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Types of Health Care Providers

Who’s right for you? What do all those initials mean?

To help you choose the right provider, here are descriptions of some of the provider types Gifford offers.

Nurse Practitioners

Nurse practitioners are registered nurses who have completed a minimum of a master’s degree and received training in the diagnosis and management of common medical conditions, including chronic illnesses.

Nurse practitioners provide a broad range of health care services, maintain close working relationships with physicians and can be a patient’s regular health care provider. Family nurse practitioners see patients of all ages. Pediatric nurse practitioners see children. Adult nurse practitioners focus on adults, often called internal medicine. The core philosophy of the nurse practitioner field is individualized care, preventing illness, promoting wellness and patient education.

Nurse practitioners are trained and board certified through the American Nurses Credentialing Center or American Academy of Nurse Practitioners in specialized areas and are licensed by the state and overseen by the Vermont State Board of Nursing.

Nurse practitioners are often identified by the letters APRN after their name. This stands for Advance Practice Registered Nurses. You may also see FNP-BC (Family Nurse Practitioner – Board Certified) or something similar like ADP-BC (Adult Nurse Practitioner – Board Certified).

Physician Assistants

Physician assistants are graduates of a Master of Physician Assistant Studies Program from which they are trained to diagnose and treat acute illness, manage chronic disease and promote healthy lifestyles.

Physician assistants work in a variety of medical specialties and as primary care providers, in consultation with a supervising physician. Like nurse practitioners and physicians, they can serve as your primary health care provider, treat illnesses, make diagnoses, prescribe medicines and work to keep you well through preventative health care.

Physician assistants are certified by the National Commission on Certification of Physician Assistants and, like physicians, licensed by the state Board of Medical Practice.

You can identify a physician assistant at Gifford by the following letters after his or her name: PA-C (Physician Assistant – Certified).

Certified Nurse-Midwives

Certified Nurse-Midwives (CNMs) are health care providers educated in nursing and midwifery who have graduated from college, passed a national examination, and have a license to practice midwifery. CNMs help over 300,000 women give birth each year in the United States. Most of these births are in hospitals. CNMs provide health care to women throughout their lives including prenatal care, birth, care after birth, care for the new baby, annual exams, birth control planning, women’s health issues, menopause and health counseling.

Why would I choose a midwife for care during my pregnancy?

Midwife means “with woman.” CNMs believe you deserve time and individualized attention during pregnancy so that you can be healthy and feel empowered to birth and take care of your baby. Midwives specialize in providing support, regular health care and information throughout your pregnancy and birth. Midwives recognize that each pregnancy and birth is unique and that each family has its own needs. Midwives help each family make decisions by taking the time to talk about all aspects of pregnancy and birth. Midwives are experts in knowing the difference between normal changes that occur during pregnancy and symptoms that require extra attention.

What if I have a “high risk” pregnancy or complications during labor?

CNMs can prescribe medications or treatments for common illness that you might get during pregnancy. Midwives work with doctors who specialize in illness and complications during pregnancy. If you have a medical problem during pregnancy or a complication during labor, your midwife will work with a doctor to make sure you get the best and safest care for your baby. Midwives also work with other health care providers: nurses, social workers, nutritionists, doulas, childbirth educators, physical therapists, counselors, and other specialists to help you get the care you need.

What if I want pain medication during labor?

If you think you want pain medicine during labor, your midwife will give you information about the medicines available so you can decide what is right for you. If you decide you want pain medicine during labor, your midwife can prescribe it for you. If you decide you don’t want pain medicine, your midwife will support that decision also and help you through your labor in other ways.

Should I see a midwife if I am not pregnant?

Many women go to their CNM for annual checkups, family planning and to get care for common women’s health needs such as testing for sexually transmitted infections, management of urinary tract infections or medicine for a yeast infection. Your midwife can answer questions about all the methods of birth control, help you decide what is best and safest for you, and prescribe it for you.

Mid-Level Providers

Nurse practitioners, certified nurse-midwives and physician assistants all fall into a category commonly referred to as a “mid-level provider.” So called mid-level providers are an integral part of your health care team. Even if you do not choose a mid-level provider as your primary care provider, “mid-levels” are essential to ensuring accessible health care throughout our nation and in our rural area of the country. Medical centers like Gifford are employing a growing base of specially trained and highly skilled medical professionals often called mid-level providers. They receive an additional 2-3 years of training and are authorized to work autonomously.

Doctors of Osteopathic Medicine

You are likely familiar with the letters MD (Doctor of Medicine) after a doctor’s name, but there are other types of doctors, including DOs or Doctors of Osteopathic Medicine. The two are very similar and have undergone similar training to become physicians. Like an MD, DOs typically have earned a four-year undergraduate degree, have spent four years in medical school, chose a practice specialty and completed an internship and residency program. They must pass licensing exams to become doctors, but they are licensed differently. In Vermont, DOs are licensed through the Secretary of State’s Office of Professional Regulation. MDs are licensed through the Vermont Board of Medical Practice.

DOs perform surgery, deliver babies, treat patients, prescribe medications and work in the same settings as MDs, using the same tools, treatments and technologies. DOs, however, receive extra training in the musculoskeletal system (your muscles and bones) and have been specially trained to perform hands-on manual osteopathic manipulations on patients.  Osteopathic medicine is also dedicated to treating and healing the patient as a whole, centers on the belief that the body’s systems are interconnected and focuses on preventative care. The goal of the DO is often not just to treat problems as they arise, but to prevent problems by evaluating your overall health, including what might be going on at home or work and your stress level.

Doctors of Podiatric Medicine

A Doctor of Podiatric Medicine (DPM), also called a podiatrist or podiatric surgeon, is specially trained in the medical treatment of disorders of the foot, ankle and lower leg. A DPM typically has a four-year undergraduate degree, has attended one of the nation’s accredited podiatric medical schools, has completed a surgical residency program as well as rigorous board certification exams. Like MDs, DPMs are licensed through the Vermont Board of Medical Practice.

Naturopathic Doctors

A Naturopathic Doctor (ND) treats all medical conditions and can provide both individual and family health care. A licensed ND has attended a four-year naturopathic medical school focusing on basic sciences as well as holistic and nontoxic approaches to disease prevention and wellness. This training includes clinical nutrition, acupuncture, homeopathic medicine, botanical medicine, psychology and counseling to encourage people to make lifestyle changes in support of their personal health.  A naturopathic physician takes board exams so that he or she may be licensed by a state or jurisdiction. In Vermont, that licensing body is Secretary of State’s Office of Professional Regulation.

Steeped in traditional healing methods, principles and practices, naturopathic medicine focuses on holistic, proactive prevention and comprehensive diagnosis and treatment. Naturopathic physicians help facilitate the body’s inherent ability to restore and maintain optimal health. It is the naturopathic physician’s role to identify and remove barriers to good health. NDs are trained to utilize prescription drugs, although the emphasis of naturopathic medicine is the use of natural healing agents.

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