I have taken two major things away from this course. Before I took this class I was of the opinion that care was more black and white. After all of the topics we have discussed I still think that some healthcare professionals need to be more compassionate than others. I did not realize how much a persons emotions and environment can affect their road to recovery.As I move forward in life and my career I have a new perspective to perceive the people I encounter. I know I will try harder to relate to people and be more empathic. I think as there is more of a push towards primary care and compassionate care in this country I will understand better what that means. Continue reading “Process Reflection”
In class on Tuesday we watched the documentary discussing the emergence of hospice care. One point that struck me was that it seemed like the people of London felt that hospice care was a worthy cause to give money and time to, and that is the reason it succeeded. Death seems to strike a chord with many people. I think it because it is a common link we all share and when confronted with the mortality of ourselves and our loved ones, priorities change. What if in the US we started tackling some of our healthcare problems using this fact? If there was a way to emotionally reach people on topics like preventative care and public health, then I don’t think there would be much of a problem trying to change the healthcare system.
In class we have been talking about long term care of the elderly and we have discussed a few different examples. There is a common thread that links solutions such as personal care, nursing homes, or home health aids, or ‘village’ communities and it is that these options are all expensive. The task of reforming the care of the elderly is a daunting task to say the least but a solution that we have not discussed comes from the field of public health. If in the future public health and healthcare measures improve the quality of life for the elderly enough, then it is feasible to see a world where the amount of care needed for these people drastically decreases. The average stay of someone in a nursing home right now is about 2 years, but if most people in the population were able to take care of themselves with minimal help until say 6 months to the end of their life then expenses would drop drastically. Im proposing that once primary care measures and public health measures in this country improve the issue of elderly care will begin to solve itself. Could these complications one day be seen as outdated problems?
In the article “Over-the Counter Medicines’ Benefits and Dangers” Jane Brody discusses Americans use of OTC drugs and how we go wrong. Last year Americans spent 44 billion dollars on OTC medications so it is safe to say that they are part of every day life. We have all at least glanced at the label on a bottle of Tylenol and somewhere it says “consult your doctor” or “consult your pharmacist”. Brody points out a fact that we probably already knew which is almost no one consults their healthcare providers about taking OTC’s. We have all become self proclaimed experts in taking common medications. Continue reading “Over the Counter, Over the Line”
In class we have been discussing how healthcare providers would do better with a more universal sense of empathy towards their patients. A doctor should let the person they are taking care of know that they are a person worthy of helping. In Timmermans article he calls out doctors and nurses in the ER for giving their ‘all’ to only patients they deem worthy. I think this is an indication that every ER technician has a different type of emotional intelligence than the rest of us. In a profession where you are constantly surrounded by death how could they not?
In the article “Does Exercise Slow the Aging Process?” Gretchen Reynolds explores the scientific data behind exercise and aging. A new study published this month showed that exercise routines are correlated with people having shorter telomeres. In the article Reynolds explains a telomere as a plastic cap on a shoelace, except the shoelace is our DNA. As we grow older our telomeres shorten and research has recently shown this may be the cause of aging. In this latest study the data showed that the people who can benefit most from exercise were in the 40-65 age group.
I thought that this article was particularly appropriate to write on because of our recent discussion of health and different SES groups. We know that SES and life expectancy are intertwined and this data on telomere length is part of the answer as to why that is. Most people who are employed are most likely not getting much exercise at their job whether they are sitting at a desk or standing at an assembly line. The major difference between the two is the amount of freedom each job allows. The high powered executive is able to take vacation days to go hiking, skiing, or running and there may even be an office gym, while the factory worker probably does not have as many freedoms or resources. Every part of being in a higher SES group gives advantages that someone in a lower groups does not have. There should be programs started to give these disadvantaged workers a chance at a healthier lifestyle. If routine exercise becomes a luxury that not only the rich can afford then the entire population would see benefits from higher life expectancy to improved levels of mental health. We saw in class that Seattle is setting a good example for this by making the lower income neighborhoods safer, bringing communities together, and starting farming programs.
Another interesting result of the data mentioned above is that it may shed some light on the “hispanic paradox”. The group of people who this paradox applies to may be seeing the unforeseen benefits of labor intensive jobs. If a worker is out on a farm 8 hours a day doing manual labor for most of their life then they have to be in good shape. Could it be that migrant workers are living longer because they are taking the physical jobs that US natives see as undesirable? This could be an interesting direction to take research studying the hispanic paradox. Are the life expectancies of workers who undertake a physical job higher than those who do not even if they are in the same SES group? Whatever the answer, I think that exercise and physical health promotion will contribute to shrinking the differences between health and SES.
As I was reading about the two different models of illness, medical and sociological, I felt strange thinking about illness as a subjective matter. I think that we are in a time period of technological change and that in many cases our knowledge base has not caught up with the sensitivity the technology we have tests with. I can imagine a future where the medical model of illness takes hold and rather than having two models there is instead a sociology of illness rather than a social definition of illness. One of the main problems is that science overwhelmingly recognizes humans to have one “set-point”, while what may be abnormal for one person may be normal for another. Hopefully this idea will change and the medical field will be able to recognize that different types of people have different is factors depending on their age, ethnicity, lifestyle, gender, and every other factor that makes up who they are.
If doctors start thinking about illness as a social problem more than a scientific problem I fear that progress in the scientific fields could halt and we could lose the next great discovery of our time. If someone is sick then it is due to a biological cause and with enough research and effort someone will find out how to change that “sickness”. Whether or not someone should change that sickness because of social factors I don’t think is a question doctors and researchers should be answering.
Reading “Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications.” gave me a few thoughts on the health care system in the US. At the end of the article Phelan remarks that the best way to fix these health differences between SES groups is to either change the healthcare system to make it more accessible, or to redistribute wealth.
I think this is an interesting point because it reminds us that the healthcare system in the US did work at one point. We weren’t always in a healthcare crisis. The real issue is the disappearance of the middle class. Granted, even in a perfect world where wealth is distributed evenly and the largest group is the middle class there would still be holes in coverage. Although, it reminds us that socialized healthcare is not the only option we have. To fix the healthcare crisis we are in there will need to be new legislation, but I think that the most effective type of legislation could surprise us.
After a month of this class I have formed and changed opinions already more times than I can recall. I have found a few things to be specifically difficult, including some of the readings, but mostly deciding which point of view I agree with. We are taking a very academic look at healthcare and I find that sometimes so much information is thrown at you that it is hard to form an opinion. For example, the first time I looked at the Rothman article I wasn’t sure what I was reading. I understood that the apathy of the middle class prevented the country from needing a national healthcare system. Still after seeing all of the anecdotal evidence I wasn’t sure who was to blame. These issues are all so complex that there are arguments to be made for so many points. Should Blue Cross be blamed for creating the apathy that struck the middle class? Should the government be blamed for not having enough foresight to see that private healthcare would get out of control? I think that in the coming months I need to spend more time reading over the articles multiple times so that I have all the facts straight enough in my head to form better opinions. Continue reading “Process Reflection 1 : Is it really all bad?”
What happens when the treatment is more harmful than the ailment? More people get sick and die. The public would rather see professionals try to do something and fail rather than let the less severe consequences play out.
In the article entitled “When Radiation isn’t the Real Risk”, NY Times writer George Johnson discusses the 2011 Fukushima meltdown and its aftermath. The surrounding 20 kilometers were soaked in radiation, and the government evacuated the whole area. So did they do the right thing? Were thousands of people saved from radiation induced cancers? Not quite.
Based on the amount of people who were evacuated and the amount of extra radiation in the atmosphere experts estimate there would have been 160 cancer related deaths. The alarming part of the article though is that 1,600 people did die in the meltdown because of the sudden evacuation. Patients in the surrounding hospitals, especially the elderly, died because of the physical and mental stress brought about by transport while being in a critical condition. The evacuation itself caused a 10 fold increase in deaths. Continue reading “The Lesser of Two Evils”