Extra Credit: Due June 9th at 11:59PM

The extra credit opportunity is to:
1. View the film below (it's the full version of the clip on genetics that we viewed)
2. Choose a health issue that was mentioned in the film, or one that could result from the trends explained in the film. Then  describe three structural factors in the health issue.
3. Write your response in the COMMENTS SECTION OF THIS POST

**This film was recommended to me, but it is biased!!! That means it was made by an activist; someone who wants to see the world change. In this case, the bias it wanting to create a global society in which everyone has a good stardard of living.
The views expressed in this film are not my own; the content is for you to use and analyze using sociology. You can earn up to 10 points for your response.

Radiologist-Patient Interaction

Radiology has been a prominent field since 1895, starting out as photographers, physicists or amateur experimenters instead of having their medical degree. At the beginning of radiology the radiologist acted as the technician—a person who takes the images—and also the interpreter of the images. This made the early radiologists be in direct contact with the patients and their contact with the patient has decreased drastically due to the radiologists wanting to increase their professional status with the public and other medical professionals. People to this day still don’t know whether a radiologist is a technician or a physician. (1) So what happened to the radiologist?

                As I said above, the radiologist had direct contact with patients because they did both the examination and the interpretation of the images with the patient along with giving the images to the patient. Radiologists stopped giving the images from the scan to their patients because it was thought of, by the medical community, to not be the patient’s property. Then in 1916, the American Roentgen Ray Society advised the radiologists to only communicate the results only to the patient’s physician. This was done so that referring physicians would find radiologists as medical experts. (1)

                In 1922 the American Registry of Radiological Technology was established creating qualification and licensure requirements for technicians. Now the radiologist was taken even further away from the patient, only doing the job of interpreting the results of the scans and communicating the results to the physicians. This required little to no communication with the patient that was getting a radiologic scan. (1)

                Location also effected the radiologist-patient interaction because as hospitals became bigger and were able to buy and keep up with the expenses of the equipment needed for scans, which made the hospital a better place for a radiologist to work, rather than an outpatient clinic. Their location within the hospital has also lead to a decline in communication, placing them in a completely different portion of the hospital, away from where all patients may go. They are also not provided with rooms in which patients could come in a talk to the radiologist about their results or ask any questions about the scan. Those questions are left to their physicians or the technician conducting their scan, which the radiologist could answer just as good, if not better than the others who are involved with the patient. (1)

                There was a study done that measured the interaction between radiologists and patients at the Mayo Clinic in Rochester and the Mayo Clinic in Jacksonville. There were three categories of patient interaction: direct radiologist-patient, variable, and no interaction. They found that at the Mayo Clinic in Rochester, 22% of radiologists performed examinations that required direct patient interaction, which include diagnostic mammography, gastrointestinal radiology, and interventional radiology. 26% of the radiologists working had no interaction with the patient. In the variable group, which means that the radiologist interacted with some of the patients or had to be available in case of an adverse reaction to the contrast given during the injection of a contrast media, 22% of radiologists had to be available to the patient during the exam. At the Mayo Clinic in Jacksonville, 18% had direct interactions with patients, 24% had no interaction, and 29% had variable interaction with patients. (1,2)

                Radiologist-patient interaction should become more important in the health care system because they are very knowledgeable and know the scans better than a general doctor does. Instead of the patient having to hear second hand information from their doctor, they should be able to go to a radiologist and be able to have all their questions asked.

Here is my question: Would having a radiologist read and explain the results of the exam to the patient be beneficial or not?

References:

1. Glazer, G. M., and J. A. Ruiz-Wibbelsmann. "The Invisible Radiologist."Radiology 258.1 (2010): 18-22. Print.

2. Williamson, Eric E., and Byrn Williamson. "Radiologist-patient Interactions: Implications For Picture Archiving And Communications Systems And Teleradiology." Journal of Digital Imaging12.S1 (1999): 137-138. Print.

The Declining State of Doctor-Patient Relationships

The Trust Factor

After reading the New York Times article entitled: "Doctor and Patient, Now at Odds", I thought I would explore the issue of the Doctor-Patient relationship. The meat and potatoes of this article basically takes a look at the idea that people today are becoming less and less satisfied with their experiences at the doctor's office, and research seems to suggest that one of the big issues here has to do with a lack of trust. This article indicates that many patients today are reluctant to trust their doctor for a variety of reasons, which range from people's increasing tendency to seek out online medical advice to the fact that many people are reporting the fact that they feel as though today's physicians seem to be diagnosing patients as quickly as possible in order to promptly get them in and out of the office. Issues such as these are making patients feel as though they are being put at risk by their doctors, or simply aren't getting the type of personal attention that they would like when at the doctor's office, and the resulting distrust between doctor and patient seems to be giving people the feeling that doctors are not doing all that they can, or that they simply don't care enough about their patients to try. Taking these issues into consideration, it's easy to see why people today are beginning to feel dissatisfied by their interactions with physicians.

What Can be Done to Fix The Problem?

While I can identify with the feeling that I'm being rushed at the doctor's office, or that the doctor simply doesn't care, I think that a little bit of understanding on both ends of the doctor-patient dynamic could go a long way towards improving relationships.
I can understand people wanting to feel like they are important when they visit the doctor's office, and I don't think there is anything wrong with that. Having said that, I think that in some cases patients are expecting far to much from physicians in this regard. The sad but true fact of the matter is that doctors are people just like you and I, and the vast majority of these people-while exceedingly well-educated, have had little to no training when it comes to people skills. While I will agree that it is really nice to feel like you have a personal connection with your physician, I personally don't really expect my doctor to hold my hand or tell me how pretty I look when I come in for a check up. These people are not trained to be personable or polite, and in my personal experience I would say that many of them can be just as socially awkward or rude as any other random person you might run into on the street. If you happen to have a doctor like this yourself, I would say that the first order of business would be to find yourself a better doctor. I think most of us would love to have a doctor who we enjoy spending time with and who we feel that we can open up to, and they are certainly out there. We just have to be more proactive as patients about seeking them out. I also feel that we as patients need to try and understand the fact that today's physician is more pressed for time than ever before, and often does not have the option of spending unnecessary amounts of time small-talking with every patient. If you are feeling rushed in and out, and believe me- I know how you feel, It probably isn't personal. Doctor's today are often pushed to be quick and efficient, and that often comes at the expense of the doctor-patient dynamic.
As I mentioned previously, the next big issue that seems to be adversely affecting the doctor-patient relationship involves patients trying to self-diagnose before they enter the doctor's office. I am guilty of this at times myself, and the fact that it is incredibly easy to jump online and find any number of idiots who think they are the next Doogie Howser (that's right; I took it there...) tossing out bogus medical advice isn't helping the situation. What results from this is the patient walking in to the doctor's office feeling as though they know just as much as the physician, and in the event that these two diagnosis' conflict, many times negative feelings and distrust can ensue. I don't know about any of you, but in the event that a battle of wits erupts between an internet random who has trouble constructing a legible sentence and a man or woman who has been studying the inner workings of the human body for at least the better part of a decade, I know who I'm taking advice from every time. While I'm not saying that doctors are always right, I find it crazy to think that people will often go as far as not taking their prescribed medications because they conflict with advice they've seen on the internet forums.
Honestly, I can certainly identify with the feeling that I'm being rushed, or my doctor just doesn't care much about me at all, and it's not a great feeling to have to be sure. Furthermore, many of us don't have the option to go out and seek out the best, brightest, or most polite doctor in town, and I understand that quite well. Having said that, I also feel that patients might need to lower their expectations a bit when it comes to the doctor-patient relationship, and try to understand that not every physician is going to be an absolute delight, and many of these physicians are being rushed to get through as many patients as possible every day. If you feel like your doctor doesn't care about you, or simply isn't a very nice guy or gal, it most likely isn't anything personal. Until medical education practices change drastically in a way that places more emphasis on the social aspects of the doctor-patient relationship, I don't really see things changing in that regard. Doctors are people just like the rest of us, and by god some of them are just assholes. I guess the best we can do in this case as patients is to simply seek out a physician we can talk to and learn to trust, and for the love of god PLEASE DON'T LISTEN TO DOOGIE!!! I'm fairly certain he hasn't even been to medical school...

Men, Women and Coping With Depression

Depression can be defined as when a person has a stressful experience where they can feel out of control which creates a sense of helplessness. The feeling that there is no hope for their immediate future can feel painful both emotionally and sometimes physically.  Experiences can be different for each person. Some examples of this are:

• Moving to a new neighborhood
• Trauma such as abuse and rape
• Unemployment and financial issues
• Stress at work and school                                                     
• Death of a loved one
• Divorce or separation
• Diagnosis of disease or illness with self or loved one
• Low socioeconomic status

It is also important to remember that not only negative events can trigger depression. Sometimes, marriage, birth of a baby or a major move up in employment can also trigger depression in both men and women.

Although signs of depression are the same between genders, women tend to experience depression more often than men and the way men and women cope and deal with depression is many times, the opposite.

                                                                                                                              

Differences between male and female depression
Women tend to:	Men tend to:
Blame themselves	Blame others
Feel sad, apathetic, and worthless	Feel angry, irritable, and ego inflated
Feel anxious and scared	Feel suspicious and guarded
Avoid conflicts at all costs	Create conflicts
Feel slowed down and nervous	Feel restless and agitated
Have trouble setting boundaries	Need to feel in control at all costs
Find it easy to talk about self–doubt and despair	Find it “weak” to admit self–doubt or despair
Use food, friends, and "love" to self–medicate	Use alcohol, TV, sports, and sex to self–medicate

While depression is found in both men and women, but women are twice as likely to seek help for depression compared to men. This is mostly in part to the fact that women are able to express their feelings, particularly to their medical provider. Dr. Mona Aquila writes in the Clinton Herald that “According to researchers, male depression is under-reported and its symptoms are different from those seen in women. Men seek help for depression less often because they tend to view mental illness as not being “masculine” and attempt to hide the symptoms. They tend not to get help due to fear that a diagnosis of depression will be made and to avoid the stigma of being depressed." 

Women find ways of coping by finding social support, talking to their physician and following the prescribed orders the amount of time required by their doctor. Men are less likely to make the appointment with their doctor and if they do end up going, there is a higher chance they will not give all their symptoms and fail to follow the doctors orders for medication and self care.

If as a society, we re examine our views of depression in both men and women, and agree that seeking help for depression is not a sign of weakness, do you think more men will report their symptoms to their doctor? Will this provide more accurate data for medical purposes along with both genders receiving the care specific to their individual needs?

References:

1. Melinda Smith, M.A., and Jaelline Jaffe, Ph.D (May 2013) Depression in women. In Helpguide.org. 

Retrieved May 28, 2013, from http://www.helpguide.org

2. Dr. Mona Aquila (January 6, 2010) Men and Women Deal With Depression in a Different Way. In clintonherald.com. Retrieved May 29, 2013, from http://clintonherald.com 

Affordable Care Act

Why do we need the Affordable Care Act? (ACA) Why is it so important?  The Affordable Care Act became law on March 23, 2010.  It was put in place to help more Americans afford health care, and also to lower health care rates.  By the year 2014, it will be required to have health insurance either with a persons’ employer or through the government’s health insurance.  If a person does not comply, there will be a penalty enforced by the I.R.S.  Who will this law benefit? Will it make a difference with SES? Will it make a difference with race?

“Statistics indicate that racial and ethnic minorities are generally poorer than whites and more likely to have family incomes below 200 percent of the federal poverty level. In 2002 more than half of African Americans, Hispanics, and American Indians/Alaska Natives were poor or near-poor. Researchers note that low SES is usually associated with poor access to care, riskier behavior, fewer community resources, and higher mortality. Racial and ethnic minorities are more likely to be uninsured as well. In 2002 more than 20 percent of African Americans and more than 30 percent of Hispanics were uninsured. Hispanics are the most likely of any racial and ethnic minority to be uninsured.  Researchers also note that when they control for SES, the respective health disparities are usually greatly reduced but not eliminated.” (William H. Frist.)

With this knowledge, will the new law be able to prevent riskier behavior and lower the mortality rate of the people who have a lower SES?  The ACA proposes that there will be more facilities available to families who are now struggling to see a doctor because there is not a clinic nearby.

“Among the social structures investigated within sociology, social class, usually operationalized as socioeconomic status (SES), has proven particularly relevant for understanding racial disparities in health.” (Williams and Sternthal)  So maybe with the addition of equal health care for most all American’s we can fill in some of the gap that we have today. 

I found a quote that was interesting.  Brings up the question, do we allow certain races, or low SES people to live in poverty because we need to have this inequality in people?

“The most difficult social problem in the matter of Negro health is the peculiar attitude of the nation toward the well-being of the race. There have . . . been few other cases in the history of civilized peoples where human suffering has been viewed with such peculiar indifference.”

      —W. E. B. Du Bois (1899 [1967]:163)

References:

 William H. Frist.Overcoming Disparities In U.S. Health Care http://content.healthaffairs.org/content/24/2/445.full. doi: 10.1377/hlthaff.24.2.445  Health Aff March 2005 vol. 24 no. 2 445-451

David R. Williams and Michelle Sternthal. Understanding Racial-ethnic Disparities in Health : Sociological Contributions. Journal of Health and Social Behavior 2010 51: S15.  DOI: 10.1177/0022146510383838

Social factors affecting Men's Health

What social factors affect Men's utilization of health care

Men have traditionally used health care services at a lower rate than women. There have been several studies to prove this fact, but most of them focus on why women use health services. Studies from the past have suggested that women use more health services due to their higher morbidity and self reported health status. Others have suggested that there is a difference between the genders associated with reproductive biology and medical issues that may be specific to one gender.

            Very few if any studies have addressed the issue of what social factors are keeping men away from the health care providers. A social factor is an influence of society on a person’s behavior. So in this case what in the lives of men are keeping them away?  The best way to answer this question immediately was to go ask a few guys why they didn’t go to the doctor even when they felt like they needed to.

            David is a 45 year old man who is married with two children; he is also employed and has health coverage. When asked about his trips to the doctor David admitted he did not go as often as he should. His explanation for this was that he was the provider for his family and did not have the time and needed to allocate his money towards providing for his family. The social factor that is keeping David away is gender. As the provider for his family, society has influenced David to believe that he must sacrifice his health for the sake of the overall good of the family.

            Phil is a twenty five year old college student. Phil said he does not go to the doctor as often as he should. In fact he only goes if it is an emergency. When asked why Phil said that men aren’t supposed to go to the doctor because they are supposed to be strong and take care of themselves.  Phil is not going to the doctor because of his group belonging. Phil being a manly man identifies with his groups customary belief that men are too strong for the doc.

            These are just two examples of social factors that are affecting men’s utilization of health care services. Although they are not scientific they do raise the possibility of asking a question that we could research. Regardless there are health implications that have been documented. Men use less preventive care. This leads to higher rates of chronic illness and higher heath care costs for everyone.

Acupuncture in daily living: Helpful or Hurtful?

There are numerous reasons as to why people would seek out complementary or alternative medicine (CAM), and some of the reasons include that while also visiting the doctor, this other form of CAM can help supplement the help offered by the physician, they may actually be dissatisfied with their care provider and do not like messing around with the insurance companies,  they want to be in control of their own health and make their own choices for their body, and they simply enjoy the different medicine techniques that are out there today. The CAM technique I will be focusing more on is acupuncture and whether it’s more helpful for an individual or hurtful. 

Acupuncture is a type of complementary medicine that is used to alleviate pain and promote natural healing in various parts of the body, known as acupuncture points, by using a needle that goes into the skin and applying heat or electrical impulses, it’s said to also treat various diseases.  

Acupuncture is helpful to the body by that it helps the flow of the energy, and when out of balance, diseases may arise in the individual; but this theory is only empirical evidence. It’s said that acupuncture can help alleviate depression, sleep disturbances, and drug addictions, but the main concern for this belief is whether the acupuncture is actually effective, or if it’s the individual who participates in new behaviors that come along with acupuncture.  However, a 2011 review found that patients undergoing chemotherapy and had regular acupuncture helped reduce the nausea and vomiting that came along with the chemo treatments. It’s said that acupuncture releases opioid peptides that are neurotransmitters such as endorphins, enkephallins, dynorphines, that are closely involved with the perception of pain. 

http://www.youtube.com/watch?v=etIUVX2Hddo

The physical effects that an individual would feel resulting in participating in acupuncture would be the prickling sensation of the needle going on in the skin, which isn't inserted very far beneath the skin, and others full a dull sensation around the needle insertion.  If done right, no harmful physical effects would leave a patient in pain or cause their illness to get worse. However, if the acupuncturist is not thoroughly careful, he can end up using needles that are not sterile, they may insert the needle too deep into the skin, but overall, as stated by the National Institute of Health, and acupuncture is relatively safe for all. Even though after receiving acupuncture, some acupuncturist receive feedback from their patients from suffering from their original symptoms after a few days following, but this is due to the acupuncture starting to take effect. Also, after the first session or two, the patient might experience deep relaxation or mild disorientation, and these side effects should go away within two days or so. Some of the rarest side effects can include bruising of the surrounding needle insertion point, fainting, muscle spasms, bleeding, nerve damage, punctured lung, and accidental injury to organs, which can stem from the acupuncturist not doing his job thoroughly. 

Overall, acupuncture is a safe treatment for any person wanting to alleviate pain in certain areas of their body. Even though each person is different, some or none of the side effects mentioned can be felt by the person, or it may not help a person at all. Even thought I've never gone through a session of acupuncture, I still believe it would be helpful in the sense that where the pain sites are located, having it punctured by a hair thin needle would help to release the neurotransmitters that are involved with the sensation to feel better. 

References:

Wanjek, Christopher. "What Is Acupuncture?" LiveScience.com. N.p., 09 May 2013. Web. 29 May 2013

“Can Acupuncture Help My Condition?" American Academy of Medical Acupuncture Home. N.p., n.d. Web. 29 May 2013.

Christensen, Emma. "Theories on the Effects of Acupuncture on the Nervous System." Serendip Studio. N.p., 15 Jan. 2008. Web. 29 May 2013.

Cockerham, William C. Medical Sociology. 12th ed. Englewood Cliffs, NJ: Prentice-Hall, 1978. Print.

Joswick, Diane. "Are There Risks or Side Effects to Acupuncture?" Acupuncture Referral Service. Acufinder.com, n.d. Web. 30 May 2013.