SD assignment

[walid m ibrahim]

A point learned from the social determination this week, as doctors, we should not limit ourselves to diseases and to think about the patient beyond the clinic boundaries. In fact, this as important as the Medicine in treating patients.

Today I have seen 70 years old pleasant women with uncontrolled Diabetes on Lantus for years; her diabetes is being managed by an endocrinologist.
I was surprised to see her HbA1c as high as 13, and her saying “ There is no way that I am going to the diabetes clinic no more.”
Me: Why? It seems that he is doing a good job, he prescribed Victoza, and Mixed insulin as well.
Have you been taken your medicines as prescribed?
The patients: He never listened to me!! I keep saying my insurance will not cover that medication and I am getting the Lantus as a free sample from the clinic.

Her social determinants of health are more important than her medicine which has never got.

I have learned that exploring the social history is as essential as prescribing the correct medicines. We are treating a human with complex aspects, not Diabetes or Hypertension.

[Abubaker Hassan]

I will never forget my experience with a young chap that I took care of at MICU rotation, he was on life support suffering from severe opioid withdrawal, he was often visited by his parents who we adored as a medical team and captured our heart and sympathy to their struggle with their only child substance abuse ordeal.
Although he was extubated uneventfully, he continued to exhibit bizarre behavior and managed to assault a healthcare provider in spite being in physical restraint.
On reflecting on his case, I came to understand that we as a medical team failed to detect that he has mental health issues and he is taking a couple of psychotropic medications that we didn’t resume during his hospitalization and might contribute in the unfortunate event.
Although we know for the fact that humans are mind and body dualism, as physicians, often tend to hyperfocus on treating physical symptoms and ignore the mental complaints.
By being mindful of psychosocial and behavioral determinants of health we shall deliver more compassionate care to our patients.

[Dr. Nnodim]

Dear Abubaker, what a wonderfully articulated reflection. I love your phrasing: “mind-body dualism”. So, true! Why do you think we as physicians tend to hyper focus on the “body” or physical aspect and neglect the metaphysical (mind, spirit, emotions), even as we are constantly learning that the metaphysical plays a huge role in health and outcomes? What are some thoughts as to how we can do better in this area?

[Kevin Martin]

A standard SD assignment is one in which a student is given an interpretation prompt and then asked to write an essay or paper on the topic.

Indoor Air Quality Services in Medford NY

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