This article examined a new plan in medical school training that would get medical school graduates working as physician sooner. Grads would skip residency and go straight to treating patients. This new model would help the physician shortage and get physicians into areas with not enough physicians. Residency programs have limited space so many med school graduates are left with the qualifications, but without residency experience, creating a bottleneck effect. However, people argue that medical school is not intended to prepare you to go into practice, that is what residency is for. Some states are trying to implement a position called a “physician in training” or an “assistant physician” (different from a physician’s assistant) who are people who have graduated from med school, but not completed residency. The job allows them to provide primary care services as long as they are supervised by a physician. These new rules and positions are not planned to take effect until fall 2016. Continue reading “New Medical Training”
Hey everyone, just one last quick question regarding some interesting news I heard about this week about ObamaCare. It seems that ObamaCare enrollees will be paying even higher premiums next year, even though the number of applicants has skyrocketed this year. Does anyone have any insight as to why these premiums are rising? I read that the Cadillac Tax is getting cut, which is meant to expand healthcare to those who cannot afford care, so with that tax getting cut and rise of premiums, where is that extra money going?
How pertinent is it know about the exact way you’re going to die, if it’s inevitable anyway? Some cultures find that telling you these *minor* details may not be the most necessary thing, and that’s just the way it plays out, living your life out in the form of a cancer-ridden body while you don’t know what exactly is going on. People take care of you, and you know you’re sick, and yet even you accept that no one is going to say anything about the matter. I’m not sure if telling my grandmother was the right thing to do, nor does it matter anymore, but how would it have changed things? Is it right to withhold this kind of information from someone, or better yet, if someone came up to you and described the way you were ultimately going to die would you want them to tell you? It’s the same thing…right?
This past week in class, we’ve finally come to what seems the perfect ending of such a class, looking at the care of those who are elderly or coming to the end of the their life. And yet, similar to many other age groups there appears to be a plethora of issues that are involved in this group as well. So considering the breadth of the issues we’ve discussed in this class, who deserves the most help? Is it those who are less affluent since they seem to be at a disadvantage compared to those who are able to receive more benefits based on their income? Or rather should we help the elderly since their age is also coupled to a need for stability, which inevitably needs some care? Should the government help anyone at all? Maybe a better question to consider is what can we do that will help the most amount of people in the long run? No answer is really the right one to any of these, yet the matter can’t be left unresolved.
End of life care provides personalized care to dying patients. The main goal of hospice care is to give the patients a sense of dignity and respect their requests. Listening to the patient’s final wishes builds a supportive environment not only for the patient, but also for their family. After all, everyone deserves to be treated as a human being when dying. Continue reading “How can applying the motives of hospice care to other medical settings improve the quality of healthcare?”
In discussion yesterday, death brokering came up as a topic. I looked further into it and looked at the idea that death is cultural, but how does brokering pay into it? How do we use death culture to our advantage? Feedback/comments would be very appreciated!
Usually, end of life care can take up the last few years of a person’s life depending on the type of illness they have. In Chapter 10 of Weitz, he tells us that Medicare only pays for 6 months of end of life care in hospices. This forces the hospices to choose patients that would fit within that 6 month time span, so that they don’t need to pay out of pocket for those patients. Becoming federally funded rather than non-profit and for care caused hospices to have to adjust to these rules. Is it fair for those who do not fit in this 6 month time span to just be sent away from hospices, just because the federal government won’t pay for them? It seems like this is very similar to the time before Obamacare when insurance companies would turn down people due to pre-existing conditions that they didn’t want to, in the long run, end up funding.
I personally have had a family member pass of Leukemia in a hospice like setting, The Abraham House. Even with the entire family in agreement, it was still difficult to see my relative there and accept that there were no available treatment options left at his stage. He was in the home for three to four months, during which time he developed strong relationships with the daily staff. This nonprofit hospice model proved to be one of the best experiences with the healthcare system that he ever had, and truly brought him comfort during his last few months. The home was modeled after a real home, with a real kitchen, living room, and patient rooms. Caregivers cooked home-esque meals, and offered to eat with patients if possible. My uncle’s health actually briefly improved once he was transferred into the home from highly medicalized hospital settings. If anything, the Abraham House is the gold standard of pallative care.
In class on Tuesday we watched the documentary discussing the emergence of hospice care. One point that struck me was that it seemed like the people of London felt that hospice care was a worthy cause to give money and time to, and that is the reason it succeeded. Death seems to strike a chord with many people. I think it because it is a common link we all share and when confronted with the mortality of ourselves and our loved ones, priorities change. What if in the US we started tackling some of our healthcare problems using this fact? If there was a way to emotionally reach people on topics like preventative care and public health, then I don’t think there would be much of a problem trying to change the healthcare system.
Last year I did my WR 150 paper on physician-assisted suicide in the U.S., and I learned a lot about what made the public so afraid of legalizing it. Most of those who were against it stated that, while they believed in supporting their loved ones’ final wishes and their right to comfortable deaths, their hesitation was rooted in both the newness of the idea, and in the lack of preparation and regulation that the laws would require. However, the article “Tip-Toeing Toward Conversations About Death”, by Martha Bebinger, recognizes the recent advances in end of life care. With physicians now being required to discuss the options available to their patients, and families being encouraged to discuss loved ones’ wishes in advance, will the public see progress being made, and perhaps support physician-assisted suicide for willing patients with terminal illnesses?