Dr. Shirey's Workplace: A Case Study

They serve as pillars of wisdom and guidance while exhibiting communication adroitness with care teams and patients to engineer top-notch medical care. To maintain high standards, effective medical professionals are constantly taking in new information through continuing education, placing providers at the pinnacle of knowledge. Moreover, physicians require affective aptitude as they must convey empathy during patient interactions. All these attributes draw me to seek the personal challenge and resulting responsibilities that are demanded. I desire to become an important contribution to society in a field I am passionate

I started my internship at Lopburi Cancer Hospital in Thailand with excitement and anxiety. “What stage is the cancer in?” I asked in an effort to leave a good impression of the attending physician as we rounded with patients. In my mind, the prognosis for cancer wasn’t a good one and making a patient comfortable was important. However, as I stood waiting on the answer to my question, which my attending had declined to

developing a rapport with ones patients and that a little compassion and understanding can mean the world to a

Interacting with these patient taught me about the challenges they face establishing reliable care. They are often assigned to one of the few clinics in town who will accept such challenging patients for such low reimbursement. Getting to the clinic may require arranging transportation that can deliver the patient to and from an office visit or referral. Often the clinics these patients are assigned to are overcrowded and may not be able to see the patient for weeks or even

The United States has a significant “delivery of care” issue wherein physicians (and other HCPs) are concentrated in and around major cities and densely populated areas. This leaves rural populations with fewer physicians and more difficult access to care.

Alissa Huston views the cancer journey as a marathon. Going through medical tests, surgery, chemotherapy and radiation is a long process, and she is there every step of the way to help her patients reach the finish line. Dr. Huston considers the doctor-patient relationship to be a partnership, and her patients praise her for her compassionate approach to them and their families. Her warm demeanor provides hope and communicates total support as she empowers those in her care to make informed decisions regarding their care. She, in turn, feels blessed to be part of their lives. According to her patients, Dr. Huston provides the best balance of cutting edge science with compassion and kindness.

The US Department of Health and Human Services (HHS) defines medically underserved area as ranking low on a scale that involves physicians per 1000 people, infant mortality rate, percentage below poverty level, and population >65 years old. 9 The HHS defines medically underserved population as that which includes “economic barriers (low income or Medicaid-eligible populations or cultural/linguistic access barriers to primary medical care services.” 9 According to the American Pharmacist Association, approximately 85% of US states have 61-100% of counties with medically underserved areas. 11 “28% of poor, 23% of near poor…[lack] health insurance coverage,” which is much higher than the national percentage of 13%.6 When reviewing the risk factors for vaginitis such as lack of health insurance, tobacco use, lack of bachelors degree, Hispanic origin, etc., many of the women suffering from the condition fall under the category of the underserved population as defined above. This means that clinics with the purpose of treating underserved areas and populations must have a heightened awareness of the prevalence and significance of vaginitis and must be interested in staying up to date on the most efficient medical practice strategies given the patient population.

According to the American Cancer Society, half of all men and one third of all women will develop cancer within their lifetime (Cancer.org). These figures are staggering. Cancer is a leading cause of morbidity and mortality worldwide and is a terrifying and unpredictable disease for many cancer sufferers. As such, it is imperative that healthcare workers have a thorough understanding of the various cancer diagnoses, treatments, and preventative strategies necessary to combat this devastating plague. Skills at managing not only the illness itself, but also the psychological and social side effects

Rural health professionals represent a diverse set of individuals seeking to meet the main goals of public health. Their desire to promote health and prevent disease is blocked by many barriers, due to the geographical position of their target population; yet they still persevere to serve their specified communities. Approximately twenty percent of America is rural, and rural counties are more likely to report fair to poor health. This particular population cannot be compared to its urban counterparts due the sheer amount of obstacles health care providers and patients face. Rural Americans are shaped by geography and tradition which creates a combination of factors that create disparities.

I shadowed Dr. Roisin Connolly, a physician-scientist at the Johns Hopkins Hospital, because I wanted to familiarize myself with different branches of oncology. I observed her communicate negative prognoses to her patients with compassion, and apply her own research on adjuvant and neoadjuvant chemotherapy directly to patient care. I found it extremely gratifying to see scientific knowledge directly translated to benefit patients. Knowing that I was interested in cancer research, she gave me publications on novel chemotherapy regimens to read, and always took the time to explain the logic behind her diagnoses. This shadowing experience allowed me to integrate academic research with clinical medicine.

As the cause of a painful death for six hundred thousand people annually, cancer affects nearly everyone in some way. Oncologist Vincent T. DeVita Jr., M.D. shares his journey while on, “the front lines of medicine,” and ,”reveals why the war on cancer is winnable- and how we can get there,”(front cover). Most think they know of the hardships cancer patients face, however, DeVita reaches knew depths to further the understanding of the disease to his readers by incorporating vast amounts of pathos and logos. Through over fifty years of extraordinary work in oncology, DeVita shares personal relationships with patients of his who survived and those not as fortunate. Since the fifties, survival rates of this disease lower every year, though

One observation that seems to be common for both rural and urban underserved areas is the relatively low physician to patient ratio. Accessing care is often difficult when there are few doctors to be seen. These physicians are often overworked and burned out. Finding an empathetic doctor willing to take the time to listen is not easy. This often leads to mistrust or resentment toward doctors. The second common thread is the lack of education the community experiences as a whole. Many members of these communities often have no college education and many times little or no high school education. This has a two-fold effect, high unemployment and little understanding of complex medical jargon. With likely little or no medical coverage, even less purchasing power, and little ability to make sense of prescribed treatment you can see how the odd are not in anyone’s favor. Last, but certainly not least, are the hours in which the clinic operates. Often, clinics are open during normal working hours. If a person was fortunate enough to be employed, they

“’So what’s your story?’” she then then replies “’I already told you my story. I was diagnosed when-‘” He interrupts and says “’No, not your cancer story. Your story. Interests, hobbies, passions, etcetera… Don’t tell me you’re one of those people who becomes their disease. I know so many people like that. It’s disheartening. Like cancer is in the growth business, right? The taking-people-over business. But surely you haven’t let it succeed prematurely’” (Green, 32).

Cancer is the scariest and devastating diagnosis to carry. As a physician, it takes a lot of self- assurance to empathize and educate the patient after the diagnosis. This involves giving away yourself for the emotional support of the patients, which requires a strong personality. The amount of trust these patients invest in Oncologist is tremendous. Working with some of the best oncologist gave me an opportunity to witness the same.

Visiting the doctor has never been viewed as an enjoyable experience for clients. It is likely considered to be a necessary evil, something that must be done but is not pleasantly anticipated. Making the encounter between health care professional and client both helpful and therapeutic can be a challenge. This is especially true for those whose financial situation is precarious, meaning, one pay check away from being homeless. So not only does the client arrive for their scheduled appointment with the normal anxiety visiting the doctor brings; added to this is fear of a serious diagnosis, and the stress of finding the funds to pay for medical services, medications, and any follow-up visits that may be required. The extra expenses will