SFSBM Flashcards
medical pluralism
no single medical philosophy or system can be expected to meet the health care needs of all members of that society
non-allopathic =
not proven by scientific investigation
pure vs impure placebos
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
nocebo effect
- some aspect of the pt experience that worsens their health outcome
- separate from specific effects of medical intervention
- ex: practitioner behavior/attitude
allostatic load
- 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
high risk strategy
focuses efforts on those with the greatest risk for future harm
low risk strategy
population based - intends to target all members of society irrespective of risk
-no benefit at all to most individuals
lead time bias
screening program detects the presence of disease many years before it becomes symptomatic —- time from diagnosis to death appears longer
length bias
screening program detects slowly progressive diseases so it appears that successful screening programs are associated with lower mortality rates
5 As
of lifestyle counseling
- Assess
- Advise
- Agree (goal setting based on stage)
- Assist (prescribe lifestyle prescription)
- Arrange follow up
triple aim
improve:
1) integrated system of care
2) population health
3) value (cost)
primary care
first source sought in response to illness
- outpatient
- entry point to system
secondary care
provided upon referral
- specialist
- inpatient or outpatient
tertiary care
highly specialized expertise/equipment
- provided in a regional medical center
- not available in every hospital system
IPO (independent provider organizations)
clinicians that organize themselves into various managed care models
-contract with insurance companies (are NOT insurers themselves)
staff model HMO
provide care + insurance
- salaried physicians
- monthly pt fee
- provides most care
group model HMO
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