for the construction ofcustom appliances.

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Duties and responsibilities of DIETICIAN (ISOManual)

To assist the surgeon in Dental Surgery.To be fully conversant with instruments, equipments and drugsused in Dental Surgery.

To maintain stock register of the equipment and dental stores.Carryout oral puophylakes procedures like sealingEducate patients regarding maintenance of good and hygiene oforal puophylakes proceduresMaintenance of Dental equipment and its day to day servicesMaintenance of dental instruments including sharpening ofinstruments

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Dieticians

Dieticians are experts in food and nutrition("dietetics").

They advise people on what to eat in order to lead a

healthy lifestyle or achieve a specific health-relatedgoal.

They work in a variety of settings from clinical to

community and public policy to mediacommunications.

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Duties and responsibilities of DIETICIAN (ISOManual)

Management of dietetic department.Management of therapeutic kitchen,Standardization of recipes and supervision of cooking.

Teaching dietetic trainees, nursing staff and others.Maintaining duty roster of kitchen staff, leave record, six monthlyhealth records of Class IV employees and other records requiredfor personnel management.Running nutrition clinic and to attend to Dietetic Clinic.Taking surprise visits to ensure proper distribution of food topatients, particularly therapeutic diets.

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Ordering dietary articles (dry and fresh) and supervising thereceipts and issues of all supplies.

Checking of purchase bills relating to dietary articles with regardto their specification, quantity and rates and passing them on toAccounts Section.

Maintenance of proper accounts for all dietary articles andinventory for dead stock articles.

Sanitation and cleanliness of kitchen areas.

Supervision of fire precautions in the department.Any other duty that may be specified by the M.S./D.M.S.

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ECG TECHNICIAN (ISO Manual)Handling and maintenance of ECG Machines.

To take E.C.G. of patients as advised by the doctor.

To maintain record of ECG done and compilation of monthlyreport.

To take ECG of seriously ill patients at bed side whenever calledby ward doctor.

Any other duty assigned by Medical Officer Inchar

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Lab assistant/ technician or medicallaboratory scientist (MLS) or clinicallaboratory technologist.

He/ she is healthcare professional whoperforms chemical , hematological , immunologic , microscopic ,and bacteriological diagnostic analyses on body fluids suchas blood , urine , sputum , stool , cerebrospinal fluid (CSF),peritoneal fluid, pericardial fluid , and synovial fluid , as well asother specimens.

Medical laboratory scientists work in clinicallaboratories at hospitals , doctor's offices, reference labs,biotechnology labs and non-clinical industrial labs.

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Lab technicians and assistants – Biochemistry

1. Ensuring proper functioning of all the equipments andinstruments such as distillation plant, colori meters, flamephotometers and water baths etc.

2. Receiving of blood in the outpatient department for variousinvestigations and ensure proper collection of blood.

3. Receiving of blood samples from the IPD, identify the samplesand do the required investigations.

4. Entry and record keeping, proper dispatch of reports of all theinvestigation done in the department.

5. Preparation of various reagents as and when required.6. Preparation of bottles with anticoagulant.7. Testing of normal and abnormal control sera for the quality

control and inter laboratory checking of the samples

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Lab technicians and assistants – Hematology

Ensure proper functioning of microscopes, centrifuge machines,colorimeters, distillation plants etc.Ensure proper cleaning of all the glassware and equipmentrequired in the hematology section

Receiving of all the samples for routine hemograms from IPD andOPD.Carrying of all the hematological investigation such as TLC, DLC,Platelets, ESR, Bleeding time and clotting time etc.

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Lab technicians and assistants – Pathology

Receiving and numbering the specimens of urine, stool, semenCentrifuge all the urine specimens and make smears from depositMaintain a proper record of all the specimens receivedAlbumin in urine to be done by heating methodUrine sugar to be tested by Benedicls reagent and random counter

checking by strip methodsMaintenance of boiling water bath, centrifuge, microscope etc.Indent and keep an account of all reagents required in the lab.To perform other tests such as blood inurine, specific gravity ofurine, Bence-Jones protein etc.To do other tests such as sputum for AFB, Serological tests forserum.

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Lab technicians and assistants – Cytology

Receiving and numbering of all aspiration smears done in the laband those received from OPDRecording in the register assisting the Medical Officer doingaspiration

Staining of all smearsPreparation of stainsMounting and labeling of slidesFiling of slides and their reports and dispatch of reports

Maintenance and repair of equipment

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Occupational therapist

An occupational therapist (OT) is trained in the practiceof occupational therapy .

The role of an occupational therapist is to work with a client to

help them achieve a fulfilled and satisfied state in life through theuse of "purposeful activity or interventions designed to achievefunctional outcomes which promote health ,prevent injury or disability and which develop, improve, sustainor restore the highest possible level of independence ."

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A practical definition for OT can also be illustrated with the use ofmodels such as the Occupational Performance Model ( Australia ),known as the OPM (A).

At the core of this approach is the ideology that occupationaltherapists are concerned with the occupations of people and howthese contribute to health .

Specifically it is a person’s occupational performance thatinfluences their health and personal satisfaction of their individualneeds.

The OPM (A) is constructed on the following definition ofOccupational Performance:

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The ability to perceive, desire, recall, plan and carry out roles,routines, tasks and sub-tasks for the purpose of self-maintenance,productivity, leisure and rest in response to demands of theinternal and/or external environment.

It can be seen that occupational performance, the roles it createsfor a client, and the areas it can encompass are so far-reaching thatan occupational therapist can work with a wide range of clients ofvarious limitations who are being cared for in an array of settings.

Occupational therapy is about helping people do the day-to-daytasks that “occupy” their time, sustain themselves, and enablethem to contribute to the wider community . It is theseopportunities to “do” that occupational therapy provides thatprove important and meaningful to the health of people.

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Physical therapy or physiotherapy

Physical therapy or physiotherapy (sometimes abbreviatedto PT or physio ) is a health care profession primarily concernedwith the remediation of impairments and disabilities and thepromotion of mobility, functional ability, quality of life andmovement potential through examination, evaluation, diagnosisand physical intervention carried out by physicaltherapists (known as physiotherapists in most countries)and physical therapist assistants (known as physicalrehabilitation therapists or physiotherapy assistants in somecountries).

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In addition to clinical practice, other activities encompassed in thephysical therapy profession include research, education,

consultation, and administration.

Duties and responsibilities of PHYSIOTHERAPIST(ISO Manual)

1. Supervise the staff members of the department2. Provide treatment to the patients reporting to the Physiotherapy3. To arrange for local purchase / audit / physical verification /

condemnation and other miscellaneous work in the department4. Maintenance of machinery / equipment / stores of the

physiotherapy department

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Radiographer or radiologic technologist or

medical radiation technologist A radiologic technologist , also known as medical radiationtechnologist and as radiographer , performs imaging of thehuman body for diagnosis or treating medical problems.Radiologic technologists work in hospitals , clinics , medicallaboratories and private practice.

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SENIOR RADIOGRAPHER To supervise the work of Radiographer / Jr. Radiographers and

making their duty rosters, maintenance of attendance register andleave matters in consultation with the RadiologistTo assist the doctor in special diagnostic radiographicinvestigation.Indenting and storage of X-ray films and other materials requiredin the departmentMaintenance of X-ray reports and films of all medico-legal casesand to produce it in court when demanded.Repair, Maintenance of and AMCs of all the X-ray and USGmachines and dark room in the departmentMaintenance of records of X-ray / CT / MRI patients referred.To monitor compliance to regulations related to TLD badges in thedepartmentAny other duties as assigned by the MS.

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RADIOGRAPHER

To take diagnostic radiographs of patients as required by doctor.Storing of unexposed x-ray films, keeping account of X-ray filmssupplied, used and balance in hand.To wear the film badge to assess exposure to X-ray of seriously illpatients.To perform round the clock duty in emergency department.To carry out the portable X-ray of seriously ill patients and to keeprecord of all X-rays taken in the register. To maintain the cleanliness of the X-ray room.

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JUNIOR RADIOGRAPHER

Registration, enquiry and dispatch work of the departmentTo receive X-ray films, loading and unloading of X-ray films,developing the films by dipping in chemical in dark room anddrying and sorting of the films.To dispatch the reports to various wards/handing over urgent X-ray to patients with signature of persons receiving it.Emergency X-rays, Bedside X-rays and OT X-raysTo develop USG films.

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Optometry is a health care profession concerned with thehealth of the eyes and related structures, as well as vision , visual

systems , and vision information processing in humans.Optometrists (also known as ophthalmic opticians outsidethe United States and Canada ) are trained to prescribe and fitlenses to improve vision, and to diagnose and treat various eyediseases.

Duties and responsibilities of OPTOMETRIST :Screening of the eyes of the beneficiariesExamination of eyes for finding out the right correction and adviceto the beneficiaries how to use the glasses and setting of visionwhile using glassesExamination of eye muscles balance with proper advice for goingin for certain exercisesTo look after the repair maintenance of various equipment in theeye department

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Allied health employment projections

Projections in the United States and many other countries haveshown an expected long-term shortage of qualified workers to fillmany allied health positions.

Studies have also pointed to the need for increased diversity in the

allied health workforce to realize a culturally competent healthsystem in the United States and elsewhere.

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

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With this growing demand for ambulatory health care, researchersexpect to witness a heavier demand for professions that areemployed within the ambulatory sector and other non-hospitalsettings — in other words, allied health.

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