Being a surgeon, or a nurse, or any sort of physician entails much more than just carrying out your rounds day-by-day and doing whatever it is you have been trained for in order helping people. It’s not just providing treatment and curing diseases and fixing traumatic injuries. With any medical position comes many social, and ethical responsibilities that are often overlooked and misunderstood as not being a major aspect of Healthcare. This class has showed me that Healthcare as a system, the relationships involved, and all of the positions of the field, not just the doctors and nurses, are a part of an elaborate environment that is constantly changing. Continue reading “Reflection”

Hospice Care

In the Documentary we watched today in class, it was mentioned that medical students should spend time on a hospice rotation before beginning their profession in medical practice. After everything we have learned throughout the semester about physician-patient relationships, and patient-centered care, and things of that nature, and now learning from the video the morals behind hospice care, it almost seems necessary to me for students to have a rotation at some point in a hospice facility. It teaches young doctors and soon to be doctors how to build relationships with the people they are treating, so that they do not lose their identity and become identified by their disease like patients so often do. Continue reading “Hospice Care”

Quality of Care in Nursing Homes

In the public health article, “Does Investor Ownership of Nursing Homes Compromise the Quality of Care?” Harrington and his co-authors looked to examine whether or not investor ownership of nursing homes affects the quality of care distributed at that home. Their study analyzed nearly 14,000 nursing home facilities across America, and measured the institutions’ quality based on a range of measures. These included the evaluation of  health outcomes, physician services, patients’ rights, and others, which all add to determine quality of care and in turn the quality of life for the institutions’ residents. The investigation revealed that investor-owned nursing homes had nearly 40% more deficiencies in all categories of quality-of-care than did non-profit and public facilities. The study concluded that investor-owned nursing homes provide lower quality care than non-profit or public facilities.

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Person-Centered Health Care

In the Chicago Sun-Times article, U. of C. part of push for ‘person-centered’ health care, the Associated Press addresses a major flaw in communication that exists in the current physician-patient relationship and in the overall system of care seen in hospitals as well as the steps that are being taken by the University of Chicago to eliminate such issues. A very prominent problem arises when complex diagnoses or diseases must be broken down for the patients to understand in order to know what exactly they have and what has to happen down the road. This problem is that the patients and family of those patients leave the hospital either not knowing what has to be done or feeling as if there is something wrong with them for not knowing all the necessary information. In an attempt to better inform patients and create better physician-patient communication and relationships, the University of Chicago has created the Comprehensive Care Program. This is a new model of care that aims to shift doctors’ from treating symptoms to treating people. This is an, “individualized model of care, called “person-centered care” or “patient-centered care,” [that] is based on the idea that costs can be reined in by preventing expensive emergency room visits.”

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Managing Emotions in Medical School

In Managing Emotions in Medical School: Students’ Contacts with the Living and the Dead, Smith and Kleinman analyze the view our culture has on the emotions expressed by medical students and also how important a role those emotions have in the students’ and even the professional’s care. An important point they make that is easy to see first hand with almost any sort of doctor’s visit is that the current view of doctors is that they are desensitized to the illnesses or traumas of their patients. I think that this poses a conundrum in the medical field because this often leads to patients feeling dehumanized and dissatisfied with their care. Continue reading “Managing Emotions in Medical School”

Trapped in The System; A Sick Doctors Story

In this article, Dr. Aaron E. Carroll provides the anecdote of his own disease to show the ineffectiveness of the current health care system that exists in the United States. He explains everything he has had to go through and continues to do as a result of having ulcerative colitis, a gastrointestinal disease with which he had no control of preventing. After months of unsuccessful treatment, his doctors suggested he take an old immunosuppressant. Despite significant possible side effects, he elected to try this medication, and to his fortune, it has sent his colitis into remission. The drug itself is very inexpensive, only $80 every 3 months for Dr. Carroll, but at the end of those 3 months, when he needs a new prescription, the inefficiency of the health care system is clearly evident. Continue reading “Trapped in The System; A Sick Doctors Story”

The Social Construct of Illness

In Conrad and Baker’s article, they claim that illness is socially constructed. They state that the social construct of illness is “rooted in the widely recognized conceptual distinction between disease (the biological condition) and illness (the social meaning of the condition).” Social constructionists emphasize how the meaning and experience of illness is shaped by cultural and social systems. This suggests that individuals and groups not only suffer from the illness physically, but that there is also a social/societal stigmatism that comes with illness/disease that brings an added burden to any sufferers. Conrad and Baker state that a stigmatized illness can make an illness much more difficult to treat and manage. The stigma that comes with disease is often brought about because of widespread publicity about the disease and/or a widespread negative view to people with the particular condition. The two claim that effective policies for these stigmatized illness have a large barrier to overcome because of the added stigma. Should policy be focussed on overcoming the barrier, or should it be focussed on educating the people so that the stigma is generally removed from a particular condition? Should limits be placed on care publicity (i.e: drug/treatment ads) so that the stigma is lessened, or should the marketing of treatment be changed so that the stigma associated with a particular illness is one that encourages early treatment and proactivity?

Status, Equality, and Healthcare

In their article “Social conditions as Fundamental Causes of Health Inequalities: Theory, Evidence and Policy Implications,” Phelan and Link discuss the reality that socioeconimc status plays a large role in the health and healthcare of an individual and even a community. They provide evidence indicating that the roles played by money, power, prestige, knowledge, and beneficial social connections allow people with higher socioeconomic statuses to receive better care and have better health overall. Continue reading “Status, Equality, and Healthcare”

Process Reflection 1

Throughout my life I have experienced many different aspects of the health care system. As an athlete with shoulder issues I had a personal orthopedic that I saw monthly for years, and was able to build a strong, mutually beneficial relationship. Before this class I was not fully aware that there were physicians in the system that would use you solely for profit because all of my personal doctors and surgeons had never given myself or my family any reason not to trust them. I think this was partially due to the fact that both my parents and myself knew that we were not educated in the fields that my medical specialists were, so we showed trust from the start that they knew what they were doing. I remember many times one of my doctors actually urging against MRIs and CT Scans; contrary to many of the things we’ve read and discussed, when either my mom or myself thought it necessary based on superficial symptoms and online research. But who knows, I could have fallen into the overtreatment trap at one point or another and not even have realized it. Continue reading “Process Reflection 1”

Drug Goes From $13.50 a Tablet to $750, Overnight

In this New York Times article, Andrew Pollack evaluates the unexpected rise in the HIV drug, Daraprim, overnight from $13.50 per pill to $700+ per pill; over a 5,000% increase. Daraprim was created in 1963, and was originally sold for $1 per pill. CorePharma then raised the price per pill to $13.50 in 2010. Nobody knows for sure what warranted this most recent price increase, but this isn’t the first time Turing Pharmaceuticals CEO Martin Shkreli has increased company prices purely for profit. Pollack writes that, “In 2011, Mr. Shkreli started Retrophin, which also acquired old neglected drugs and sharply raised their prices. Retrophin’s board fired Mr. Shkreli a year ago. Last month, it filed a complaint in Federal District Court in Manhattan, accusing him of using Retrophin as a personal piggy bank to pay back angry investors in his hedge fund.” This is not the first time a pharmaceutical company has raised the price of a drug, however, unlike many drug price increases, the Daraprim spike was not because of a shortage of the drug. Under Federal rules, Medicaid and certain hospitals will be able to get the drug inexpensively, but private insurers, Medicare, and hospitalized patients would have to pay an amount closer to the new list price of $700 per pill, which would make annual payments for Daraprim users upwards of $50,000. Continue reading “Drug Goes From $13.50 a Tablet to $750, Overnight”