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.

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Final Process Reflection

Sociology of Healthcare has opened my eyes to the many multifaceted  problems within the healthcare system, especially in the United States. As a developed country, one would expect the best quality care and equality for all its citizens. This is clearly not the case. Our current system has been  and is continually hesitant to change.

Traditional medicine and practices are not always the answer to good care. Some major takeaways from this class are equity and access to care and the importance of a universal healthcare system. There are large disparities in health among racial and ethnic minorities. These disparities create major spikes in healthcare costs and promote a continual decline in health that impacts the overall health of the United States. There are more problems to consider such as doctors and feeling, and how it affects the patient and health outcomes. The lack of feeling and emotion in healthcare overlooks patient needs. This leads to a poor experience and in some cases poorer health outcomes. If doctors would take the time to get to know their patients, they would be better able to address their problems (some that may not be easily identified in a healthcare setting).

In the end, it is crucial for the individual to be the focus in healthcare. At the end of the day, we are caring for people not human bodies. Access to quality care is a must to promote healthy lives at all stages of life.

How do other countries deal with end-of-life care?

Within the article “Fight to Honor A Father’s Last Wish: To Die At Home,” it was mentioned that “most developed countries spend much less on medicare, but twice as much on social supports.” Thus, I wonder how end-of-life care is structured and regulated in other countries? Is nursing home abuse as rampant and overlooked? What checks and balance do they have in place to ensure the people’s best interests? Is the cost much higher in comparison to the US?

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.

Continue reading “Quality of Care in Nursing Homes”

Rise in Early Cervical Cancer Detection Is Linked to Affordable Care Act

Earlier in the semester we watched a documentary about how health care coverage varied based on age. The highest rate of uninsured Americans were between the ages of 18 to 25. Most were unable to afford healthcare because they didn’t have access to employer-based health plan and were not covered by their parents’ health insurance. Health and finances of young Americans were at risk. In 2010, the provision of the Affordable Care Act allowed young adults to stay on their parents’ insurance until the age of 26. The number of uninsured adults in this age group declined significantly.

Continue reading “Rise in Early Cervical Cancer Detection Is Linked to Affordable Care Act”

Extent of Medical Technology and what’s to come

In this article, Patrick Hardison, a firefighter, undertook an extensive face transplant. It started when he entered a burning house for a rescue search, but had the roof collapse on him, burning the firefighter’s mask into his face. A donor however was found for him and they were able to give him a full face transplant, as well as 70 other surgeries, for 850,000 to 1 million dollars paid for by NYU. This shows the extent to which medical technology has advanced to the point where almost any type of transplant is possible with the right amount of money.

The extent of medical technology to be able to repair an entire face is absolutely astounding. This article reminds me a bit of Frankenstein, how they were able to piece together dead body parts and bring it alive. In a way, we are moving closer to what we thought was purely science fiction, with the extent to which we complete transplants nowadays. It also raises many questions for where medical science is to go from here and how will it improve even further. It almost seems quite surreal how we are now able to fix any broken limb or organ just with a transplant whereas a few years ago we were lacking all sorts of technology. Could it be possible that we move from a time where we can fix any body part to curing any disease? Whatever path or direction we take for medical science, it will only bring further better outcomes for the whole of society.

 

http://www.cnn.com/2015/11/15/health/face-transplant-firefighter/index.html

Quantifing Quality of Life and Overcoming Social Death

In the article, “social Death as Self-Fulfiling Phophecy”, Timmermans makes a plethora of pertinent points to the effect of proving that there is “no equalizing potential of rationalization of resuscitation techniques and legal protections.” I find the last discussion about quality of life to be most personally resonant. The anecdote about the nightmare scenario is something that does present the personally worst case scenario for a medical procedure. It does bring into question the quality of life that is acceptable for ‘success’. Is it a common feeling that mentally disabled lives resulting from a medical procedure are “not worth living?” In what ways can the quality of life be quantitatively measured in order to weigh the risks of a procedure? How can the resuscitative efforts have a better outcome than the original expectations?

Social Viability in Resuscitation

In Timmerman’s “ Social Death As Self-Fulfilling Prophecy”, Timmerman describes the impact of social value on the fervor and vigor in which resuscitating techniques are applied to a patient. Certain positive characteristics contribute to the patients presumed social viability such as age, social importance, and identification with the patient. Negative characteristics include seriously ill or older patients and addicts, who have less effort put into their resuscitation. In terms of seriously ill patients, less effort is put into resuscitation because the medical staff sometimes believes that sudden death is not the worst possible end of life and these patients may be in significantly more pain living. However, Timmerman does not mention the impact physical manifestations of defects would have on an individual’s social viability. Are those with genetic disorders or birth defects who exhibit these disorders/defects also viewed as less socially viable even though they are not seriously ill? For example, would someone with Down syndrome have less of an effort put into resuscitating him or her even though they may be perfectly healthy and happy in life otherwise? Additionally, would someone exhibiting a physical birth defect but otherwise healthy have less vigor put into his or her resuscitation? What is the impact of disorders and defects on resuscitative efforts?

Parsons’ Sick Role and Society

Parsons defines the sick role to be ‘the social expectations regarding how society should view sick people and how sick should behave’. Parsons was also one of the first people to recognize illness as a deviance. He talks about how people may consciously or unconsciously use illness as a means of evading their social responsibilities. He also contemplates how society would function if people weren’t allowed to take sick days.

I decided it would be interesting to look up average numbers of hours worked annually for the average American worker and compare this number to other countries. For example the average American worked 1789 hours in 2014. Compare this to Germany, 1371, France, 1473, and United Kingdom, 1677. Would it be effective to shorten the work day in an effort to improve health for workers? if this was the case then sick days could be reduced, which would discourage people from taking “personal days”, would this increase overall health and work efficiency in our country?

Statistics from: https://stats.oecd.org/Index.aspx?DataSetCode=ANHRS

See Something? Say Something: Health Inequalities in Boston By T-Stops {Process Reflection 2}

The discussions revolving around the impact of social factors on health and illness have expanded my perspective tremendously. There is certainly stark health inequality between countries, like the US and Sierra Leone, but what about between cities in the US? In fact, if we zoomed in all the way down to a single city, like Boston, would we begin to see a clearer picture of health inequality at a relatively microscopic level?

Dr. Sandro Galea, Dean and Professor of the Boston University School of Public Health, did just that. In his Dean’s Note, Dr. Galea paints a picture of Boston’s health and its determinants geographically using the map of the T (see below).

T

Dr. Galea asks us, “Suppose we are riding the T and stopping at various stops: What does health look like at these stops, and what do the drivers of health look like?” The results are dramatic. First, Dr. Galea starts by mapping the core health indicator: premature death rates per 1,000. We can see that the death rate around the Arlington stop on the green line is the lowest, with 2.6 per 1,000, and the highest death rate is at the Dudley Square station on the silver line, with 5.7 per 1,000.

Premature death rates

He then goes on to map the homicide rates that are linked to violence; again, we can see that the Arlington and Maverick stations have the lowest homicide rates, while Dudley Square and Mattapan (with a whopping 32.2) have the highest homicide rates.

Homicide rates.PNGHealth differences are then mapped onto the T by low birth weights, percent of adults with diabetes, SES, and levels of physical activity. The health inequality between various geographic areas of Boston are large and strong. Yet, what surprised me the most was that, despite how geographically close the T stations were with one another (geographic differences of approximately four miles), and despite how each station had nearby access to healthcare facilities (Boston Medical Center, Tufts Medical, Mattapan Community Health Center), I was shocked that areas so close to one another and with top-notch healthcare facilities still have large health inequalities that exist due to varied health indicators. This case-study opened my eyes to realize that we don’t have to look globally to witness health inequality. It exists right around the corner, in every city, and Boston is certainly no exception.