In the article “What Happens When the Patient Becomes the Boss” it mentions the lack in inclusion of technology in health care. Doctors are not always able to keep up with the latest technology nor are they always taught how to use it. It mentions that sometimes patients have to do their own research on what conditions they have in order to be able to ask the doctors the right questions with the limited time they have during their appointment. They gave the example of Christi Shaw who had to do her own research when her sister was diagnosed with cancer. She had been told that there was nothing they could do to help her sister. In her own research she was able to find a clinical trial of a drug that might have been able to help her sister. After consulting the doctor, they agreed to try it resulting in her sister’s cancer to significantly reduce within a month’s time. WIth the advancements of technology, the health care system should work on including and updating the technology in their practice. In addition, more patients should try to do some research into their health and make themselves more familiar with their health.

https://time.com/5207531/what-happens-when-the-patient-becomes-the-boss/

In “How Artificial Intelligence is Changing Healthcare”, Bernard Merr discusses what artificial intelligence does, and how it can benefit medicine. The use of artificial intelligence can create different health outcomes because it has access to more information. A doctor will not remember everything that they learned while in school, and has a brief window of time to spend with the patient and diagnose them. In addition, doctors are not always on top of all the new medical findings. Artificial intelligence contains access to all medical information, and has databases to reference back to all of the patient’s past medical history. With the information that artificial intelligence has, it may be possible for it to give a more accurate diagnosis than a doctor who is skimming the intake notes for the patient. Also, artificial intelligence could potentially be easier to access than doctors with the extended periods patients have to wait to get an appointment or where they live geographically. 

Manifest functions of using artificial intelligence in medicine are that it has access to past and new medical information. It knows everything about medicine and is up-to-date. Latent functions are the convenience that comes with its use. If you go to the doctors and they do not get the diagnosis correct, you have to keep going back to the doctor until the correct diagnosis and treatment is found. With artificial intelligence, it can minimize the back and forth because it is preloaded with lots of information that will potentially be able to find the issue faster.

I think that we should implement artificial intelligence into medicine. I don’t think that it should replace doctors because doctor patient interactions are still important, but I think it can be used as a resource. I think it could be used to help doctors with potential diagnoses for the patient, and the doctor could use the suggested diagnoses to figure out what the patient has, what diagnostics to run, and how to treat it. 

In the article “Patient-Provider Interaction Top Priority For Consumers”, it talks about what patients are truly looking for in their healthcare interactions. In the study, patients were asked to make a fantasy football like bracket of 64 healthcare interactions. They were asked to rank what healthcare interactions were the most important to them, and later in focus groups they were asked why they made those choices. The most important healthcare interactions were personalized interactions, positive patient-provider interactions, cost effective care, and convenient access to care. Patients are looking for providers who they can establish meaningful relationships with, take their time with them and do not rush appointments, who show that they are listening to them, who offer self-care instructions, and who provide clear information on diagnoses. The second highest ranking was cost effective care. Patients specifically had short term stays in mind. The patients want affordable care, no surprises on their medical bills, in-network providers, notifications when insurance will not cover part of their treatment, and accurate cost estimations. The third priority was convenient access to care, especially for people with chronic illness. Patients want help finding the right doctor for their health needs. Additionally, patients want short wait times, customer service and billing agent assistance, and appointments that are available when it is convenient for them. The patient’s wants for their care can definitely play a role in their satisfaction with current care. Deloitte, who conducted the study, said they would be working towards finding solutions for the patients’ healthcare wishes.

https://patientengagementhit.com/news/patient-provider-interaction-top-priority-for-health-consumers

In the article Making Profits and Providing Care, researchers studied the relation of providing large profit services and which hospitals employed them more often. For profit, nonprofit, and government hospitals were included in the study. They took into account the size of the hospital, the area it was in, and teaching status. The study found that for profit hospitals were more likely to offer highly profitable services. They were followed by nonprofit hospitals and then government hospitals were more likely to offer unprofitable services. The services that were offered was found to differ based on ownership, but it is possible that it could be due to each type of hospital prioritizing different goals. “the evidence here suggests that for-profits are more likely to respond to profitability than the other types are when making supply decisions. Since government hospitals are most likely to supply the unprofitable services that are disproportionately needed by poor and underinsured patients, the evidence also suggests that such hospitals are caregivers of last resort. Nonprofit hospitals are often the intermediate type in terms of balancing profit seeking and serving the poor through service choices(Horwitz)”. Depending on where the patient goes will reflect the services they receive, and whether the patient truly needs them or if the hospital is looking to make money off of the hospitalization.

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.24.3.790

In the article “Stress Can Make You Sick. Take Steps To Reduce It” Dr Chatterjee talks about ways in which stress affects our daily lives. Dr Chatterjee is an author, television host, and influential doctor in Britain. He hosts the show Doctor in the House, in which he visits overweight and chronically ill patients, and transforms their diet, exercise habits, and relationships. He also has a podcast, “Feel Better, Live More”, where he talks about lifestyle medicine. In his most recent book he addresses the ways stress can be a detriment to our health, and how managing our stress can help us maintain our health. He recounts an interaction he had with one of his patients who could not control his blood sugar even though he was exercising and following an intense diet. Dr Chatterjee states that the root of the problem was unmanaged stress. He urged his patient to practice forms of meditation and to reduce his use of electronics before bedtime, and six months later there was a drop in the patient’s blood sugar, levels bringing it close to normal. Stress can play a role in other chronic diseases such as insomnia, high blood pressure, depression and weight gain. Dr Chatterjee recommends changes such as calm morning routines, minimizing the use of social media, and participating in some form of exercise or meditation. These methods tend to have better results than telling people to change their diets. 

Managing stress is important because it can consume our lives, and lead us to have poor health. When a person is constantly stressed it takes an effect on their immune system which could potentially have the person become sick more often. In addition, it can lead to things such as weight gain and high blood pressure. The management of stress and importance of one’s mental health does not always take precedence in people’s life, but it is detrimental to start focusing on it. SImple things like doing breathing exercises and cutting down on social media use can greatly improve stress.

The piece of media I am analyzing is Nurse Jackie. The tv show Nurse Jackie follows a nurse in a fictional New York hospital. Jackie, the nurse, works at All Saints Hospital in the ER, and tends to stray from normal nursing practices. She using her experience to make judgement calls on patient care which causes conflicts in the workplace.

 The theme of conflict in the workplace ties in with our lecture on the authority of doctors. Due to Jackie’s unorthodox decisions, she tends to be in conflict with Dr Cooper, the new ER doctor, and Mrs Akalitis, the nurse manager. An example of conflict between them is when a patient with cancer was admitted due to extreme dehydration and constant nausea. Dr Cooper planned on prescribing an antinausea medication, and Jackie suggested to the patient to try marijuana, which at that time was an illegal substance. Another example of conflict in the workplace was when Jackie flushed a man’s ear down the toilet because he continually stabbed a woman and was not being charged for the assault. When the ear came back up, Jackie ended up in trouble with the nurse manager. A third example, is when a young boy had been brought into the hospital because his parents suspected that he had cystic fibrosis. Jackie decided to discharge the patient because preliminary results had came back that suggested the boy was not sick. However, when the final results came in Dr Cooper became angry with Jackie for overstepping boundaries, and trying to give the family the results which is the job of the doctor. 

Jackie is not one to follow the rules, and works based on her own outlook of ‘what is best for the patient’. She disregards the authority of doctors and administration which causes a troubling work environment. Her character brings up the question whether you should always follow the rules or if you should make other decisions because you believe them to have a better outcome?   

A few things that surprised me while reading the articles were that women’s issues can be immediately dismissed and overlooked, race and/or sexual orientation can affect the treatment you receive from some people in the medical field, and that power of attorney was overlooked. I think the greatest surprise occurred while reading about Dr Wyatt. In that article there did not seem to be a lot of consideration to the patient care. His wife who could have given information about him and had the power to do so was ignored. In addition, I was surprised at how little education is given in relation to the care of LGBT patients. Only having a few hours to cover this patient population over the course of four years of schooling is definitely not right. Furthermore, the health care provider’s personal thoughts and feelings should not stand in the way of the patient’s right to care. Lastly, I was surprised at the prevalence of women’s health concerns being dismissed and ignored. Women’s health should be just as important as men’s health, and they should be thought of more while doing clinical trials. Some ways to challenge these biases in the future would be to expand the education given to health care providers on each of these patient populations. By expanding the amount of education given on each of these groups it can hopefully help propel us in the right direction and diminish the biases that are present in our current health care system.

The television show that I decided to watch was Nurse Jackie. In one of the episodes there is a kid who falls from the playground. When he arrives to the ER it is discovered that he has a collapsed lung. The reason for the injury is due to the neighborhood that the family lives in, The Alphabets. It is revealed that The Alphabets is a poor neighborhood, and that the playground has concrete rather than the nicer neighborhoods that have rubber floors under the playground. Though not discussed in depth, it is inferred that if the family had lived somewhere else the injury would not have been sustained. 

Another injury that occurs is a kid who falls off his skateboard. He is rushed into the ER, and undergoes diagnostics which eventually reveal that he has an abdominal aortic aneurysm and increased intracranial pressure. At first the mother is given sympathy by the nursing staff because she wasn’t able to do anything about her son falling. Later on in the episode the mother reveals what was going on before the fall. She explains that her son had been booked for the cover of Pottery Barn Kids, and she had asked the photographer to take photos of her son without his helmet for his portfolio. There was social judgement associated with how the kid sustained the injury. Nurse Jackie yells at the boy’s mother for putting her son in danger and allowing him to go down a half pipe without a helmet. She tells the mother that her responsibility should be to protect her child, and that because of the injury it would take him over a year to relearn how to walk.  

The CSUEB Student Health Services provide students with medical services, counseling, and health education. This relates to the article because this is an example of an individual-level intervention. Student’s overall health is extremely important while they are going to school, and having access and resources on campus makes it easier for students to receive help they need. I personally have never used the services in the health center, but I have a friend who uses the counseling services. She has mentioned that having that resource on campus has helped her a lot in her time at East Bay. Student’s mental well-being is something that is not talked about all the time, but can cause issues with their schoolwork if not taken care of. Having these counseling services on campus opens the door to the discussion of mental health, and makes it something of importance. In addition, having health education provided at school is important for those who are becoming sexually active or who are already active. It is imperative students know how to take care of themselves, and are given proper information. It may be intimidating for some people to talk about what is going on if they get an STD, and having the health center on campus helps students to ask questions or get any treatment they may need.

My House

My house is not very accessible. The way that it is built is for able bodied people. All of the bedrooms are upstairs which would cause difficulty for someone who couldn’t walk and could be tricky for a blind person. In addition, the backyard can be difficult to maneuver. The majority of our backyard is taken up by our pool, and with how the patio furniture is set up it leaves little room to walk around. Lastly, it can be hard to figure out where things are or how to use them for someone who has mental disabilities. 

CSUEB

I would say that CSUEB is accessible. In most buildings we have functioning elevators for those who are unable or have difficulty climbing stairs. There is braille on the signs for those who may have sight impairments. In addition, we have an accessibility department who works with students to accommodate for their disabilities. There are ramps across campus to help people get where they need to go, and there are wide walkways so you are able to maneuver freely. The only building on campus that I think isn’t very accessible is Meiklejohn Hall. There are a lot of stairs in that building, and I haven’t really seen an elevator when I’m in that building.

Hayward Shoreline

The Hayward Shoreline is not very accessible. Though it is somewhere that I enjoy to go to take walks, it is not accessible for people with disabilities. All of the signs that are hung near the entrance are tailored for people who can see; there is no braille. In addition, the people who go there need to be able bodied. Areas of the shoreline have gravel which would be tricky to move on for someone with physical disabilities. Lastly, for those who has mental disabilities, this place would be a little dangerous because there are some areas of the shoreline that have rocks near the water so if they weren’t careful they could get hurt.

Mia’s Dream Come True Playground

Though this park is not yet open, I think it is one of the most accessible things we have in Hayward. Mia’s Dream Come True Playground is a playground that is currently being built in South Hayward and will be opening later this year. It is being designed specifically for people with disabilities. The closest playground for children with disabilities in in Palo Alto, and the addition of this playground helps make Hayward into a better city by meeting the needs of everyone. The playground was designed by a little girl with cerebral palsy and her parents. They plan on making the park accessible to all children. The park will feature wheelchair accessible play structures, multiple walkways, and a quiet play area for children with autism.

All Saints Church

Growing up I went to church at All Saints, and until this assignment hadn’t put thought into whether the church is truly accessible. I believe that in parts the church is accessible, but it is not completely accessible to everyone. It does have ramps around the area, and they do have speakers and screens inside the church for those who may have trouble hearing or seeing. What they lack is braille for those who are blind, wider walkways to better accommodate for those in wheelchairs, and resources for those who have mental disabilities. They do give out pamphlets for children that contain activities and break down what they week’s mass is about, but they don’t really have anything for people with mental disabilities.