Direct patient care is often a difficult concept to define. There is no universally accepted definition of this phrase in our society. For example, when searching for the term “direct patient care” on the Centers for Disease Control and Prevention (CDC) or the National Institute of Health (NIH) websites, there are no concrete definitions. However, the healthcare community often distinguishes between direct and indirect patient care. Direct patient care is generally understood as “hands-on” care involving direct interaction with patients, while indirect patient care refers to roles that do not involve direct contact with patients, such as hospital administrators or billing and coding professionals. In this chapter, we will define direct patient care as healthcare services provided directly to patients either suspected of having an ailment or being treated for a physical or mental illness.

Direct patient care roles are driven by provider orders. However, before we address provider orders, let’s take a look at what exactly a provider is. Traditionally, a provider was a board-certified medical physician who provided care to their patients. Today, in addition to physicians licensed as medical doctors (MDs) or doctors of osteopathic medicine (DOs), medical providers include certified physician assistants (PA-Cs) and nurse practitioners (NPs).

All of the healthcare practitioners or providers mentioned above give “providers orders” to the various professionals described in this chapter. A physician’s order, or doctor’s order, consists of directing the medical team to carry out a specific service, such as diagnostic testing, skilled nursing services, and physical therapy. For example, in a cardiology office, a physician may order a medical assistant to perform an electrocardiogram on a patient. In another example, a physician assistant (PA-C) might order a registered nurse (RN) to start an IV prior to a surgical procedure. While the medical provider gives the order, the healthcare setting is team-based, as discussed earlier in the textbook.

Direct patient care can occur in various settings, such as medical clinics, physicians’ offices, or inpatient hospital settings. It may also occur in telehealth-based settings, where medical providers attend to patients’ needs remotely via the internet. Telemedicine involves clinical medical care provided at a distance through technology. While telemedicine has existed for some time, the Covid-19 pandemic provided an opportunity for medical providers to utilize distance treatment more frequently. It is now regularly used in various hospital and physician office settings.

Healthcare workers in direct patient care settings often possess distinctive qualities and characteristics. These include strong communication skills, empathy in patient care, a passion for helping others, attention to detail, and the ability to work effectively as part of a team. Direct patient care workers frequently handle bodily fluids and may encounter patients facing challenging health conditions, such as trauma injuries, surgeries, heart disease, and cancer. All healthcare workers are trained in standard precautions, which we will discuss next.

Attributions

1. Figure 5.1: image released under the Pexels License
2. Figure 5.2: image by Karolina Grabowska is released under Pexel license