Wednesday, May 15, 2013

Reflection on RMED

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

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

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.

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.

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.