Friday Reflection

[Carli Denholm]

One point that was demonstrated by both Youtube videos this week was that our healthcare system is inefficient. And while we are not as bad as China at this point, we could go that way if things are unchecked. One particularly poignant point in the second video was how some of our inefficiency comes from treating healthcare as a market commodity and expecting patients to be informed consumers, which is basically impossible in such a complex field as healthcare. I agree with the gentleman’s statement that we need to find ways to streamline our system and reduce redundancy. That may only be possible with universal healthcare and a nationwide information sharing system. If we do not do something, healthcare will continue to bankrupt our country and it’s most at-risk citizens. We also need to incentivize efficient care through things like preventative medicine. The points made this week seem to be system problems, but we as individuals can help through political activism and participating in policy creation.

[Hassan Mohamed]

It is clear that major changes need to be made to our current, business-oriented, healthcare system to decreased the excessive expenditure. One change that I believe need to be implemented as soon as possible, is introducing a single national information network that allows healthcare providers instant access to a patients records. This can decrease the number of unnecessarily repeat tests, and decrease the ntime needed to treat (such as waiting weeks on end for records to be retrieved from a different institution).

[Adel Elmoghrabi]

It is evident that a single national information network to allow providers to instantaneously view records is imperative to avoid redundancy, expenditure and most importantly to improve patient care.

[Pranav Shah]

I am actually looking forward to see what Amazon/Berkshire Hathaway/JP Morgan Chase create in the upcoming years with Atul Guwande as their CEO. Their goal is to create a healthcare system that has transparency of prices and costs. Maybe being aware and cognizant of prices in our healthcare will help lower prices. Once example of this was in the ICU 2 weeks ago when we had a patient pass away from aspiration. Patient had ESRD, CHF, and chronic dementia s/p 2 massive strokes who was again admitted for another HF episode. Family wanted an autopsy on the patient but when they were told they would have to pay $4000 out of pocket, they quickly turned to “it’s not worth it”. Had the autopsy been covered they would have opted for it with. I cannot predict what the autopsy would show, but I don’t think the information would have been helpful for the family or the physicians taking care of the patient. This was one example, but so many of our labs and medications would be “not worth it” if the prices were shown to each patient.

[Ahmed Yeddi]

Taking care of a patient involve multilevel process, that needs special relationship between the patient and physician with the main component is trust and understanding. Mrs. X she is 58 year old lady with PMH of DM and HTN, when she started to follow up with me she was complaining of non-specific joint pain that is worsening gradually, she was already referred to pain clinic and she follows with them for pain management which also did not improve her pain. All her rhematological work up with rheumatology clinic evaluation which was done later was negative. She complained of whole body pain and unable to cooperate with physical therapy. Of a note from 2 -3 clinic visit with the patient that she was silent most of the time, has very little knowledge of her medical problems or her medications, though she is complaint. When discussed her social issues, she lives by herself, has friends from church and one son who lives in far city. PHQ9 was done and it is positive. She was referred to psychotherapy, after 2 months she came for follow up visit, with significant improvement, in her pain level to the point that her pain clinic decreased her pain medications and though she was ok with it. She looked different, even the way she dressed and the smile on her face. She reported much improvement
It is crucial component of patient care is to address social issues and environmental circumstances, though sometimes it becomes challenging to address these issues with busy schedule but that can be managed better with continuity of care for patients.

[Mowyad Khalid]

Current healthcare system is inefficient especially the records part. Retrieving them takes hours and even days. A single system will
Expediate it and improve care and outcome. Constant analysis is imperative tor improvement.

[Antonio Smith]

healthcare in the US is a mess. especially considering our dependence on insurance companies and how their impact has drastic consequences for our patients. I Just has a patient at karmanos that was seen in henry Ford for lymphadenopathy. due to his insurance he was told to find another Dr. He had never seen a PCP before and was lost to follow up. He presented later to DMC with profound fatigue and decreased exertional capacity. At this time he has active lymphoma that was found to be in its advanced stage. His care would not have been fractured if he had better insurance. We need more providers present in the community to build awareness of disease but also to help individuals better navigate the system

[Jasleen Kaur]

This week’s Caring with Compassion module focused on the disparity that arises from inadequate medical insurance coverage within the United States.
It’s been demonstrated timely that there is a large gap pf more than 20% in health care utilization by patients who have health insurance coverage compared to those who do not. There is a barrier to heath care utilization due to limited health literacy among uninsured people.
This video reminds me of one of my patients middle-aged African-American who has chronic medical conditions and comes with severe fatigue and weight loss, only to get tested here at GMAP for HbA1c going up to 13.6. He was diagnosed with DM at some other clinic and he stopped following the clinic and stopped taking his Insulin due to lapse in his insurance coverage. He uses cane to ambulate and stated that he had a stroke in the past. There was no documents available to me from his previous medical history, but to believe him. He stated that he did not know his he could also get the Insulin as some other brand with minimum amount of copay and can continue to take Insulin to keep his blood sugar under control. I even called the pharmacy to confirm his medications so that he knows how to confirm by calling the pharmacy and knowing if insurance covers his meds.
This is one of the many examples of limited knowledge of health care among our population of Detroit. The video and many daily examples that we witness in our clinics or inpatient services highlights the need for widespread access to patient records and prior medical care for continuity of care.

[custom assignment]

To take good care of our health we need to eat healthy & the foods that are rich in proteins and minerals.

[Author]

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