View source for Allied health professions

{{short description|Health care professions distinct from optometry, dentistry, nursing, medicine, and pharmacy}}

'''Allied health professions''' (AHPs) are a category of [[health professional]]s that provide a range of diagnostic, preventive, therapeutic, and rehabilitative services in connection with [[health care]]. While there is no international standard for defining  the diversity of allied health professions, they are typically considered those which are distinct from the fields of  [[medicine]], [[nursing]] and [[dentistry]].<ref name="RRHreview">{{cite journal |doi=10.22605/RRH8374 |title=Recruitment and retention of rural allied health professionals: a scoping review |year=2024 |last1=Peterson|first1=M |last2=Nielsen |first2=S | last3=Olson |first3=D |journal=Rural and Remote Health |volume=24 |pages=8374 | doi-access=free}}</ref><ref name="RRH">{{cite journal |doi=10.22605/RRH7882 |title=Relative remoteness and wage differentials in the Canadian allied health professional workforce |year=2023 |last1=Gupta |first1=N |last2=Gulliver |first2=A | last3=Singh |first3=P |journal=Rural and Remote Health |volume=23 |pages=7882 | doi-access=free}}</ref> 

In providing care to patients with certain illnesses, AHPs may work in the public or private sector, in hospitals or in other types of facilities, and often in [[clinical collaboration]] with other providers having complementary [[scope of practice|scopes of practice]]. Allied health professions are usually of smaller size proportional to physicians and nurses. It has been estimated that approximately 30% of the total health workforce worldwide are AHPs.<ref name="QA2022"/>

In most jurisdictions, AHPs are subject to [[health professional requisites]] including minimum standards for education, regulation and licensing. They must work based on scientific principles and within an [[evidence based practice]] model.<ref name="QA2022"/> They may sometimes be considered to perform the role of [[mid-level practitioner]]s, when having an advanced education and training to diagnose and treat patients, but not the certification of a [[physician]]. Allied health professionals are different from [[alternative medicine]] practitioners, also sometimes called natural healers, who work outside the conventions of modern biomedicine.  

== Definition ==
The organization of International Chief Health Professions Officers (ICHPO)<ref name="QA2022">{{cite journal |title=Quality assurance in allied healthcare education: A narrative review |year=2022 |last1=Sreedharan |first1=Jithin K | journal=Canadian Journal of Respiratory Therapy |volume=58 |pages=103-110 | doi=10.29390/cjrt-2022-009 |pmc=9318339 }}</ref> developed a widely-used definition of the allied health professions:

{{Blockquote|Allied Health Professions are a distinct group of health professionals who apply their expertise to prevent disease transmission, diagnose, treat and rehabilitate people of all ages and all specialties. Together with a range of technical and support staff they may deliver direct patient care, rehabilitation, treatment, diagnostics and health improvement interventions to restore and maintain optimal physical, sensory, psychological, cognitive and social functions.<ref name="UIS_">{{cite web | title=Department of Allied Health | publisher=[[University of Illinois Springfield]] | url=https://www.uis.edu/alliedhealth/ | access-date=February 3, 2020}}</ref>}}

== Professions ==
The allied health professions represent a large cluster of health and care service providers, which usually require specific training and/or certification, but which are distinct from the [[medicine]], [[nursing]] and [[dentistry]] professions.<ref name="RRHreview"/> There is a large demand for allied health professionals, especially in rural and medically underserved areas.<ref name="RRH"/> AHPs are generally considered distinct from other healthcare service providers on the basis of several factors. These factors may include AHPs offering services in ways which support treatments provided by other healthcare professionals (working either in independent autonomous practice or under direct supervision), or by offering services which other healthcare professionals require but do not provide themselves (for example in the use of medical technologies).<ref name="AHS">{{cite book | last = Institute of Medicine | title = Allied Health Services: Avoiding Crises | publisher =  National Academies Press (US) | location = Washington, DC | year = 1989}}</ref> 

The precise titles, roles and [[Healthcare provider requisites|requisites]] of AHPs vary considerably from country to country. For the United States, a generic definition is in the [[Public Health Service Act]], including those with "training, in a science relating to health care, [and] who shares in the responsibility for the delivery of health care services or related services" (other than a registered nurse or physician assistant).<ref name="USAUSC42">{{Cite web|url=https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section295p&num=0&edition=prelim|title=United States Code Title 42 The Public Health and WelfareChapter 6A Public Health Service, Subchapter V: Health Professions Education Part G-General Provisions|date=2015|access-date=2020-07-27|website=The Office of the Law Revision Counsel|at=section 295p. Definitions (5)|language=en}}</ref> In South Africa, AHPs are identified and regulated through the [[Health Professions Council of South Africa]] (e.g., clinical technologists, dental therapists) or through the Allied Health Professions Council (e.g., massage therapists, chiropractors).<ref>{{Cite web|url=https://ahpcsa.co.za/|title=The Allied Health Professions Council of South Africa (AHPCSA)|access-date=2024-09-20|language=en}}</ref> 

Depending on the country and local health care system, the professions that are considered AHPs vary. For example, in some contexts [[optometry|optometrists]] are not considered AHPs, as the profession has a longer history of [[primary care]] practice independent of modern medicine,<ref>{{cite book | last1 = Nancarrow | first1 = Susan | last2 = Borthwick | first2 = Alan | title = The Allied Health Professions: A Sociological Perspective | publisher =  Oxford Academic | year=2021 | doi=10.1332/policypress/9781447345367.003.0004 }}</ref> whereas in others optometrists are identified as falling under the AHP umbrella.<ref>{{Cite web|url= https://alliedhealthservices.gov.mt/en/professions/ophthalmic/optometry|title=Directorate Allied Health Services: Optometry | website= Government of Malta | access-date=2024-09-21|language=en}}</ref><ref>{{Cite web|url= https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/heath-care-partners/health-newsletter/enews-allied-health-summer-2022.pdf|title=Who Makes Up the Allied Health Workforce in B.C.? | website=British Columbia Ministry of Health | access-date=2024-09-21|language=en}}</ref> Similarly, in some health care jurisdictions [[physical therapy|physiotherapists]] are not considered AHPs, as they tend to have more autonomy in private practice without the need for [[referral (medicine)|medical referral]],<ref name="AHS"/> whereas in other jurisdictions physiotherapists are identified and regulated as AHPs.<ref>{{Cite web|url= https://www.betterhealth.vic.gov.au/health/serviceprofiles/physiotherapist-service | title=Seeing an allied health professional: Physiotherapists | website=Better Health Channel, Victoria State Government | access-date=2024-09-21|language=en}}</ref><ref>{{Cite web|url= https://www2.gnb.ca/content/gnb/en/corporate/promo/careers_in_healthcare/allied_health/ah_renderer.heath-careers.allied-health.34.html | title=Career Profiles - Allied Health: Physiotherapist | website=New Brunswick Department of Health | access-date=2024-09-21|language=en}}</ref> 

A limited subset of the following professional areas may be represented, and may be regulated:
<!-- Keep the DISPLAYED entries in alphabetical order. -->
{{Columns-list|colwidth=18em|
* [[Anesthesia technician]]
* [[Anesthesiologist assistant]]
* [[Art therapy|Art therapist]]
* [[Athletic trainer]]
* [[Audiology|Audiologist]]
* [[Autotransfusionist]]
* [[Cardiovascular technologist]]
* [[Clinical psychologist]]
* [[Clinical social worker]]
* [[Communicative disorders assistant]]
* [[Dental assistant]]
* [[Dental hygienist]]
* [[Dental therapist]]
* [[Denturist|Denturist / clinical dental technician]]
* [[Dietitian]] / [[nutritionist]]
* [[Environmental health officer|Environmental health officer / public health inspector]]
* [[Exercise physiology|Exercise physiologist]]
* [[Healthcare technician]]
* [[Lactation consultant]]
* [[Massage|Massage therapist]]
* [[Medical assistant]]
* [[Language interpretation#Medical|Medical interpreter]]
* [[Medical laboratory scientist|Medical laboratory professional]]
* [[Medical physicist]]
* [[Medical radiation scientist]]
* [[Mental health counselor]] / [[psychotherapy|psychotherapist]]
* [[Midwife]]
* [[Music therapist]]
* [[Occupational therapy|Occupational therapist]]
* [[Operating department practitioners|Operating department practitioner]]
* [[Orthoptist]]
* [[Orthotics|Orthotist]] / [[prosthetics|prosthetist]]
* [[Paramedic]]
* [[Pedorthist]]
* [[Perfusionist]]
* [[Pharmacy technician]]
* [[Phlebotomist]]
* [[Physical therapy|Physiotherapist / physical therapist]]<ref name="RRH"/><!-- Do not remove PT from this list. Indian editors should read [[Talk:Allied health professions#India classifies Physiotherapy as an allied health profession]]. -->
* [[Radiographer|Radiographer / radiology technologist]] / [[mammography|mammographer]] / [[angiography|angiographer]]
* [[Radiation therapist|Radiotherapist / radiation therapist / medical dosimetrist]]
* [[Recreational therapy|Recreational therapist]]
* [[Rehabilitation counseling|Rehabilitation counselor]]
* [[Kidney dialysis|Renal dialysis technologist]]<ref>{{cite web|last=Allied Health|first=Sciences|title=Renal Dialysis Technology|url=http://sruahs.com/home/view/renal-dialysis-technology|publisher=SRU AHS|access-date=26 May 2014}}</ref>
* [[Respiratory therapy|Respiratory therapist]]
* [[Sonographer]] 
* [[Speech-language pathology|Speech and language pathologist]]
* [[Surgical technologist]]
}}

==Training and education==
Some allied health professions are more specialized, and so must adhere to national training and education standards and their professional scope of practice. Often they must prove their skills through degrees, [[diploma]]s, certified credentials, and continuing education. Other allied health professions require no special training or credentials and are trained for their work by their employer through on-the-job training (which would then exclude them from consideration as an allied health profession in a country like Australia). Many allied health jobs are considered [[career ladder]] jobs because of the opportunities for advancement within specific fields.<ref name="BLS">{{cite web|url=http://www.bls.gov/oco/cg/cgs035.htm#training|title=United States Bureau of Labor Statistics|access-date=2010-04-24| archive-url= https://web.archive.org/web/20100420045930/http://www.bls.gov/oco/cg/cgs035.htm| archive-date= 20 April 2010 | url-status= live}}</ref>

Allied health professions can include the use of many skills. Depending on the profession, these may include [[basic life support]]; medical [[terminology]], [[acronym]]s and [[spelling]]; basics of medical law and [[ethics]]; understanding of human relations; [[interpersonal communication]] skills; [[counseling]] skills; computer literacy; ability to document healthcare information; [[interviewing]] skills; and proficiency in [[word processing]]; [[database]] management and electronic dictation.<ref name="NHS AHP skills">{{cite web|url=http://www.nhscareers.nhs.uk/explore-by-career/allied-health-professions/skills-required/ |title=Explore by career: Allied Health Professions: Skills required |website=NHS Careers |publisher=NHS (UK) |access-date=17 August 2014}}</ref>

==History and growth==
The explosion of scientific knowledge that followed [[World War II]] brought increasingly sophisticated and complex [[medicine|medical]] diagnostic and treatment procedures. Increasing public demand for medical services combined with higher health care costs provoked a trend toward expansion of service delivery from treating patients in hospitals to widespread provision of care in physician's private and group practices, ambulatory medical and emergency clinics, and mobile clinics and community-based care. 

Changes in the health industry and emphasis on cost-efficient solutions to health care delivery will continue to encourage expansion of the allied health workforce. The World Health Organization estimates there is currently a worldwide shortage of about 2 million allied health professionals (considering all health workers aside from medical and nursing personnel) needed in order to meet [[global health]] goals.<ref>World Health Organization (2006), ''The World Health Report 2006''. Geneva: World Health Organization.</ref>

In recognition of the growth of the number and diversity of allied health professionals in recent years, the 2008 version of the [[International Standard Classification of Occupations]] increased the number of groups dedicated to allied health professions. Depending on the presumed skill level, they may either be identified as "health professionals" or "health associate professionals". For example, new categories have been created for delineating "paramedical practitioners"—grouping professions such as [[clinical officer]]s, [[clinical associates]], [[physician assistant]]s, [[Feldsher]]s, and [[Assistant Medical Officer|assistant medical officers]]—as well as for [[community health worker]]s; [[dietitian]]s and [[nutritionist]]s; audiologists and speech therapists; and others.<ref>Dal Poz MR et al. (2009), Boundaries of the health workforce: definition and classifications of health workers. In: ''Handbook on monitoring and evaluation of human resources for health''. Geneva: World Health Organization.</ref>

In developing countries, many national [[Health Human Resources|human resources for health]] strategic plans and international development initiatives are focusing on scaling up training of allied health professions, such as HIV/AIDS counsellors, [[clinical officer]]s and [[community health worker]]s, in providing essential preventive and treatment services in ambulatory and community-based care settings.<ref>{{cite web|url=http://www.pepfar.gov/documents/organization/116294.pdf |title=PEPFAR Country Profile |access-date=2012-03-06}}</ref>

With growing demand for [[ambulatory care|ambulatory health care]], researchers expect to witness a heavier demand for professions that are employed outside of hospital settings — including allied health.<ref name="CHJ_Help Wanted" />

==Modern times==
===India===
In India, the [[National Commission for Allied and Healthcare Professions]] identifies and sets quality standards for 56 professions in diagnostics, therapeutics, community health, and biomedical technology (e.g., physiotherapists, radiologists).<ref>{{Cite journal |last1=Arfat |first1=Mohd |display-authors=etal |date=September 2023 |title=The National Commission for Allied and Healthcare Professions Act, 2021: A Step Towards Regulating and Standardizing Allied and Healthcare Education and Practice in India |url=https://jchr.org/index.php/JCHR/article/view/898/800 |journal=Journal of Chemical Health Risks |volume=13 |issue=4 |pages=717-721 |issn=2251-6727}}</ref>

===United Kingdom===
In the United Kingdom there are 12 distinct professions who are considered allied health professionals; in combination they account for about 6% of the NHS workforce. In 2013 the annual expenditure on services provided by allied health professionals amounted to around £2 billion, although there is a lack of evidence around the extent to which these services improve the quality of care.<ref>{{cite web|last1=Bardsley |first1=Martin |title=Focus on: Allied health professionals |url=http://www.qualitywatch.org.uk/focus-on/allied-health-professionals |website=QualityWatch |publisher=Nuffield Trust/Health Foundation |archive-url=https://web.archive.org/web/20220120224637/https://www.nuffieldtrust.org.uk/research/focus-on-allied-health-professionals |date=30 September 2014 |archive-date=20 January 2022 |url-status=dead}}</ref>

===United States===
In the United States, the [[Association of Schools of Allied Health Professionals]]<ref name="ASAHP_def">{{cite web |url=http://www.asahp.org/what-is/ |title=What is Allied Health? |publisher=Association of Schools of Allied Health Professionals |access-date=10 March 2020}}</ref> uses wording from the [[Public Health Service Act]] to list those who are considered to be allied health professionals.<ref name="USAUSC42" /> 

Professionals who are ''excluded'' under the Act from the list of AHPs, although they may possess degrees or diplomas in health sciences, include the following:
<!-- Keep the DISPLAYED entries in alphabetical order. -->
{{Columns-list|colwidth=18em|
* [[Chiropractic]]
* [[Clinical psychology]]
* [[List of counseling topics|Counseling]]
* [[Dentistry]]
* [[Health administration]]
* [[doctor of medicine|Medicine]]
* [[Nursing]]
* [[Optometry]]
* [[Osteopathic medicine in the United States|Osteopathic medicine]]
* [[Pharmacy]]
* [[Physician assistant]]
* [[Podiatry]]
* [[Public health]]
* [[Social work]]
* [[Veterinary medicine]]
}}

====Employment projections====
Projections in the United States and many other countries have shown an expected long-term shortage of qualified workers to fill many allied health positions. This is primarily due to expansion of the health industry due to demographic changes (a growing and aging population), large numbers of health workers nearing retirement, the industry's need to be cost efficient, and a lack of sufficient investment in training programs to keep pace with these trends.<ref name="National Skills Coalition">{{cite web|url=http://www.nationalskillscoalition.org/assets/reports-/americasforgottenmiddleskilljobs_2007-11.pdf|title=National Skills Coalition, America's Forgotten Middle Skills Jobs Report|access-date=2010-04-24|url-status=dead|archive-url=https://web.archive.org/web/20110727112033/http://www.nationalskillscoalition.org/assets/reports-/americasforgottenmiddleskilljobs_2007-11.pdf|archive-date=2011-07-27}}</ref><ref name="AAHC">{{cite web|url=https://www.aahcdc.org/Publications-Resources/Books-Reports/View/ArticleId/15926/Out-of-Order-Out-of-Time|title=Association of Academic Health Centers Out of Order Out of Time Report|access-date=2020-07-27}}</ref>

Studies have also pointed to the need for increased [[Diversity (politics)|diversity]] in the allied health workforce to realize a [[Cultural competence|culturally competent]] health system.<ref name="California Endowment diversity">{{cite web|url=http://www.calendow.org/Collection_Publications.aspx?coll_id=30&ItemID=320|title=California Endowment, Workforce Diversity|access-date=2010-04-24|archive-url=https://web.archive.org/web/20100525011153/http://www.calendow.org/Collection_Publications.aspx?coll_id=30&ItemID=320|archive-date=2010-05-25|url-status=dead}}</ref> 

Workforce and health care experts anticipate that health services will increasingly be delivered via ambulatory and nursing care settings rather than in hospitals. According to the [[North American Industry Classification System]] (NAICS), the health care industry consists of four main sub-sectors, divided by the types of services provided at each facility:<ref name="NAICS">{{cite web|url=https://www.census.gov/cgi-bin/sssd/naics/naicsrch?chart_code=62&search=2017%20NAICS%20Search|website =North American Industry Classification System |access-date= 14 December 2018|title = 2017 NAICS Definition}}</ref>
* [[Hospital]]s: primarily provides [[inpatient]] health services and may provide some [[outpatient]] services as a secondary activity.
* [[Ambulatory care|Ambulatory health care]] settings: primarily provides outpatient services at facilities such as doctors' offices, outpatient [[clinic]]s and clinical laboratories.
* [[Nursing home|Nursing and residential care facilities]]: provides residential care, such as community care for the elderly or [[mental health]] and substance abuse facilities.
* [[Social work|Social Assistance]]: provides services for the elderly and/or disabled, services for the homeless and poor, vocational rehabilitation, or child day care services.

In the US, a larger proportion of the allied health care workforce is already employed in ambulatory settings. In California, nearly half (49.4 percent) of the allied health workforce is employed in ambulatory health care settings, compared with 28.7 percent and 21.9 percent employed in hospital and nursing care, respectively.<ref name="CHJ_Help Wanted" /> One source reported allied health professionals making up 60 percent of the total US [[health workforce]].<ref name='University of California San Francisco'>{{cite web|url=http://www.futurehealth.ucsf.edu/Public/Center-Research/Home.aspx?pid=88 |title=University of California San Francisco, Advancing the Allied Health Professions |publisher=Futurehealth.ucsf.edu |access-date=2012-03-06}}</ref> Advancements in medical technology also allow for more services that formerly required expensive hospital stays to be delivered via ambulatory care. For example, in California, research has predicted the total consumption of hospital days per person will decline from 4 days in 2010 to 3.2 days in 2020 to 2.5 days in 2030. In contrast, the number of ambulatory visits per person will increase from 3.2 visits per person in 2010 to 3.6 visits per person in 2020 to 4.2 visits in 2030.<ref name="CHJ_Help Wanted">{{cite web|url=http://www.calhealthjobs.org/system/files/attachments/helpwantedreport_48.pdf |website=www.calhealthjobs.org |title=California Health Jobs, Help Wanted Report |pages=13–14 |date=2009|access-date=18 February 2016}}</ref>

==See also==
* [[Health care provider]]s
* [[Health Human Resources|Human resources for health]]
* [[Paramedicine]]
* [[Unlicensed assistive personnel]]

==References==
{{Reflist|30em}}

==External links==
{{Commons category}}
* [https://www.healthcareers.nhs.uk/we-are-the-nhs/allied-health-professionals Allied Health Professionals on NHS Careers] (UK)
* [http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-medical-service/reports-topic/allied-health-professionals.page AMA Allied health professionals]
* [http://www.asahp.org/ Association of Schools Advancing Health Professions] (ASAHP)
* [[National Commission for Allied and Healthcare Professions]] (India)

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{{Authority control}}

[[Category:Allied health professions| ]]