A plan to create change in the healthcare world

Before taking this class, I will admit that I had a very narrowed view of the healthcare industry, and was not familiar with all the intricate components that make up the healthcare sector. The beauty of becoming a doctor is all too glamorized, and many fail to realize that the healthcare industry is not solely about the doctor and their practice. Medicare, Medicaid, pharmaceutical companies, healthcare laws, the doctor-patient relationship, elderly care, overtreatment, overdiagnosis – these are just a few of the many things that this sociology class has introduced me too. As a future healthcare provider, I now realize the importance in understanding these individual components and how they shape the way patients receive care.

The most fulfilling thing this class has instilled in me is a desire to change all the negative aspects of healthcare. One of the major parts that we focused on in class is the lack of care millions of Americans receive, despite Medicare, Medicaid, and private insurance companies. I was baffled by the staggering numbers of Americans that find themselves unable to provide medically for themselves, and find themselves resorting to alternative methods, foreign country care, or simply avoiding medical care altogether. As I’ve discussed before in a previous reflection post, I believe the most impactful way to change the course of our current healthcare is to become educated, and vote. This upcoming presidential election is inching closer and closer, and educating myself of each party’s platform and ideals in the best way to see change in the healthcare world.

Although I initially took this class as a fulfillment for my Public Health Minor, the wealth of knowledge I have acquired will better me as a healthcare consumer, and a future healthcare provider. Even after finishing this class, I plan to keep educating myself on the persisting changes in the healthcare world.

How much control should a doctor truly have over a dying patient?

In the New York Times article “Fighting to Honor a Father’s Last Wish: To Die at Home”, we are introduced Ms. Stefanides and her dying father, Mr. Andrey, and their battle with the healthcare system. Unfortunately, Ms. Stefanides could not afford out-of-pocket home care, and though her father qualified for both Medicaid and Medicare, “the flow of money seemed to bypass what he actually wanted at the end of life”. In addition to emphasizing that Mr. Andrey couldn’t even be granted his basic wish to die at home, the article further talked about all the abuse that occurs at rehabilitation homes that care for the elderly. Ms. Stefanides recalled her own mother’s month-long abuse and eventual death in the hospice, and refused to subject her father to that kind of tragedy. Unfortunately her options were incredibly slim, and she felt that the doctors were “bullying her to disregard her father’s wishes”, and they basically wanted him sent somewhere else to die.

This incredibly touching and sad article sheds light on the difficult position many are faced with due to a failing healthcare and abusive system. One must wonder if all of this heartache for Ms. Stefanides and her father were worth it, and if his dying wish should’ve been granted in the first place. This brings up the issue of the doctor-patient relationship, and how invested a doctor should truly during a patient’s final years. And so I ask – Where do we draw the line to how much say a doctor has during a patient’s time for his/her death? Should the patient have full ownership over their body and where they will rest during their final time, or does the doctor know what is best?

How do we justify our failing nursing home system?

It’s no secret that the life in a nursing home isn’t what people imagine it to be. Most expect a warm and nurturing environment that comforts the elderly, but realistically speaking, nursing homes revolve around a “profit-driven system” (Weitz, pg.241). Chapter 10 in Weitz emphasizes the truth behind modern-day nursing homes, indicating that may nonprofit nursing homes and for-profit homes significantly lack both quality of life and quality of care. Nursing assistants are considered “budgeted expenses”, nursing home administrators and owners keep overall care to a minimum, and health and safety violations are at an all time high. In fact, “federal regulators in 2008 cited more than 90% of nursing homes for health and safety violations” (Weitz, pg.241). This overwhelmingly large percentage of nursing home violations places residents at risk of “bedsores, malnutrition, pneumonia, and other avoidable health problems” (Weitz, pg.241).

With all these federal health and safety violations, it makes one wonder what is being done to fix these problems. Weitz indicates many problems that come with nursing homes, as well as at-home care and hospices, but fails to provide solutions to this increasing problem. And so I ask – What are possible solutions to this failing, profit-driven system that so many people rely on? How do we stop the process of commodification – turning patients into commodities?

Everyone’s Health Records… All In One Place?!

http://www.fastcompany.com/3054027/elasticity/ge-wants-to-move-all-your-health-data-to-the-cloud

In this day and age, everything is computerized and shared virtually, whether it be pictures, videos or notes. However, medical records are usually lost between hospitals, and patients find that they’re required to get the same CT scan that they did months ago at another hospital, doubling their exposure to radioactivity as well as accumulating ridiculous amounts of costs. Luckily enough, GE Healthcare has introduced a service that could fix this problem altogether – a service they call GE Health Cloud that links up “medical devices around the world, processes the data, and stores patient records securely online so they can be viewed from anywhere” (Captain, par.4). Indeed it’s true that something of this magnitude has the possibility of violating patients’ confidentiality, but the company promises that Health Cloud meets all U.S. HIPPA privacy requirements for healthcare records. GE Healthcare is planning to launch their new service in late spring 2016, revolving around devices like “CT scans, ultrasounds, and MRI scanners, and starting off with 500,000 of GE’s machines” (Captain, par.5). De Witte, the president and CEO of GE Healthcare, emphasizes that this service could save time and money, as well as even save lives. He gives the example of a patient with an ischemic stroke, which requires immediate diagnosis and treatment within 3-4 hours. A CT scan would require at least 4-5 hours, and the duration would put the patient’s life at risk. But with this service, any of the patient’s radiological records can be examined within minutes using the Health Cloud. The problem will eventually come with the hospital’s decisions to participate in the service, which can obviously be costly to the hospitals. It’ll be a difficult problem to come across when one hospital decides to participate in the service, and another hospital decides to ignore it.

I think this is one of the most promising articles I’ve come across in a long time. Medical technology is always being reinvented and expanded, so it’s shocking that a service like this hasn’t already been created. The biggest obvious downside to this service will indeed be the costs that hospitals will have to manage, but this is a situation where the positives greatly outweigh the negatives. Aside from saving the patient a great deal of time, effort, and money, this could ultimately save a patient’s life (as explained in the paragraph above) as well as help the patient’s health in ensuring they aren’t overly exposed to unnecessary and redundant radioactivity that comes from many of these scanners. I am, however, skeptical of how every hospital will react to this service. I do believe many will reject this service solely based on costs, but if the costs are evenly distributed between the hospital and patients, I feel that the costs would end up being reasonable for both parties, still saving patients money from the ridiculous costs that come with all these expensive tests. I look forward to following up on the service’s success

Doctors or Robots – What is going on with this generation of doctors?

In the excerpts of How Doctors Think, Jeremy Groopman explores a common theme revolving around doctors and how they approach their patients. In the immediate introduction, he tells the story of Anne Dodge, who had been misdiagnosed for so long that she her body was so close to completely shutting down on her. Groopman emphasizes that poor communication between doctors and patients, and doctors lack of empathy towards patients and willingness to actually HEAR them, contributes immensely to the all-to-common problems of misdiagnosing and overtreatment. Groopman also demonstrates how this current generation of doctors are programmed to function as computers, rather than caring and empathetic humans. “Every morning as rounds began, I watched the students and residents eye their algorithms and then invoke statistics from recent studies. I concluded that the next generation of doctors are being conditioned o function like a well-programmed computer that operates within a strict binary framework” (pg.6).

And so with all this being said, my question is this – Who/What is to blame for the lack of empathy and lack of humanistic qualities that doctors currently possess? Do we blame medical schools for enforcing strict rules and forgetting to instill such basic qualities in a doctor or do we blame and criticize doctors individually? How do we begin to fix these problems?

Teen Health Study Shows There’s Not Enough Screening for Depression

http://bringmethenews.com/2015/10/31/teen-health-study-less-than-half-are-being-screened-for-depression

The article “Teen Health Study: Less Than Half Are Being Screened For Depression” reminds us about the importance of screening for depression, and sheds light on the issue of inadequate screening for depression. A recent health study in Minnesota concluded that less than half of teenagers are being adequately screened for depression. The analysis focused on patients aged 12-17, and highlighted that Minnesota health clinics are failing in their job to accurately test for depression. The study found that “only 40 percent of those teens received a mental health screening” (Sommers, par.3). The health department emphasized the importance of mental health screening, “since half of all cases of mental illness begin showing up by age 14” (Sommers, par.6). Even concerned parents emphasized there disappoint in Minnesota health clinics, with one parent stating the how effective adequate mental health screening can be. The Minnesota Department of Health is working on a solution to this problem, one of them being that they developed a “standard set of criteria to measure the quality of health care providers across the state” (Sommers, par.12). They are hopeful that they can fix this problem, in order to more accurately inform patients about their mental health status.

I think this article does a great job in emphasizing the importance of mental health status. It is very encouraging that the state of Minnesota recognizes their inadequate mental health screening, and work on a solution to fix this problem. Depression is a major mental health issue in the United States, and many patients often go untreated or undiagnosed. Accurately diagnosing someone with depression can cause a lot of relief for the patient, and as we discussed in class, can help with de-stigmatization. Diagnosing someone with depression, or any other mental illness, can help decrease the blame that person gets for being the way they are. Having a medical label justifies that they cannot perform in the level that they are expected too, so the blame is no longer on them, but on their condition. The article is definitely encouraging, and I truly hope they find the solution they need in order to fix this problem, as it could help a lot of teenagers overcome the obstacles that come with mental diseases.

Gender Inequality – in the form of synthetic estrogen?

Women have been fighting for gender equality since the beginning of time, and indeed we’ve come a long way – but the battle is surely not over yet. We still see inequality with regards to income, job positions, household positions, etc, and for the latter part of the 20th century, we saw gender inequality in the form of estrogen therapy. In the article “Tall Girls: The Social Shaping of a Medical Therapy” by Lee et al., they explore the popularity of estrogen therapy for tall girls, and explain how social norms perpetuated this idea that tall girls were, basically, too tall. In a study described in the article, these conclusions were stated: “men are almost always taller than women among lovers and married couples by the fact that “most men do not feel attracted to taller women. In this study, desirable women were almost never described as tall and attractive men were almost never described as short. (Lee et al., par.13). So because of this general idea that tall women were inadequate for men, estrogen therapy was highly utilized in the latter part of the 20th century.

Although it is true that this stereotype has declined, along with estrogen therapy in general, it still exists and tall women find themselves in this perpetuating stereotype – men just can’t be with tall women. And to replace the once popular estrogen therapy, short men now find themselves increasingly utilizing growth hormones in order to combat the stigma placed among short men. Is the popularity of estrogen therapy and GH therapy perpetuating the negative connotations associated with tall women and short men, and encouraging gender inequality and discrimination? Is getting rid of these synthetic therapies the next big step we need to take in order to achieve gender equality?

Why are we ignoring the importance of socioeconomic status?

We’ve become all too familiar with the racial disparities that African Americans have faced, and continue to face on a day to day basis. African Americans have constantly been faced with social disadvantages, including “poor heredity, neglect of infants, bad dwellings, poor food, and unsanitary living conditions” (Williams and Sternhal, pg. S16). African Americans have also been noted to have among the lowest socioeconomic statuses of all races, which have detrimental and perpetuating effects on healthcare, access to education, living environments, job opportunities, etc. Racial segregation also has a huge impact on African Americans, as “blacks currently live under a level of segregation that is higher than that of any other immigrant group in U.S. history” (Williams and Sternhal, pg. S20).

It’s evident in Williams and Sternhal’s article, Understanding Racial-ethnic Disparities in Health : Sociological Contributions, that these issues that African Americans face have stemmed from a historical lineage of constant oppression and stratification. It has also been highlighted the importance of approaching these issues from a socioeconomic standpoint, rather than just a basic race stance. Race has already been proved to have absolutely no biological context to it, and is simply a social construct that we as a society have created. “Sociological research has shown that differences in SES affect patterns and trajectories of health in important ways” (Williams and Sternhal, S21). Analyzing social issues from a socioeconomic point of view has given sociologists not only a better image of the problem, but an even better image of possible solutions to such a perpetuating problem. Since SES includes the many aspects that simply “race” does not, including education, living conditions, income level, etc., sociologists are able to isolate problems and provide reasonings and methods as to ways of combatting the problem.

My question begins with this: It is clear that the general consensus among many sociologists is that socioeconomic status can provide much insight into why exactly certain racial problems exist, and in what ways they’re affecting a racial group. SES is also extremely helpful in determining solutions and rationalizing these persisting problems, evident from Williams and Sternhals paper. Why is it, then, that the U.S. public system continues to report national health data by race? To put it in context, “For over 100 years, the U.S. public health system has routinely reported national health data by race. Instructively, although SES differences in health are typically larger than racial ones, health status differences by SES are seldom reported, and only very rarely are data on health status presented by race and SES simultaneously” (Williams and Sternhal, S22). Why are health status differences by SES seldom reported, when it is in fact SES that helps determine solutions and preventative measures in order to fix such a persisting problem? Is the U.S. public system trying to purposely hide such a significant problem, or are they avoiding the potentially costly measures we need to take in order to fix the problems we see through socioeconomic status?

A Desire for Change in the Healthcare World

Reflection Essay #1

Taking Sociology of Healthcare has made me realize how sheltered and ignorant I have been to the real life problem known as the healthcare crisis. From the issues of bioethics to the controversies of the ACA and Medicaid/Medicare, America is facing a severe healthcare problem that seems to be progressively getting worse. As a future healthcare provider, I am thankful that this class has opened me up to the various negative aspects in healthcare, and has persuaded me to think into solutions for these perpetuating problems.

The New York Times article “Millions of Poor are Left Uncovered by the State Law” has been one of the most eye opening articles I’ve read for SO215. It’s saddening to see that potential solutions to the healthcare problem, solutions such as Medicaid, are barely affecting the people that need healthcare the most. “You got to be almost dead before you can get Medicaid in Mississippi.” This simple, yet emotion-filled sentence shows how drastic and real the healthcare problem has become.

One of the biggest aspects of the healthcare crisis that has struck me the strongest is that people find that they can’t afford common medicine or procedures that they need to basically survive. From blood pressure pills, to medicine for diabetes, many people find that they are forced to put their health last in order to simply keep a roof over their heads.

This class has instilled in me a desire to create change in the health care world. I myself have never taken an interest in politics, but after physically seeing how much the political and healthcare world intersects, I plan to vote in this upcoming election in order to see change in the healthcare world. This has class has rewarded me with a wealth of knowledge that I have never considered as a student or as a healthcare consumer. I plan to use this knowledge to my benefit, and seek for change in the perpetuating healthcare crisis.

Has healthcare become an industry of business, or do doctors just really, REALLY, care about their patients?

There are always two sides to every situation. On the one side, you have Dr. Atul Gawande and his article “Overkill”, in which he essentially criticizes the current healthcare situation and blames doctors for overdiagnosing and overtesting their patients. On the other side, you have doctors – doctors that are just trying to do their job. So which is it?

Indeed Dr. Atul Gawande makes incredible points, followed by his own experiences in the medical profession and the experiences of fellow colleagues. He has firsthand witnessed the detriment known as overtesting, which he says leads to overdiagnosing. Not only does he highlight the health issues that come with overtesting, but he states the obvious; it’s expensive and is costing us way too much money. “The medical system had done what it so often does: performed tests, unnecessarily, to reveal problems that aren’t quite problems to then be fixed, unnecessarily, at great expense and no little risk.”

But one could argue that doctors are just doing everything in their power to run excess test to ensure the health of their patient. People could even agree that the importance of their health far surpasses any monetary value, hence my question: Has healthcare become an industry of business, or do doctors just really, REALLY, care about their patients?

Are healthcare providers just looking to make money? Have they turned an industry based on providing and caring for people into an industry run by money? Or are these tests necessary in insuring the complete health of patients?