No Country For Urban Doctors
A study on the health care practices of urban and rural medical professionals
Monday, May 2, 2016
Monday, April 18, 2016
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!
Saturday, April 9, 2016
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.
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.
Tuesday, April 5, 2016
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!
Tuesday, March 29, 2016
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.
Monday, March 21, 2016
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.
Friday, February 26, 2016
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!
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!
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