December Analytical Posting

http://www.medscape.com/viewarticle/856197

Skin cancer has been recently on the rise, especially among young people. Just today, the FDA released new guidelines regarding the use of tanning beds. Specifically, the guidelines would prevent anyone under the age of 18 from using high-powered UV sunlamps. In addition, anyone over the age of 18 will be required to sign a waiver every 6 months that says that they understand that using these lamps has health risks that include burns and skin cancers. According to Dr. Peiris of the FDA’s Center for Devices and Radiological Health, tanning lamps give off ultraviolet radiation that’s 10-15 times stronger than the midday sun. Skin damage from UV radiation is cumulative. In other words, it adds up over the course of one’s lifetime, which implies that the concentrated doses of radiation that are delivered by tanning beds are especially dangerous to children and teens.

These guidelines come approximately 1 year after the FDA reclassified tanning beds from lower risk to moderate risk devices. These very moderate risk devices were subsequently banned from anyone that was either under 18, had open wounds or injuries, or had a family history of skin cancer. The FDA also required that anyone that was regularly using tanning beds should get regular checkups for skin cancer. Although this reclassification initiated the suspicions regarding tanning beds, it was only a month later that the surgeon general publicly singled out tanning beds as a cause of disease.

Understandably, the Indoor Tanning Association (ITA) has been very public about its belief that the decision to use tanning beds should be a personal one, even despite the risks. Of course, it is easy to see the profit incentives driven behind this statement, since teens are the industry’s biggest customers. Nevertheless, 13 states as well as the district of columbia have banned indoor tanning for minors, and 23 other states have requires tanning booth operators to adhere to time limits set by sunlamp manufacturers. While restricting access continues to be the main priority, the FDA also has made suggestions to make tanning beds safer, including improving labeling and eye safety.

Personally, I feel that the tanning bed debate speaks to a broader dilemma within healthcare – that regarding the autonomy of the patient in making individual health choices. It’s been well established that tanning beds pose significant health risks, but does this mean that it is appropriate to restrict access? A similar argument could be made regarding the relationship between smoking and lung cancer and alcohol and drunk driving. The risk is well-defined in these cases, but nothing prohibits Americans from being able to engage in these risky acts. Should tanning beds be treated differently? Given the precedents that have been set, I’m not so sure.

 

 

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New Medical Training

This article examined a new plan in medical school training that would get medical school graduates working as physician sooner. Grads would skip residency and go straight to treating patients. This new model would help the physician shortage and get physicians into areas with not enough physicians. Residency programs have limited space so many med school graduates are left with the qualifications, but without residency experience, creating a bottleneck effect. However, people argue that medical school is not intended to prepare you to go into practice, that is what residency is for. Some states are trying to implement a position called a “physician in training” or an “assistant physician” (different from a physician’s assistant) who are people who have graduated from med school, but not completed residency. The job allows them to provide primary care services as long as they are supervised by a physician. These new rules and positions are not planned to take effect until fall 2016. Continue reading “New Medical Training”

Final Reflections

At the begging of the semester, this was the class I was most looking forward too. As a future healthcare provider, I feel that it is important to understand the system in which providers work in. While doctors are often thought to reside at the top of the medical hierarchy there are so many individuals and factors behind the scenes that contribute to an effective medical practice. Coming into this class I had a basic understanding of the healthcare system and had read enough articles to know that the although the U.S system was one of the more prominent in the world, there still a few rough patches.

 

Overall, I left this class with an almost melancholy feeling. While I was appreciative of a greater understanding of the U.S healthcare system I could not help but think how bleak the situation had become at times. It’s hard to sugarcoat the fact that Americans are living in a fragmented consumer driven healthcare system. I hope that some day I will be able to utilize the knowledge I have learned in this class to help alleviate alleviate the power as well as profit imbalances in healthcare and overall foster a attitude of altruism.

Informed Health Care Consumer

As the semester is ending and I begin to reflect on this course and what I have learned I realize that a lot of Americans will go their whole lives without knowing the basics of our healthcare system. It is hard to believe that that is where I was at at the beginning of the semester. Since then I have learned and immense amount of information that I believe will forever be valuable.

Our health care system is a complex one and very different one when considered internationally. It is also in danger of collapsing our economy if regulations on spending are not put in place soon. The reason health care is so expensive is because it is treated like another commodity in the US rather than a basic human right.Now this may be because health care rose alongside the medical profession. However, there is nothing that can be done to change the past we can only learn from this mistake so that we are able to improve. No country in the world has perfected their health care  system. In Japan the cost of health care is too low and Switzerland it is too high (although not as high as it is in the US). Regardless improvement to our system is necessary.

This is only one of the issues with health care in the United States there are others like medicalization, long term care, and medical training. All of which deserve attention for the American public.  Having taken this course I am now a more informed consumer of health care but I know there is still so much to learn.

Process reflection

This course has really informed me a lot in terms of the way how policies are carried in our capitalist economic system, not only in the States but also in other countries as we do comparative studies. Before I came to this course, I only knew as much as the social construction of illnesses and how social institutions like the pharmaceutical companies have a huge influence in the diseases and drugs that become marketed. After this course, I learnt a lot more things and question a lot more things that I used to take for granted; such as the options we may have for our end of life care, and alternative care providers such as hospices and nursing homes. If anything, this course has made me more reflexive as a potential patient of our complex healthcare system.

Process reflection 3

What interests me most throughout the course is how actors such as big pharma, insurance companies, medical providers, policy makers and consumer groups influence the medical landscapes today on a macro level. Unlike most of the premed students in the classroom who resonate with the medical professionals more often, as a business major student I think more about the regulatory environment and sustainable growth for the companies (outside the limitation that defining ourselves by our majors, I surely learned a lot from my classmates and adjusted my opinions along the course). Not surprisingly, the mainstream sentiment in the teaching materials is the anger towards almost all the for-profit entities. But since further commercialization is inevitable in our social development, we need to shift from being angry to collaborating with the businesses with new corporate social responsibilities to create a better healthcare system. Furthermore, policymakers have huge power to allocate the interests among different groups thus shifting the whole landscape. For example, the coverage change in Medicare can transform the model of nursing homes, create a new industry such as Hospice, or significantly impact the life of certain population such as people diagnosed with cancer. Those topics are probably outside the scope of this course, but they could be very good extensions and leave questions for further research. Besides, I have only been in this country for about four months, so all the assumed knowledge towards US healthcare system is very new to me! Therefore, this course has been very eye-opening and rewarding.

Process Reflection: End of Semester

As the semester comes to a close, I feel lucky to have taken this class for a number of reasons. I enrolled in the class as an undeclared sophomore, attempting to decide between a sociology and international relations major. I knew that I wanted to work with people in some practical capacity, and that I was interested in the effect that big systems like healthcare systems had on human life at the most personal and individual level. While I will not be pursuing a public health major or minor at least in undergrad, the knowledge I have gained in this class is something so fundamentally relevant to my own life and the lives of those in the community that I am quite grateful to have taken the course.

I believe everyone would benefit from a basic knowledge of the materials learned in this class – no matter their profession or stage in life. Americans particularly live in a healthcare system that is very flawed, and often ends up taking a financial, physical and psychological toll on the people who need it the most. Other countries work as examples for systems functioning more efficiently or more poorly than ours, and educating ourselves about these differences is the first step to positive change. I am especially glad that I took this course at a time when the world is beginning to have more of these conversations – vast changes may be made to these existing systems in just the next few years.

In this class I learned a myriad of things I did not know before – from the consumer-centric and often arbitrarily priced mess of health care services, to conversations around death and dying and the shocking discrepancy between the care Americans want and the care they receive. I am grateful for all of it, and will absolutely consider taking more classes about health care in the future.

Final process reflection

Dr. Martin Luther King Jr. once stated “Of all the injustices in the world, injustice in health care is the most shocking and inhumane.” Equitable civil rights not only exist at the forefront of medical practice, but just living as a whole. Sociology of Health Care lectures throughout the semester have made it clear that care quality is highly variable between the sexes, races, and financial sectors of society. While I aim to touch the lives of each patient I have the opportunity to treat, I would like to also influence the medical community as a whole in a lasting manner. As such, I would like to begin further study in the field of health policy while I continue my education in medical school. Personally, the most influential lectures were those that spoke of fundamental causes of disease and the social factors affecting health, namely SES, race, and gender. Too often health policy is instated by those who lack understanding in the biological/social factors that affect illness. As I am already well equipped in this regard due to past enrollment in numerous basic science courses, I must gain fluency in the nuances of social justice regarding healthcare. SO 215 has started me on the path towards it.

Semester Reflection

As the semester comes to a close, I’ve realized just how aware I’ve become of the issues in the U.S. healthcare system. I remember coming to the first lecture not having any concept of the Affordable Care Act, but can now discuss it in a constructive and analytical manner with my peers. I didn’t know that our healthcare system was so multi-faceted and had so many contributing parties, especially in terms of deciding the cost of care. As a student interested in becoming part of the healthcare system as a physician, I was reminded of the importance of empathy and emotion in the medical field. The moving films we watched in lecture really opened my eyes to how important a stable healthcare system is and has inspired me to take initiative in actively reshaping our overpriced and inefficient system. “The Importance of Touch” really helped me understand that healthcare is more than just providing a solution to a disease, but nurturing and developing connections with others. A lot of the semester was spent hopelessly reading articles about the horrible consequences of a dysfunctional system, but the last lectures on hospice care have reassured me that with passion and initiative, we can find a way to organize and establish healthcare as a basic human right. I am curious as to what we can do right now as students and future leaders of the healthcare system. I cannot wait to see the progress we make as a generation on the medical field!