Understanding the Difference Between Physicians and other Providers
Medical care is increasingly provided by providers who
refer to themselves as "doctor" or "physician," but do not
possess a Doctor of Medicine (MD or Osteopathy (DO) degree.
The education, training, responsibilities and scope of
practice vary greatly among Medical Doctors (MDs or DOs)
and other providers. Below is a list of various health care
professionals as summarized from 2002 Revised Code of Washington
(RCW),Chapter 18.120, Regulation of Health Professions-Criteria.
*"Health professions" means and includes the following
health and health-related licensed or regulated professions
and occupations: (Definitions, 18.120.020 (4))
Provider Definitions
Acupuncturist(18.06)
A health care service based on an Oriental system of medical
theory utilizing Oriental diagnosis and treatment to promote
health and treat organic or functional disorders by treating
specific acupuncture points or meridians
Educational requirements: A course of didactic training
in basic sciences and acupuncture over a minimum period
of two academic years; a course of clinical training in
acupuncture over a minimum period of one academic year.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.06
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Chiropractor (18.25)
The practice of health care that deals with the diagnosis
or analysis and care or treatment of the vertebral subluxation
complex and its effects, articular dysfunction, and musculoskeletal
disorders, all for the restoration and maintenance of health
and recognizing the recuperative powers of the body.
Educational requirement: Not less than one-half of the
requirements for a baccalaureate degree at a college or
university; graduation from a chiropractic school or college;
evidence of completion of a resident course of study of
not less than four thousand classroom hours of instruction
in such school or college.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.25
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Counselor
Those employing any therapeutic techniques, including but
not limited to social work, mental health counseling, marriage
and family therapy, and hypnotherapy, that offer, assist
or attempt to assist an individual or individuals in the
amelioration or adjustment of mental, emotional, or behavioral
problems, and includes therapeutic techniques to achieve
sensitivity and awareness of self and others and the development
of human potential.
Educational requirements: No listed educational or training
requirements in the 2002 RCW. Counselors must be registered
with the state Department of Health.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.19
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Dental hygienist (18.29)
A dental hygienist may remove deposits and stains from the
surfaces of the teeth, may apply topical preventive or prophylactic
agents, may polish and smooth restorations, may perform
root planning and soft-tissure curettage, and may perform
other dental operations and services delegated to them by
a licensed dentist. Such licensed dental hygienists may
perform dental operations and services only under the supervision
of a licensed dentist.
Educational requirements: An educational program that includes
course work encompassing the subject areas within the scope
of the license to practice dental hygiene in the state of
Washington; an examination administered or approved by the
dental hygiene examining committee.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.29
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Dentist (18.32)
A person able to diagnose, treat, remove stains and concretions
from teeth, operate or prescribe for any disease, pain,
injury, deficiency, deformity, or physical condition of
the human teeth, alveolar process, gums, or jaw.
Educational requirements: Graduation from a dental college,
school, or dental department of an institution approved
by the Washington state dental quality assurance commission;
an examination prepared or approved by and administered
under the direction of the commission.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.32
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Denturist (18.30)
A person licensed to engage in the practice of making, placing,
constructing, altering, reproducing, or repairing a denture;
and taking impressions and furnishing or supplying a denture
directly to a person or advising the use of a denture, and
maintaining a facility for the same.
Educational requirements: Formal training with a major
course of study in denturism of not less than two years
in duration; a written and clinical examination.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.30
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Dietitian/nutritionist (18.138)
Dietetics - the integration and application of scientific
principles of food, nutrition, biochemistry, physiology,
management, and behavioral and social sciences in counseling
people to achieve and maintain health.
General nutrition services - the counseling and/or educating
of groups or individuals in the selection of food to meet
normal nutritional needs for health maintenance.
Educational requirements: Dietitian - a major course of
study in human nutrition, foods and nutrition, dietetics,
or food systems management, and a baccalaureate or higher
degree from a college or university; continuous preprofessional
experience in dietetic practice of not less than nine hundred
hours under the supervision of a certified dietitian or
a registered dietitian or completion of a coordinated undergraduate
program in dietetics; an examination; and courses of continuing
education.
Nutritionist - the qualifications required to be a certified
dietitian; or a master's degree or doctorate degree in one
of the following subject areas: Human nutrition, nutrition
education, foods and nutrition, or public health nutrition
from a college or university.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.138
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Dispensing optician (18.34)
A dispensing optician is a person who prepares duplications
of, or prepares and dispenses lenses, spectacles, eyeglasses
on written prescriptions from physicians or optometrists,
and measures, adapts, adjusts and fabricates lenses, spectacles,
eyeglasses for the aid or correction of visual or ocular
anomalies of the human eye.
Educational requirements: Graduation from an accredited
high school; at least three years of apprenticeship training;
or successful completion of a prescribed course in opticianry
in a college or university.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.34
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Embalmer/Funeral Director (18.39)
A funeral director is a person engaged in the profession
or business of conducting funerals and supervising or directing
the burial and disposal of dead human bodies.
An embalmer is a person engaged in the profession or business
of disinfecting, preserving or preparing for disposal or
transportation of dead human bodies.
Educational requirements: A funeral director needs an associate
of arts degree in mortuary science or completion of a course
of not less than two years in an accredited college, and
a one-year course of training under a licensed funeral director
in this state. Must also pass an examination in the funeral
arts and an examination in the laws of this state pertaining
to the handling, care, transportation, and disposition of
human remains.
An embalmer must obtain an associate of arts degree in
mortuary science or complete a course of instruction in
an accredited mortuary science college program and other
college courses that total sixty semester hours or ninety
quarter hours, complete a two-year course of training under
a licensed embalmer in this state, and pass an examination
in the funeral sciences and an examination in the laws of
this state pertaining to the handling, care, transportation,
and disposition of human remains.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.39
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Emergency medical technician (18.73)
An emergency medical technician renders medical treatment
and care at the scene of any medical emergency or while
transporting any patient in an ambulance to an appropriate
medical facility, including ambulance transportation between
medical facilities.
Educational requirements: An emergency medical technician
course; training under the supervision of an approved medical
program director according to training standards prescribed
in rule to perform specific phases of advanced cardiac and
trauma life support under written or oral authorization
of an approved licensed physician. Must be examined and
certified as a physician's trained emergency medical service
intermediate life support technician and paramedic, by level,
by the University of Washington's school of medicine or
the department of health.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.73
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Health care assistant (18.135)
An unlicensed person who assists a licensed health care
practitioner in providing health care to patients
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.135
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Hearing instrument fitter/dispenser/Audiologist/Speech-language
pathologist (18.35)
Hearing instrument fitter/dispenser - a person who is licensed
to engage in the practice of fitting and dispensing of hearing
instruments.
Licensed audiologist - a person who engages in the application
of principles, methods, and procedures related to hearing
and the disorders of hearing and to related language and
speech disorders.
Licensed speech-language pathologist - a person who engages
in the application of principles, methods, and procedures
related to the development and disorders, whether of organic
or nonorganic origin, that impede oral, pharyngeal, or laryngeal
sensorimotor competencies and the normal process of human
communication.
Educational requirements: A hearing instrument fitter/dispenser
must complete a required examination, or complete a minimum
of a two-year degree program. A speech-language pathologist
or audiologist must have a master's degree or a doctorate
degree from a program at an institution of higher learning,
which includes completion of a supervised clinical practicum
experience, and has completed postgraduate professional
work experience.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.35
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Massage practitioner (18.108)
Service involving the external manipulation or pressure
of soft tissue for therapeutic purposes.
Educational requirements: A course of study in an approved
massage program or approved apprenticeship program; an examination
administered or approved by the Washington state board of
massage.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.108
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Mental health counselors/Marriage and
family therapist/Social worker (18.225)
Advanced social work - the application of social work theory
and methods including emotional and biopsychosocial assessment,
psychotherapy under the supervision of a licensed independent
clinical social worker, case management, consultation, advocacy,
counseling, and community organization.
Independent clinical social work - the diagnosis and treatment
of emotional and mental disorders based on knowledge of
human development, the causation and treatment of psychopathology,
psychotherapeutic treatment practices, and social work practice
as defined in advanced social work.
Marriage and family therapy - the diagnosis and treatment
of mental and emotional disorders, whether cognitive, affective,
or behavioral, within the context of relationships, including
marriage and family systems.
Mental health counseling - the application of principles
of human development, learning theory, psychotherapy, group
dynamics, and etiology of mental illness and dysfunctional
behavior to individuals, couples, families, groups, and
organizations, for the purpose of treatment of mental disorders
and promoting optimal mental health and functionality.
Educational requirements: Licensed social work - a master's
or doctorate social work educational program; an approved
examination; a supervised experience requirement - a minimum
of three thousand two hundred hours with ninety hours of
supervision by a licensed independent clinical social worker
or a licensed advanced social worker who has been licensed
or certified for at least two years; continuing education
requirements of thirty-six hours, with six in professional
ethics.
Licensed independent clinical social worker - a master's
or doctorate level social work educational program; an approved
examination; a supervised experience requirement - a minimum
of four thousand hours of experience, of which one thousand
hours must be direct client contact, over a three-year period
supervised by a licensed independent clinical social worker
who has been licensed or certified for at least five years
and who has had at least one year of experience in supervising
the clinical social work practice of others, with supervision
of at least one hundred thirty hours by a licensed mental
health practitioner; continuing education requirements of
thirty-six hours, with six in professional ethics.
Licensed mental health counselor - a master's or doctoral
level educational program in mental health counseling or
a related discipline from a college or university; an approved
examination; a supervised experience requirement - a minimum
of thirty-six months full-time counseling or three thousand
hours of postgraduate mental health counseling under the
supervision of a qualified licensed mental health counselor
in an approved setting; continuing education requirements
of thirty-six hours, with six in professional ethics.
Licensed marriage and family therapist - a master's degree
or doctoral degree educational program in marriage and family
therapy or graduation from an educational program in an
allied field equivalent to a master's degree or doctoral
degree in marriage and family therapy; passage of an approved
examination; a supervised experience requirement - a minimum
of two calendar years of full-time marriage and family therapy;
continuing education requirements of thirty-six hours, with
six in professional ethics.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.225
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Midwife (18.50)
One who renders medical aid for a fee or compensation to
a woman during prenatal, intrapartum, and postpartum stages.
Educational requirements: A high school degree or its equivalent,
a certificate or diploma from a midwifery program, and the
following: (a) a minimum period of midwifery training for
at least three years; (b) minimum educational requirements;
(c) undertaking the care of not less than fifty women in
each of the prenatal, intrapartum, and early postpartum
periods; and (d) observing an additional fifty women in
the intrapartum period.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.50
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Naturopath (18.36A)
Practices the art and science of the diagnosis, prevention,
and treatment of disorders of the body by stimulation or
support, or both, of the natural processes of the human
body.
Educational requirements: Successful completion of a doctorate
degree program in naturopathy, which includes a minimum
of two hundred post-graduate hours in the study of mechanotherapy
from an approved educational program.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.36A
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Nursing assistant (18.88A)
An individual, regardless of title, who, under the direction
and supervision of a registered nurse or licensed practical
nurse, assists in the delivery of nursing and nursing-related
activities to patients in a health care facility.
Educational requirements: Completion of an approved training
program or successful completion of alternate training meeting
established criteria approved by the Washington nursing
care quality assurance commission; a competency evaluation.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.88A
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Nursing care (18.79)
(1) Registered nursing - the observation, assessment, diagnosis,
care or counsel, and health teaching of individuals with
illnesses, injuries, or disabilities, or in the maintenance
of health or prevention of illness of others; the executing
of medical regimen as prescribed by a licensed physician
and surgeon, dentist, osteopathic physician and surgeon,
podiatric physician and surgeon, physician assistant, osteopathic
physician assistant, or advanced registered nurse practitioner.
(2) Advanced registered nursing - the performance of the
acts of a registered nurse and the performance of an expanded
role in providing health care services as recognized by
the medical and nursing professions. (3) Licensed practical
nursing practice - the performance of services requiring
the knowledge, skill, and judgment necessary for carrying
out selected aspects of the designated nursing regimen under
the direction and supervision of a licensed physician and
surgeon, dentist, osteopathic physician and surgeon, physician
assistant, osteopathic physician assistant, podiatric physician
and surgeon, advanced registered nurse practitioner, or
registered nurse.
Educational requirements: (1) Registered
nurse - a diploma from an approved school of nursing. (2)
Advanced registered nurse - completion of an advanced registered
nurse practitioner training program. (3) Licensed practical
nurse - a high school diploma or general education development
certificate or diploma, and completion of an approved practical
nursing program.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.79
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Nursing home administrator (18.52)
An individual qualified by education, experience, training,
and examination to administer a nursing home.
Educational requirements: A baccalaureate
degree; successful completion of a practical experience
requirement as determined by the state board of nursing
home administrators.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.52
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Occupational therapist (18.59)
The scientifically based use of purposeful activity with
individuals who are limited by physical injury or illness,
psychosocial dysfunction, developmental or learning disabilities,
or the aging process in order to maximize independence,
prevent disability, and maintain health.
Educational requirements: An educational
program in occupational therapy, with concentration in biological
or physical science, psychology, sociology, and with education
in selected manual skills; a period of supervised fieldwork
experience or a training program (for an occupational therapist,
a minimum of six months of supervised fieldwork experience
is required. For an occupational therapy assistant, a minimum
of two months of supervised fieldwork experience is required).
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.59
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Ocularist (18.55)
An ocularist designs, fabricates, and fits ocular prosthetic
appliances. An ocularist is authorized to perform the necessary
procedures to provide an ocular prosthetic service for the
patient in the ocularist's office or laboratory on referral
of a physician
Educational requirements: High school
diploma or a general equivalency degree, at least ten thousand
hours of apprenticeship training under the direct supervision
of a licensed ocularist; or (a) completing a prescribed
course in ocularist training programs; or (c) completing
at least ten thousand hours of apprenticeship training under
the direct supervision of a practicing ocularist.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.55
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Optometrist (18.53 & 18.54)
The examination of the human eye, the examination and ascertaining
any defects of the human vision system and the analysis
of the process of vision.
Educational requirements: A diploma or
other certificate of completion from an accredited college
of optometry or school of optometry.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.53
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Osteopathic medicine and surgery
(18.57 & 18.57A)
The use of any and all methods in the treatment of disease,
injuries, deformities, and all other physical and mental
conditions in and of human beings, including the use of
osteopathic manipulative therapy.
Educational requirements: Diploma from
an accredited school of osteopathic medicine and surgery,
and not less than one year served in a postgraduate training
program.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.57
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Pharmacist (18.64 & 18.64A)
A pharmacist is responsible for: Interpreting prescription
orders; the compounding, dispensing, labeling, administering,
and distributing of drugs and devices; the monitoring of
drug therapy and use; the initiating or modifying of drug
therapy in accordance with written guidelines or protocols
previously established and approved for his or her practice
by a practitioner authorized to prescribe drugs; the participating
in drug utilization reviews and drug product selection;
the proper and safe storing and distributing of drugs and
devices and maintenance of proper records thereof; the providing
of information on legend drugs which may include, but is
not limited to, the advising of therapeutic values, hazards,
and the uses of drugs and devices.
Educational requirements: A baccalaureate
degree in pharmacy or a doctor of pharmacy degree granted
by a school or college of pharmacy, and internship experience,
by practice in any licensed pharmacy.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.64
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Physical therapist (18.74)
A physical therapist treats any bodily or mental condition
by the use of the physical, chemical, and other properties
of heat, cold, air, light, water, electricity, sound, massage,
and therapeutic exercise, which includes posture and rehabilitation
procedures; the performance of tests and measurements of
neuromuscular function as an aid to the diagnosis or treatment
of any human condition.
Educational requirements: A baccalaureate
degree in physical therapy from an institution of higher
learning or a baccalaureate degree from an institution of
higher learning; a certificate or advanced degree from a
school of physical therapy.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.74
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Physician (18.71)
A physician is one who offers or undertakes to diagnose,
cure, advise or prescribe for any human disease, ailment,
injury, infirmity, deformity, pain or other condition, physical
or mental, real or imaginary, by any means or instrumentality;
administers or prescribes drugs or medicinal preparations
to be used by any other person. A resident physician means
an individual who has graduated from a school of medicine
and is serving a period of postgraduate clinical medical
training sponsored by a college or university in this state
or by a hospital accredited by this state. Includes individuals
designated as intern or medical fellow.
Educational requirements: Graduation
from a school of medicine, and two years of postgraduate
medical training
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.71
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Physician assistant (18.71A)
A person who is licensed by the commission to practice medicine
to a limited extent only under the supervision of a physician
Educational requirements: An accredited
physician assistant program; an examination
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.71A
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Podiatric medicine and surgery
(18.22)
The diagnosis and the medical, surgical, mechanical, manipulative,
and electrical treatments of ailments of the human foot.
Educational requirement: A course in a
school of podiatric medicine and surgery; one year of postgraduate
podiatric medical training.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.22
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Psychologist (18.83)
A psychologist engages in the observation, evaluation, interpretation,
and modification of human behavior by the application of
psychological principles, methods, and procedures for the
purposes of preventing or eliminating symptomatic or maladaptive
behavior and promoting mental and behavioral health.
Educational requirements: A doctoral degree
obtained from an integrated program of graduate study in
psychology; no fewer than two years of supervised experience,
at least one of which shall have been obtained subsequent
to the granting of the doctoral degree; written or oral
examinations.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.83
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Radiologic technician (18.84)
(a) Diagnostic radiologic technologist - a person who actually
handles x-ray equipment in the process of applying radiation
on a human being for diagnostic purposes at the direction
of a licensed practitioner; (b) Therapeutic radiologic technologist
- a person who uses radiation-generating equipment for therapeutic
purposes on human subjects at the direction of a licensed
practitioner; or (c) Nuclear medicine technologist - a person
who prepares radiopharmaceuticals and administers them to
human beings for diagnostic and therapeutic purposes and
who performs in vivo and in vitro detection and measurement
of radioactivity for medical purposes at the direction of
a licensed practitioner.
Educational requirements: Graduation from
an approved school or successful completion of alternate
training that meets the criteria established by the secretary
of health.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.84
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Respiratory care practitioner
(18.89)
A respiratory care practitioner is employed in the treatment,
management, diagnostic testing, rehabilitation, and care
of patients with deficiencies and abnormalities which affect
the cardiopulmonary system and associated aspects of other
systems, and is under the direct order and under the qualified
medical direction of a physician.
Educational requirements: Graduation from
a school approved by the secretary of health or successful
completion of alternate training which meets the criteria
established by the secretary; an examination; completion
of experience requirement
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.89
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Veterinarian/Veterinary technicians (18.92)
One who diagnoses or prognoses or treats diseases, deformities,
defects, wounds, or injuries of animals; prescribes or administers
any drug, medicine, treatment, method or practice, or performs
any operation, manipulation, or applies any apparatus or
appliance for cure, amelioration, correction or reduction
or modification of any animal disease, deformity, defect,
wound or injury.
Educational requirements: Graduation from
a veterinary college.
More info: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.92
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