During this past year, I have learned a lot about Sullivan County's healthcare system as well as a greater appreciation of rural medicine in general. There were some outstanding lecturers as well as some good readings and posts. I have discovered some of the breadth of programs available in Sullivan County that aid in keeping the population healthy and happy. Also, I had learned that practicing rural medicine would not be without its challenge but that the reward is great. No matter where I end up in the future, I need to keep these lessons in mind and aim to make a positive change in the health of my patients.
I have learned of programs ranging from therapy dogs for the elderly to early intervention for children with developmental disabilities and many in between. These programs are all aimed at improving the health of the residents of the county. As we learned during the post on health measures of the counties, Sullivan County is very poorly ranked amongst the counties in the state. Programs like those I had read about can help to start improving the health of the residents and provide better health outcomes.
One particular program I thoroughly enjoyed reading about was the Early Intervention Program. Since 'children are our future', I feel it is our duty to ensure that they get the help they need to succeed early and often. The sooner children with developmental delays are identified the sooner they can get the help they need to catch up to their peers and find future success.
There would be some challenges associated with living and practicing in Sullivan County. One such challenge would be the distances I would have to travel to get places such as the grocery store, any kind of larger shopping area, or to get to a city. Also as a future practitioner, I would have to deal with some of the health problems that are more endemic to a rural population. On the other hand, there would be many benefits to living in a rural area. For one thing, I enjoy being out in the fresh air away from all the noise, clamor, crowds, and traffic associated with cities. With that, the rural lifestyle also just seems more relaxed and easy going than that of the city. Also, as a practitioner, I would be able to establish lasting relationships with the community and provide a much needed service to the residents and feel personally rewarded.
In my future career, I can make a difference by providing the best healthcare I can. I would try to focus on preventing disease before it happens through creating healthy habits and stopping the unhealthy ones when possible. I will then treat disease when prevention is not possible. Also, I would try and establish a solid reputation with my patients to help achieve this goal. I could make use of some of the variety of programs available in my county to help further this aim. No matter where I end up following my time in the Navy, I will aim to provide solid healthcare to my patients
Wednesday, May 15, 2013
Thursday, April 11, 2013
Flu
A condition that may be commonly encountered in just about every location is the influenza virus. The flu can cost adults and children several days of being sick and it has a very high rate of transmissibility. The flu can be found just about everywhere and is particularly prevalent around the winter months when everyone is in close quarters with little ventilation and children are in school. Early recognition and treatment are essential to reducing the spread and duration of the illness.
My role as a local medical expert is to recognize the signs and symptoms of the flu and if early enough I can prescribe treatment to help lessen the duration of the flu. Additionally, in doing so I should make sure that the patient receives bedrest and avoid contacts with others, especially those without a flu vaccine. I should also be careful to distinguish between the flu and the common cold which may not be affected by the treatment for the flu. Additionally, the influenza virus is a preventable condition for which a new vaccine of the most likely strain to come that year come out once a year. I feel it is also my role to encourage people to get their flu vaccine to avoid falling prey to this virus and additionally help to dispel some of the false beliefs surrounding vaccines and their safety/efficacy
The flu costs the community many sick days and the effect of the flu can linger for some time, making people more fatigued. Avoiding the flu altogether by actively encouraging patients to take the vaccine is the best way of avoiding the problems associated with the illness.
http://co.sullivan.ny.us/?TabId=3307
My role as a local medical expert is to recognize the signs and symptoms of the flu and if early enough I can prescribe treatment to help lessen the duration of the flu. Additionally, in doing so I should make sure that the patient receives bedrest and avoid contacts with others, especially those without a flu vaccine. I should also be careful to distinguish between the flu and the common cold which may not be affected by the treatment for the flu. Additionally, the influenza virus is a preventable condition for which a new vaccine of the most likely strain to come that year come out once a year. I feel it is also my role to encourage people to get their flu vaccine to avoid falling prey to this virus and additionally help to dispel some of the false beliefs surrounding vaccines and their safety/efficacy
The flu costs the community many sick days and the effect of the flu can linger for some time, making people more fatigued. Avoiding the flu altogether by actively encouraging patients to take the vaccine is the best way of avoiding the problems associated with the illness.
http://co.sullivan.ny.us/?TabId=3307
Sunday, March 10, 2013
Hospice of Orange and Sullivan Counties
http://hospiceoforange.com/clinical-care/
The hospice of Orange and Sullivan Counties offers care to patients in home, hospital, adult care facility, or hospice care to help alleviate pain and suffering for the terminally ill. The non-profit programs offers pain management available 24 hours a day from home health nurses through a variety of therapies and medications which can be tailored to the patient's needs including massage therapy, reiki, music therapy, aromatherapy, and pet therapy. They also offer a number of other programs to help support the families and the patient.
I think this program is invaluable to the people of Sullivan and Orange Counties because it offers patients the ability to receive care while in the comfort of their own home with their families rather than in the hospital. Additionally, the breadth of the services offered seem like they could really help to alleviate some of the suffering these patients could be going through. This patient centered approach is an idea that can hopefully be implemented in the majority of the country. By doing so, I believe patient satisfaction would increase while at the same time the cost of providing healthcare would go down. In the future, I can see myself seeking out these opportunities for my patients to have convenient access to health care with an emphasis on the patient.
The hospice of Orange and Sullivan Counties offers care to patients in home, hospital, adult care facility, or hospice care to help alleviate pain and suffering for the terminally ill. The non-profit programs offers pain management available 24 hours a day from home health nurses through a variety of therapies and medications which can be tailored to the patient's needs including massage therapy, reiki, music therapy, aromatherapy, and pet therapy. They also offer a number of other programs to help support the families and the patient.
I think this program is invaluable to the people of Sullivan and Orange Counties because it offers patients the ability to receive care while in the comfort of their own home with their families rather than in the hospital. Additionally, the breadth of the services offered seem like they could really help to alleviate some of the suffering these patients could be going through. This patient centered approach is an idea that can hopefully be implemented in the majority of the country. By doing so, I believe patient satisfaction would increase while at the same time the cost of providing healthcare would go down. In the future, I can see myself seeking out these opportunities for my patients to have convenient access to health care with an emphasis on the patient.
Monday, February 11, 2013
Sullivan County Rural Health Network
http://www.scrhn.org/
When I began looking for an example of a rural heatlthcare team in my study county I quickly found the Sullivan County Rural Healthcare Network (SCRHN). Their mission is "to collaborate to improve the health status of Sullivan County residents by increasing access to coordinated, cost effective health care services." The team consists of a number of healthcare offices, schools, and programs aimed at improving access to and outcomes of healthcare as well as some other programs designed to improve education, help families, and ensure the appropriate upbringing of children. One such healthcare office, Hudson River Healthcare, Inc. provides primary, preventative, and behavioral care regardless of ability to pay. They have offices located through southeast NY. I think this is a step in the right direction for helping people get in to see a doctor and get care when they need it before their issue becomes an emergency. Additonally, there is Maternal Infant Services Network for the needs of women of childbearing age and their families, hospice care for those that need end of life care, The Recovery Center for recovery from alcoholism and drugs, Prasad Children's Dental Health Programs for dental care and others all made widely available to those who need it.
In the future, I am still not entirely sure where I see myself in the healthcare team. I know that I will be going into the Navy after medical school and I think I may want to specialize in Emergency Medicine, although I am still leaving myself open to all options (save Ob-Gyn). Once I am out of the Navy (should be about 12 years after graduating or more depending on what happens), depending on where I am at that point I could possibly pursue a job in a rural area ER and work to make sure that appropriate care is provided for members of my community. If there is a need for more care then I would work to try find solutions like the one presented in the article we had read before the last class to ensure everyone is able to get access to healthcare.
When I began looking for an example of a rural heatlthcare team in my study county I quickly found the Sullivan County Rural Healthcare Network (SCRHN). Their mission is "to collaborate to improve the health status of Sullivan County residents by increasing access to coordinated, cost effective health care services." The team consists of a number of healthcare offices, schools, and programs aimed at improving access to and outcomes of healthcare as well as some other programs designed to improve education, help families, and ensure the appropriate upbringing of children. One such healthcare office, Hudson River Healthcare, Inc. provides primary, preventative, and behavioral care regardless of ability to pay. They have offices located through southeast NY. I think this is a step in the right direction for helping people get in to see a doctor and get care when they need it before their issue becomes an emergency. Additonally, there is Maternal Infant Services Network for the needs of women of childbearing age and their families, hospice care for those that need end of life care, The Recovery Center for recovery from alcoholism and drugs, Prasad Children's Dental Health Programs for dental care and others all made widely available to those who need it.
In the future, I am still not entirely sure where I see myself in the healthcare team. I know that I will be going into the Navy after medical school and I think I may want to specialize in Emergency Medicine, although I am still leaving myself open to all options (save Ob-Gyn). Once I am out of the Navy (should be about 12 years after graduating or more depending on what happens), depending on where I am at that point I could possibly pursue a job in a rural area ER and work to make sure that appropriate care is provided for members of my community. If there is a need for more care then I would work to try find solutions like the one presented in the article we had read before the last class to ensure everyone is able to get access to healthcare.
Monday, January 14, 2013
Sullivan County Health Measures
I was a little shocked when I first started reading about how my study county compared to the rest of the state and the nation in these factors. Just looking at the the scores, Sullivan was 62/62 in NY state in mortality outcomes, 58/62 in morbidity outcome, and 59/62 in social and economic factors. The premature death expressed in years of life lost before age 75 per 100,000 population has been holding relatively steady with maybe a slight increase over the past 10 years at 8761 compared to the state at 5812 and the nation at 5466. The national and state averages have also been decreasing over the past 10 years while there has been no improvement in Sullivan. The vast difference in these numbers is quite alarming and should raise some questions at the county health office. Additionally, Sullivan County performs more poorly on measures of morbidity than the state and nation as well with more physical and mental health days, more complaints of poor or fair health, and lower birth weights. Part of the problem may lay in the social and economic indicators which report lower reported rates of some college, and higher rates of unemployment, children in poverty, and inadequate social support. On the plus side, Sullivan has higher rates of high school graduation than the rest of the state as well as lower rates of violent crime and children in single parent households. Although the latter two measures are much lower than in the nation.
An interesting fact in the health behaviors section is that 30% of adults reported smoking >=100 cigarettes during the year compared to 14% in the nation and 18% in the state. I find this fact quite alarming as well. Undoubtedly this contributes to the early deaths and poor health outcomes as well as more than likely to low birth weights if mothers are smoking while pregnant. With as many people smoking as there are doctors in the county should be encouraging their patients to quit smoking as well as offer ways to help quit. Additionally, the county should be making effort to cut down on smoking through public health measures.
In the clinical care indicators section I found that much like the rest of the nation, Sullivan has a shortage of primary care doctors, altough to a much greater extent. There are 1767 people to 1 doctor in Sullivan County compared with 631:1 in the nation and 781:1 in the state. Clearly this could have an impact on the poor health outcomes Sullivan is experiencing as well. Hopefully some of the changes currently coming about in health care will help to alleviate some of the shortfalls in primary care both in Sullivan County and across the nation.
An interesting fact in the health behaviors section is that 30% of adults reported smoking >=100 cigarettes during the year compared to 14% in the nation and 18% in the state. I find this fact quite alarming as well. Undoubtedly this contributes to the early deaths and poor health outcomes as well as more than likely to low birth weights if mothers are smoking while pregnant. With as many people smoking as there are doctors in the county should be encouraging their patients to quit smoking as well as offer ways to help quit. Additionally, the county should be making effort to cut down on smoking through public health measures.
In the clinical care indicators section I found that much like the rest of the nation, Sullivan has a shortage of primary care doctors, altough to a much greater extent. There are 1767 people to 1 doctor in Sullivan County compared with 631:1 in the nation and 781:1 in the state. Clearly this could have an impact on the poor health outcomes Sullivan is experiencing as well. Hopefully some of the changes currently coming about in health care will help to alleviate some of the shortfalls in primary care both in Sullivan County and across the nation.
Sunday, December 2, 2012
Early Intervention Program
http://www.co.sullivan.ny.us/Departments/PublicHealthServices/ChildrenwithSpecialHealthCareNeeds/EarlyInterventionProgram/tabid/3347/Default.aspx
The Early Intervention Program through the Sullivan County Public Health Services helps to screen for developmental delays in children ages newborn to 3 years old and get them early help. The program offers speech, physical therapy, occupational therapy, case management, and special education. The referrals can come from just about anyone familiar with the child, and physicians can play an important role in making sure these children get help early. I think this program is very important in making sure that children of Sullivan County are able to get the necessary help early so that when school comes around they are not lagging behind, a hole that could be difficult to get out of. Additionally, the wide range of services can help with many different developmental disorders that may be encountered.
As a future practitioner, I believe my role is to help keep patients aware of the benefits of programs such as this one and the one in the paper in order to promote better health amongst them. The aim is to help prevent diseases and other ailments before they begin and a good way to do that is with good public health. Many of the ailments that are affecting the population today can help to be mitigated with more programs to stop them. The example in the paper of the program to lower heart disease is a good example. Simple things such as promoting a better diet and exercise can lower the incidence of heart disease.
Additionally, as a future practitioner I feel I have some role in helping to create such programs if I perceive a deficit in public health. This can be through things such as jogging groups with patients or on a larger scale by talking to public health officials about creating programs. Proper education about program availability and programs to reduce risk factors for poor health outcomes will undoubtedly benefit patients.
The Early Intervention Program through the Sullivan County Public Health Services helps to screen for developmental delays in children ages newborn to 3 years old and get them early help. The program offers speech, physical therapy, occupational therapy, case management, and special education. The referrals can come from just about anyone familiar with the child, and physicians can play an important role in making sure these children get help early. I think this program is very important in making sure that children of Sullivan County are able to get the necessary help early so that when school comes around they are not lagging behind, a hole that could be difficult to get out of. Additionally, the wide range of services can help with many different developmental disorders that may be encountered.
As a future practitioner, I believe my role is to help keep patients aware of the benefits of programs such as this one and the one in the paper in order to promote better health amongst them. The aim is to help prevent diseases and other ailments before they begin and a good way to do that is with good public health. Many of the ailments that are affecting the population today can help to be mitigated with more programs to stop them. The example in the paper of the program to lower heart disease is a good example. Simple things such as promoting a better diet and exercise can lower the incidence of heart disease.
Additionally, as a future practitioner I feel I have some role in helping to create such programs if I perceive a deficit in public health. This can be through things such as jogging groups with patients or on a larger scale by talking to public health officials about creating programs. Proper education about program availability and programs to reduce risk factors for poor health outcomes will undoubtedly benefit patients.
Sunday, November 4, 2012
Sullivan AIDS doctor is back in business
http://www.sc-democrat.com/news/12December/19/news.htm
This article is about an infectious disease specialist, Dr. Gary Good who is opening his new office in Monticello. Leaving his training in the 1990's, Good saw an overwhelming rate of diagnoses of HIV in Sullivan County and decided to help meet the need. He had originally worked with a medical center, and then a non-profit healthcare system, Hudson River Healthcare (HRH), but was removed from the services due to funding. His patients continued to contact him for help on how to deal with the complicated healthcare system and to receive treatment, and Good decided he couldn't abandon them and decided to set up his own practice in Monticello.
I believe that Dr. Good displays some valuable qualities that are important in the patient-doctor relationship. He must have earned their trust to have them follow him across two healthcare systems and then continue to contact him for advice after he was removed from HRH. Additonally, he is seeking to provide the latest in drug therapy and keep his knowledge of his specialty up to date by applying for funding for new drug trials. Moreover, he has respect for his patients and after developing a long relationship with many of them, he doesn't want to abandon them and considers them to be very close.
I think some of the values displayed by Dr. Good are very important in the doctor-patient relationship. I feel that another aspect not yet touched on is the importance of teaching patients to help them stay healthy. For patients to improve their own health, they have to be able to understand what they need to do, be that information on their medications, the harmful effects of drugs and cigarettes, or how to maintain a healthy diet to avoid heart disease and obesity. Additionally, having a respect for patients while still developing a healthy relationship is very important. If patients respect you and you show them respect then they are more likely to listen to what you have to say and advise them to do. Compliance will go up as will health outcomes. Strong patient-physician relationships lead to healthier patients.
This article is about an infectious disease specialist, Dr. Gary Good who is opening his new office in Monticello. Leaving his training in the 1990's, Good saw an overwhelming rate of diagnoses of HIV in Sullivan County and decided to help meet the need. He had originally worked with a medical center, and then a non-profit healthcare system, Hudson River Healthcare (HRH), but was removed from the services due to funding. His patients continued to contact him for help on how to deal with the complicated healthcare system and to receive treatment, and Good decided he couldn't abandon them and decided to set up his own practice in Monticello.
I believe that Dr. Good displays some valuable qualities that are important in the patient-doctor relationship. He must have earned their trust to have them follow him across two healthcare systems and then continue to contact him for advice after he was removed from HRH. Additonally, he is seeking to provide the latest in drug therapy and keep his knowledge of his specialty up to date by applying for funding for new drug trials. Moreover, he has respect for his patients and after developing a long relationship with many of them, he doesn't want to abandon them and considers them to be very close.
I think some of the values displayed by Dr. Good are very important in the doctor-patient relationship. I feel that another aspect not yet touched on is the importance of teaching patients to help them stay healthy. For patients to improve their own health, they have to be able to understand what they need to do, be that information on their medications, the harmful effects of drugs and cigarettes, or how to maintain a healthy diet to avoid heart disease and obesity. Additionally, having a respect for patients while still developing a healthy relationship is very important. If patients respect you and you show them respect then they are more likely to listen to what you have to say and advise them to do. Compliance will go up as will health outcomes. Strong patient-physician relationships lead to healthier patients.
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