Final Reflection

As many of the others in this course have reflected about, I too did not know much about this country’s healthcare system.  Which is ironic given that both of my parents are doctors.  Healthcare was not really a topic that I talked about with my parents until I started this course.  I assume they didn’t want to bore me with their talks but after being in this course I have begun to engage them about topics we learn about.  It’s interesting to hear their perspective as doctors in today’s healthcare system.  For example, I asked my dad who is an emergency room doctor in Worcester, MA about a topic we just recently learned about.  I asked him how he breaks the news to families that their family member is dying.  Firstly, he confirmed that doctors are not taught how to deal with this situation.  He told me that he basically learned partly by watching other doctors do it and partly by himself.  What he told me was that it is a very hard thing to do and that you must be professional yet compassionate at the same time.  He said he tells them the situation but also puts his hand on their shoulder or arm.  This made me think of the doctor who recounted crying with a family as their family member died.  I think that when a family or patient makes a human connection with the doctor, the experience is a better one in the sense that they know the doctor is also human and understands the grief of the situation.

I think also this course has broadened my view on healthcare as a whole.  What I mean is that I now look at health related news more analytically and have opinions on it rather than before when I had no feelings toward these news.  For example the recent coverage that Martin Shkreli has been getting.  Shkreli is the founder of Turing Pharmaceuticals which has been in the news because he raised the price of a drug called Daraprim from $13.50 to $750 per pill, overnight.  Now I had heard of this dramatic price increase in September when it actually happened and I thought it was unfair, as many other people did, but I didn’t think much of it afterwards.  Then I heard about the new Wu-Tang Clan album that was going to be released.  Wu-Tang Clan is a rap group from the 90’s-early 2000’s that hasn’t released an album in a while.  However, they created one copy of this new album that they auctioned off without letting people hear the entire album.  The album was bought for $2 million so I was extremely surprised.  I did some research to find out that the person who bought it was Martin Shkreli the same guy who skyrocketed the price of Daraprim.  So as I was investigating I realized it was the same guy and I got pretty upset.  I was angry that this business guy can just create his own pharmaceutical company, buy the rights to a drug that a very small percentage of people use, and screw them by raising the prices to an absurd amount.  Then, on top of that, he buys the only copy of an album which thousands of people would love to hear for himself to do who knows what with just because he owns millions of dollars all that he earned at others people’s expenses.  I probably wouldn’t have had such an opinion if I hadn’t taken this course is my point.  In taking this course I have realized that pharmaceutical companies are not exactly trying to help people who need their drugs.  But not only pharmaceuticals, many other aspects of the healthcare system which I previously thought was there to aid those in need has come to light for me and shown its negative aspects.  In conclusion, I think that if I hadn’t taken this course I would be much more naive as a pre-med student.  Its made me more knowledgable and made me reflect on my experiences and my future in this area and for that I am grateful.

Massachusetts Raising Legal Age of Buying Cigarettes to 21

http://www.nytimes.com/2015/11/29/us/massachusetts-like-boston-weighs-raising-legal-age-for-buying-cigarettes-to-21.html?ref=health

This article refers to the recent bill that will be decided on next year on whether to raise to the legal age of the purchase or tobacco and nicotine products from 18 to 21.  This bill is looking to curb smoking by forcing the legal age higher.  Some towns in Massachusetts have already set minimum ages to 21 for tobacco/nicotine products.  Boston’s Board of Health scheduled a hearing and potential vote on Thursday for the ban of sales to those under 21.  New York City for example has already raised the legal age to 21 in 2013.  Supporters use a report from March which found that 90% of daily smokers used cigarettes before the age of 19.  Opposition has come from convenience store operators, gas stations, etc. because they stand to lose business. Continue reading “Massachusetts Raising Legal Age of Buying Cigarettes to 21”

Groopman – How Doctors Think

Groopman’s book on how doctors think got me thinking about a couple of things.  He starts off by introducing us to a woman named Anne Dodge who had been going to many doctors over the past 15 years because of a problem that didn’t seem to be getting better.  Her problem was that she couldn’t hold her food down because her stomach would hurt after eating and sometimes throw up.  The doctors that she had been seeing had diagnosed her with anorexia nervosa and bulimia.  She had been told that she needed to eat 3000 calories a day which included a lot of cereal and pasta along with other things.  The doctors she was seeing kept telling her the same thing and although she was following their orders, her health had steadily been deteriorating over the past 15 years.  Finally, Dr. Falchuk decided to ignore the previous doctors observations and assessments and he had Anne tell him her story from the beginning.  He listened intently and let her tell her entire story.  In the end, Dr. Falchuk diagnosed Anne with celiac disease which meant that she was allergic to gluten.  All the doctors before him had been encouraging her to eat more food along with gluten because they didn’t know she had this disease.

When I thought about this story it made me disappointed in the doctors that had cared for Anne before Dr. Falchuk.  Although I accept that doctors make mistakes, I feel like with the amount of doctors that Anne had seen one of them should have caught something else.  It bothers me that as Anne’s case was passed from one doctor to the next, the previous observations and assessments were glorified.  Although they should take into consideration the previous information, they should also think for themselves.  Groopman talks about how the doctors now have algorithms for diagnosing patients.  He argues that they should learn to think outside of the box.  He thinks doctors should listen for clues in patients’ stories, analyze their body language, assess their emotions, etc.  However, he finds it hard to teach his students this.  My question is, how does one teach doctors to think critically and investigate a patient’s story to find the real problem they are having?

Process Reflection #1

To be honest I only took this course because the Sociology 100 class was already full.  Coming into this course I didn’t know what sociology of healthcare was, but since I am interested in medicine I thought it would be interesting.  As soon as we began with the material I was excited.  I never understood health insurance before and I was relieved to learn that I would now understand the mechanics of it.  If I wasn’t taking this class I most likely would still not know anything about health insurance and wouldn’t learn about it for awhile.

My parents are both doctors, my father is an emergency room doctor and my mother a gynecologist.  Growing up I would hear stories from their work but nothing too in detail.  It wasn’t until this class that I began drawing parallels which is helping me understand the material we are learning.  Although they never talked about insurance I did hear about their jobs being professions like we learned about.  I knew about medical school obviously but also about how specializations are chosen and how they are regulated by superior doctors who decide the curriculum which relates to what we learned in lecture.

I probably have a bias view since I come from a background in medicine in regards to the things we’ve been learning about but sociology is about have a neutral stance and looking at the facts.  I found it surprising to learn about the malpractice and defensive treatments doctors use because while I had heard about it happening I never asked my parents.  So I did, and they basically said that they must exercise caution when dealing with patients because you never know when patients might decide to sue.  This upset me a little bit because I could never imagine suing a doctor for doing their job.  The doctors are the ones treating, healing, helping the patient and yet they are the ones who get sued.

In regards to the class, I think that the textbook is really good.  When reading it, I really understand the topics and the underlying themes.  Also, it helps a lot to have that recap at the end of the chapters to finalize the main points.  On the other hand, some of the articles are a bit more confusing.  I also find it difficult to keep the main ideas in my head while reading some of the more lengthy articles.  Finally, I think that the videos and clips Professor Guseva shows us are very easy to understand and help me to learn the material.  In some of them they use real life examples and show hospital settings, etc. which is helpful to my understanding.

Drug Companies Hire New Lobbyist to Answer Critics

http://www.nytimes.com/2015/09/26/us/drug-companies-hire-new-lobbyist-to-answer-critics.html?ref=health&_r=0

This article pertains to the newly chosen lobbyist for the drug companies.  This lobbyist, by the name of Stephen J. Ubl, is there to defend drug companies from critics who are saying the drug companies are charging too much money for drugs.  Ubl will become president of Pharmaceutical Research and Manufacturers of America (PRMA) which defends many big name pharmaceutical companies such as Johnson & Johnson, Merck, and Pfizer to name a few.  Ubl has been one of the top lobbyists for medical manufacturing companies for the past decade.  His presidency was announced by the chairman of Merck, who is also the chairman of the pharmaceutical trade group.  For the past 10 years Ubl has been defending the notion that medical technology has been raising health care spending and he will have to do the same for the pharmaceuticals charging more money for drugs.

This article clearly outlines the points we have come across in class about commercialism in health care and how medical companies use operating and managing principles typically found in business settings.  Big pharmaceutical companies are charging more money for drugs than they have in the past.  Consequently, consumers dislike paying more money if they don’t have to so they protest.  Instead of taking the stance of helping the consumer, which is what medicine is based around, these companies hire a powerful lobbyist to defend their rising prices.  Of course this increases spending because the pharmaceutical companies are the ones who control how much consumers spend since they usually have to buy whatever is prescribed to them.

Also, I think this system is corrupt.  The fact that the chairman, Kenneth C. Frazier, of the big pharmaceutical company Merck announced that Ubl would become the president of the PRMA (the organization that defends Merck and others) is pretty fishy.  This shows how these companies are all in unison so that they can keep high drug prices.  This is wrong because health care should not be used as an area where business can be utilized by taking advantage of the stranglehold the consumers are held in.  These companies should be making it easier for patients to buy their needed drugs.  In doing this they would be contributing to saving lives.

Refusal of Medical Care in Hospitals

In the “Money & Medicine” video about how medical treatments cost money and whether or not all of those treatments are necessary there was a section that rose some questions.  About 20 minutes in to the video there is a patient named Mrs. Stonum who had been in the hospital for about 10 months because she could not live without the advanced life supporting machines that the hospital had.  In the video, Mrs. Stonum’s son was having a difficult conversation with a doctor about continuing life support on his mother.  The son was very adamant about how he would like to continue keeping his mother alive and how his mother would express the same thing if she could still speak.  After that, the narrator declared that the UCLA hospital that Mrs. Stonum was in had a non-resuscitation policy.  This meant that if Mrs. Stonum, having been in the hospital for such an extended period of time, contracted an infection for example from being in the hospital the staff would not treat that infection and only provide the care they had originally been providing.  This struck me as unethical because how was a hospital allowed to not treat their patients when that is the sole purpose of a hospital?  And yet I also understood that Mrs. Stonum was taking up valuable resources from other patients when the fact is that she is going to be on life support until the day she dies.  So I guess my question is, how is a hospital allowed to have such a policy where they refuse to take care of problems that could kill their patients?