5: Conventional Medical and Health Care Flashcards
Self-care
personal health maintenance
Practicing self-care at home is a way to combat ______
rising doctor costs
OTC medicine
sold without a prescription
The Centers for Disease Control and Prevention (CDC)’s list of general prevention = ‘Tips for College Health and Safety’
- Eat healthy and be physically active
- Diet with variety of fruits/vegetables/whole grains daily
- Limit calories, sugar, salt, fat, alcohol
- Maintain a healthy weight
- 2.5 hours of activity that increase heart rate/week - Stay safe: manage stress levels by …
- Getting enough sleep
- Avoid overuse of alcohol
- Build social supports while retaining time for yourself
- Seek necessary help if struggling with depression/suicidal thoughts
- **be aware/keep safe from sexual assault - Prevent the spread of infectious disease
- 1/2 of all new STIs occur in people under 25
- Get tested, know status, immunizations - Avoid substance abuse
Know the impact of binge drinking and how it contributes to poor decision making and injury/violence
Monitor your symptoms
Describe nature of symptoms
- when they began
- how long they’ve lasted
- severity
who is responsible for monitoring and approving OTC drugs
The Food and Drug Administration (FDA)
The Food and Drug Administration (FDA) states drugs will be available OTC if:
- Drug’s benefits outweigh its risks
- Potential for misuse and abuse is low
- Consumer can use them for self-diagnosed conditions
- Drug can be adequately labeled
- Health practitioners are not needed for the safe and effective use of the product
Pain Relievers (analgesics )
Come in 2 forms
- Acetaminophen
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
Acetaminophen
- Ex. Tylenol
- Found in over 600 drugs
- Reduces sensation of pain by blocking pain receptors in the brain and spinal cord
Nonsteroidal anti-inflammatory drugs (NSAIDs)
- ex. naproxin, aspirin, ibuprofen
- Slows the production of enzymes that in turn slow the production of prostaglandins
prostaglandins: responsible for swelling and pain production when body suffers injury
prostaglandins
responsible for swelling and pain production when body suffers injury
T or F Each NSAID has different dosing requirements
T
Antihistamines
Allergy Medicine
= counteract the physiological effects (symptoms) of histamine production in allergic reactions and colds
= When the body senses a foreign agent it releases histamine to defend itself, causing an individual to experience runny nose, sneezing and scratchy eyes/throat
1st vs 2nd generation antihistamines
**30+ OTC approved
First-generation antihistamines - Benadryl, Dimetapp
Second-generation - reduces degree of tiredness people feel after use, yet no more effective than first-gen (Cetirizine, Loratadine)
Decongestant
Common Cold
= breaks up congestion, as of the sinuses, by reducing swelling
= Reduces the blood flow to the nasal capillaries, reducing swelling of the tissues in the nose; opening air passages for easier breathing
Few oral decongestants are approved by the FDA, primarily pseudoephedrine and phenylephrine - why?
2006 - George Bush signed a revised version of The Patriot Act directing products containing pseudoephedrine to be pulled from availability as OTC drugs due to its use in making methamphetamine
- 38 states in US have laws restricting availability of pseudoephedrine, most limiting amount you can buy and indicating purchase must come from a pharmacist
Antitussives & Expectorant
Nagging Cough - caused by excess phlegm OR dryness causing cough reflex
Antitussives: stop the cough reflex
- Reduce the sensations in the nerves to tell the brain to cough
- Dextromethorphan = most common, found in nearly all OTC cough suppressants
Expectorant: combat significant phlegm
- Thins and loosens the phlegm so the cough is more “productive”, allowing phlegm removal
- Guaifenesin = only approved OTC expectorant
Natural approaches instead of OTC
- Rest
- Warm salt water gargle (relax nasal passages for a stuffy nose and temporarily ease sore throat pain)
- Hot, steamy shower (temporarily help loosen stuffed nasal passages and relax sore muscles)
Treat yourself when…
○ Illness is minor; cold, influenza, diarrhea, stomach/headaches (OTC medications can be effective)
○ You are not on medication for a chronic illness
○ Symptoms are mild and familiar
○ Symptoms do not last long
○ Pharmacist has given advice on OTC medication to take
See a doctor when…
○ You have a chronic illness and are unsure if this illness is related
○ Symptoms continue or get worse even with rest and use of OTC meds
○ You experience something new
○ You think you may need antibiotics
○ Experience diarrhea or constipation for longer than a week/ notice blood or mucus in diarrhea
○ Feelings of worthlessness or helplessness lasting for at least 2 week
○ You are injured and cannot self-treat
Primary Care Provide
= physicians
= person first seen for checkups and health problems (MD or DO)
Nonphysician Healthcare Providers
- Nurse Practitioner (NP)
- Physician assistant (PA)
Nurse Practitioner (NP)
= RN who has obtained advanced education and clinical training
- Work independently or collaboratively on a healthcare team
- Provides preventative and acute care
- Take health histories, physical exams, diagnose/treat acute and chronic problems, interpret lab/x-ray results, prescribe medications .etc
Physician assistant (PA)
= works under guidance of a physician
- May be principal care providers in rural/inner city clinics where physician is present for only 1-2 days/week, conferring with physician as need as required by law
- may take medical histories, examine and treat patients, order and interpret laboratory tests and X-rays, and make diagnoses
- treat minor injuries by suturing, splinting, casting and may prescribe certain medications
Orthodox or Conventional Physicians
- Allopathic Physician = conventional MD
- Osteopathic Physician = conventional physicians
- “whole person” approach, not just treating specific symptoms
- body’s systems are interconnected
- Believe the musculoskeletal system reflects and influences the condition of all other body systems and that symptoms may be caused by disturbances of bones, muscles or ligaments
MD vs NP vs PA
1. supervision
2. prescribe medications?
3. physical exams?
4. order/iterpret tests?
5. perform surgeries?
6. deliver babies?
7. diagnos/treat illness?
- MD & NP = independent
PA = must be supervised by MD/DO - MD & NP = yes, PA = yes WHEN supervised and delegated by physician
- all
- all
- MD = yes, NP/PA = assist
- all
- all
How to Physician assistants save $$$ from an overburdened healthcare system
they are paid significantly less than doctors
do all provinces have PAs?
No - not BC
Believe enabling practice of a new group of health-care practitioners requires careful consideration, management and resources to understand issues that may emerge
Nova scotia - PA are in military only, not civilian hospitals
○ Pilot project - hiring 3 Pas for 3 year trial period
Andrew Taylor Still (MD)
- founded osteopathic medicine in 1874
- Believed adequate functioning of the body depends on uninterrupted nerve and blood supply to tissues - began using spinal manipulation to remove inference
Flexner Report
1906 - Flexner was commissioned to review medical schools and their curriculum
1910- Flexner Report published
- discrepancies in length of program and type of courses @med schools
- lax admissions standards
- no accreditations, certifications, residency training
- Report rank ordered medical schools and triggered reforms in their standards, organization and curriculum
- Some schools closed, others restructured
1926 - American Medical Association (AMA) had a monopoly over education and licensing of physicians
- All med schools in US were based at universities and curriculum became consistent
Physician network
if doctor accepts your insurance plan, list of physicians associated with specific plan is identified
Physicians listed have agreed to accept a specific payment level from the insurance company for providing services
*seeing a provider “outside” the network can result in paying more out of pocket
After selecting a new physician what do you need to do
ask in writing to have your records transferred to your new doctor
Check to determine if a doctor is affiliated with a hospital accredited by the Joint Commission
___% of the nation’s hospitals are currently accredited by the Joint Commission
88%
Public vs Private hospitals
Public (non-profit)
- Owned by government and receives government funding
- Patients receive care free of charge
Private (for-profit)
which is Often affiliated with a religious denomination and have charitable purposes ; public or private hospitals
public (non-profit)
Healthcare conglomerates
comprised of hospitals, clinics, and research facilities that either include or are affiliated to a medical school
what is considered the crown jewels of health care in the US
Major medical centers
current version of Patients’ Bill of Rights as released by the Obama Administration in 2010 as a component of Patient Protection and Affordable Care Act
- Ensuring coverage for those people with pre-existing conditions
- Ensuring the right to choose your doctor
- Ensuring fair treatment when you need emergency care
- Making sure your policy cannot be canceled unfairly
- Ending annual and lifetime limits
- Enhancing access to preventative services
- Ensuring your right to appeal health plan decisions
- Ensuring young adult coverage under their parents’ plan
Medical malpractice
professional negligence by act or omission by a healthcare provider in which care provided deviates from accepted standards of practice in the medical community and causes injury or death to the patient
Legitimated reasons for medical malpractice suits
- Failure to diagnose a disease
- misdiagnosis
- causing patient death (medication error)
- error in surgery etc.
2016 - $3.8 billion in medical malpractice payouts
- most common reasons being …
- Diagnosis (34%)
- Surgery (24%)
- Treatment complications (18%)
Most common outcome as the basis of the suit was ____ (1/3 of all lawsuits)
followed by ________
patient death
significant/permanent injury
__% of liability claims against doctors were dropped, withdrawn, or dismissed without payment
72%
Of cases that go to trial, over __% found that physicians were not negligent
90%
Malpractice needs to be proven in court, and cases are most often settled before reaching court (___/___)
9/10
Frivolous cases (without merit) cause …
a.
b.
- the cost of malpractice insurance to explode
- shortage of doctors in speciality areas that receive many lawsuits
