SFSBM Flashcards

1
Q

medical pluralism

A

no single medical philosophy or system can be expected to meet the health care needs of all members of that society

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2
Q

non-allopathic =

A

not proven by scientific investigation

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3
Q

pure vs impure placebos

A

PURE: lack pharmacologically active ingredients for the condition being treated

IMPURE: substances/interventions that have some clinical value for some ailments but not for the condition prescribed

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4
Q

nocebo effect

A
  • some aspect of the pt experience that worsens their health outcome
  • separate from specific effects of medical intervention
  • ex: practitioner behavior/attitude
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5
Q

allostatic load

A
  • consequences of allodynamic regulatory wear/tear on brain/body leading to multisystem dysregulation
  • allostasis: drive to maintain homeostasis
  • explains how accumulated effects of lifelong stressors translate to poor health
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6
Q

high risk strategy

A

focuses efforts on those with the greatest risk for future harm

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7
Q

low risk strategy

A

population based - intends to target all members of society irrespective of risk

-no benefit at all to most individuals

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8
Q

lead time bias

A

screening program detects the presence of disease many years before it becomes symptomatic —- time from diagnosis to death appears longer

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9
Q

length bias

A

screening program detects slowly progressive diseases so it appears that successful screening programs are associated with lower mortality rates

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10
Q

5 As

A

of lifestyle counseling

  • Assess
  • Advise
  • Agree (goal setting based on stage)
  • Assist (prescribe lifestyle prescription)
  • Arrange follow up
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11
Q

triple aim

A

improve:

1) integrated system of care
2) population health
3) value (cost)

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12
Q

primary care

A

first source sought in response to illness

  • outpatient
  • entry point to system
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13
Q

secondary care

A

provided upon referral

  • specialist
  • inpatient or outpatient
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14
Q

tertiary care

A

highly specialized expertise/equipment

  • provided in a regional medical center
  • not available in every hospital system
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15
Q

IPO (independent provider organizations)

A

clinicians that organize themselves into various managed care models
-contract with insurance companies (are NOT insurers themselves)

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16
Q

staff model HMO

A

provide care + insurance

  • salaried physicians
  • monthly pt fee
  • provides most care
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17
Q

group model HMO

A

physicians and medical professionals belong to a multi specialty physician group

  • HMO pays the group in bulk
  • physicians only see patients that signed up for the HMO that contracted them
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18
Q

open panel HMO

A

similar to a multi specialty physician group but members are allowed to treat non HMO patients

19
Q

network model HMO

A

combo of group and open

-independent HMO contracts some multi specialty practices, independent practices, and fully independent physicians

20
Q

accountable care org (ACO)

A

set up similarly to HMO, but NO insurance function]

-shared savings, better metrics

21
Q

tertiary prevention

A

preventing morbidity/mortality from a disease late in the disease course

22
Q

delivery system reform incentive payment (DSRIP)

A

incentive payment model that rewards providers for performance on delivery system transformation projects that improve care for low income patients
-funded via medicaid waivers

23
Q

federal public plan

A
  • designed to work within current ACA structure
  • add a public plan to health insurance marketplaces that were established by ACA
  • ONLY include private health insurance plans
  • goal: create more competition with private insurance
24
Q

health insurance premiums based on

A
  • age
  • smoking status
  • geographic location
  • individual vs family coverage
25
Q

medicare part A

A

hospital insurance

26
Q

medicare part B

A

medical insurance (outpatient care)

27
Q

medicare part C

A

Medicare Advantage

  • private
  • provides all medicare benefits
28
Q

medicare part D

A

outpatient prescription drugs only

29
Q

moral hazard

A

one party gets involved in a risky event knowing that it is protected against the risk and the other party will incur the cost
-occurs with all insurance

30
Q

tragedy of the commons

A

tendency to overuse a resource because the cost the individual incurs only a small fraction of the cost which is shared
-ex: open bar

31
Q

babbling occurs

A

9-14 months

before age 1

32
Q

school aged children

A
  • increased group (team) activities
  • need consistency, reinforcement
  • need to be challenged
  • need clear consistent rules
  • need clear standards for success
33
Q

early adolescence

A

11-14

  • physical changes
  • developing interests
  • need adult supervision
  • need structure and monitored expectations
  • want greater privacy
  • more aware of emotions
  • reflect on self
34
Q

mid adolescence

A
  • more time with peers
  • strong desire to belong
  • beginning partnering
  • abstract reasoning (diabetes), problem solving
  • wants more independence
  • expects competence, and to make contributions to social groups
35
Q

late adolescence

A
  • greater self direction, self monitoring
  • greater capacity for judgement, impulse control
  • more involvement in longer term relationships
  • parents/adults more in role of advisor/mentor
  • more consistent values/beliefs
36
Q

female growth/development timing/order

A

pubs
boobs
spurts
squirts

(8-14)

37
Q

male growth/development timing/order

A

hairy
balls
grow

(10-18)

38
Q

cognitive development: 0-2 years

A

sensorimotor

39
Q

cognitive development: 2-7 years

A

preoperational

  • symbolic thought
  • irreversibility
  • centration
  • egocentrism
40
Q

cognitive development: 7-11 years

A

concrete operational

  • mental operations applied to concrete events
  • mastery of conservation
  • hierarchical classification
41
Q

cognitive development: 11+ years

A
  • abstract ideas
  • logical
  • systematic thinking
42
Q

building blocks of family life

A
  • coherence
  • organization
  • communication
  • values/beliefs
43
Q

components of parenting

A
  • nuturance
  • structure
  • affiliation
  • attachment