Careers in medical fields are full of responsibilities, and dexterity in the specialized line of medical affairs is important. As time goes by, a career in the medical profession becomes more of a challenge, adventure and competition.

A medical career is often the most admired career of the world. A medical career is humanitarian, noble and is undoubtedly holds a very bright future for those who are after it. In terms of money, this field is promising. But in order to get into the medical arena, one has to have the patience and spend time in places like medical school, learning human anatomy and biology. The medical world has become a hive of inventions, discoveries and knowledge, based on up-to-date awareness. Therefore, it requires more knowledge to get established as a professional.

In recent days the coding industry offers many career opportunities to those who have certificates in coding. Starting from physician’s offices and hospitals to healthcare plans, medical coding certification finds its way into the industry. There are a few organizations that provide certificates in medical coding. One of them is the AHIMA (American Health Information Management Association), which has provided over 50,000 certified medical coders with proper certification. Broadly, there are three types of certificates issued by most of the organizations in the field of medical coding. They are:

(a) Certified Coding Associate (CCA)

(b) Certified Coding Specialist (CCS) and

(c) Certified Coding Specialist-Physician-based (CCS-P)

Other providers of such certificates are the University of Phoenix, Boston University, Center for Professional Education, University of Connecticut, University of Massachusetts – U Mass Online, Netcom Information Technology, Sacramento State University, Northern Illinois University and many others.

With the complexities of the modern age, it is not surprising that the process of medical billing has also become more complicated. Nowadays, when patients no longer need to pay cash directly for medical services, doctors, nurses and other medical practitioners have to contend with the tedious task of processing their patients’ medical bills in order to collect their due. Between that and their medical duties, doctors and nurses no longer have time for the more important thing in life which they are called for: saving lives.

This is where the medical billing career comes in. Today, people are recognizing more and more the need for medical billing professionals. Therefore, if you are seriously contemplating of going into a career or a profession where the industry is lucrative, a medical billing career should be one of your top priorities.

A medical billing career is actually a management practice. It entails processing medical and insurances claims, which doctors and other busy medical professionals find time-consuming. However, since medical institutions can’t do without processing medical bills, the only other way around it is to employ or to hire medical billing specialists.

A medical billing career requires the expert handling of billing codes and patient information without which, could result to errors: either the patient could be billed with the wrong, higher amount or, the doctor would be paid less than their due. With medical billing specialists, both doctors and their patients are guaranteed of being efficiently billed with the correct and accurate amount.

What It Means To Pursue a Medical Billing Career

The primary responsibility of having a medical billing career is, again, making sure that doctors receive their due payment for the medical services to patients. Technological advancements and the increasing health insurance plans have made sure that hospitals, medical clinics and medical offices keep correct and updated financial records as well as bill patients accurately. Thus, the birth of the medical billing career out of a developing necessity rather than as a way of delegating a task.

A medical billing career, like any other job, also involves working the regular forty office hours on the five working days, Monday to Friday, even for those who are practicing the medical billing career at home. Furthermore, to be able to be an effective and efficient medical billing specialists should be well-versed on the medical billing codes as well as well-knowledgeable on insurance claims, and on the complicated processes which it involves.

Could a medical coding career be the answer for a long-term employment experience that you’ll greatly enjoy? If you’ve ever considered getting into the medical coding industry, you might be surprised to learn just how amazing this type of profession can be.

Here, we’ll look at a few of the reasons that a medical coding career is so sought after in today’s global marketplace:

1. A Medical Coding Career Can Be Done at Home

Are you interested in working out of your home? As a medical coding professional, you may be able to work out of the comfort of your living room or eat-in kitchen while your kids are in school or in bed at night. Truly, the flexibility of medical coding is a boon to persons who want to be available to their families but also want to make a steady income.

2. A Medical Coding Career Can Be Highly Lucrative

It’s no surprise that the medical industry is popular in our society, especially due to the rising costs of pharmaceuticals and health care. Thus, medical coding specialists are needed across the board. And employers are willing to pay well for medical coding professionals who have credentials and/or experience. Hence, you could wind up making a better salary working part time as a medical coding pro than you would working full time in another field.

3. A Medical Coding Career Is Flexible

Does your family move around periodically because of a household member’s professional (such as military work or sales)? If so, you’ll be pleased to know that medical coding is useful practically anywhere you go. Consequently, you won’t have to worry about finding work… typically, medical coding specialists are able to get “up and running” in a new city in a very short amount of time.

Today medical billing careers and jobs are very exciting and are in great demand allover the world. A medical billing career is the right option for service minded job seekers who wish to help patients. Top colleges and universities with medical billing career training programs offer you challenging jobs in medical billing careers. With the advent of modern technology, there has been a great demand for work from home medical billing careers.

Medical billing and coding specialists are generally employed in clinics, hospitals, insurance companies, consulting firms, medical coding and billing services firms, governmental agencies and computer software companies. The basic function of a medical billing and coding specialist is to assign codes to diagnoses and procedures. This ensures correct transformation of information between the insurance and the medical facilities.

If you opt for a rewarding career in medical billing, there are numerous online institutions, formal vocational schools, and colleges that can prepare you for the online medical billing field. Your education will include training in communication skills, office management, billing, coding, insurance coding, insurance law, computer science and more.

Medical billing careers are on the rise these days. Medical billing claims due to erroneous billing cost hospitals a lot of money and they are actively searching for medical billing specialists. Billing specialists are badly wanted to solve the problem of errors in billing and relieve the physician of this time-consuming task

There are a number of fields in the medical career for you to choose from. Medical billing is a thriving career among them. Throughout the medical billing career, a billing specialist has to train himself constantly to upgrade his skill levels. A good temperament is an important quality that a medical billing professional ought to have. It helps him better interact with patients, their relatives, medical representatives, medical professionals, colleagues, doctors, and other office personnel.

A medical career is often the most admired career of the world. A medical career is humanitarian, noble and is undoubtedly holds a very bright future for those who are after it. In terms of money, this field is one of the most promising of all.

But in order to get into the medical arena, one has to have the patience to spend several years in medical school learning human anatomy and biology, and then more time working in hospitals, nursing homes and so on.

There are a number of fields where one can specialize: Master of Healthcare Administration, RN to BS in Nursing, BS in Health Administration, Doctor of Health Administration, MS in Nursing / MBA / Health Care Management, Healthcare Management, Medical Office Billing and Coding Specialist, Patient Care Technician, Pharmacy Technician, Medical Assisting, and Medical Insurance Billing/Coding. Even in the field of medicine, an MBA becomes a priority as management nowadays plays a key role in this field.

But if someone wants to excel in his medical career, the most promising jobs are those of medical transcriptions, medical coding, pharmaceutical field officers, medical representatives, managers, deputy managers and, most importantly, medical doctors.

Two of the most respectable jobs in the field of medicine are that of medical marketing management and medical coding. Marketing management is valuable as a medical career and has a bright prospect in terms of social respect and money. But one who wants to do so will gain an upper hand if he or she completes a marketing course like an MBA. This profession not only deals with the knowledge of medical affairs and medicines, but also applies the business administrative skills to it, thereby making it rich and interesting.

The purpose of this article is to identify and describe four essential skills for effective supervision of family therapy trainees in primary care medical settings. The supervision skills described include: (1) Understand medical culture; (2) Locate the trainee in the treatment system; (3) Investigate the biological/health issues; and (4) Be attentive to the self-of-the-therapist. Recommendations are also made to help supervisors become better prepared for the questions. medical family therapy trainees bring to supervision.

Since the publication of Medical Family Therapy (McDaniel, Hepworth, & Doherty, 1992), there has been an eruption of interest in the integration of family therapy and medicine, which has been noticeably apparent in marriage and family therapy (MFT) training programs. Many accredited MFT programs are starting courses, creating specialized tracks, and developing full curricula devoted to the practice of family therapy in medical settings. Once exposed to the diverse problems and patients in medicine and the effectiveness of a collaborative care model (Blount, 2003), students flock to training opportunities that set the stage for a career committed to practicing alongside medical professionals and helping patients and families coping with a variety of health-related concerns.

As more family therapy students pursue clinical training in medical settings, an important question emerges: What specialized training are supervisors receiving in medical family therapy supervision? Although much has been written about the skills needed by medical family therapists (Blount, 1998; McDaniel & Campbell, 1996,1997; McDaniel et al., 1992; Patterson, Peek, Heinrich, Bischoff, & Scherger, 2002; Rolland, 1994; Seaburn, Lorenz, Gunn, Gawinski, & Mauksch, 1996), little attention has been given to the skills supervisors need when training medical family therapists.

Just as the context of a client is important to appreciate in therapy (e.g., family interactions, neighborhood, community), we believe the context of training (e.g., clinical setting and characteristics) is critical for the supervisor to understand. This is especially important for contexts that are less familiar to family therapists, such as the context of medicine. Similar to the challenges in many graduate psychology training programs (Pisani, Berry, & Goldfarb, 2005), family therapy training programs are often separated physically, administratively, and culturally from medical settings. Further, it is rare to find family therapy supervisors with clinical or administrative experience in medical settings. Training in medical family therapy supervision has the potential to narrow this gap between family therapy and medicine and benefit therapists-in-training.

In this article, we describe four essential skills for supervisors of students training in primary care medical settings. The clinical skills needed by family therapists in primary care have been discussed elsewhere and are beyond the scope of this paper (Edwards & Patterson, 2003; Gawinski, Edwards, & Speice, 1999; McDaniel, Doherty, & Hepworth, 1997; Seaburn et al., 1993). Although the supervision skills described here could apply to other medical settings, such as inpatient settings, they are most relevant for primary care.

TRAINING FAMILY THERAPISTS IN MEDICAL SETTINGS

To date, the literature on medical family therapy training has focused on the skills needed by trainees. Several excellent articles have been written on the experiences of trainees and supervisors in medical family therapy internships (Gawinski et al, 1999; Hepworth, Gavazzi, Adlin, & Miller, 1988; Muchnick, Davis, Getzinger, Rosenberg, & Weiss, 1993). In addition, models on the joint training of family therapists and family physicians have provided guidance for family therapy educators (Edwards, Patterson, Grauf-Grounds, & Groban, 2001; Patterson, Bischoff, Scherger, & Grauf-Grounds, 1996; Patterson, Bischoff, & McIntosh-McIntosh-Koontz, 1998). In an editorial on training for collaboration, McDaniel et al. (1997) describe the fundamental skills needed by family therapy trainees, which include conceptual skills (e.g., biopsychosocial theory), clinical skills (e.g., the ability to partner with patients, families and medical professionals) and personal awareness skills (e.g., health and illness countertransference).

How do MFT graduate programs, specifically the supervisors in MFT programs, teach the fundamental clinical skills necessary in medical settings? The required curriculum content of accredited MFT programs provides a glimpse into how MFT faculty prepare students for work in medical settings. The current curriculum standards from the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE, 2003, version 10.3) require training in collaboration between disciplines, the effects of physical health on families, psychopathology, and psychopharmacology. These are significant content areas for the preparation of trainees to work in medical settings. However, research has raised questions about how this content is presented.

A Young Physician’s Toughest Trial May Be Confessing Mistakes

“Love” is a dangerous word in philosophy or theology. But a Christian cannot escape using it in describing the spiritual life. In love, one puts one’s own person at risk-exposing one’s own dignity for possible rejection, disappointment, and even possibly annihilation. Love requires the exposure of the soft underbelly of one’s person. The vulnerability of another requires a response in love. And love requires vulnerability.

Vulnerability is at the core of love, because love requires risks. It means, at the very least, exposing oneself to the risk of rejection. It means focusing on the needs of another and thereby forgoing some of one’s own (often unconscious and reflexive) self-protective mechanisms. If another human being has been made vulnerable and one reaches out in genuine love, one is thereby also made vulnerable.

I can best illustrate this with a story. Early in my internship year, I cared for a patient with advanced breast cancer who had developed a pleural effusion (fluid between her lungs and her chest wall) as a result of the spread of her cancer. She was certainly dying, but awake and alert and having great difficulty breathing because of the effusion. We decided that she needed to have the fluid removed by a procedure called thoracentesis. In thoracentesis, the skin is anesthetized and a needle is inserted through the chest wall, between the ribs. A small plastic catheter is inserted through the needle, attached to a syringe, and the fluid is drained. When the appropriate amount of fluid has been drained, the catheter is then removed. In her case, this procedure had a palliative purpose-removing the fluid would help her shortness of breath. The oncology fellow asked me to perform the procedure.

Now I had seen this done a few times as a medical student, and I had helped to perform it once, but I had never done one on my own. It was clear to me, however, that the fellow expected as a matter of course that I was already quite skilled in this procedure. Fearful of seeming less skilled than expected, I answered, “Sure,” and proceeded to prepare the equipment to perform the procedure.

I spoke to Mrs. Hertz,* explained what we planned to do and why, obtained her written consent, and proceeded to perform the thoracentesis. With a slight give, the needle penetrated into the space where the cancerous fluid was located and a straw-colored liquid flowed effortlessly back into the syringe. The patient appeared comfortable, with no pain or additional shortness of breath.

I breathed a sigh of relief. I had done it.

I next proceeded to thread the sterile plastic catheter through the needle so that I could take off a large volume of fluid. We thought she needed to have at least one, or maybe even two, liters of fluid removed in order to make her feel more comfortable. But then, as I was inserting the catheter, the flow of liquid suddenly stopped. Thinking that the catheter might have become kinked, I pulled it back into the needle to try to reposition it. The catheter seemed stuck for a second, then suddenly came back easily. A moment later, the catheter was out of the needle and I realized that the end of it had sheared off somewhere into the fluid filled space between her lungs and her chest.

I broke into a sweat. “How are you doing there?” I asked.

“Just fine,” she replied. “It doesn’t even hurt a bit. You’re a great doctor.”

I wasn’t sure how to respond. I blurted out, “Well, for some reason the flow of the fluid has stopped. I’m afraid we didn’t get much out, and this may not have helped so much. But we’re going to have to stop.”

“OK,” she said. “You’re the doctor.”

My heart was pounding in my chest. What had I done? I should never have tried this without more supervision. Not only was I was stupid, I was clumsy. I had visions of the plastic floating around in there. I wondered if its jagged edge might get stuck somewhere between her chest wall and lung and cause a puncture. Maybe it would become infected. I wondered what I could do or should do.

WISDOM FROM THE ELDERS

So I ordered an X-ray (which was standard after such a procedure anyway) and with trembling hand I paged the fellow.

I remember vividly how very kind he was. I had expected an upbraiding, but he was calm and constructive. He told me, first things first, that the patient was stable and at least for now seemed no worse for the wear. We looked at the X-ray together, and the catheter tip was just sitting there at the bottom of her lung cavity. He told me that everybody makes mistakes, and that I should not be too hard on myself. He told me that I should make this a learning opportunity-first, that I should never be afraid to ask questions or ask for help out of fear of what someone else might think of me, especially when this put patients at risk. Second, in this specific case, that one should never pull back on this type of catheter, whether it is inserted into a body cavity or a vein, because the design makes shearing off the tip very likely.

Each year, thousands of soon-to-be music graduates begin thinking about job prospects after graduation. Some of their concerns are reflected in questions like, “What am I going to do?” “How am I going to support myself?” “Will I be able to survive as a musician?” Here in the Career Development Office at Juilliard, we are no strangers to these questions. I want to share some general career issues I believe are germane to all music students and offer some practical advice to help music students succeed in their careers. As a student, you may find these issues apply to you. As a faculty member or an MTNA Collegiate Chapter advisor, this information may be useful in your role as a mentor.

Contrary to popular opinion, career development is not about getting a job. Surprised? I certainly was when I first began to learn about the professional field of career development. It seemed obvious to me that the word “career” must have something to do with “job,” until someone asked me to provide a solid definition. I was hard-pressed to give a definition my colleagues would agree on. After struggling for a few painful minutes, I gave up and ran to the nearest dictionary. The first words given for career are “course” or “passage.” Career development is literally about developing the course of one’s life.

I discovered early in my work that I was not alone in my initial interpretation of the word “career.” When asked, many colleagues and students struggle to define the word–even though they generally know its gist. This quasi-understanding has implications on how all of us approach our career.

The concept of career development is especially difficult for music students because the course of a musician’s life is so uncertain. For students majoring in a profession like law or medicine, the future is considerably more focused. After graduation, a medical student usually will apply for an internship at a hospital–followed by either a promotion, a job offer by a private office or plans to start a private practice. For musicians, there are few certain paths. If you currently are enrolled or recently have graduated with a music degree, I encourage you to consider some of the following thoughts and suggestions.

Niches

In the ten years I have been working in this field at the collegiate level, I’ve discovered essentially two career approaches that seem to be the default setting for most students. I’ve loosely titled these approaches as find-a-niche and create-a-niche. The find-a-niche or FAN is the easiest to consider. Students who are interested in finding a job in an orchestra or ensemble, a teaching position or some other work such as directing, presenting, producing, marketing, consulting and so forth, are looking for a niche in an established organization. They are, in essence, using a FANing approach in their career development. To succeed using FAN, students must learn certain skills–some of which pertain to their craft, many more that are needed to find the jobs and succeed in them.

The other approach is the create-a-niche, or CAN. Students who prefer a CANing approach to their career development like to create their own jobs. They usually are entrepreneurial and tend to be independently minded. Some of my professional colleagues have drawn the conclusion that all music graduates should be “entrepreneurial” to succeed. To some degree, this might be true. But I’m weary of any strategy that applies one solution to everyone. There are many graduates who find incredibly meaningful and successful careers but who do not fit the “entrepreneurial” definition.

In the first meeting, students usually indicate which approach they are leaning toward by their initial question(s). “I am interested in job opportunities after graduation. What can you tell me?”(FANing), or “I have this idea, but I’m not sure where to begin. Can you help me?”(CANing). Sometimes, students will start off a meeting with interest in job opportunities but suddenly change course by sharing what they really want to do–which is often a CAN idea. This is because some students are shy about sharing personal ideas if they perceive a potential rejection. This is why an open and encouraging environment is critical to this process. If you are a student, seek someone who is open to your ideas and will encourage you to explore all your interests. If you are a faculty member, or professional staff member, focus on listening instead of advising.

Getting to Know You

I like to spend some time getting to know students before working on a career strategy. I want to establish a welcoming environment where students feel comfortable sharing all their ideas. The meeting is about them. Too often, I find myself chomping at the bit, ready to download 600 gigabytes of information at the slightest sign of interest. After all, I have both experience and resources to offer. This is a tricky path to navigate. Once the downloading begins, it’s difficult to stop. The result is information overload, and the student becomes paralyzed because he or she doesn’t know where or how to begin. Downloading also robs students of their time to learn about themselves.

Q I’m taking a course on medical billing. Is this still a good business?

Name withheld

A We’ve included medical billing as a “best business” since the first edition of our book The Best Home Businesses for the 90s (J.P.Tarcher) came out, despite the harm done to this field by business opportunities that promised more than they could deliver to prepare people to do medical billing. Experts estimate 30 percent of doctor’s offices and other medical providers contract out their billing.

The homebased medical biller needs to think of his or her market as smaller practices and medical providers that seek payment for services to their patients from third patties. These include chiropractors, dentists and psychologists.

A small office often has difficulty keeping and training an employee to do its billing accurately. Thus, independent medical hillers have more expertise than employees with a variety of office duties. Outside medical billets should be able to increase the revenue of their clients while reducing their overhead.

As the academic year gets under way, the nation’s medical, dental and nursing schools are seeing fewer minorities in the classroom. The numbers are so low that a commission, led by former U.S. Secretary of Health and Human Services Dr. Louis W. Sullivan, is examining how to boost minorities in the medical field.

“We are hearing from deans and other university officials who are saying they have none or only one new Black or Hispanic student in their classrooms for the first time in decades,” Sullivan says.

While African Americans, Hispanics or Latinos, and American Indians represent more than 25 percent of the U.S. population, they represent less than 14 percent of physicians, 9 percent of nurses, and only 5 percent of practicing dentists.

The Sullivan Commission on Diversity in the Healthcare Workforce held its first heating on the matter this summer in Atlanta, collecting testimonies from educators, local legislators, business leaders, students and community advocates. Just last month, the 15-member commission held hearings in Denver and is planning to hold hearings in other major cities before the end of the year (see Black Issues, May 22).

“Although the problem of underrepresentation of minorities in the health professions is well documented, both state and federal tax dollars continue to support medical schools and residency training programs whose production of physicians falls far short of the goal,” Dr. George Rust told the commission at the Atlanta hearing. “In 1997 the Medical College of Georgia had only one African American student matriculate in its freshman class,” said Rust, professor of family medicine and deputy director, National Center for Primary Care at Morehouse School of Medicine.

“The real questions should no longer focus on ‘does it matter’–but rather how to address the long-standing need for greater depth and diversity in our health care work force. The ‘how’ must consider a wide range of multi-faceted interventions that bring together parents, young people, educators and educational institutions, providers and professional associations, federal, state and local agencies, and society in general,” said Valerie Hepburn, director of the division of health planning for the Georgia department of community health, also testifying before the commission at its Atlanta hearing.

Recent action by the U.S. Supreme Court in support of affirmative action in college admissions does not offer a solution for the lack of minorities in health-related fields, according to Sullivan.

“We know this ruling will not automatically lead to changes in how schools, especially health professional schools’ recruit, admit and retain underrepresented minority students,” Sullivan says. “It will take innovative approaches by schools to fulfill the dream or putting a health professions career within reach for more of our nation’s qualified minority students.”

Findings from the hearings will inform the commission’s final report, scheduled for release in Spring 2004, on bringing about systemic change at U.S. health professionals schools, and ultimately, to eliminate disparities in health status and unequal access to health services. The commission is administered by the Duke University School of Medicine and funded by the Kellogg Foundation.