As this course progressed, I gained a lot of maturity in terms of the way I perceived healthcare. Being from Jordan, where most of the hospitals and clinics were privately owned, I was accustomed to a privatized healthcare system that also rode on the sympathy and empathy of the physicians. Many physicians had the habit of waiving fees or taking less money when they were dealing with less fortunate patients, or friends and family. Additionally, since I moved to the US after I was eighteen, I never had to take charge of my own healthcare, and so knew very little about the healthcare system in general. My knowledge of US healthcare was limited to knowing that several of my sick relatives with severe illnesses would come to the US for healthcare, so I thought it must be great. Because of this, I was shocked when professor Guseva started talking about this severely flawed system. Continue reading “Final Process Reflection”
In “Tip-Toeing Towards Conversations About Death,” the article pushes towards starting to make preparations about the way you want to die. Although these conversations can be uncomfortable, it is really important to have a health proxy to be able to speak for you when you can speak for yourself, and to make sure your wishes are fulfilled. A new state law urges that doctors start these conversations about death by providing pamphlets to the patients, but there are no required forms to fill. Additionally, several state members think these conversations should also be initiated outside of the hospital, in places where people feel more comfortable opening up. Continue reading “Tip-Toeing Towards Conversations About Death”
In the study “Does Investor Ownership of Nursing Homes Compromise the Quality of Care,” Dr. Harrington et al. concluded that investor owned nursing homes have larger deficiencies in patient care. They found several reasons that point to this, including the fact that for-profit homes have lower nurse staffing ratios, and that most investor-owned facilities were part of a chain. They also suggested that the large size of the facilities lead to lower quality of care, but public nursing homes had larger facilities yet maintained a better quality of care. They though the most palpable explanation for the reduced quality of care is the cost-driven mindset of for-profit facilities: overall, investor owned health maintenance organizations have lower quality of care, and spend less money and emphasis on clinical care and divert their focus to administration and profit. Continue reading “Does Investor Ownership of Nursing Homes Compromise the Quality of Care?”
In Abby Goodnough’s article “Shopping for Health Insurance is New Seasonal Stress for Many,” she discusses the Affordable Care Act’s new markets for insurance, and the new way of ‘shopping’ for it via an online platform that allows price comparison across a span of health insurance policies. Although these markets have helped millions of people who could not previously afford insurance, or have been rejected by insurers, they have also seen sudden price or policy changes that force many consumers to change plans every year. Continue reading “Shopping for Health Insurance is New Seasonal Stress for Many”
In Robert Zussman’s excerpt, The Patient in the Intensive Care Unit, he talks about how most patients in the ICU are unresponsive, so that the patient’s role as a participant in his/her own care disappears. The physicians’ and nurses’ main objective is to treat the existing problem rather than examine the underlying cause or address the reason for the problem. He also says that despite moral judgments exist, whether positive or negative, they matter very little: the ICU staff, for the most part, treats patients the same without regard to social judgment. In a non-ICU setting, the patient is usually a participant and less dehumanized than in the ICU. But when the patient is treated as an person, rather than “a set of numbers and dynamics”, bias and discrimination begin to play a larger role. So my question is: does the patient need to be regarded as an object rather than a person to escape social judgment in a medical setting? Does a patient’s lack of alertness and participation correlate to their not being treated with bias and discrimination? Or does time with the patient affects this, i.e. if the patients were more alert in the ICU for longer periods of time, would the ICU staff treat them differently based on social judgment?
In the excerpt, The Rise of the Modern Hospital, Charles Rosenberg argued that medical and technological advancements, such as the establishment of the germ theory and x-rays, contributed to the people’s changing opinions towards hospitals. The continuous advancement of both medical and non-medical technology, in addition to performance of major surgical procedures, contributed to the steady rise of costs. Continue reading “The Rise of the Modern Hospital”
In Managing Emotions in Medical Schools, Smith and Kleinman explain certain processes by which medical students deal with taboo and ‘unacceptable’ emotions, such as disgust and arousal, towards patients they encounter.
The students feel it is unacceptable to openly discuss these feelings, and so, must process them on their own. To combat them, they turn to several techniques that essentially dehumanize the patient. They rely on the mechanical and technical aspects of medicine instead of the emotional and psychological ones when they find themselves in uncomfortable situations. Continue reading “Managing Emotions in Medical Schools”
In the article “Many Schools Failing on Type 1 Diabetes Care,” Catherine Saint Louis points out the lack of school-administered care towards children with Type 1 diabetes, which is considered a disability that should be tended to.
The number of people with type 1 diabetes in the United States has risen, yet schools do not comply with the federal law that states that students with disabilities, including diabetes, must be accommodated. Before budget cuts, nurses used to assist these diabetic pupils by performing procedures such as administering insulin via pumps or injections before meals. Unfortunately, the number of nurses in schools has decreased since. Despite it being permitted for trained teachers, administrators or coaches to administer these injections, they still refuse to do so. Continue reading “Many Schools Failing on Type 1 Diabetes Care”
Where Did the Humanity Go?
When I was thirteen, I took my first human biology class. It was then that I decided I wanted to pursue medicine. I went home after my first class and told my father, a physician, that I wanted to do what he did when I grew up.He laughed—his thirteen year old had decided on becoming a physician based on a simple biology class. Despite the improbability of this, he decided to start taking me to the hospital with him, to show me what it was like. I shadowed him on his rounds and met his patients. He taught me how to read an X-ray and how to suture orange peels together. By the time I graduated from high school, I had watched several surgeries, spent countless hours shadowing doctors, drawn blood, and volunteered at my local hospice care. By the time I graduated from high school, I was certain about the path I wanted to take in my life. I fantasized about the thought of being as good of a doctor as my father is: a caring, philanthropic physician who aimed to help people—someone who was going to make a substantial difference in people’s lives. I think most people who decide to pursue medicine start off with this type of humanitarian goal in mind. Continue reading “Process Reflection 1”
In Jane E. Brody’s article on lung screening, she discusses a recent study headed by Dr. Steven Zeliadt. It was performed on 37 current smokers who were offered lung cancer screenings at DVA centers across the nation. Zeliadt thinks that the large sums of money being spent by insurers on lung cancer screenings for smokers would be spent better on helping smokers stop smoking and preventing others from taking up the harmful, addictive habit. Continue reading “Lung Screening May Not Push Smokers to Quit”