Last Post

This is my last official post for this service learning project; and I have to say that I did indeed learn alot. The San Jose Clinic is doing amazing things everyday to change lives and I am glad that I have been able to be a part of it, no matter how insignificantly. I hope to continue to volunteer at the clinic in my spare time, and on into med school when I can hopefully contribute in a larger way that has more of an impact medically. I can only imagine what kind of situtation health care administration will find itself in after the full implementation of the new legislature--hopefully it will be a positive result. Also, we definitely need to look into having Tri-Beta volunteer at Art with Heart again if the date is feasable (last year it was on graduation) because that is the main event where San Jose is able to collect generous funds for what they do, and a lot of effort goes into pulling off the successful event right down to helping out with the bidding itself the night of so that the clinic can benefit to the maximum amount. Having taken the Honors Service Learning Course, and having a service learning component in Cell, Medical Microbiology, and Ecology has definitely added a more tangible aspect to the course so that you are reminded of the bigger picture. Good night, and good luck...I'm going to need luck for those finals tomorrow ;)

Grown-Up Christmas Wish

When I was volunteering at San Jose yesterday, I worked in the dental clinic again on the file records. There were five boxes left to get through: I finished one box and a half, so there are still three entire boxes left. They are hoping to have them done before the holiday because they are taking up space. The files are old (from patients who have not returned in a while) and they are going to be shredded; that's why we are recording the names of the patients to go into a database. But I also did something new. I helped sort medical supplies that had been donated by St. Joeseph's Hospital. It was really interesting to through all of the equipment and surgical materials such as sterile gloves, needles, syringes, stitches, gause, emesis trays etc. Most of the kits were surgical eye kits for injections and procedures. That was particularly interesting to me because of my time shadowing ophthamologists: I have seen many a intra-vitreal or sub-conjunctival injection, and it looks painful. But, its better to endure that small period of pain rather than to go blind from the likes of macular degeneration. Wet AMD (age-related macular degeneration) is treated with intra-vitreal Avastin injections which just so happens to be an anti-tumor drug as well. This is because Avastin as a anti-VEGF (vascular endothelial growth factor), and macular degenration is mostly a problem of neo-vascularization. Anyhow, it really struct me how blessed San Jose was that they were the recipients of such awesome medical supplies that can help them continue to provide the much needed care to the uninsured. My grown-up Christmas wish is being realized by them everyday.

Thanksgiving

I have sooooo much to be thankful for. Volunteering at San Jose Clinic has completely opened my eyes to all of the people out there who need healthcare but can't afford it. Of course I know that it is a problem, especially in light of the new health care legislature that just passed, but at San Jose I can match faces and names to the statistics. When my grandpa was first diagnosed with Mantle Cell Lymphoma sophomore year, I was frustrated that his Medicare supplement plan was not accepted by M.D. Anderson. Of course, when you think cancer you think M.D. Anderson, but to go for preliminary testing and workups would cost ~$13,000 out of pocket. At the time, I did not realize how lucky he is that he even has access to any kind of healthcare, and thank God he is now in a partial remission. Anyhow, this thanksgiving even further indicated to me how lucky and fortunate I am as I heard on Wednesday about two young people from church who were in the hospital. One of them is a priest's four-month old daughter who (against all odds!!!) was born with trisomy-18. Most babies with this genetic disorder don't even make it to birth. Tuesday night was a rough one for her, and they decided to remove her breathing tube, but she is still going strong. Last week at San Jose, watching all of the children get helmets made me realize how much I take for granted. If I wanted/needed a bike helmet, I would just drive over to Target and pick one up. But some of these families don't even have a car, let alone the extra cash to buy something as seemingly unnecessary as a helmet. I bet most of those children do not even have bikes, which made me a little unformatable that we were putting the parents on the spot like that. I remember in health class in eighth grade, we went out to the football bleachers and watched our teacher toss two cantelopes off the backside of the bleachers: one with a helmet, and one without. The cantelopes were supposed to represent what would happen to the brain upon impact with concrete without the protection of a helmet. That image will stick with me forever, and I will never ride a bike without a helmet ever again. Anyhow, this thanksgiving truly was one of sincere gratitude thanks to my time at San Jose.

Hard Hats for Little Heads

Yesterday, Saturday the 20th, I volunteered at San Jose's partnered event with the Texas Medical Association: Hard Hats for Little Heads. Certain patients with ages ranging from 4-13 were mailed letters informing them that they were selected to recieve a free helmet from the TMA as well as a helmet sizing. Pediatricians from Texas Children's Childhood Injury Prevention Program were there to size the children with the appropriate size helmet and to offer safety tips when riding bikes, roller blading, skate boarding, or riding a scooter. The children were also filling out pledge cards that stated that they promised to wear their shiny new red and white helmets. There was also an arts and crafts table where they were coloring Christmas ornaments to put on the San Jose Tree. Some kids were even playing jump rope and hula hoops with some representatives from the American Heart Association. It is so important to get kids used to living healthy and active lifestyles from such a young age, especially in a country in which the childhood obesity rate is at an all-time high. Obesity-related illnesses such as type II diabetes have been placing a significant burden on patients as well as the healthcare system in general, and it is unfortunate because obesity is definitely preventable. It was my job to check in the families according to their letters, hand out the goody bags, and "sort" the children to the proper age-group stations. It was awesome to see how excited the children were to get their helmets. A lot of proud older siblings were proclaiming that they were going to teach their younger siblings how to ride a bike now that (in certain cases) got their first helmet. But of course, some of the parents started to roll their eyes when their kids came up to them and told them that they wanted Santa to bring them a new bike for Christmas to go along with the new helmet :)

Now for the Opposite Argument

This past Wednesday when I was at San Jose, I continued to record patient names and clinic card numbers from old files as I did last week. Again, I encountered the same issues that would lead me to highly favor a universal switch to electronic medical records, however, during this blog I want to consider some of the downsides to EMR as well. It may seem, at first, that there are no downsides especially considering all of the confusion and how computers can substantially ameliorate it. However, a physician that I have shadowed for a quite a while seems to be adamant against a switch because he believes that it will make private patient files extremely vulnerable to Internet hackers and contribute to the already rampant identity theft. Despite assurances about safety and security of electronic records you can never be certain--furthermore, what are you supposed to do if there is a power outage, or the electronic files are inadvertently deleted? When I was in high school and used to shadow physicians in the primary care clinics of the VA, I witnessed an EMR system first hand. At my interview for A&M, my interviewer mentioned that the Scott and White Health care System has been using EMR since 1989--the year I was born! I communicated to him my experience with the system at the VA, and that the only drawback that was very blatant to me was the fact that the doctors and nurses must type into the computer in order to chart, with their backs toward the patient. Not only does this create an off-putting environment in terms of a health care worker and patient relationship, but also, everything that the HCW is entering into the patient chart is clearly displayed on the computer screen for all in the room to see. Because my dad (an optometrist) has implemented the following in his own clinic, I offered the following suggestion: that instead of desktop PCs, patient files should be accessed via tablet PCs or even iPads. As soon as I said this, my interviewer agreed that they have witnessed the same problem with the backs turned to patients so they have re-oriented exam rooms as a result, and the next step is indeed to purchase tablet PCs. I was excited to see the progress that they have made from the last 21 years in utilizing EMR. Therefore, I suppose this is not necessarily "a case against EMR," rather a consideration of possible improvements to make it more palatable and feasible to be applied in the real life health care setting.

Medical Records (a case for going electronic!)

Today I was organizing files for the dental clinic with Michelle. There were large boxes of patient files that were numbered--basically all we had to do was "inventory" the files by writing down the patients' names and clinic card number. While I was working, I realized many little glitches that could cause serious problems with the administration of health care. First of all, since all the records were hand written (and often times in different handwritings) it was very difficult to read and confirm proper spellings of patient names. Also, many people had very similar names, or families who were all patients could easily have mixed-up records. For example, today there were two patients who had the exact same first and last name. Firstly, I needed to make sure that the two files did not both belong to the same person by looking at the date of birth in both files. BUT,the birthdate just offered more confusion (and a random coincidence) considering that both of the patients with the exact same name were born on the exact same day of the month of September, but one was born in 1937 and the other was born in 1995. At first, this just raised further suspiscion for me that the two files belonged to the same person and that the date in 1995 just referred to the date of an exam. But after further careful inspection, I had to accept that the files belonged to two seperate people that just happened to have the same name and be born on the same day. Such cases can really have a negative effect on health care in case these two patient files were ever mixed up, especially considering that one is an elderly lady and the other is a 16-year old girl. Also, I had many cases in which the patients were named "Jr." or had a "II" or "III" in their name, resulting in a John Smith I, John Smith II, and John Smith III. This further facilitates a recipe for chaos. For this reason, I feel like I can say firsthand what an impact electronic medical records (EMR) can have in the medical field. Computers with patient databases can quickly run searches regarding birthdate, allergies, etc. instead of having to sift through a file and trying to decipher a doctor's scrawl.

OCTOBER is Health Literacy Month!!!

October brings to mind Halloween, my mom's birthday, and Breast Cancer awareness month. I never knew October was Health Literacy Month until I was researching it for the workshop that I gave! There is even a website called healthlteracymonth.org!! It Health Literacy is such a vitally important issue today, especially in light of the health care debate and all of the efforts to lower health care costs, because health literacy costs the system millions in the long run simply because people are either uninformed, do not understand how to manage their health, or wait to the very last minute for treament to the point that radical and expensive measures need to be taken. Anyways, health literacy is especially important at San Jose, which I have stated before, sees a large indigant patient population who are Spanish speakers. I was shadowing a physician the other day at the Cizic Eye Institute and I sat in on two exams that were entirely in Spanish. All I understood was "insulin," "testosterone," the number "five"...and that was about it. I tried to pay attention to infliction and facial expression--but that definitely is not going to cut it. After the exam, the doctor asked me if I knew Spanish. He was quick to tell me what I already knew: I need to learn it, and fast! Anyhow, I decided to write this post about Health Literacy Awareness yet again because it is the cause's month AND I got very excited not to be the only one who seems to know: When I went to my interview at UT-San Antonio last week, it was in the library. And right there, as I was anxiously awaiting my second interview, I found myself face to face with a health literacy poster that had a huge mind-map depicting how it truly influences a great deal of medicine and quality of care and how it actually affects us ALL despite what our own level of health literacy might be. I was so excited that when the interviewer asked me how my day was so far, that was the first thing I told him!

Christmas Card Contest

San Jose Clinic is hosting a Christmas Card Coloring contest for the children. I helped out with making the entry box, cutting paper for the children to color on and typed out directions for the contest. The winner's picture will be used on the cover of the San Jose Clinic's Christmas Card. We needed to have the directions translated to Spanish too, so we found someone to translate and printed copies of those. I always feel very limited by not knowing Spanish, especially when volunteering at San Jose and realizing that it can be a serious barrier to health care administration. But then again, there are ways of communicating that do not involve language. I have been able to interact with many patients at the clinic without knowing a bit of Spanish--especially while coloring with kids in the waiting room. When I went on the first day of classes this semester, I was coloring with a little four-year-old girl who kept calling me teacher because all of her older siblings had gone off to school that day too. We played "school," colored, and put a puzzle together while her family was waiting for the pharmacy to open and fill their prescriptions. It is extrremely satisfying to know that I was able to help out a family that was already stressed out with regards to medical concerns, just by coloring with a little girl. Even though we couldn't understand each other's language, we still understood each other.

Health Literacy

Health Literacy is just as important and fundamental a task as it is to get people to go see the doctor in the first place. Since such a big part of the medical examination depends on obtaining an accurate patient history, miscommunication and not understanding the language can be a HUGE hindrance to quality health care administration that has little to do with the competence of the physician or with the patient. It is important to patient's to become their own advocates and take ownership of their health. Even in cases in which there is absolutely no language barrier what-so-ever, there are medical miscommunications in which patients do not fully understand how to take a particular medication regimen, or become confused from a doctor's medical gargon. In this case, the doctor needs to speak in a clear, non-technical, and concise manner, while the patient is responsible for asking questions and asking for clarifications as needed instead of passively absorbing everything and then missing out on something important. Working with the Literacy Council of Fort Bend County on Health Literacy Awareness has been brought to life at the San Jose Clinic. It is a real problem that needs to be addressed. In October, I put on a health literacy workshop for all of the ESL and basic literacy tutors in hopes that they will incorporate health-related vocabularly and dialogue in their lessons, so as their students learn English, they also learn practical everyday applications. I was proud to present The San Jose Clinic to the tutors to pass on to their students as a place to recieve health care because most of them are uninsured and therefore don't see the point of learning health literacy if they never have any chances of seeing a doctor anyway. But San Jose is offering hope to such individuals! October is Health Literacy Awareness month and I hope to put on the workshop again. Students at the literacy council have even been practicing by role playing doctor visits with a toy doctor's kit so that they can become familiar with common medical situations and how to deal with them.

San Jose

Working on the brochure, I realized how many medical professions take time out from their own busy practices in order to see patients at the San Jose Clinic. That, to me, seems to epitomize what medicine truly is about. I would do the very same one day. I am so blessed and so fortunate to be provided with the basic necessities and then some, that some people just go without on a daily basis. One day when I was walking in the front door, I walked in with a couple that were looking for a doctor under their medicaid plan and I couldn't help but listen to what they were told at the front desk -- basically what I already knew from previous information that I had learned and on the website, that individuals on Medicaid, Gold Care, Medicare, CHIPs, or any other type of discounted or government funded insurance plan, they are not eligible to be seen at the San Jose Clinic because these patients are have the means to be seen anywhere else by doctor's who would be actually getting compensated for their services. But the San Jose Clinic then truly is a safe haven for those that are completely uninsured to receive health care and health care services that they would otherwise be completely deprived of due to lack of insurance and/or funds to pay for such costly medical visits and pharmaceuticals. People need to know that the Clinic is here to help them so they can take full advantage of what the amazing people at the San Jose clinic are willing to offer to them.

Art with Heart 2009

San Jose

I was involved in helping create a brochure/hand-out to add to the annual report packets. The purpose of this brochure is to highlight the San Jose Clinic's brand new home, and especially their brand new dental clinic and equipment. Unfortunately the clinic has a much harder time attracting dentist volunteers as opposed to any other medical specialty (including optometry). In the old location, space and equipment were not as great as they could have been becuase of the great demand for dental work. Now, with the generousity of many organizations, the San Jose Clinic has very good quality equipment and technology in a large brand new and beautiful space. Now all they need are the volunteer dentists. Hopefully by exhibiting the pictures of the brand-new facility on the brochure, this will attract more volunteers to realize that they would be capable of providing the exact same level of care from the San Jose Clinic, that they do in their own private practices.

San Jose

Art with Heart is the San Jose Clinic's main fundraising event. I was lucky enough to volunteer at this event last year as a part of Tri-Beta's spring major volunteer event. Local artists donate their work and put them up for silent auction--all proceeds benefit the clinic. All of work an effort goes into arranging this event, as it involves a lot of coordination and organization. As volunteers last year, we were primarily involved in helping with the silent auction bidding which was conducting on electronic bidding tablets. A number of us were also responsible for "guarding" the art and sculptures that were on display for the auction. So the other day I was helping out at the San Jose Clinic by getting pieces of art ready for the Art with Heart Event. I got to witness first hand really how much work goes into creating such an affair behind the scenes. Each work of art had to be individually wrapped in protective plastic wrap, and then labeled and sorted. Again, it amazed me at how many local Houston artists had donated to the cause--it was very heartening.

San Jose Clinic

The first time I went to the new San Jose Clinic building, I was very excited! Its a very good feeling to realize that they operate primarily through the work of volunteers and donations and still manage to maintain such a high level of patient care and quality, especially in such a beautiful facility. I was especially amazed that the pharmacy is entirely stocked by way of donations! It is very touching to see the people really do care about their fellow humans and are willing to donate their time and efforts for the good of society. Health care in particular is the most precious and vital thing that every human should be entitled to, becasue without healthcare, there is no basis for living a fulfilling and productive life in the first place. It is first and foremost our good health which allows us to live, dream, and hope to the fullest extent possible. While volunteering at the Literacy Council of Fort Bend County, especially with regard to Health Literacy, I realize how many people really do not get the proper health care that they deserve, and then end up becoming seriously ill because of something simple that could have been prevented. When we advise people to go to the doctor more often for check-ups, its not so easy. It may be too expensive or difficult to see a doctor, and unfortunately some people just end up accumulating illnesses and ultimately having to go the emergency room. Therefore, the services that the San Jose Clinic offers to the uninsured of Houston really is heroic in my eyes.