---------------------------The Value of Drug Addiction Research---------------------------

Michael Nader from the Wake Forest Primate Center presents his talk titled The Value of Drug Addiction Research. He suggests that we are approaching the problem of drug addiction in the wrong manner, and we need to reassess our current policies.
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Wednesday, October 01, 2014

Saturday, September 06, 2014

Culture Influences on Healthcare


 
 
 
 
 
 
 
 
Cultural influences, particularly religion and ethnicity, must be considered when policy attempts to overcome barriers or resistance to delivering healthcare. As with women in Nigeria under Sharia law who struggle to have even basic rights, such as the right to life and free from harm (Deeter, 2003), there are many challenges to deliver healthcare around the world that relate to culture.

            The examples are numerous: Jehovah’s Witnesses refuse blood transfusions. Recently in Seoul,  routine heart surgery to correct a child’s congenital abnormality was refused; the child died (Deccan Herald, 2014). Other notable cases of ultra-conservative religious parents refusing medical treatment for their children are easily found and numerous. Also, religious issues present health concerns. One such issue occurs in New York City. The Orthodox Jewish custom of oral suction circumcision appears to have infected male babies in New York with herpes (Blau & Lestch, 2014).

Americans have heard of cases of African girls enduring genitalia mutilation and female circumcision with horrific life-long complications (Katz, 2014). Many American health clinics have seen parents object to vaccines, such as the Human Papilloma Virus (HPV) vaccine Gardasil, which not only prevents the HPV, but significantly reduces risk of cervical cancer. (Nierenberg, 2013). Other examples of atrocities against women, same-sex oriented persons, and so on, as well as examples of one ethnic group or religion acting against another occur around the world. Those affected experience debilitating injuries, starvation, lack of medical care, or even death.

As healthcare policy makers address issues along these lines, they must allocate funding to address core issues to resolve inter-tribal conflicts and inter-religious conflicts. They must address misunderstanding and misinformation concerning healthcare issues with respect to many religious and cultural beliefs, but do so in a culturally-sensitive manner.

I personally experienced some of these cultural challenges abroad. While in Haiti in 2000, I was one of three healthcare providers leading a large team to deliver much-needed medical care to the local population. Cultural-sensitivity and respect was a must when interacting with Haitian patients. Voodoo is a significant religion and often the only resource for combating disease. Getting buy-in from the local leaders and those seeking care is essential. Very often, the voodoo priests were threatened and drum-beating would occur outside the camp – which was quite unsettling if you have seen Hollywood movies of voodoo rituals. Appropriate interviews with patients to ascertain what they believed and what they had tried prior to seeing us was essential. Then we used interpreters to explain why certain remedies we provided might be more helpful or work alongside voodoo remedies that were not harmful. Ideally, the government moving voodoo into a purely religious profession and out of healthcare practice is needed, but a difficult task. Addressing cultural inputs is essential in Haiti, around the world, and at home in America.

 

 

 

 

 

 

 

References

Baby dies after parents refuse treatment for religious reason. (2014, December 13). Deccan

             Herald. Retrieved from http://www.deccanherald.com/content/120327/baby-dies-

             parents-refuse-treatment.html

Blau, R. & Lestch, C. (2014, August 3). Herpes in newborns raise concerns about oral suction

             circumcisions, city officials hope to regulate practice. New York Daily News. Retrived

             from http://www.nydailynews.com/new-york/herpes-newborns-raises-concerns-oral-

             suction-circumcisions-article-1.1890169#ixzz3C6oVx659

Deeter, J. (2003). Nigeria -The road north. Nigerian women speak out. [Television series

             episode]. FRONTLINE/World. Berkley, CA: WGBH educational foundation. Retrieved


Katz, A. (2014, February 6). Blood, fear and ritual: Witness to female circumcision in Kenya.

              Time Lightbox. New York, NY. Retrieved from http://lightbox.time.com/2014/02/06/

             female-circumcision-kenya/#1

Nierenberg, C. (2013, March 18). Despite physician advice, parents refuse HPV vaccine.

              Yahoo News. Sunnyvale, CA. Retrieved from http://news.yahoo.com/despite-physician-

              advice-parents-refuse-hpv-vaccine-120102385.html

 

 





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Tuesday, September 02, 2014

American Healthcare Looks to the East



 
 
 

            As America attempts to improve its faltering healthcare system, it is beneficial to look abroad to other nations to examine how they have solved their own health care dilemmas. A look to Asia may be helpful. Japan is the second richest country in the world following America and has an extremely capitalist economy (Palfreman & Reid, 2008). Also, the Japanese have the longest life expectancy on the planet and only spend half of what the United States does per capita on healthcare (Palfreman & Reid, 2008). Similarly, the Japanese have a mostly private healthcare system like America’s, yet include some distinct differences that may shed light onto much-needed changes here in the United States (Palfreman & Reid, 2008).

            Japanese patients are highly satisfied with their system (Palfreman & Reid, 2008). There are no long waiting times to see a doctor; house calls are common; numerous doctor visits per patient are routine; a referral from a primary care physician to see a specialist is not required; and no appointments are necessary (Palfreman & Reid, 2008). Length of hospital stays are longer and accessibility to modern medical technology is high (Palfreman & Reid, 2008). Most importantly, patient costs are very low (Palfreman & Reid, 2008).

            The government has great control in the healthcare system and has made certain requirements upon doctors and patients. Mandated insurance coverage for all citizens has been legislated (Palfreman & Reid, 2008). While most insurance coverage is tied to employment, the government pays for insurance coverage of the poor (Palfreman & Reid, 2008). A patient cannot be denied healthcare coverage due to a pre-existing condition and denials of claims are not permitted (Palfreman & Reid, 2008). The government tightly controls prices with a fee schedule which is negotiated between doctors and the government (Palfreman & Reid, 2008).

            Yet this system is hardly perfect and presents one problem that many modern healthcare systems face: Financial solvency (Palfreman & Reid, 2008). Not only are doctors paid very little for their work in Japan, but hospitals are in serious financial distress due to the government-mandated fee schedule (Palfreman & Reid, 2008). So although there are many positive aspects to the Japanese healthcare system which America has recently adopted due to the Patient Protection and Affordable Care Act (PPACA), such as mandated health insurance for all Americans and the elimination of denial of coverage due to a pre-existing conditions (2010), our country is also faced with the serious question of how to pay for all this healthcare and are there true limits to government oversight.

            Some comparisons simply cannot be made between the systems. Japan has a relatively homogenous population with healthy diet and lifestyle as compared to America. America’s serious healthcare problems relate to poor diet, lack of exercise, and other lifestyle inputs such as tobacco. So as comparisons continue between different healthcare systems, applying the effective solutions is good while avoiding the serious missteps others nations have made will be necessary. The key is innovation as America continues to seek cost savings and improved delivery of high-quality health care and prevention.

                                                                    
                                                                     References

Palfreman, J. (Writer/Director) & Reid, T.R. (Writer) (2008). Sick around the world.

[Television series episode]. In D. Fanning (Executive producer), Frontline.

Arlington, VA: Public Broadcasting Service.

Patient Protection and Affordable Care Act, 42 U.S.C. section 18001 (2010).

 

 



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PATIENT PROTECTION AND AFFORDABLE CARE ACT


 
 
 
 
Patient Protection and Affordable Care Act

The United States (US) health care system is considered by some to be the best in the world and by some to be utterly dismal. The truth certainly lies somewhere in between these two extremes. In 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA). I believe this law has begun a necessary process of improvement, while retaining much of what is good about the current US healthcare system.  The US healthcare system must be analyzed closely to determine its strong points and its serious weaknesses within the context of the PPACA to determine what is good, what issues are being addressed, and what needs to still occur.           

One mechanism for studying healthcare systems focuses on six critical health-system building blocks: service delivery, health workforce, health information, medical technology, health financing, and leadership and governance (Johnson & Stoskopf, 2010). The first of these building blocks is service delivery. Although the US delivers very highquality care to much of our population as well as dignitaries from across the globe who seek the very best care in the world (Stosell, 2007), many US citizens had no access to routine healthcare prior to the PPACA.

A key component of the law mandates health insurance for every American; this includes direct purchase, employment, and through the government for the poor and elderly (PPACA, 2010). Equal access is a key component to any healthcare system (Palfreman & Reid, 2008). By mandating insurance coverage; eliminating the exclusion for those with pre-existing conditions; continuing coverage for young adults under a parent’s policy; ending arbitrary denials; and assuring an appeal process for denial of coverage equal access is assured (United States Department of Health and Human Services (HHS), 2014). Also, the law mandates preventative care at no cost to the insured (HHS, 2014). Many more Americans are currently covered although many still have yet to buy-in as directed, but with increasing penalties and further ducation, coverage should continue to increase over time. By not creating a shared burden on the patient population for health maintenance and by not creating incentives to keep healthcare visits low have become an unsustainable financial burden in some countries, so universal coverage may  have limits in the US system (Palfreman & Reid, 2008; Stossel, 2007).

A well-functioning health-information system is also a critical success factor for any healthcare system (Johnson & Stoskopf, 2010). America has begun to address this factor with the creation of Meaningful Use incentives for health information technology, which requires healthcare providers to use electronic medical records in a progressively meaningful way to receive payments (Center for Medicare and Medicaid Services [CMS], 2014a).  This will be done through various stages over the coming years by incentives initially, followed by exclusion from contracting within the government system for those who fail to participate (CMS, 2014a). This has been a very productive for the advancement and coordination of health information technology amongst providers and has demonstrated that private business, various stakeholders, and the federal government can work well together to move the healthcare system in the right direction.  This was not an aspect of the PPACA, but demonstrates the adaptability and dynamic nature of our current healthcare system.

            Healthcare financing is the next critical area of any healthcare system (Johnson & Stoskopf, 2010) and represented one of the biggest problems about the American healthcare system. Our country represented the only modern country that allowed for financial bankruptcy in the face of a medical crisis (Palfreman & Reid, 2008). The PPACA addresses this issue by mandating health insurance for all Americans (2010). The PPACA also addresses lifetime limits, premium increases, and administrative costs (HHS, 2014). Although not found in the PPACA, other mechanisms for financing improvements in healthcare occurred during the same time with Meaningful Use incentives (CMS, 2014a) and Physician Quality Reporting Systems (PQRS) reporting to ensure quality care on various areas is being achieved (American Medical Association (AMA), 2014).

A legislated single-fee standard has been has been suggested for America and has been attempted with varying success and challenges in other countries (Palfreman & Reid, 2008). America does currently have a standard fee schedule for Center for Medicare and Medicaid Services (CMS), and private payers as well as providers use this as a gauge for services. Another idea proposed and used with some success abroad is the removal of profit for basic services and capping of administrative costs to reduce overall healthcare costs (Palfreman & Reid, 2008). These may have a place in our system and could be attempted. Also, although some still advocate for a single-payer system, countries that attempted this have found it is unsustainable financially, while mixed systems have performed better (Palfreman & Reid, 2008).

Two other important building blocks are health workforce and medical technology (Johnson & Stoskopf, 2010). Generally-speaking, it is well-known that America has one of the best health workforces in the world with cutting-edge technology (Stossel, 2007). As such, very little focus was placed on these factors when writing and enacting the PPACA. These areas of success were also found in other healthcare systems around the world that used a mixed system of private and government mechanisms to deliver healthcare (Palfreman & Reid, 2008).

The final factor of critical success is leadership and governance (Johnson & Stoskopf, 2010). Although generally there are many complaints about the federal government and its ability to create effective policy in healthcare, the PPACA does offer an example of government working with various stakeholders to address the most important issues that were crippling the healthcare system, namely equal access and costs. The federal government, working closely again with leading stakeholders to effect further change in critical areas not yet addressed in this country, will be essential.

The PPACA did not address all of the issues facing the American healthcare system. Other problems such as improving cost-effectiveness and reducing administrative costs still exist. Also, it is unclear  if the solutions begun in America with the PPACA will create new problems with regard to large numbers of patients with ready access to healthcare or increased cost of insurance premiums as a consequence of allowing those with pre-existing conditions into insurance pools.

Reid, in his reporting around the world on healthcare issues, found that various countries used some solutions that solved problems completely without negative consequences, while other solutions created more problems (Palfreman & Reid, 2008). In looking abroad to other countries, creating a single-fee system or a single-payer system actually bankrupts hospitals or creates financial distress on the government or even extreme rationing of services (Palfreman & Reid, 2008; Stossel, 2007). While some countries use market mechanisms to improve their heavily socialized healthcare systems, other countries remove profit from basic care to improve their system (Palfreman & Reid, 2008). As such, Americans need to appreciate that as a large country with a diverse population with specific lifestyle challenges that solutions that may work for the Swiss or Japanese may not work for us.

Innovation may offer the best solutions for further improvements of the American healthcare system. When CMS began to address cost containment, they looked to physician practices for the answer. Accountable care organizations (ACOs) were formed as pilot programs to address inefficiencies in healthcare delivery (CMS, 2014b). ACOs permit doctors to form organizations together to address numerous inefficiencies found in coordinating care of patients. These are physician-owned organizations, which were encouraged to try different models to contain costs. Any cost savings would be shared amongst the ACOs, while any cost overruns would cause a penalty. If ACOs are able to demonstrate improvements in quality as well as cost containment, they may be the mainstay for healthcare delivery, but more importantly this demonstrates the need for government, business, and providers to work in unison to find solutions.

Patient centered medical home (PCMH) is another innovation that has finally come to the forefront of our health care discussion (National Committee for Quality Assurance (NCQA), 2014). Again, the goal is to improve coordination and the quality of care while containing costs by taking an individual medical practice and turning it into a team-based medical home that focuses on a high level of coordinated care and preventative measures (NCQA, 2014). Similar initiatives certainly will be the answer to problems faced today and tomorrow.

The PPACA is really just another improvement in a long line of recent improvements in the American healthcare system. Some of these programs will make a demonstrable difference in the current healthcare system while others may not demonstrate effectiveness. Many may be good in their current form, while some may need more work to be effective. It is known that mixed systems of healthcare delivery have demonstrated the highest level of effectiveness while containing costs (Palfreman & Reid, 2008), and recent improvements regarding equal access, costs, and care that have been made possible due to the PPACA have addressed some of the most serious issues with American healthcare (PPACA, 2010). Other initiatives have been extremely helpful as well, and in the future Americans should expect to see more innovations to improve upon the high quality of healthcare in the United States. Repeatedly, private business, providers, and other stakeholders have worked with the government to meet current challenges in healthcare. With success, more projects and initiatives should be forthcoming to further improve the quality of healthcare while containing costs and improving access. Only time will tell which programs will be most effective.

  

References

American Medical Association. (2014). Physician quality measure reporting. Retrieved from

http://www.ama-assn.org/ama/pub/physician-resources/clinical-practice-improvement/clinical-quality/physician-quality-reporting-system.page

Center for Medicare and Medicaid Services. (2014a). EHR incentive programs.

Retrieved from http://www.cms.gov/Regulations-and-Guidance/Legislation/ EHRIncentivePrograms/index.html

Center for Medicare and Medicaid Services. (2014b). Accountable Care Organizations (ACO).

Retrieved from http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html

Johnson, J., & Stoskopf, C. (2010). Comparative health systems. Global perspectives.

Boston, MA: Jones and Bartlett Publishers.

National Committee for Quality Assurance. (2014). Patient centered medical home recognition.

Retrieved from http://www.ncqa.org/Programs/Recognition/ Practices/PatientCenteredMedicalHomePCMH.aspx

Palfreman, J. (Writer/Director) & Reid, T.R. (Writer) (2008). Sick around the world.

[Television series episode]. In D. Fanning (Executive producer), Frontline.

Arlington, VA: Public Broadcasting Service.

Patient Protection and Affordable Care Act, 42 U.S.C. section 18001 (2010).

Stossel, J. (2007). Sick in America, whose body is it anyway? [Television series episode].  20/20.

New York, NY: American Broadcasting Service News.

United States Department of Health and Human Services. (2014). About the law.


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Tuesday, July 22, 2014

Improving Writing Skills





There are a number of ways in which a budding writer can improve his or her writing skills. I think about golf. To me, golf is a lot like writing. For one, you must know the rules. Without the rules, you do not know what you are supposed to be doing out there. So, I take a few lessons and watch a few videos. Also, I’m not very good at golf, but the more I play, the more I improve. And the more I improve, the more I enjoy the game and can share it with others.

There are different ways to learn these rules of grammar, punctuation, and so on. And they do not have to be boring either. You can take a writing class, such as the one we are taking now or adult learning class. These force you to write, which I really needed in the beginning. Also, I see articles and websites that offer instruction and information in the easy, fun way. Recently, I ran across several articles about word usage by Jeff Haden (2014a, 2014b). These are fun articles about words routinely misused. I could have easily kept web surfing along and not read these articles, but one has to have intellectual curiosity in writing well. Because of this, I can catch many of my errors which might have made me look pretty silly to a more educated reader. Knowing proper grammar and punctuation gives me much more confidence in writing.

            Practice, practice, practice. The only way to improve our writing is to put pen to paper and write. It is simple, but true. Outlining your ideas, creating an introduction followed by the body of your article, and finishing with a nicely packaged conclusion takes practice. Moving easily from rough draft to final product is something which does not happen overnight. This includes reading it out loud and getting a second opinion from an objective friend or coworker. Over the years, I have been able to improve on my writing ability in this way by lots of practice. Remember: Progress – not perfection.

            Having an issue or idea which is worth presenting to others is a great start. Something you truly believe in and wish to express to a wide audience. Also, being challenged by tackling issues you have never thought about before is another great way to improve your writing. I tend to be comfortable about issues relating to recovery and addiction because I have written about these topics over the years, but I also have allowed myself to be challenged by writing about topics I had not considered until asked by others. Being open to these challenges has also made me a better writer.

Just recently, an editor of a magazine asked me to write an article about gun violence.

To be honest, she had presented me with several different topics and I had produced several articles for her, noticeably avoiding the issue of gun violence which was also listed. Although it is an important issue, I can see both sides and I did not easily fall into one camp or the other when it came to gun control and related issues. But when she pressed me I was willing to take a stab at it. She accepted my article for publication, and I was able to weigh both sides of the issue for the reader in an authentic way. Being open to such writing opportunities has been important in developing my writing skills.

            I wrote a short little post about improving writing skills. Only one person commented on it. So, I asked to attach it just in case anyone missed it. I hope it is also helpful:


As important as writing courses and English classes are, I have found that my writing has been mostly improved by two things: reading and writing.

1. Reading: One must know the basics of grammar and apply them. One must have a general idea of structure with respect to sentences. Yet, these basics do little to ensure the production of excellent articles, plays, papers, screenplays, and so on. It was many years after finishing the bulk of my formal education that I began to read more for leisure. But I had in ulterior motive. Routinely, I found that I wasn't nearly as educated as many of my peers. I was not as comfortable as I would like with many topics, ranging from literature to philosophy and history. Particularly, I revisited certain authors because I felt that my vocabulary and ability to express myself eloquently lacked much. Such authors included DH Lawrence, Evelyn Waugh, e. e. cummings, and many others from the 19th and early 20th century. These authors elevated the English language in my estimation. Obviously they use proper grammar, but their word usage amazed me. In a time where one must depend solely on words to express and describe so much, routinely they were able to transport me to amazing places and communicate numerous, challenging ideas. Notice that authors such as Dean Koontz and Michael Creighton were left off of that list. Such authors do very well commercially, but they did not offer me through their writings a greater knowledge of the English language. After becoming more comfortable with regard to English literature and advanced use of the English language, I pursued many original texts from Freud, Darwin, Marx, and many others. I rarely agreed entirely with these great thinkers, but I was seeking knowledge. Their work changed how we view our world, and therefore I wanted to know how they arrived at their theories. I needed more than a nice Wikipedia summary to assure myself that I had substantive knowledge about the world around me. This autodidactic process was truly formative for me and offered me an outlet I had not expected through a very difficult transition in my life. It not only prepared me for other graduate and postgraduate work that I was about to undertake. This sort of substantive knowledge was exactly what I needed as a writer.

2. Writing: So I had become more comfortable with the English language and had continued to challenge myself with study of my own design. But I also felt the need at that time to begin writing about my life and experiences and possibly pursue some positive change where I could. The only way I could do this was to begin. My first article was in a regional publication on recovery. I had been asked to write something, anything, and I did. There was a true thrill to see my name in black and white and it was very affirming to receive positive feedback. After that I began writing in several national publications, then came a journal from a law school and then a psychology journal. Every time I saw my words in high-gloss magazine or journal, I felt that I could make a difference. It was not always easy. I received many kind letters of rejection in the beginning, but it never dissuaded me. I was usually amazed at what editors accepted for publication and what they didn't. Several of the articles that I wrote merely out of boredom were praised highly (one of those "boredom" pieces actually won a Ford Foundation writing competition in 2009), while some that I thought were truly insightful, never got published - or at least not in their entirety. I will acknowledge that a lot of time had to be spent in the work of writing. This means many hours alone, without television, without friends, without Facebook or other distractions. This means clearing your mind and focusing on an outcome. I have absolutely no idea how many times certain articles were rewritten, laid aside, and rewritten again and again. Some articles did flow right out of my pen. Those are usually the articles where I was being most authentic and those were usually the articles that were best received.

There is no easy way, but this is surely rewarding beyond measure. Everyone of us has the opportunity to touch the lives of other people in a meaningful way. Through writing you affect people's lives who you would never have a chance to meet. You may offer solace or inspiration to somebody thousands of miles away. Your writing may live on beyond your life, continuing to touch other people. Never discount your abilities to help your fellow man in this very remarkable way. I encourage all of you to pick up your pen and start writing.

 

 

 

References

Haden, J., (2014a). 30 incorrectly used words that can make you look horrible: Easy to

get wrong. And easy to get right. Inc.com. Retrieved from http://www.inc.com/  

jeff-haden/30 incorrectly-used-words-that-can-make-us-look-stupid.html

Haden, J., (2014b). 20 more incorrectly used words that can make you look horrible; Easy to get

wrong. And easy to get right. Inc.com. Retrieved from http://time.com/101160/20-

 incorrectly-used-words/

Richardson, C. J., (2014). A single step. Spotlight on recovery, Spring 2014, 8-9.

 
 
 
 
 






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Consider Yourself A Writer




 




 
Before you begin the process of writing, you must first consider yourself as a writer. What are your reasons and motivation for writing?

Like others, I feel my work and life are driven to achieve certain goals that mean very much to me. Particularly goals which improve society and ease human suffering. This is why I chose medicine initially. Over the course of my life, my training, education, and experiences have given to me a unique perspective. It is through writing that I can reach and possibly help other people in ways not possible in a clinic setting.

I have had a varied writing past over the last ten years, ranging from essays in college text books to articles in high-gloss magazines, and even first prize in a Ford Foundation writing competition. Some of my writing has been in more scientific publications, such as the Association for Humanistic Psychology's official journal Perspective (Apr/May 2010). Other writing has been more activist, such as my article in The long term view: A journal of informed opinion (Vol. 7, Number 2. 2010) from the Massachusetts School of Law at Andover. Yet most of my writing has attempted to help people suffering from addiction and pursuing a life in recovery. This writing has been very personal. I have written numerous such articles in publications that range from Spotlight on recovery to Alcoholics Anonymous' official international publication, AA Grapevine.

My writing has not been the best it could be, but it is through these words that I have been able to touch people not just in other areas of my country but in other areas of the world. I hope that some of my writing has been challenging and caused people to think of situations in a new perspective. I hope that most of my writing has been supportive and encouraging, helping people find new meaning and purpose in recovery.

I believe I can write much better as I look over the articles I've written. I often see areas that I can improve. More importantly, I believe I am missing opportunities to improve. I hope this course will help take my writing to a much higher level than I have done on my own. I feel as if my career is only just beginning and that much more is ahead. I see writing and publishing as a big part of this next chapter in my life.



 
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Defining Health




When defining health, the online information available usually presents us with the World Health Organization (WHO) definition we found in our text: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity” (Johnson & Stoskopf, 2010, p.3). Having been trained as a physician assistant and studying for many years through the lens of the biopsychosocial model, this concept of health is fundamental.

Building upon the physical, mental and social aspects of the definition, we are able to give much depth and exactitude by furthering the definition through such dimensions as biological, genetic, and sexual; psychological and spiritual; political and cultural; educational and financial; and so on. Many of these factors directly or indirectly affect the health of individuals. Not only are they interconnected in each one of us, but similarly they demonstrate how we are interconnected to each other by means of our community or family or organizations or nations.

Initially in my training as a physician assistant, I necessarily focused on the biomedical aspects of disease and treatment. It was only later through my personal journey in recovery as well as my own training and clinical experience in behavioral health that I was able to gain a greater appreciation for the interconnectedness of mind and body as well as behavior and social interaction. Where before, I would only look at cirrhosis and try to determine the cause and treatment, later on I would understand that very often a disease like chronic pain could lead to addiction to opiates, and addiction might predispose for various reasons to certain medical diseases, such as HIV, or the early progression of any disease process due to drug abuse-related noncompliance or weakening of the body’s system.

As my work today focuses on the treatment of substance use disorder, the other aspects of health such as environmental factors, psychological factors, social interaction, financial, recreational, and so on bolster recovery and protect against relapse or trigger one into a recurrence of substance use and the negative health, social, and personal consequences that follow. Hence, many of us are very comfortable with the Axis I-V categories of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013), which categorize different clinical diseases as well as levels of functioning and numerous environmental and social factors. The American Psychiatric Association keenly devised a system which helps me every day as I diagnose new patients, create service contracts and treatment plans, and follow a patient’s course of treatment. A patient in my practice is more than a mere prescription or a designated hour of psychotherapy, so the goals, objectives, and treatments are created with the patient leading the discussion and attempt to address all of a person’s needs.

I also like the commentary that was offered on page 8 of chapter 1 of Comparative health systems. Global perspectives. (Johnson & Stoskopf, 2010). The mental illness dilemma which faces our country and many others was succinctly described by the writer. Again political and economic factors greatly influence the disease of mental illness as well as the psychological, social, and cultural aspects. Therefore, the treatments necessary to effectively address mental illness must also take into account the psychological, biological, and social aspects of people.

This is why my definition of health and well-being easily dovetail with the one offered by the WHO, and is firmly planted in my mind as I seek to treat patients for both medical and behavioral health issues. We truly are these amazing dynamic beings and so much of our health relies on a fine tuning of these numerous and multifaceted dimensions of who we are. As I look at my own life, I also try to balance these factors so I might have a little bit of health and wellness myself.

 

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Arlington, VA: American Psychiatric Publishing.

Johnson, J. & Stoskopf, C. (2010). Comparative health systems. Global perspectives. Boston,

            MA: Jones and Bartlett Publishers. ISBN-13: 978-0763753795

 
 

 




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Sunday, June 01, 2014

Dear Mr. President!!!

Dear Mr. President!!!

Haven't you ever wanted to give the man who runs this country a piece of your mind??

Well, the latest issue of Spotlight on Recovery does that. A varied selection of authors present their perspectives, including Mr. Richardson.

He addresses the War on Drugs in a way you may not have thought of before - and how our Commander in Chief could have been the one behind bars had things been different.

To read more, order your copy today from Spotlight on Recovery by clicking this link.


A Single Step........


Our country has been torn apart by gun violence. Corey Richardson offers a balanced approach on

this issue in the latest issue of Spotlight on Recovery, Spring 2014. For more on Gun Violence and other recovery issues - click this link to go to Spotlight on Recovery



InsideOut ABC Training

InsideOut is a cognitive-based (CBT) program for substance abuse treatment in correctional settings.



Developed with NIDA support, InsideOut can help your facility quickly deliver a high-quality, secular, and engaging substance abuse treatment program. Based on SMART Recovery, InsideOut trains counselors, has versions for male and female populations, teaches offenders the SMART Recovery Four-Point Program, and works to lower recidivism.

Visit http://www.smartrecovery.org/resource... for more information on InsideOut.

♦ An Eye On Our Kids ♦

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♦ Drug Laws ♦

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