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Translate the following word combinations paying your attention to the word formation:
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Health Care
Health care or healthcar e is the maintenance or improvement of health via the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental impairments in human beings. The delivery of modern health care depends on groups of trained professionals and paraprofessionals coming together as interdisciplinary teams. This includes professionals in psychology, physiotherapy, nursing, dentistry, midwifery and allied health, along with many others such as public health practitioners, community health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services. It includes work done in providing primary care, secondary care, and tertiary care, as well as in public health. Health care can be defined as either public or private.
Access to health care may vary across countries, communities, and individuals, largely influenced by social and economic conditions as well as the health policies in place. A health system, also sometimes referred to as health care system or healthcare system is the organization of people, institutions, and resources that deliver health care services to populations in need. Its exact configuration varies between national and subnational entities. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others, planning occurs more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization, a well-functioning health care system requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; and well maintained health facilities and logistics to deliver quality medicines and technologies.
Primary care constitutes the first element of a continuing health care process and may also include the provision of secondary and tertiary levels of care.
Primary care refers to the work of health professionals who act as a first point of consultation for all patients within the health care system. Such a professional would usually be a primary care physician, such as a general practitioner or family physician. Another professional would be a licensed independent practitioner such as a physiotherapist, or a non-physician primary care provider such as a physician assistant or nurse practitioner. Depending on the locality, health system organization the patient may see another health care professional first, such as a pharmacist or nurse. It can be provided in different settings, such as urgent care centers which provide same day appointments or services on a walk-in basis. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care, health education, and every time they require an initial consultation about a new health problem. Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care.
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Secondary care includes acute care: necessary treatment for a short period of time for a brief but serious illness, injury, or other health condition. This care is often found in a hospital emergency department. Secondary care also includes skilled attendance during childbirth, intensive care, and medical imaging services. The term "secondary care" is sometimes used synonymously with "inpatient care". Depending on the organization and policies of the national health system, patients may be required to see a primary care provider for a referral before they can access secondary care. Allied health professionals, such as physical therapists, respiratory therapists, occupational therapists, speech therapists, and dietitians, also generally work in secondary care, accessed through either patient self-referral or through physician referral.
Tertiary care is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital, e.g. cancer management, palliative, neurosurgery, advanced neonatology services. The term quaternary care is sometimes used as an extension of tertiary care in reference to advanced levels of medicine which are highly specialized and not widely accessed, e.g. experimental medicine and some types of uncommon diagnostic or surgical procedures.
There are a lot of types of health care interventions delivered outside of health facilities. They include many interventions of public health interest, such as food safety surveillance, distribution of needle-exchange program for the prevention of transmissible diseases and others. They also include the services of professionals in residential and community settings in support of self-care, home care, long-term care, assisted living, treatment for substance use disorders and social care services.
Unit 19
Outpatient Care
T opic Outpatient Care
Grammar Function of ‘one’ Revision Present Participle, Past Participle
Vocabulary Outpatient Care, Noun Suffix -logy, - ist, -ics, - ian
Reading ‘Outpatient care facilities’, ‘Healthcare professional’
Listening ‘Telemedicine Transforming Rural India’ (video)
Speaking Group Work (Rout Map)
Getting started
1. Look at the pictures and answer the questions:
ü Can you give the definition of ‘Outpatient Care’?
ü What health facilities provide the outpatient care?
ü Have you ever visited a doctor at the policlinic? What was the reason?
ü Were you satisfied with doctor’s visit? What did you feel? (nervous, calm, irritated, etc.)?
Vocabulary 
Word building:
Noun Suffix – ology, - ologist, - ics, - ician
Names of specialties usually and in suffix – ology; names of specialists end in suffix – ologist: dermatology – dermatologist. If the name of a specialty ends in suffix – ics, the name of the specialist ends in suffix – ician: obstetrics – obstetrician. There are some exceptions: anaesthetics - anaesthetists.
Remember: therapy – therapist, surgery – surgeon, hospital – hospitalist, dentistry – dentist.
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2. Translate the following words paying attention to the suffixes:
Pediatrics – pediatrician, neurology – neurologist, ophthalmology – ophthalmologist, cardiology – cardiologists, urology- urologist, endocrinology – endocrinologist, pathology – pathologist, gastroenterology – gastroenterologist, geriatrics – geriatrician, nephrology – nephrologist, neonatology – neonatologist, pulmonology – pulmonologist, radiology – radiologist, orthopaedics – orthopaedcian, oncology - oncologist
3. Read and translate the anatomical terms of Latin-Greek origin. Pay your attention to the pronunciation of the words:
Ambulatory [`xmbjqlqt(q)rI], basis [`beIsIs], diagnosis [,daIqg`nqusIs] (pl. diagnoses [,daIqg`nqusJz]), observation [,Obzq`veIS(q)n], acute [q`kjHt], chronic [`krOnIk], symptom [`sImptqm], clinic [`klInIk], emergency [I`mE:dZ(q)n(t)sI], assistance [q`sIst(q)n(t)s], therapy [`TerqpI], major [`meIdZq], pharmacy [`fRrmqsI]
Useful vocabulary
outpatient care [`aut,peIS(q)nt `keq] (ambulatory care [,xmbjqlqt(q)rI `keq]) - амбулаторное лечение, амбулаторная помощ
medical care [,medIk(q)l `keq] - медицинское обслуживание, медицинская помощь
to observe [qb`zWv] - наблюдать, замечать
acute [q`kjHt]- острый, сильный, пронзительный
acute care [q`kjHt `keq] (emergency [I`mE:dZ(q)n(t)sI])- неотложная помощь, скорая медицинская помощь
preventive health care [prI,ventIv `helT,keq] - профилактика здоровья, профилактика заболеваемости
minor surgical procedure [`maInq,sE:dZIk(q)l prq`sJdZq] – малая операция (осуществляемая амбулаторно)
to include [In`klHd] - включать в себя, охватывать
condition [kqn`dIS(q)n] - состояние, условие
doctor's visit [,dOktqz `vIzIt] (physician office visit [fI`zIS(q)n,OfIs `vIzIt]) – визит к врачу, посещение врача
to prevent [prI`vent]– предупреждать, проводить профилактику
hospital admission [`hOspIt(q)l qd,mIS(q)n] – поступление в больницу
health care facility [`helT,keq fq`sIlqtI] - учреждение здравоохранения
follow-up [`fOlquAp] – последующее наблюдение врача, контроль, больной, состоящий на учёте, диспансерное наблюдение
physician [fI`zIS(q)n] – врач, терапевт
to see a patient [`peIS(q)nt]– принимать пациента
house call [`haus,kLl]– вызов врача на дом
to make an appointment [`meIk qn q`pOIntmqnt] (with the doctor), to book an appointment [`buk qn q`pOIntmqnt] – записываться на приём к врачу
referral [rI`f E:r(q)l] – направление к врачу-специалисту
to make a referral [meIk q rI`f E:r(q)l] – выдать направление к врачу-специалисту
to deliver [dI`lIvq]– проводить, предоставлять
doctor's office [`dOktqz,OfIs]– кабинет врача
OB\GYN [`qubI,dZIn]– obstetrics\gynecology – акушерство\гинекология
urgent care center [`WdZ(q)nt `keq,sentq] - центр неотложной помощи
to evaluate [I`vxljueIt] - оценивать, определять
severe [sI`vIq]- острый, тяжёлый, серьёзный
complication [,kOmplI`keIS(q)n] – осложнение (вследствие заболевания)
general medical practice [`dZen(q)r(q)l,medIk(q)l `prxktIs] - врачебная практика
to run [`rAn] - управлять
general practitioner [,dZen(q)r(q)l prxk`tIS(q)nq] - врач общей практики, терапевт
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to provide ambulatory care [prq`vaId,xmbjqlqt(q)rI `keq] - предоставлять уход за амбулаторными пациентами
walk-in clinic [`wLk,In,klInIk] - клиника, обслуживающая бед предварительной записи
healthcare service provider [`helTkeq,sWvIs prq,vaIdq] – поставщик медицинских услуг (доктор, больница)
physical injury [,fIzIk(q)l `IndZ(q)rI] – телесное повреждение
medical record [,medIk(q)l `rekLd] – медицинская карта, медицинская документация
overnight [,quvq`naIt] - на ночь
to offer [`Ofq] – предлагать, оказывать
staff [stRf]– штат сотрудников
internal medicine [In,tWn(q)l `medIsIn] – медицина внутренних болезней, терапия
registered nurse [`redZIstqd,nWs] – младшая медсестра
nurse practitioner [,nWs prxk`tIS(q)nq] – практикующая медсестра
clinical nurse specialist [,klInIk(q)l,nWs `speS(q)lIst]– частнопрактикующая медсестра - специалист
disease management [dI`zJz,mxnIdZment] - ведение больного, управление течением заболевания
to present with [prIz`ent wID] (symptoms) - получить консультацию и пройти первичный осмотр по поводу….. (у врача), обратиться к врачу по поводу…..
Translate the following word combinations paying your attention to the word formation:
To care – health care – medical care, to provide the care - provided on an outpatient basis - providing health services, to diagnose - primary diagnosis - diagnostic procedures - diagnostics, to observe symptoms – clinical observation, to prevent - preventive health care, emergency - emergency department, the patient - outpatient care, a health condition - conditions of the environment, to follow up a patient - revisits for follow-up – follow-up patient, to deliver the outpatient care - the delivery of ambulatory care, clinic – polyclinic – clinician, nurse – registered nurse - the nursing care of patients, to manage a patient – publicly managed - disease management, to practice - medical practice - general practitioner, to injure - injured - physical injury.
5. Translate the following word combinations into Russian:
Medical care provided on an outpatient basis, minor surgical and medical procedures, to get health advice or treatment for a symptom or condition, usually presents withambulatory care sensitive conditions, prevents or reduces the need for hospital admission, one or more planned revisits for follow-up, usually sees 50-100 patients per week, have to pay dues to a particular practice to underwrite house calls, to evaluate and treat conditions, provide same day surgery services, organizational and professional activities engaged in by registered nurses with and for individuals, primarily focused on the care of outpatients, covering the primary healthcare needs of populations in local communities, a general medical practice run by one or several general practitioners, the major surgical and pre- and post-operative care facilities, advanced diagnostic or treatment services for specific diseases, a network of clinics staffed by a group of general practitioners and nurses.
6. Look at the pictures below. Decide what pictures refer to the outpatient care:
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1. 
2. 
3. 
4. 
5. 
6. 
What facts are true?
· Hospital refers to outpatient care.
· Outpatient care is provided on an outpatient basis.
· A physician sees each patient for 13-16 minutes.
· The service ‘a house call’ is available for everybody.
· Doctor's office is the most common site for the delivery of ambulatory care.
· Nurse-led clinic is any inpatient clinic run or managed by registered nurses
8. Read the text and check your predictions:
Outpatient care facilities
Outpatient care or ambulatory care is medical care provided on an outpatient basis, including diagnosis, observation, consultation, treatment, intervention, and rehabilitation services. This care includes advanced medical technologies and procedures. A lot of medical investigations and treatments for acute and chronic illnesses and preventive health care can be performed on an ambulatory basis, including minor surgical and medical procedures, most types of dental services, and many types of diagnostic procedures. Other types of ambulatory care services include emergency visits, rehabilitation visits, and in some cases telephone\on-line consultations.
A meeting between a patient and a physician (family doctor, general practitioner) to get health advice or treatment for a symptom or condition is a doctor's visit (physician office visit). A patient usually presents with ambulatory care sensitive condition (ACSC), an illness or a health condition the appropriate ambulatory care prevents or reduces the need for hospital admission, e.g. asthma, diabetes mellitus, dental conditions and others. If it is necessary to visit to a specialist, GP can supply a patient with a referral (referral letter) and make an appointment. Appropriate care for an ACSC can include one or more planned revisits for follow-up, such as when a patient is continuously monitored or otherwise advised to return when (or if) symptoms appear or reappear. According to a survey in the USA, a physician usually sees 50-100 patients per week. A physician sees each patient for 13-16 minutes. Anesthesiologists, neurologists, and radiologists spend 25 minutes or more, whereas dermatologists and ophthalmologists spend 9 - 12 minutes per patient.
The service ‘ a house call’, a visit to the patient’s home by a doctor or other professional, can be also provided. Depending on Action Plan for Healthcare patients have to pay dues to a particular practice to underwrite house calls, some patient having Health Insurance Plan cards are able to take advantage of the house call system, and arrange for appointments with physicians at their home.
Health care organizations use different ways to provide the care as an "ambulatory" one. Sites where ambulatory care can be delivered are the following:
Doctor's office (doctor's surgery).This is the most common site for the delivery of ambulatory care and usually consists of a physician’s visit. Physicians of many specialties deliver ambulatory care, including specialists in family medicine, internal medicine, OB\GYN, cardiology, ophthalmology, etc.
Clinics. Clinics include ambulatory care clinics, polyclinics, ambulatory surgery centers, and urgent care centers. These centers are designed to evaluate and treat conditions that are not severe enough to require treatment in a hospital emergency department but still require treatment beyond normal physician office hours or before a physician appointment is available.
Hospitals. Hospital emergency departments and other hospital-based services provide same day surgery services and mental health services.
Telemedicine. The telemedicine-based follow-up is feasible and safe for the evaluation of early postoperative complications. Telemedicine-based follow-up is becoming a standard practice with the development of a specific mobile application.
Ambulatory care nursing is the nursing care of patients who receive treatment on an outpatient basis. Ambulatory care includes those clinical, organizational and professional activities engaged in by registered nurses with and for individuals, groups, and populations who seek assistance with improving health and/or seek care for health-related problems.
Non-medical institution-based settings, including school and prison health; vision, dental and pharmaceutical care.
The most common type of ambulatory care institutions is a clinic (Greek κλίνειν klinein ‘to slope, lean or recline’, κλίνη klinē ‘couch, bed’) or outpatient clinic (ambulatory care clinic). It is a healthcare facility primarily focused on the care of outpatients. Typically covering the primary healthcare needs of populations in local communities clinics can be privately operated or publicly managed and funded. They are often associated with a general medical practice run by one or several general practitioners. Also there are specialized clinics, e.g. physical therapy clinic run by physiotherapists.
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Some clinics are operated in-house by employers, government organizations, or hospitals, and some clinical services are outsourced to private corporations which specialize in providing health services. Typical large outpatient clinic houses general medical practitioners (GPs) such as doctors and nurses to provide ambulatory care and some acute care services but lacks the major surgical and pre- and post-operative care facilities commonly associated with hospitals. Besides GPs, if a clinic is a polyclinic, it can house outpatient departments of some medical specialties, such as ophthalmology, neurology, cardiology, and others. There are many different types of clinics providing outpatient services. They are:
- a walk-in clinic in the U.S. describes a very broad category of medical facilities defined as those that accept patients on a walk-in basis and with no appointment required. A number of healthcare service providers include urgent care centers, retail clinics and even many free clinics or community health clinics. Walk-in clinics offer the advantages of being accessible and often inexpensive. All types of walk-in clinics provide basic medical services, such as routine vaccinations, evaluation of cold and flu symptoms, and treatment for less severe physical injuries. Access to the patient's regular medical records depends on the agreements that the clinic has with other organizations.
- a general out-patient clinic offers general diagnoses or treatments without an overnight stay.
- a polyclinic provides a range of healthcare services without need of an overnight stay.
- a specialist clini c provides advanced diagnostic or treatment services for specific diseases or parts of the body.
- an ambulatory surgery clinic (outpatient surgery, day surgery ) offers outpatient or same day surgery services, usually for surgical procedures less complicated than those requiring hospitalization., including diagnostic and preventive procedures.
- a healthcare center, health center, or community health center is one of a network of clinics staffed by a group of general practitioners and nurses providing healthcare services to people in a certain area. Typical services covered are family practice and dental care, but some can include internal medicine, pediatric, women’s care, family planning, pharmacy, laboratory testing, and more.
- a nurse-led clinic is any outpatient clinic run or managed by registered nurses, usually nurse practitioners or Clinical Nurse Specialists. Nurse-led clinics typically focus on chronic disease management, but also where a patient may not necessarily need to see a physician at every visit.
One can state that ambulatory care services represent the most significant contributor to increasing hospital expenditures and to the performance of the health care system in most countries, including most developing ones.
9. Read the text and choose the correct answer for the question:
1. What is outpatient care?
· the medical care provided on an inpatient basis
· the medical care provided on an outpatient basis
· the medical care provided on an nursing basis
2. What is a doctor's visit?
· a meeting of the team with the attending doctor to get health advice or treatment for a symptom or condition
· a meeting between a patient and a nurse to get health advice or treatment for a symptom or condition
· a meeting between a patient and a physician to get health advice or treatment for a symptom or condition
3. What is a follow-up?
· a patient is continuously monitored or otherwise advised to return when (or if) symptoms appear or reappear.
· a patient is monitored once a year or otherwise advised to return when (or if) symptoms appear or reappear.
· a patient is not monitored or otherwise advised to return when (or if) symptoms appear or reappear.
4. What is a house call?
· a meeting between a patient and a doctor or other professional
· a visit to the patient’s home by a doctor or other professional
· a visit to the doctor’s office by a patient
5. What is a doctor's office?
· the most common site for the delivery of inpatient care and usually consists of a physician’s visit.
· the most common site for the delivery of ambulatory care and usually consists of a nurse’s visit.
· the most common site for the delivery of ambulatory care and usually consists of a physician’s visit.
6. What is a clinic?
· a healthcare facility primarily focused on the care of outpatients
· a healthcare facility primarily focused on the care of inpatients
· a healthcare facility primarily focused on the care of aged patients
7. What is a walk-in clinic?
· a very narrow category of medical facilities that accept patients on a walk-in basis and with no appointment required.
· a very broad category of medical facilities that accept patients on a walk-out basis and with no appointment required
· a very broad category of medical facilities that accept patients on a walk-in basis and with no appointment required
8. What is a polyclinic?
· a healthcare facility providing a range of healthcare services with a need of an overnight stay.
· a healthcare facility providing a range of healthcare services without need of an overnight stay.
· a healthcare facility providing a range of healthcare services with a need of a week stay.
9. What isan ambulatory surgery clinic?
· a healthcare facility offering outpatient or same day surgery services, including diagnostic and preventive procedures.
· a healthcare facility offering outpatient or the other day surgery services, including diagnostic and preventive procedures.
· a healthcare facility offering inpatient or same day surgery services, including diagnostic and preventive procedures.
10. What isa healthcare center?
· one of a network of clinics staffed by a group of general surgeons and nurses providing healthcare services to people in a certain area.
· one of a network of clinics staffed by a group of general practitioners and nurses providing healthcare services to people in different areas.
· one of a network of clinics staffed by a group of general practitioners and nurses providing healthcare services to people in a certain area.
11. What isa nurse-led clinic?
· a clinic run or managed by registered nurses providing services where a patient may not necessarily need to see a physician at every visit.
· a clinic run or managed by registered doctors providing services where a patient may not necessarily need to see a physician at every visit.
· a clinic run or managed by registered nurses providing services where a physician may not necessarily need to see a physician at every visit.
10. Read the following sentences and choose a correct word:
1) Outpatient care or ambulatory care is medical care provided on an outpatient basis\inpatient basis.
2) At a doctor's visit the patient usually presents with ambulatory care sensitive condition \ ambulatory care signs and symptoms.
3) Some patient having Health Insurance Plan cards are able to take advantage of the house call system\doctor’s visit system, and arrange for appointments with physicians at their home.
4) Physicians of many specialties deliver ambulatory care\healthcare, including specialists in family medicine, internal medicine, and others.
5) The telemedicine-based follow-up\treatment is feasible and safe for the evaluation of early postoperative complications.
6) Clinics are often associated with a general medical practice\primary care run by one or several general practitioners.
7) Typical large outpatient clinic\hospitals houses general medical practitioners (GPs) such as doctors and nurses to provide ambulatory care and some acute care services.
8) All types of walk-in clinics\healthcare centers provide basic medical services, such as routine vaccinations, evaluation of cold and flu symptoms, and treatment for less severe physical injuries.
9) A specialist clinic\general clinic provides advanced diagnostic or treatment services for specific diseases or parts of the body.
11. Fill in the missing letters:
C_re, d_agnos_s, s_rvi_e, pro_ed_re, ac_te, c_nd_tion, s_m_tom, ho_p_tal, admi_sion, p__sician, p_ti_nt, ap_ointm_nt, pol_clini_s, eme_genc_, tel_medi_ine, n_rse, _mb_latory.
12. Make a word combination, match the words:
Ambulatory visit
Medical clinic
Diagnostic nurse
Doctor's center
House investigation
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