The Importance of Conversation

As the semester nears its end, I think back to the topics we, as students, have touched upon in the course. I reflect on the the progression of our coursework from the history of the US healthcare system as a whole to the conditions and ethics of end of life care. To be honest, prior to entering the course, I assumed the class would be limited to the statistical, broader aspects of healthcare and stray from localizing the errors in our system to its true sources of misconduct and unfairness. Furthermore, I expected the extent of discussion regarding solutions to our nation’s faulty system to be a sort of “blame game,” void of seeking and/or discussing possible solutions but rather putting the blame on someone/something. What I found, rather, was a class which, primarily through discussion sections, worked together to examine errors in our system, share ideas for mediation of particular flaws, and debate both sides to elements of topics relevant to the state of our current system. Continue reading “The Importance of Conversation”

Planning Ahead

Earlier last week, in discussion sections, students debated the pros and cons of implementing governmental intervention and regulation of nursing homes. In my particular discussion section, I was in a group which debated against government regulation and as we formulated our arguments against governmental control, we began to consider an underlying decision which would ultimately trump whether or not government regulation would even have an opportunity to influence nursing home care. This underlying factor is individual choice of the caretaker of a grandparent, whose decision to provide care for his or her grandparent trumps any sort of need for a nursing home. Continue reading “Planning Ahead”

A Dependence upon Human Interaction

In “The Patient in the Intensive Care Unit,” author Zussman draws contrast between the degree of patient involvement in his or her care dependent upon chronic or acute care. More specifically, the state of mind of the patient, as a result of his or her condition, further dictates as to whether or not a relationship can be built with the assigned doctor or nurse. In an interview with an Outerboro resident, the emergency room is described as a place in which a patient’s acute illness is immediately mediated under circumstances in which there is little to no time to even bother with the patient’s emotion or character. Continue reading “A Dependence upon Human Interaction”

A Broadened Scope of Practice

Gerry Tout

In the past year, communities across the nation have had an astonishing rise in opiate abuse, predominantly heroin. Massachusetts and New Hampshire are several of the states with a greater percentage of opiate-caused deaths in the form of overdose and deterioration of the body’s functions from consistent use of heroin. With an overdose, assuming 9-1-1 has been called and pre-hospital intervention is available, a necessary, often life saving step for an EMT is to administer Narcan to the patient. Narcan is a narcotic antagonist, meaning it works through effectively blocking opiate receptor sites, thus reversing or preventing the toxic effects of particular opioid analgesics. Among the techniques used to save an overdosed patient in an ambulance, administration of Narcan is a quick, seemingly simple step, yet its effects are a critical precursor to further care in saving the individual. Continue reading “A Broadened Scope of Practice”

Preemptive Action in End of Life Care

In Timmermans’ “Social Death as Self-Fulfilling Prophecy,” it is argued that in a decision between life or death in the absence of patient choice, as a result of incapacitation, medical professionals find more worth in saving one patient over another. Said worth is arguably influenced by the age of the patient, as well as his or her overall condition at the moment. Furthermore, said choice is swayed under consideration of the patient’s projected condition following a particular procedure, be it from initial CPR to emergency surgery. In some cases, individuals either prone to sudden consequence from a particular condition or of old age sign a DNR (do not resuscitate) which serves as a preemptive step for the inevitable situation of life or death in which he or she is unable to express consent. Also, there is an advance directive which, in essence, provides a doctor with the requested care and desired ramifications of end of life care under the pre-written consent of a patient.

Thus, in order to alleviate the pressure upon the emotionally charged choice of immediate family and advice of a medical professional, how can an individual be urged to prepare, if willing, for a situation of life or death? Is the consideration of the emotional toll upon one’s family enough? Or is the unwillingness of an individual to sign an advanced directive unrelated to the consideration of close ones, but rather a result of indifference or blind confidence in one’s health? Continue reading “Preemptive Action in End of Life Care”

Honesty in Empathy

In Chapter 1 of Jerome Groopman’s How Doctors Think, Groopman emphasizes three main conditions which a doctor must consider in order to most effectively care for his or her patient. Ultimately, one suggests that doctors must better listen to their patients in order to avoid mistakes in diagnosis and treatment, and another urges patients to assume a more weighted role in their care. The third, which I find to be one of the most important of the three, sheds light upon the lack of self-awareness in doctors when communicating with a patient. In Thursday’s lecture, we spoke of emotional labor, the emotional requirement of a career transcending mental and physical duty, and the two techniques which arise from it. On one end, there is surface acting, which involves the doctor essentially forcing empathy void of any genuine emotion or true cognitive reaction. Deep acting, rather, is when the doctor is capable of generating a true sense of empathy through altering his or her internal emotion. The underlying difference between the two, as a result, revolves around the honesty within the doctor’s presented emotion, which gives rise to my question. Continue reading “Honesty in Empathy”

A Silent Curriculum

Upon reading “A Silent Curriculum,” and in consideration of the discussion students have shared in particular sections as well as absorbed in lecture, it seems as though race plays an underlying role in healthcare which some find difficult to address. Katherine C. Brooks, author of the opinion piece, sheds light upon the unfortunate habit of some physicians to treat a patient to the extent of his or her assumed stereotype, thus limiting the level of care to a degree unfairly, and often times immorally, set forth by the provider. There is an incident Brooks shares which I find particularly misguided. She reports how she was told not to continue following a, “…black woman fighting drug addiction and struggling to adhere to medications, since [she] wouldn’t change her behavior,” (Brooks 1). While said reasoning to relent patient care is by no means valid and arguably racist, one must also heavily consider the willingness of the patient to change his or her lifestyle.

Throughout the course, students have learned of the growing involvement of the individual in his or her health, especially when making choices surrounding treatment in coordination with a professional. Personal choice transcends factors of race and socioeconomic status because choice is a rooted concept in every individual’s sense of self-awareness. Rather than basing an unwillingness to change one’s lifestyle upon the color of his or her skin, what method could doctors use to better express the consequences of effective treatment to a patient? Also, to avoid the slippery slope of stereotyping, what can the hospital, or others involved in monitoring the behavior of doctors, do to enlighten those who have difficulty seeing the patient as any other patient?

The Drop Out Club (October)

In 1999, obstetrician Rael Mazansky, like many other doctors in his position, began to speculate about the political and social direction in which healthcare in the United States was headed. He, along with several colleagues, had recently abandoned their careers in medicine to pursue alternate means of work. In doing so, Mazansky cofounded the Drop Out Club, a social networking platform in which individuals, with a skill range of entry level med-students to professionals who have worked 20 plus years, could converse and share insight. Continue reading “The Drop Out Club (October)”

Self-Efficacy in the Health Belief Model

In Chapter 2 of The Sociology of Health, Illness & Health Care, Weitz describes the Health Belief Model, a psychological model used to effectively predict and account for health behaviors of a population. Through consideration of diversity in the collective attitude and beliefs of a group of individuals, the model outlines several core assumptions indicative as to why a particular individual acts in a health-related action. Some of the assumptions include: perceived susceptibility, one’s consideration of the chances of acquiring a condition, perceived severity, one’s consideration of the consequences to a condition, and perceived benefits, one’s belief that he or she can take the greatest course of action to reduce the risk or danger of a condition. Weitz addresses the model’s underlying concept of self-efficacy and applies its effect in a hypothetical perspective of those with power in healthcare. He suggests that under the consideration of the assumptions outlined in the model, individuals responsible for the promotion or other public expression of particular forms of medicine would be more inclined to empathize with the general public and heed warning to the possible side effects and dangers of not only an immediate medication, but as well as an unhealthy lifestyle often seen in Americans today. Continue reading “Self-Efficacy in the Health Belief Model”

Process Reflection 1

Throughout the past several weeks in our Sociology of Healthcare course, I have been able to effectively narrow what limited knowledge I have regarding the errors in our nation’s healthcare system to a finer understanding. Initially, my image of our healthcare system was thought to have revolved primarily around profit-oriented politicians, businessmen, and pharmaceutical companies situating their respective motives on self-benefit over the patient/consumer. While much of our nation’s inefficiency lies in the overshadowing of greed upon the lives of the patient from these overarching companies and personnel, one must consider the differences between “sociology in medicine” and “sociology of medicine.”

Continue reading “Process Reflection 1”