Final Blog Post: SRP Presentation

https://docs.google.com/presentation/d/1ULPzZxd4cvinpvRZddAbGV7nGU2H8f098YLWMU0R70A/edit#slide=id.p

Blog Post: 4/18/16

Hey guys! This week has not been very busy or as hectic as they have been in the past. Talk about a much needed break! 

So, recently I have been working on my Senior Research Presentation, which has been quite difficult. What I have been doing a lot of lately is doing a lot of research, trying to assemble my different points and observations as to make some concrete points on the matter. I, as everyone else does while doing research, have run into a few different problems. For instance, as you all know, I shadowed a French rural doctor and not an American one. This is problematic because a lot of the research I am doing is centered around the problems of American rural medical professionals. 

One way I have found to solve this is by just using the research on American Rural medicine and also just general on rural medicine. I then just describe the basic differences between French and American medicine to show the that there are not as many differences as we think. Hopefully, this along with some more research I did on global rural medical practices, I can have a more full study of rural medicine and be able to compare it to American Urgent Care. 

Anyways, I know this blog post was not exactly all about the science or patient care of medical practices but I hope it illustrated to you a little about my research quandaries. Thank you for reading!

Blog Post: 4/8/16

So, once again I have spent more time with Dr. Mohty who is the medical professional that I am shadowing while trying to fully wrap my head around the American Medical system. Things are pretty complicated and there is usually a lot going on at the same time but I having a lot of fun. I am also, of course, learning a lot so all is quite good.

Now, I have really talked about the flow a lot of this urgent care center because I truly think it is fascinating and cool. I mean, in the rural areas, there was a lot more disorganization because so many things were happening so fast. She was so busy that we didn't have time to really arrange a lot of things before they happened. We were also so on the move and always exhausted from working all day that we did not really spend a lot of time organizing different things.

However, I did spend a better portion of my time with her organizing certain medical documents in alphabetical order. First, I separated the exam results to letters sent by colleagues which depict what that patient went through with that doctor such as a cardiologist appointment or a surgery. After that I properly threw away all of the medical tests that were over a year old. Then, after that I put the medical tests in alphabetical order and sorted out the letter by date. After that I put them all in special files, and stowed them away. Also, if we are speaking on organizing, I organized the entire medicine cabinet as well.

Thank you for reading! Keep it cool in the sun.

Blog Post: 4/3/16

Welcome back! I have been shadowing my urgent care doctor in America now for a little and I am really in awe of how much she seems to manage. Not only is she the lead physician at the urgent care she is also a part of this company called PediatriX which works in pediatric centers around AZ. I believe she is stationed at the Honor Health on Shea and usually works night shifts. Then, to top it all off, she is also an associate professor at University of Arizona Medical School. All the while she has managed to be married to a hand surgeon and raise four boys while staying sane. I honestly cant picture how she is able to juggle it all. 

Now, one thing I noticed while I was shadowing Dr. Mohty at her urgent care center, is how much more advanced there system of medical record and assignments is to those in rural areas. For instance, when a doctor sees a patient he or she must then write several notes about their symptoms, progress, medication etc. However, they must write these notes in a certain extended fashion several times in different places. At the rural medical practice or any of the other sites in Puget, the doctor I shadowed had to write in everything by hand several times which really extended the process and made everything happen at a much slower pace. It obviously was not her fault at all, it's just she didn't have  the technology available. 

Also, in the urgent care center I am in right now, they have a flow of accepting patients and treating them as I have described in the previous post. They also have a system of lights which tells them when a patient is in a room or requires aid. They also have an arsenal of nurses which helps them with several tasks and a series of steps on where to put a patient and how to draft a document to cure them. These kind of resources are not available to rural medical professionals who instead have to work with swamped nurses and almost no flow in the hospitals. This makes their jobs much more challenging as well as strenuous. 

So far this has been a very interesting few weeks and I look forward to continuing my shadowing, research and comparison. Thank you for reading!

Blog Post: 3/29/16

Recently, I have started shadowing a doctor who works at an urgent care center run by an insurance company, Cigna. However, even though it is run as Emergency Room, there are a few difference. One is that they don't accept many emergent cases as in an ambulance does not arrive and deliver someone with a gun shot wound who is bleeding out. Instead, people come into the waiting room and prove that they have the insurance needed to have them undergo medical care. Now, here is the actual flow of the urgent care center. 

First, patients come in and provide their information to a nurse at the front. She then checks their insurance, observes their issues and processes their paperwork. After that, they get a wrist band and are brought into see another round of nurses. These nurses then do a very important and sacred job: they triage. Basically, they look at the patients issues, blood pressure, other health issues and assess how problematic they might be and how in danger they actually are. After that, they write up a chart for them and put them in one of two rooms. One room is simple with all the general amenities of a general physicians clinical room. The other room is like a hospital room with heart monitors and an oxygen supply. Then, after that, the doctors get the chart and are able to see the patient and provide curative measures such as medication or run labs. 

Now, what is cool about this urgent care center is that it has its own lab and they are able to run some of their own tests. This is very practical because they can do what they need to do as fast as they can. The operation itself flowed really well and it seemed as if things went very smoothly throughout the day. The doctors and the nurses together work in unity and with great spirits. Overall, it is an awesome and fun environment that is exceedingly efficient and beneficial for the patients. It really is a great experience and opportunity. 

Blog Post: 3/18/16

I am finally back in America after spending just a little bit over a month in France. Wow, what a trip! I learned so much during my time with Dr. Godart and really reenforced my want to become a medical professional (however, not in rural areas). I realized how often rural doctors are forced to work and was shocked by the sheer number of patients and problems she had to face on our daily basis. 

Now that I am back I will embark on the second part of my research project which is studying the different mechanisms of American urgent care and the patient care it creates. I really wanted to just compare the habits of these two practices and found that this type of medical care would be best to compare to rural medicine. This comparison will allow me to really gain a full, well-rounded picture of what exactly rural medicine entails not only for the patients but also the doctor.

I, also, think its important to understand the trends that are happening in both urgent care in large cities (such as Phoenix) and in rural medical care. In urgent care, more and more doctors are pouring into these emergency departments because it seems exciting and fun whereas more and more doctors are pulling away from or leaving rural areas because it is too much work. Also, medical students are opting to not go into rural medicine because they think it will be boring. However, it really isn't at all with different patients coming about everyday with different complex problems to solve. 

So, anyway, today I am meeting with a doctor who I will shadow through urgent care and will be able to observe her moves and tactics for care. She will be my most direct link to American urgent care and I am super excited to work with her in her medical center. Lets hope it all goes well! 

Thanks all of you for reading. I loved my time in France and hoped you could experience some of it through my blog posts. I'll tell ya'll how the other shadowing goes. 

Blog Post: 2/26/16

Hello again! I have now been working for over three weeks now here in Puget. It has been really hard and long but thankfully also very interesting and fun.

Now, this week a lot has happened however nothing that I would really want to expand upon for over 400 words. So, what I thought I could do for this blog post is, instead of talking about my week, I could explain a little bit more about how the medical emergency systems work here in
France, especially the rural aspects of it.

So, unlike in America, where for any sort of emergency, you call 911; here, in France, for medical emergencies you call the number 15. Then, on the fifteen, you have a dispatcher. Now, unlike the dispatchers for 911 which have no real medical training but instead training in emotional support and triaging, these dispatchers have actual medical training and really have to understand the calls they are receiving. Now, what do I mean by "really understand the calls they are receiving"? Well, what I mean by that is that the dispatcher needs to take a medical emergency and organize it into three categories: non-emergent, slightly emergent and very emergent. Then, with each category the dispatcher has to then send in a different group of people or do a different action.

For non-emergent cases, the dispatcher just gives medical advice over the phone such as disinfect the cut and cover it or take this medication. That is all that is required and is why the medical dispatchers on the fifteen need to have basic medical training such as first aid. The, for slightly emergent cases, the dispatcher has the doctor in the region on-guard come over and examine the situation. That is what it means to be on-guard. It means that if there is ever an emergency and it is in our region, the fifteen calls us and we must go over there. This also applies for hospitals in that they can call us too. So, when we were on call, we had calls that came in around ten at night that we had to go too; the most dramatic one being two women in a psych ward getting into a fight.

Now, lastly, for very emergent cases, the dispatcher chooses to either send your stereotypical ambulance or a SAMU. A SAMU is a traveling hospital bed, in that a very skilled doctor and two very talented nurses with an abundant amount of medical supplies that set up there and work on the patient on site. The dispatcher must choose between these two types of groups to send for emergent situations. All of these different situations and outcomes are why the dispatcher for the 15 must very well trained and good at what they do.

Now, as a bonus for reading this lengthy post on French medical procedures, I have included a very ugly photo of myself at the local hospital in Puget. Now, if you look in the upper right corner of the photo, you will see that the clock reads 10, it was a fun night! Thanks for reading!

Blog Post: 2/19/16

Hello again,

I have now been in Puget for around a week and am just starting to adjust to the time difference and busy work life of the doctor I am shadowing. We have been very busy racing around town and the mountains for house calls and hospital calls, barely squeezing in time to eat and sleep. However, even though it is taxing and long and difficult, it is, most of all, super fun.

On my very first day, we had a practically full practice in which- in one day- we saw nearly 50 patients. Then, afterwards, we did a few house calls that took a lot of time because it took almost thirty minutes to get to the actual house! Here, I am really seeing another side of France that I really had never seen and that is the countryside. There are some very small towns with very few people and lot of animals and nature.

Then after those house calls and after we finished up at the medical practice, we went home to have dinner. However, we were on call and of course around ten at night, we got a call from a hospital almost thirty minutes away. When we arrived, we discovered that not only was it to assist a death but also that the man who was dying happened to be the father of the last patient who had come into the practice that day. What had occurred was that this 84 year old man was perfectly fine until fifteen days ago when he experienced an AVC, which is the french acronym for an accident vasculaire cerebral which basically means a stroke. Because of this incident, he went from a happy, healthy senior to an impaired, dying man. When we entered his room, we automatically saw that he was in a lot of pain and that his 'pauses' were long, therefore indicating that he was, in fact, near-death. So, in the dark of night, in a room with peeling, pale paint and under a flickering, yellow light, Dr. Godart administered two doses of morphine and we spent that night, with his daughter, watching him slip into the cold embrace of death. And, that was only my first day!

Since then, there has been nothing as extreme and intense but there has been plenty of stuff just as depressing. When we visited the retirement home, I was able to personally give basic check ups, such as measuring pulse, blood pressure, breathing, for several patients and most had severe cases of dementia or Alzheimers. It reminded me of my time volunteering at Hospice but unlike that time, I much more enjoyed it here because I really felt I was helping them and making a difference. To sum it up, even though I am seeing a lot of pain and suffering and undergoing a lot of back-breaking work, I am having the best time and loving every minute of it. This experience so far has definitely reaffirmed my want to be a doctor.

Thanks for reading and I'll post in another few days!

Blog Post: 2/12/16

Hello all!

I have just flown from Scottsdale to France and am now up in the mountains with my aunt, the doctor I am shadowing. The trip has been very long and strenuous because we had several crazy and terrible mishaps. We stayed in this one small, dingy airport in Paris for almost 8 hours! Now, I am super excited to be in the town I will be doing my internship, Puget. Here we are up in the mountains where it is beautiful and cold. Brrrrrrrr....... but it is so picturesque.

I will be starting in the practice tomorrow that Dr. Godart runs herself. What she does is that every day she begins with doing some clinical rounds with her patients from 9 a.m. to 12 p.m. Then, after that she either goes to the hospital, retirement home, or house visits. However, she does multiple of these shifts a day! Then, we go back to the practice for another six hours finishing around 7 or 8 and then we go either back to the hospital or more house calls. What this means is that we usually are working from 9 a.m. to 10 or 11 p.m.

I am just starting to learn the stressful and difficult job it is being a rural medical professional. The hours are crazy, the people are rude and the driving is insane. However, she says it is very rewarding and she is able to make a good living. One thing that really strikes me is the personal toll that weighs on the rural medical professional. She says that if she does not set breaks for herself then she will go crazy just thinking about what to do and if she made the right calls etc. She always says that being a doctor is difficult because if she makes a mistake someone dies or is seriously injured. People definitely rely on her.

She gave me a tour of her practice and while she was on the computer, I asked her how many patients she might have. She typed a few buttons scrolled down and told me 2,000 as on the computer. All these people that she either travels to or has come in need her to give them medical care. Most of them are very old and frail and are lost in the vast, bureaucratic mess that is the French Medical system. She has to sometimes drive for over forty minutes just to get to some small, rickety home to help an 94 year old woman. That day I also asked her how old was her oldest patient was and she said somewhere around 100. Yet, because she is one of two doctors in the immense region of the mountains in the South of France, she also takes care of children and newborns. Its a crazy job and life!

Thanks for reading! Ill keep ya'll updated. Bye!

Introduction

Hello all and welcome to my first blog post! I am very excited to begin this journey with all of you and hope you guys are excited too! I have decided to dedicate this first post to explaining more in depth my project and why it is important to me.

Ever since I was little, I have wanted to be a doctor and while my specific field of interest has changed from obstetrics to pediatric surgery to cardiology, I have always maintained my passion for the field of medicine. I have pursued this love through volunteer programs, internships, and lectures. So, when the opportunity arose where I could pursue a project of my own choosing, I jumped on the idea of shadowing several medical professionals ranging from a rural family physician to an ER doctor.

I will begin my project by flying to a town in the south of France, Puget. There I will shadow a female physician who is the only woman capable to birth a baby in a one hundred mile radius. She works under a practice with a few other doctors and she makes frequent home visits, in which she must travel through several miles of mountainous countryside just to reach one of her patients. In France, I will be able to interview her and the other doctors in her practice, follow her during home visits, and visit the Emergency Room which is located miles away from the town itself. I will also be able to give each patient I meet a survey to measure the level of patient care and health care they experience. My time in France (30 days) will mainly be spent just analyzing rural medical practices and accumulating data on the care the patient's experience.

Puget, France

Then, on March 13th, I will return to Scottsdale. Here, I will follow a doctor through an urgent care center where I will be able to watch her administer medical aid and interview her patients. I will interview her and survey the patients in the urgent care center as well. I will also spend my time volunteering at Honor Health Hospital where I will be able to observe the working of a major hospital and interview other volunteers, administrators, and nurses.

All of these experiences will provide me with a firm understanding and data on how rural and urban medical practices work. Using this newfound knowledge, I will be able to make a comparison between the two forms of healthcare and infer ways in which both could learn form each other in terms of patient care. My general hypothesis (which may change) is that in rural medicine, the personal relationship between the doctor and patient creates a better and more beneficial form of healthcare. However, this again is limited by the lack of resources and other doctors in rural areas thereby making a rural doctors job harder.

I hope that by reading this you learned a bit more about what I will be exploring for the next few months! My Senior Project Proposal (linked in the right tab) goes much more into detail of the specifics, so feel free to check that out as well. Again I am very excited to embark on this journey and am eager to see where my research takes me! Thank you for reading!