AU Blogspot

In my opinion, the ability to maintain positive “human relations” is one of the most important aspects of modern pharmacy.  We are fortunate that the public has always viewed pharmacy as an honorable profession.  I believe we owe this to our ability to serve our customers well, acting always in their best interests.  For one thing, we are much more accessible to the public than any other healthcare professionals.  Therefore, patients trust us with their health concerns and feel comfortable confiding even embarrassing problems with us.  If we maintain a professional attitude and treat our customers with respect, they’ll return and tell us even more about their conditions, which will help the supervising pharmacist advise them and, in some cases, provide vital information to the attending doctors.

While working in retail, I had many opportunities to practice my interpersonal skills.  Remember, when patients come to you, they may already be sick and may have spent time at a doctor’s office that day.  By the time they get to the pharmacy, they may have run out of patience.  I’ve found that greeting patients with a smile and a pleasant manner puts them at ease.  They don’t mind waiting for a prescription if they feel you are taking good care of them.  Be sure to explain what information you need from them to make the process go more quickly and why you need it.  If there’s a delay or if it takes longer than normal to prepare the prescription, give them updates.  For example, you may have to wait for insurance approval, or a suspension might need time to dissolve.  Information lets customers feel they are part of the process.  When they understand what is going on, they usually remain calm.

Tina Boyd Stacy
Pharmacy Technology Instructor
Ashworth University

              Thanks to timtinman for permission to use this Photo.                 

Even though you massage only one body part at a time, it’s critical that you keep the body’s “wholeness” in mind.  The book explains this concept well.  For example, when someone has a headache, you know that they will benefit from a head massage.  That’s obvious.  But if you have a good understanding of the body’s wholeness, you’ll know that you need to massage the neck and shoulders as well.  As we’ve discussed in previous lessons, it’s all connected.  Everything!  I know you’ll be absolutely amazed as you begin to experience for yourself the interconnectedness of bodily regions and parts.   

You’ll probably find that the majority of the massages you give focus on relaxing the neck or back.  These are the two most common “problem areas.”  Both of these regions affect posture, which can be dramatically improved with massage.  I’m sure you know someone who spends a good part of the day sitting hunched over a computer or desk.  Prolonged sitting with a forward head position is by far the most common cause for bad posture.  Again, consider the body’s wholeness.  Work the neck and back, but don’t forget about the chest.  By loosening up the chest and the front of the shoulders, you can “open up” the upper body, bringing shoulders and neck back into proper positioning.  Stretch the neck, shoulders, and chest on a regular basis, and you will improve posture. 

Kristy Carter
Massage Techniques Program Instructor
Ashworth University

Let’s face it, not everyone is an effective communicator.  Some people are more reserved and must put forth a great deal of effort to be sociable and interact with others on a daily basis.  For other people, it’s not difficult at all to put on a smile, chat with, and listen to others. And although sometimes it’s tough to listen to the problems of others, especially when we’re distracted by our own troubles, the bottom line is that as health care workers, our own needs and desires take a back seat to those of our patients.  Put yourself in their shoes:  When we’re not feeling well, or must have a procedure performed, we certainly don’t want to encounter a grumpy, rude, or disinterested medical office employee.  We want to be considered important, and we want to be able to interact  with caring medical staff members who act as though they truly are concerned with our well-being.  Therefore, as a medical assistant, it is imperative that you keep your own expectations and requirements in mind when you are dealing with patients.  Remember, you represent the physicians and the entire office staff.  The attention and impression you give will improve or detract from the quality of the patient’s encounter, as well as the overall success of the health-care facility.

As the key link between the office and the patient, you must learn to give patients the individual care that they require and deserve.  You must learn to assess a patient’s needs quickly so that you can address their problems and concerns effectively. Part of this process is being able to tailor your response to each individual.  For example, you certainly would not communicate with a sick child the same way you communicate with an 80-year-old patient.  Think about how would you deal with a patient who speaks little or no English.  Would you greet a patient coming to the office for an immunization shot differently than you would treat a patient coming in to be treated for HIV?  Throughout your Medical Office Assisting program, we’ll consider the answers to these critical questions.

In learning how to individualize your approach to helping each patient, you will also learn about Abraham Maslow’s hierarchy of needs in this program.  As well as being able to assess the needs of a patient, you must also understand how those needs can be met.  To determine this, you must decide where you perceive those needs falls in the hierarchy of needs.  Maslow believed that basic, physiological needs must be met before higher goals can be reached.  For example, if a patient is homeless, his primary concern will be that he has something to eat and a place to sleep tonight, not that his blood pressure is elevated and he may have a stroke someday.

With respect to terminally ill patients, we will focus a lot on Elisabeth Kubler-Ross’s five Stages of Dying.  You should take note of her highly insightful theories.  The chances are very good that you will at some point manage patients who are terminally ill (these five stages also apply to patients suffering from grief).  Knowing the emotional state of the patient makes empathy and communication easier.  The stages also explain why a patient might be cooperative and pleasant one day and angry and combative another day. 

Remember, it’s a privilege to work in a medical office.  I never take this privilege for granted and encourage you to demonstrate the same kind of pride when dealing with your patients.  At the end of the day, we’re here for the patients and are held to standards of excellence that should never be compromised.

John E. Long
Medical Office Assisting Program Instructor
Ashworth University School of Health Care

                            Image courtesy of Susanne Riber.

As a physical therapy aide, you should be aware of a number of exercises that may be beneficial in promoting healing of lower back pain.  The following exercies have proven very effective for me during my career. 

Have the patient lie on his or her back with a rolled blanket or small pillow under the knees and with hands held beside the head; in this position, have the patient tilt the pelvis to flatten the lower back by pulling up and in with the lower abdominal muscles; instruct the patient to hold the back flat and breathe easily in and out; relax the muscles of the upper abdomen.

Instruct the patient to lie supine with knees bent and feet placed flat on the table.  With hands beside the head the pelvis should tilt to flatten the lower back.  In this position, straighten the legs as much as possible.  Return the knees to a bent position, one leg at a time.

The patient should sit with legs extended forward.  Place a rolled blanket under the knees to allow a slight bend.  Then, pull in with the abdominal muscles, keeping the pelvis tilted back.  Reach toward the toes, bending the lower back.

If you’ve had anyexperience working with these particular methods, be sure to share your story in the comments section.

Wade Balance, PTA
Physical Therapy Aide Instructor
Ashworth University

               Thanks to Rachel Zack for permission to use this Photo.I want you to understand how truly wonderful an experience massage can be for the terminally ill.  No matter what condition the person is in, conscious or unconscious, it’s nice to think that somehow, on some level, he or she knows that you are there and are caring for them in such a gentle, loving way.  This type of massage may not seem appealing to you.  Maybe you have a hard time dealing with death.  That’s okay.  Never do anything that makes you uncomfortable.  But if someone you love is at the end of his or her life, you may be surprised by the strength you are able to find.  It is very important that you practice self-care in this situation.  If you are able to maintain your emotional well-being, this massage can be a very powerful experience for both the receiver and the giver.  This memory will be one you will cherish after your special friend is gone.  Also keep in mind that massage can be a blessing to the grieving family members of the person who has passed.  Be prepared for emotional release.  Just be loving and understanding.  That’s all you can do. Kristy CarterMassage Techniques Program InstructorAshworth University

             Thanks to Kimberly Hurst for permission to use this Photo.

The following Wall Street Journal article should be of great interest to our medical students.  Insurance companies, never on anyone’s sympathy list, have long been complaining that they should not be responsible for paying out insurance claims related to hospital errors.  This position in itself is reasonable; however the issue also contains elements of a slippery slope argument.  Instead of simply refusing accountability for grave errors (mistaken operations, infected blood transfusions, etc.)—industry experts foresee private insurers, much like Medicaid, gradually widening the definition of “errors” to include non-coverage of patient infections alledgedly contracted during a hospital stay.  The CDC states that approximately 99,000 deaths occur annually due to hospital-based infections!  With added pressure being placed on them from the insurance industry, hospitals find themselves under fire for not improving their health safety standards.  In response, hospitals say that increased regulation will only increase health care costs for the patient and further complicate a hospital system already drowning in bureaucracy. 

The medical billing implications are also intriguing.  Due to dense and often confusing medical billing language, many patients are more often than not unaware that they are being billed for hospital errors.  Now that private insurers are beginning to adopt the Medicare model, patients may well be more informed about what exactly is on their medical bill, but hospitals will ultimately have to find new ways to offset the added costs they absorb to raise their infection prevention standards.  As this story continues to unfold, I have a feeling that the patients’ best interests will get lost in the details. 

Ryan Rode
Interactive Services Manager
Ashworth University School of Health Care       

                   Thanks to Bethany for permission to use this Photo.

Last week, I appeared on a four-person health care panel that was televised in New Hampshire.  The panel included a conservative who surprised me by arguing that the difference between the progressive candidates’ proposals for health care reform and the conservatives’ position on health care just isn’t that great. Looking at the candidates’ proposals, I disagreed.  Put simply, the conservatives would like to make government smaller. They want to “outsource” many of government’s jobs to the private sector. They tried to privatize Social Security, and they have partially succeeded in privatizing Medicare by paying private insurers a steep premium to take care of seniors under Medicare Advantage. (See my post about the high cost of the program here).

Finally, the vote on SCHIP split along conservative/ progressive lines, with conservatives voting against expanding SCHIP. As President Bush explained, more funding for SCHIP would expand the government’s role in our health care system. The progressives who voted for SCHIP believed that government should expand, as needed, to provide a safety net for its citizens. If the market cannot provide affordable, high quality health care for all Americans, then the government must step in. (more…)

                 Thanks to Gianni for permission to use this Photo.

Daniel Carlat, of the Carlat Report, has an article in the New York Times Magazine.  It’s six pages long, and decidedly anti-Pharma.  But Daniel Carlat isn’t from New York– so why would he have an article published there?

You say: well, where he’s from has nothing to do with it, the New York Times is publishing it because of what he says.

Exactly.

His article, well written and persuasive, stands as is, undisputed because there is no forum in which to dispute it.  I guess it would be nice if the Times would allow me to write an op-ed– you know, in op to the ed– but I guess this blog will have to do.

Carlat is wrong, very wrong, not because he is factually incorrect about his target, but because his target is a straw man.  The problem isn’t Pharma.  It’s doctors.

The article, called Dr. Drug Rep, chronicles his introduction into the world of lecturing for drug companies– a company hires you to give a talk about a topic or drug to a bunch of doctors– and the effects of the lecturing on doctors and himself, and then his pulling out.  For context, Carlat is a fairly famous psychiatrist blogger who is both a sort of watchdog of Pharma, as well as a source of information about psychiatric drugs. 

The general message is that Pharma softly manipulates doctors to act as proxy drug reps, which in turn lends credibility/celebrity endorsement to the Pharma message, and thus influences other doctors to prescribe the medicine.  Ok, I hear you.  I have no beef with Carlat, his point is not unique.

But break it down:

So we don’t want doctors lecturing about the drugs.  Okay.  Well, who do we want?  More reps?  Here’s where it all falls apart, and I defy anyone to contradict me: doctors aren’t studying these drugs on their own. (more…)

 
                Thanks to supergiball for permission to use this Photo.

On the surface, it seems that American voters have made their will clear.  Poll after poll shows that they are calling for a major overhaul of our health care system.  But when you look closer, their responses bristle with contradictions, contradictions that I think the reform-minded presidential candidates will have to consider when deciding how to approach health care reform. 

In a poll reported in Health Affairs at the end of last year, sixty-nine percent of respondents rated the US system as “fair” or “poor.” Yet in the same survey, when asked about their own experience with receiving medical services or with their own physician, 80 percent who had received care in the last year ranked their care as “excellent” or ”good.”  Other polls reveal the same pattern.

According to a survey released by Greenberg Quinlan Rosner in July, voters express doubts about the quality of the American health care system (with 49 percent dissatisfied), while 74 percent were dissatisfied with the cost.   Yet, “at another, more personal level,” the pollsters note, “a slightly different picture emerges. Fully eight in ten (82 percent) describe themselves as satisfied with the quality of the health care they receive personally. This number jumps to 90 percent among seniors (64 percent very satisfied), but includes impressive majorities of nearly all groups…”

Nevertheless, when the pollsters asked the same group about health care reform, three-quarters called for “major changes” or “completely rebuilding” the system.  If they are satisfied with the care they are receiving, why would they want radical change? Because they don’t feel secure that they will be able to keep what they have:  “There’s a precariousness to Americans’ contentment with their own health insurance coverage,” the Kaiser Family Foundation reported after looking at a number of polls at the end of last year.  “Among the insured, six in ten are at least somewhat worried about being able to afford the cost of their health insurance over the next few years, and nearly as many (56 percent) said they worry that by losing a job, they or their family might be left without coverage.”

This, then, is why so many Americans want universal health care: it would guarantee that they and their families would always be covered. (more…)

A new study has found that older people with less omega-3 in their blood are more likely to suffer from dementia. The study involved about 1000 persons 65 or older randomly sampled from two Italian towns. They were given mental tests and divided into three groups: no cognitive impairment; cognitive impairment but not demented; and demented. In addition, their blood was measured. Worse mental function was more strongly associated with total omega-3 fatty acids (p = .01) than any of the other fatty acid measures.One more reason to think that consuming more omega-3 might improve your brain function.  

Dr. Seth Roberts
Author of The Shangri-La Diet
Ashworth University Contributing Blogger

*Dr. Seth Roberts is a renowned psychologist and author of the critically acclaimed book, The Shangri-La Diet.  Mr. Roberts is one of those rare types of innovative thinkers that change the way you perceive the world.  We’re honored that Seth Roberts has provided us with the opportunity to share his dynamic perspectives with the Ashworth University student community.  Seth’s dedication to scientific inquiry and experimental analysis serves as an inspiration to all those interested in the mysteries of the body and mind.  Visit Seth’s blog to learn more about Seth Roberts’ life and work.  Thanks Seth!

           Thanks to Dr. Caffeine for permission to use this Photo.