Tag Archives: cultural competency

The Rural Doc Crisis and the Med Students Who Plan to Be Where They’re Most Needed

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The Truths and Solutions for Small-Town Healthcare.

We’re talking about rural medicine, where the needs are huge, the systems are broken, and sometimes, you just have to trust the process. Did you know that rural Americans have only 13.1 docs per 10,000 people compared to 31.2 in urban areas? Yeah, the need is real. But why are these students signing up for the challenge? And what the heck does a $50 billion Senate program have to say about processed cheese slices?

M2s Srishti Mathur, Megan Perry, Kassidy Brady, and M1 Megan Ahman grew up seeing the healthcare gaps firsthand, and now they’re dreaming of a career in rural medicine. From small town Iowa, Nevada, and Illinois, they explain that coming from a smaller area often fosters a skewed (but positive) perception of healthcare. Learn why practicing in a smaller community will allow them to wear multiple hats and take on greater roles, not just as a physician but as advocates for public health.

We look at the incentive programs designed to lure doctors into underserved areas, offering significant loan forgiveness if you practice primary care rurally for a number of years. We then open up the debate on compulsory rural service (a common practice in other countries). Does it work? We also discuss the new $50 billion Senate program intended to transform rural healthcare, analyzing the requirement for physicians to take continuing education on nutrition, and Feds’ barring of low-income people from buying “non-nutritious” foods (whatever that means).

You’ll discover the crucial pros and cons of rural practice, the opportunities rural physicians have to offer a wider medical practice than would be practical in an urban setting. The crew examines how telehealth might bridge the specialist gap, not just for patient-to-physician interaction, but for physician-to-physician collaboration. We also explore the valuable lessons learned from required under-resourced community rotations, emphasizing that knowing where patients come from and learning the community culture is beneficial, even for future urban specialists.

Finally, stick around as we take an unexpected, macroscopic look at everyday office objects and ultra-processed food–things look great from a distance but are confusing, even off-putting, when you zoom in; but can the co-hosts figure out what they’re seeing?

Episode credits:

  • Producer: Megan Perry, Kassidy Brady
  • Co-hosts: Srishti Mathur, Megan Ahmann

The views and opinions expressed on this podcast belong solely to the individuals who share them. They do not represent the positions of the University of Iowa, the Carver College of Medicine, or the State of Iowa. All discussions are intended for entertainment purposes only and should not be taken as professional, legal, financial, or medical advice. Nothing said on this podcast should be used to diagnose, treat, or prevent any medical condition. Always seek qualified professional guidance for personal decisions.

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Continue reading The Rural Doc Crisis and the Med Students Who Plan to Be Where They’re Most Needed

The Ethics of End-of-Life Care (Recess Rehash)

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[We’ll be back next week with a new episode! For now, take a listen to this re-run!]

Decisions made at the end of life are among the most complicated.

  • M1 Jeff, M3 Ananya, and MD/PhD students Riley and Miranda discuss what they’re taught about the ethics surrounding the end of life.
  • What are the physician’s responsibilities? How do they balance the patient’s wishes, the family’s desires, the directive to do no harm and to provide the best possible care, and the need to ensure that such considerations are supplied to any and all patients.
  • Add in the myriad cultural and religious beliefs that doctors, patients, and families have, and you get quite a difficult set of calculations to ponder.

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No matter where you fall on any spectrum, we want your thoughts on our show.  Do you agree or disagree with something we said today?  Did you hear something really helpful?  Are we delivering a podcast you want to keep listening to?  We’ll be sure your ideas are heard by all–leave a message at 347-SHORTCT (347-746-7828) and we’ll put your message in a future episode (use *67 to be an “Unknown caller”).

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Continue reading The Ethics of End-of-Life Care (Recess Rehash)

The Ethics of End-of-Life Care

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Decisions made at the end of life are among the most complicated.

  • M1 Jeff, M3 Ananya, and MD/PhD students Riley and Miranda discuss what they’re taught about the ethics surrounding the end of life.
  • What are the physician’s responsibilities? How do they balance the patient’s wishes, the family’s desires, the directive to do no harm and to provide the best possible care, and the need to ensure that such considerations are supplied to any and all patients.
  • Add in the myriad cultural and religious beliefs that doctors, patients, and families have, and you get quite a difficult set of calculations to ponder.

We Want to Hear From You: YOUR VOICE MATTERS!

No matter where you fall on any spectrum, we want your thoughts on our show.  Do you agree or disagree with something we said today?  Did you hear something really helpful?  Are we delivering a podcast you want to keep listening to?  We’ll be sure your ideas are heard by all–leave a message at 347-SHORTCT (347-746-7828) and we’ll put your message in a future episode (use *67 to be an “Unknown caller”).

We want to know more about you: Take the Listener Survey

Continue reading The Ethics of End-of-Life Care

How Med Students Learn about Cultural Competency

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viagra photo
Photo by sonyaseattle

Cultural competency is a tough thing to teach, but so important.  Today’s physician (and med students!) encounter patients from wide range of backgrounds, any of which could come into play in a patient-provider interaction.  In this episode, Brent asks how med students learn about the nuances that come with treating people of different backgrounds, from ethnicity to gender to religion to disability.  Aline Sandouk and Brady Campbell consider the question and offer their experiences.

And Brady, who’s co-hosting on the eve of leaving CCOM for a year-long Masters in Public Health program at Hopkins, talks about why he’s pursuing a whole ‘nother degree and why he’s decided Hopkins is the right place for that given that we have a lovely Public Health school right next door.


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This Week in Medical News

A New Jersey pastor and a British clairvoyant are under investigation for promoting the use of ‘miracle mineral solution’ as a cure for malaria in Uganda.  The WHO has removed ‘gender identity disorder’ from the International Classification of Disease.  And with Viagra’s patent set to expire, what’s on the horizon for ED treatment?  Don’t worry, we make plenty of jokes about that, as if you had any doubt.

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Dr. Paul Farmer and Liberation Medicine

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"Any serious examination of epidemic disease has always shown that microbes also make a preferential option for the poor. But medicine and its practitioners, even in public health, do so all too rarely." -Paul Farmer, MD, PhD
“Any serious examination of epidemic disease has always shown that microbes also make a preferential option for the poor. But medicine and its practitioners, even in public health, do so all too rarely.” -Paul Farmer, MD, PhD. From left to right: Petra Hahn, Greg Yungtum, Paul Farmer, Katie Ryken, Josh Bleicher, and Jordan Harbaugh-Williams
Dr. Paul Farmer is sort of the rock god of global health.  He’s an incredibly busy and influential guy, so when he flew in from Liberia to spend the entire day here with us at the Carver College of Medicine, it wasn’t easy to keep the stars from our eyes.  Of course, he’s a physician, but he’s also a medical anthropologist, chief of Brigham and Women’s Division of Global Health Equity, professor of medicine at Harvard, and the UN Special Adviser to the Secretary-General on Community Based Medicine and Lessons from Haiti.  One of the things you notice about Dr. Farmer is that although he’s clearly a celebrity in his field, it doesn’t dampen his enthusiasm, idealism, and the pleasure he takes in meeting students who share his passion for understanding and changing how healthcare is delivered to the world’s neediest people.
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What Cultural Competency Really Means

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You’ve practiced how to extract from a patient their chief complaint.  You’ve memorized lists (and lists and lists) of drugs, treatment modalities, and other interventions.  You’ve learned all the physical exam skills on the test, and you’ve got every organ system down pat.  You even remember the Kreb’s cycle.

Japanese Apothecary Mannequin by Curious Expeditions

Now, your patient has walked into the exam room looking for help with her headache (although she turns out to have none), doesn’t appreciate your blank stare when she says her soul is lost, and is very confused about why you’re treating her clearly ‘hot’ illness with a ‘hot’ medicine.  Time for a psych consult?

Nope.  Time to delve into the patient’s cultural beliefs about illness, treatment, and doctors, and reach some sort of understanding between you and your patient that allows for a good outcome.  That’s what cultural psychiatrist Hendry Ton, the Medical Director of the Transcultural Wellness Center and Director of Education at UC Davis School of Medicine Center for Reducing Health Disparities, advised UI student Lisa Wehr to do when she encounters a patient whose beliefs just don’t line up with those taught by Western medicine.

Recommended:
National Culturally and Linguistically Appropriate Services (CLAS) Standards in Health and Health Care

Listen to Episode 028: What Cultural Competency Really Means.

The opinions expressed in this feed and podcast are not those of the University of Iowa or the Roy J. and Lucille A. Carver College of Medicine.