I realized that often in my blog I will say something and then say I will explain it at another time... but then I never do. I am sure lots of blog writers do this but I thought it might be nice to actually go back once in a while and give the back story on something that would have made a previous blog entry to lengthy.
In one of my posts, I mentioned how there is a severe shortage of primary care physicians in the United States. Being someone who wants to go into family medicine this shortage is obviously interesting to me. After going to some seminars and talking to classmates, I have come to believe that this shortage is caused not only by the way our health care system is arranged but also by how society views health and success.
In our health care system doctors are able to bill insurance companies not based on the time they spend with a patient but by the number of procedures they perform. A doctor is not paid to counsel a patient on disease prevention, to answer their questions about medications or to take a detailed history in order to understand how a patient's personal life may be effecting their health. And yet, these are all things that good primary care physicians must do. It is easier for a specialist to skip these steps. If you are in the hospital for knee surgery, it is not necessary that your surgeon know all the life choices that led to your bad knees. It is important for them to make sure you understand the surgery and the steps you will need to take in order to recover. The surgeon will spend less time with you and get more money for doing it. I understand why, there is a lot more training that goes into learning how to perform surgeries and there is a lot more risk involved. Still, it seems wrong that doctors can only get paid for doing procedures on sick patients and not keeping their patients well in the first place. This discrepancy in pay between primary care physicians and other specialties is what causes part of the deficit.
Some would say that this proves that doctors are simply greedy but I would disagree. Medical school is expensive, very expensive and there are students who pay for it all in loans and don't get help from family. For these students, when it comes time to pay the loans back it can actually be hard to make it on a primary care physician's salary especially in the first few years of practice (and if the student has a family of their own it only adds to the burden). So unless you have someone who is truly passionate about primary care, the financial security of a different specialty is all too tempting.
Then you have how our society views health. It is no wonder we have a payment system built on procedures because society as a whole cares little about the prevention of disease. The sad truth is that we have become a people who simply look to treat our symptoms without pausing to consider what might be the root of the problem or what might have prevented the condition all together. Both doctors and lay people are guilty of this. It is much easier for a patient to take (or for a doctor to prescribe) a pill to lower cholesterol once the patient already has high cholesterol than it is to put in the work to prevent the condition in the first place. If the campaign for prevention could be set in motion it would spread to future generations. I truly believe that if doctors could get more compensation for keeping their patients healthy in the first place then they would spend more time educating their patients on disease prevention. If this became the norm instead of the glory of procedures we would see more of a balance between those doctors who want to specialize in preventing disease and those who want to specialize in treating the inevitable.
I hold nothing against my classmates who want to go into surgical or other non primary care specialties. I just find it sad that we have created a system where that number is so high and those who want to go into primary care is so low. We need primary care physicians. Helping people with their basic health and preventing disease is just as important as treating major diseases and it is time our health care system reflected this. It shouldn't be all about procedures, money and glory, it should be about the patients. It should be about making people well and keeping them well. I hope little by little our system can change, but if not, I guess in the future I will be doing lots of little procedures in my office to make up for all the time I will spend talking with and educating my patients, even if I can't bill for it.
Tuesday, February 28, 2012
Thursday, February 23, 2012
Lent
I was not raised Catholic but hubby was and I have a deep interest in the Episcopal faith (which is the denomination we chose to be married in). I have always liked the idea behind Lent even though I have never participated in it before. It seems very fitting to give something up in order to allow yourself to get closer to God. So this year I have decided to participate in Lent by giving up "trash" tv. (Game shows and reality television) We don't have cable at our house but do get a few stations and I am embarrassed to say that on days that I did stay home from school game shows, Maury and Jerry Springer were how I spent my time.
When deciding what in my life seemed pointless and possibly even harmful to my spiritual self these television shows are what kept coming to my mind. The game shows I don't think are really bad, but once I start watching those the tv stays on through the rest of the afternoon lineup so it seemed best to give them all up. In addition to giving up these television shows I am going to work my way through a devotional book and start attending an Episcopal church I found near our home.
I have never lost my faith but am ready to get more serious about it and to become closer to God. A series of events including the death of a friend and severe episodes of OCD have left me with a fear of attending church. (My OCD is religious based but that is a story for another time.) This Lent/Easter season I am finally ready to face those fears and I think that God will help me find my personal way to worship him again.
Blessings to you all.
When deciding what in my life seemed pointless and possibly even harmful to my spiritual self these television shows are what kept coming to my mind. The game shows I don't think are really bad, but once I start watching those the tv stays on through the rest of the afternoon lineup so it seemed best to give them all up. In addition to giving up these television shows I am going to work my way through a devotional book and start attending an Episcopal church I found near our home.
I have never lost my faith but am ready to get more serious about it and to become closer to God. A series of events including the death of a friend and severe episodes of OCD have left me with a fear of attending church. (My OCD is religious based but that is a story for another time.) This Lent/Easter season I am finally ready to face those fears and I think that God will help me find my personal way to worship him again.
Blessings to you all.
Sunday, February 19, 2012
I Helped Someone :)
A lot of studying to do today so this will be a short post. Longer ones to come during the week, I promise!
If you follow my blog you will have heard me mention how I help out at my school's Student Run Free Clinic usually one Saturday a month. I usually help out in patient education which means I counsel patients on life style changes including diet, exercise, smoking cessation and drug/alcohol abuse. It is something I enjoy and it is nice to get to have actual patient contact when most of my time is spent reading my notes or listening to lectures. The clinic only sees patients without health insurance so I know we are helping those who need it most.
Even though I enjoy doing it, patient education can be frustrating because you don't know if people are really listening to what you are telling them. A patient may seem receptive to lowering their salt intake because of their high blood pressure but we all know how hard life style changes can be. I only get maybe 10 minutes with a patient and then they have to go home and try to navigate the change by themselves. Many times in the back of my mind I wonder if I will simply be having the same talk with the same patient (or if another student will) when they come back for a follow up visit. I don't do my job any different because of this, but it is a thought that is there. I am grateful we can even provide these education services, I know many clinics can't because of the time it takes, but it is nice to know if what you do is really working.
Well yesterday I was estatic to learn that some of our patients are encouraged by our dedication to couseling them on good habits! I was outside the room while a fellow student was with a patient and heard the patient say how he was smoking 1-2 cigarettes per day. Afterwards the student was commenting on how this wasn't a very high number and I realized that the patient's name sounded familiar. The other student checked the chart and realized him and I had couseled this patient at his last appointment about cutting down on his smoking. At that time he was smoking 10 cigarettes per day!
Now I know the patient did most of the work. He was the one that had to make all that effort to cut down on a habit that is very addicting, but I also know that the encouragement from me and my fellow student at that previous appointment helped him on his way and that makes me very happy!
I didn't cure a disease, I didn't save a life, but I helped someone! To me, it feels like my first victory in my medical career. Maybe it is small but it is an encouragement and that is what is important because it will keep me going towards my goal!
If you follow my blog you will have heard me mention how I help out at my school's Student Run Free Clinic usually one Saturday a month. I usually help out in patient education which means I counsel patients on life style changes including diet, exercise, smoking cessation and drug/alcohol abuse. It is something I enjoy and it is nice to get to have actual patient contact when most of my time is spent reading my notes or listening to lectures. The clinic only sees patients without health insurance so I know we are helping those who need it most.
Even though I enjoy doing it, patient education can be frustrating because you don't know if people are really listening to what you are telling them. A patient may seem receptive to lowering their salt intake because of their high blood pressure but we all know how hard life style changes can be. I only get maybe 10 minutes with a patient and then they have to go home and try to navigate the change by themselves. Many times in the back of my mind I wonder if I will simply be having the same talk with the same patient (or if another student will) when they come back for a follow up visit. I don't do my job any different because of this, but it is a thought that is there. I am grateful we can even provide these education services, I know many clinics can't because of the time it takes, but it is nice to know if what you do is really working.
Well yesterday I was estatic to learn that some of our patients are encouraged by our dedication to couseling them on good habits! I was outside the room while a fellow student was with a patient and heard the patient say how he was smoking 1-2 cigarettes per day. Afterwards the student was commenting on how this wasn't a very high number and I realized that the patient's name sounded familiar. The other student checked the chart and realized him and I had couseled this patient at his last appointment about cutting down on his smoking. At that time he was smoking 10 cigarettes per day!
Now I know the patient did most of the work. He was the one that had to make all that effort to cut down on a habit that is very addicting, but I also know that the encouragement from me and my fellow student at that previous appointment helped him on his way and that makes me very happy!
I didn't cure a disease, I didn't save a life, but I helped someone! To me, it feels like my first victory in my medical career. Maybe it is small but it is an encouragement and that is what is important because it will keep me going towards my goal!
Friday, February 17, 2012
New Addition to our Family
So anyone who knows me knows that I have this love (read: obsession) for animals. I have been asked on more than one occasion why I didn't choose to be a vet instead of a doctor. To that I usually laugh and say I don't know but the real answer is that while I love my pets I could not imagine putting my talents to use saving animals instead of people. I have nothing against vets in any way. I obviously appreciate all they do. I just feel that my personal calling in life is to help people and my fur babies at home are more of a stress relief than life passion for me.
Anyway, back on topic. Our house has a new pet even though I swore many times we were at our capacity.
It started when my fish (Mr. Pebbles) died. I don't know why, he was just dead one night when I went to feed him diner, but he was a gold fish, and almost a year old, so we'll just say it was old age. I made hubby flush him and tried not to be sad because I felt a little silly seeing as it was the fish and not one of the cats.
Valentine's Day was coming up so hubby decided the perfect gift was a replacement fish. It was very thoughtful. He looked very similar to my lost fish. I named him Goggles but unfortunately he died about 3 days after I got him. Too bad hubby wasn't home, I had to flush him myself. I said I didn't want another fish but that night I decided to go to the pet store and pick out a Betta since I had luck with them in the past and they are pretty hardy.
Well, long story short, I went to the pet store but instead of falling in love with a Betta I fell in love with a hamster. oops. So I bought a cage, bought a hamster ball and brought the hamster (which I have named Dizzy) home. Part of me was sure hubby would demand I take this rodent back to the store. But I told him there was a 14 day return policy and he said we would see how it works out. That night he even said he really hopes Dizzy can stay and he has commented a number of times how much I seem to like him.
So this makes our count 2 cats, a parrot and a hamster. Am I crazy? Probably. And I have to say that our house is beginning to look a little like a pet store, but everyone who needs to be in a cage is in one and no one is in danger of being eaten by the cats. I make sure everyone is fed and the cages are clean. I don't know why but having the animals around makes me really happy and hubby doesn't mind so I guess those things are what matter. So if Dizzy passes his 2 week test I think our house will officially be full (until we move into a bigger place, then I want a big fish tank, but don't tell hubby).
Anyway, back on topic. Our house has a new pet even though I swore many times we were at our capacity.
It started when my fish (Mr. Pebbles) died. I don't know why, he was just dead one night when I went to feed him diner, but he was a gold fish, and almost a year old, so we'll just say it was old age. I made hubby flush him and tried not to be sad because I felt a little silly seeing as it was the fish and not one of the cats.
Valentine's Day was coming up so hubby decided the perfect gift was a replacement fish. It was very thoughtful. He looked very similar to my lost fish. I named him Goggles but unfortunately he died about 3 days after I got him. Too bad hubby wasn't home, I had to flush him myself. I said I didn't want another fish but that night I decided to go to the pet store and pick out a Betta since I had luck with them in the past and they are pretty hardy.
Well, long story short, I went to the pet store but instead of falling in love with a Betta I fell in love with a hamster. oops. So I bought a cage, bought a hamster ball and brought the hamster (which I have named Dizzy) home. Part of me was sure hubby would demand I take this rodent back to the store. But I told him there was a 14 day return policy and he said we would see how it works out. That night he even said he really hopes Dizzy can stay and he has commented a number of times how much I seem to like him.
So this makes our count 2 cats, a parrot and a hamster. Am I crazy? Probably. And I have to say that our house is beginning to look a little like a pet store, but everyone who needs to be in a cage is in one and no one is in danger of being eaten by the cats. I make sure everyone is fed and the cages are clean. I don't know why but having the animals around makes me really happy and hubby doesn't mind so I guess those things are what matter. So if Dizzy passes his 2 week test I think our house will officially be full (until we move into a bigger place, then I want a big fish tank, but don't tell hubby).
Sunday, February 12, 2012
Quick Laugh
Not writing a full post today. Just wanted to post a picture that I saw on facebook that I thought was funny. Even when life is busy, always make time to laugh!!
Saturday, February 11, 2012
Planning my summer
The summer between my first and second year of medical school is the only one where I get a long break (2.5 months). A lot of people choose to do some sort of internship or fellowship to fill the time and I am no different. I don't really need it to pad my resume as I don't plan on going into a competitive residency (family medicine is really under-represented by US graduates but that is a post for another time), but I don't want to spend my time just sitting on my butt at home. A year of medical school doesn't qualify me to do a whole lot but it will be nice to do something where I will be getting some patient contact!
Since I don't get any loan money over the summer I have had to look for opportunities that pay interns and I was lucky enough to find quite a few! If I don't end up getting accepted into any of those programs I will spend my time volunteering somewhere but for now I am putting a lot of effort into my applications.
There are a few local hospitals that let students shadow doctors in a variety of specialties. The pay varies from $150-300 per week and programs vary from 1-8 weeks. The programs are competitive but give preference to students from local schools. My top choice is for the hospital that is right down the street from where hubby and I live. I would get to do two 3 week programs. One in family medicine and one in internal medicine. My plan is to save part of my money from the program and go volunteer in Haiti for an additional 3 weeks of my summer (my dad is a missionary there please check out his work at sevendollarbills.com). This choice would be my number one way to spend my summer and I have already sent in the application in hopes that being so early will up my chances of being accepted! I would get to shadow in the specialty I am most interested and get to spend time with both my husband and dad over the summer. Sounds good to me!
My close second plan would involve me being in Haiti for the whole summer (10 weeks). If I didn't have a husband this would probably be my number one plan, haha, but I do and I have to admit being away from him for 2.5 months would be really hard! Anyway, there is a foundation that offers grants to medical students doing research or service projects over the summer. You have to write a proposal of what you will be doing and then report on your project within four weeks of your return. For students doing international work they have to have mentors both at their school and in the country they are volunteering in. My plan is to write a proposal to work with the Baby Rescue Program at the orphanage where my dad is in Haiti (check out danitaschildren.org). I know while I am there I would do more than work with just the babies in this program but for the grant my project has to have a focus. I really wish I didn't have exams right now because the application is due March 1st and there is little chance of me getting it in early but I guess at least it won't be late. My dad was so helpful to find someone to be my mentor in Haiti and my adviser at school will help me find a doctor to be my mentor here once I finish my proposal. I can not even imagine how much a summer in Haiti would change my life and how many people I would be able to help!!
There are a couple other things I am applying to like a family physician shadowing program in Delaware and an internship at NIH but these are more "back-up" plans. I would do those for the times they are and then used the money I saved to do 3 or 4 weeks in Haiti at the end of the summer.
Guess the main thing is no matter what happens I want to spend at least 3 weeks in Haiti with my dad helping out at Danita's Children! It would be really nice to get the opportunity to shadow some doctors in the area here as well but I will just have to wait and see what programs accept me. Whatever happens I am looking forward to an awesome summer! I can not wait to be out there helping people as a student doctor. I may only know a little but I am well on my way to becoming the doctor I want to be!!
Since I don't get any loan money over the summer I have had to look for opportunities that pay interns and I was lucky enough to find quite a few! If I don't end up getting accepted into any of those programs I will spend my time volunteering somewhere but for now I am putting a lot of effort into my applications.
There are a few local hospitals that let students shadow doctors in a variety of specialties. The pay varies from $150-300 per week and programs vary from 1-8 weeks. The programs are competitive but give preference to students from local schools. My top choice is for the hospital that is right down the street from where hubby and I live. I would get to do two 3 week programs. One in family medicine and one in internal medicine. My plan is to save part of my money from the program and go volunteer in Haiti for an additional 3 weeks of my summer (my dad is a missionary there please check out his work at sevendollarbills.com). This choice would be my number one way to spend my summer and I have already sent in the application in hopes that being so early will up my chances of being accepted! I would get to shadow in the specialty I am most interested and get to spend time with both my husband and dad over the summer. Sounds good to me!
My close second plan would involve me being in Haiti for the whole summer (10 weeks). If I didn't have a husband this would probably be my number one plan, haha, but I do and I have to admit being away from him for 2.5 months would be really hard! Anyway, there is a foundation that offers grants to medical students doing research or service projects over the summer. You have to write a proposal of what you will be doing and then report on your project within four weeks of your return. For students doing international work they have to have mentors both at their school and in the country they are volunteering in. My plan is to write a proposal to work with the Baby Rescue Program at the orphanage where my dad is in Haiti (check out danitaschildren.org). I know while I am there I would do more than work with just the babies in this program but for the grant my project has to have a focus. I really wish I didn't have exams right now because the application is due March 1st and there is little chance of me getting it in early but I guess at least it won't be late. My dad was so helpful to find someone to be my mentor in Haiti and my adviser at school will help me find a doctor to be my mentor here once I finish my proposal. I can not even imagine how much a summer in Haiti would change my life and how many people I would be able to help!!
There are a couple other things I am applying to like a family physician shadowing program in Delaware and an internship at NIH but these are more "back-up" plans. I would do those for the times they are and then used the money I saved to do 3 or 4 weeks in Haiti at the end of the summer.
Guess the main thing is no matter what happens I want to spend at least 3 weeks in Haiti with my dad helping out at Danita's Children! It would be really nice to get the opportunity to shadow some doctors in the area here as well but I will just have to wait and see what programs accept me. Whatever happens I am looking forward to an awesome summer! I can not wait to be out there helping people as a student doctor. I may only know a little but I am well on my way to becoming the doctor I want to be!!
Thursday, February 9, 2012
I'm Back!!
I'm back (and very lucky if anyone is still following this blog)!!
Yes, I am still in school and loving it (mostly) and yes, things are improved on the home front. Christmas break did hubby and me a world of good. It was nice to get some time to relax and reconnect. It is hard to make time for each other with our schedules but we have been doing much better and it makes a big difference.
So the quick version of what I have been up to in my absence: I had my Christmas break in which I spent a lot of time with family and friends! My dad was home from Haiti and I actually hosted Christmas at my house, lol. It made our little 2 bedroom place quite full for a couple days but everyone had a great time. I made a great Christmas dinner and my dad taught me how to make gravy :) All my brothers were home (2 from college, 1 from the marines) so I got to see them too. I also spent some time in Midland (my home town) so I got to see my mom's side of the family and a lot of my friends from high school/undergrad.
I also had my birthday so I am now the ripe old age of 24. On my birthday the actually Dr. Patch Adams that the movie was based on was speaking in Dearborn so I got to hear him speak and meet him afterwards (he signed a book for me!!) It was probably my most memorable birthday yet. I wrote an essay my first time trying to get into medical school about how he was the one person in medicine that I would want to meet and now I have. He is a very inspirational person and I promise to dedicate and entire post to the experience sometime in the future. My mom, grandma and brother came to visit the day after my birthday and we went out for pizza and a couple weeks later my brother (youngest) visited again and we did a late b-day trip to Chuck-E-Cheese. So overall I felt very loved and was happy to turn another year older.
Now I am finishing up my BioChemistry and Physiology courses so I can have spring break at the end of the month. Then it is just one more round of courses and I will be done with my first year of medical school in May!! I can hardly believe it. I am hoping to do an externship this summer either at a local hospital or in Haiti with my dad. Again, more on that later.
Hopefully I will keep my blog up this time. Thanks for reading!!
Yes, I am still in school and loving it (mostly) and yes, things are improved on the home front. Christmas break did hubby and me a world of good. It was nice to get some time to relax and reconnect. It is hard to make time for each other with our schedules but we have been doing much better and it makes a big difference.
So the quick version of what I have been up to in my absence: I had my Christmas break in which I spent a lot of time with family and friends! My dad was home from Haiti and I actually hosted Christmas at my house, lol. It made our little 2 bedroom place quite full for a couple days but everyone had a great time. I made a great Christmas dinner and my dad taught me how to make gravy :) All my brothers were home (2 from college, 1 from the marines) so I got to see them too. I also spent some time in Midland (my home town) so I got to see my mom's side of the family and a lot of my friends from high school/undergrad.
I also had my birthday so I am now the ripe old age of 24. On my birthday the actually Dr. Patch Adams that the movie was based on was speaking in Dearborn so I got to hear him speak and meet him afterwards (he signed a book for me!!) It was probably my most memorable birthday yet. I wrote an essay my first time trying to get into medical school about how he was the one person in medicine that I would want to meet and now I have. He is a very inspirational person and I promise to dedicate and entire post to the experience sometime in the future. My mom, grandma and brother came to visit the day after my birthday and we went out for pizza and a couple weeks later my brother (youngest) visited again and we did a late b-day trip to Chuck-E-Cheese. So overall I felt very loved and was happy to turn another year older.
Now I am finishing up my BioChemistry and Physiology courses so I can have spring break at the end of the month. Then it is just one more round of courses and I will be done with my first year of medical school in May!! I can hardly believe it. I am hoping to do an externship this summer either at a local hospital or in Haiti with my dad. Again, more on that later.
Hopefully I will keep my blog up this time. Thanks for reading!!
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