Month: October 2015

Health Coaching

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During my first year of medical school, I found health coaching to be an interesting concept but was also skeptical about its effectiveness. Essentially health coaches meet with patients who have chronic health issues such as diabetes, smoking, alcoholism and spend time formulating ways to improve a patient’s health. The health coach does not provide solutions but instead helps guide the patient to create her own step by step plan on improving health. This seemed rather inefficient as the discussion would take a long time and the patient would need to be motivated to start thinking about making a lifestyle change. However after our simulated health coaching sessions, I could see the benefits of this method of coaching. A patient has the luxury of sitting down with a professional to discuss her health and leaves the session with a reasonable plan to improve her health. Furthermore, the patient gains a sense of accomplishment from generating a plan from her own ideas that would fit well with her personal schedule. Finally, the patient is able to stay on task by meeting frequently with a health coach to track her progress and adjust the plan accordingly. Therefore I gained a newfound appreciation for health coaching through this exercise. I was also able to help out other medical students as my video was used as part of an e-module for health coaching.

I chose to use health coaching as a demonstration of the patient care competency as it emphasizes the idea that patient care is a cooperative endeavor. The old idea of a paternalistic physician is no longer and is now replaced by informed and interactive decision making. Health coaching really displayed this idea as it attempts to draw out solutions for disease prevention and health promotion by encouraging patients to suggest ideas that are feasible for them.

In my future career, I plan to recommend health coaching to my patients so they can reap the long term benefits from this practice.

The video below shows the longer version of my health coaching interview session where the patient and I discussed small steps to help better control her diabetes.

https://vitals.osumc.edu/articulate/4737/player.html <– shorter version on slide 9

 

Community Health Education Project Poster

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During our first and second year of medical school, students were designated into groups of 2 to 3 to create a community health education project at our longitudinal preceptorship sites. I was assigned to the Stefanie Spielman Breast Center.  Our group met with a nurse practitioner/researcher to discuss interventions that were necessary at the breast center. Though many interventions have already been implemented in the center such as support groups as well as fitness classes and nutrition consultations for patients and family members, there was yet to be a comprehensive information session for newly diagnosed breast cancer patients. Fortunately, the breast center had just started creating information sessions for breast cancer patients and family members that were usually scheduled several days after a patient learned about their diagnosis. This was important because at the day of diagnosis, most patients and family are overwhelmed by the new information and cannot process all the scientific terms and treatment options that are discussed with the doctor and nurse. Therefore, this information session provides a way to go over the disease process, the treatment options, and the amenities offered at the breast center in a calmer setting. Afterwards, it also provides a space for patients and family to ask questions they may have to doctors, pharmacists and nurses.

Our role was to determine whether these information sessions were indeed effective and the most direct way was through pre and post surveys. The idea was discussed with nurses and a brief meeting about the implementation of the project was posted as an audio file on the “OSU breast channel” podcast. The survey drafts were finalized and we also did an online search to refer to other institutions’ surveys but there were only one or two published. Therefore, this was a relatively novel endeavor for this specific patient population. In a course of a month, we had gathered several surveys and found that indeed the information sessions were effective. This whole process helped me learn about the steps involved in clinical research and it was very satisfactory to find answers to our clinical question. Finally, this project opened a pathway for more questions and research to be implemented in the breast center which I am looking forward to reading about in the future!

The CHE project fulfilled the “systems-based practice” competency by teaching me about the interdependence of different fields in the healthcare system such as medicine, nursing and pharmacy. Furthermore, this project showed that appropriately using system resources can improve health care.

I will be reading more about system-based practices and conducting CHE projects in the future to further develop this competency.

**Please click on the image or link below to take a closer look at the poster.

CHE-Poster-Group-34-updated-2-1ggcp74 (1)

Community Health Education Poster

 

Patient Experience Elective

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In the summer between second and third year of medical school, I chose patient experience as my advanced elective. Our main assignment was to make a video demonstrating patient care at OSU. Our group of three medical students interviewed OSU staff, organized a meeting with patients and even tried our hand at acting to create this fun and informative final product! We explored the concept of diversity and how it’s utilized in hospitals (OSU as our example). Furthermore, we demonstrated some potential situations where diversity can become an important aspect of patient care such as when one’s culture utilizes alternative medicines. This project really helped me to see beyond the basic health care needs and routine history taking and physical exam techniques I had honed throughout medical school. I learned more about the necessity to learn more about alternative medicine, the importance of body language when speaking to patients as well as the importance of demonstrating autonomy, beneficence, non-maleficence and justice. This elective helped me to delve deeper into the humanistic aspects of medicine and further confirmed my interest in becoming a great patient advocate throughout my career. In addition, this piqued my interest into exploring what else alternative medicine has to offer for patients.

My patient experience elective fulfilled the “interpersonal communication” competency by helping me to understand how human diversity can influence or interfere with the exchange of information. I understand that different cultures have varying perspectives on medicine and I must accommodate each patient accordingly.

As I practice medicine in the future I will develop my interpersonal communication by using interpreters and also learning more about different cultures. I am currently taking a course in medical Spanish, learning Italian and actively trying to improve my medical Korean to help my future patients!

Internal Medicine – Personal Statement

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As I was making my final decision on my career path I tried to write several personal statements for different specialties. The one that was the easiest and most enjoyable to write was the one I wrote for internal medicine. I found that there were lots of stories I’ve gathered during my third year rotation in internal medicine that resonated with me and affirmed my determination to become a physician.

I felt that my personal statement reflected on the “professionalism” competency as my initial story demonstrated my personal struggle between social stigma and maintaining professionalism by growing out of fear. I’m happy that I was able to stay respectful and compassionate and grow as a professional.

I plan on continuing this competency by being an honest, kind and respectful health care provider throughout my medical career.

 

PERSONAL STATEMENT

“Who are you?”… “I’m the medical student working with the internal medicine team. It’s nice to meet you.” On my first day of my internal medicine rotation I was assigned a unique patient. He was a prisoner with a fever, melena, cellulitis and signs of acute kidney injury. As I walked into the inmate’s room—no doubt looking very nervous—I quickly introduced myself. Wasting no time, I took a brief history and proceeded onto my physical exam. His right leg was visibly inflamed and swollen, with pus seeping from a superficial wound. His foley catheter had minimal amounts of urine and he exhibited costovertebral angle tenderness. On a rectal exam, the melena was apparent by sight and smell. I began to formulate a list of hospital problems, and with the help and guidance of my attending physician and residents, we created a treatment plan. Each day as I visited my patient, I began to see the positive effects of our treatment. His wounds were healing. As I measured the amount of lower extremity edema with a measuring tape, I found the swelling had decreased dramatically in a matter of days. He began to have adequate amounts of clear, yellow urine, and he had multiple days without a fever. Even his melena resolved! However, the best part was that I grew to know this patient as a person. He was a proud father of two grown children: one a kindergarten teacher, the other an engineer for the Navy. He enjoyed a close relationship with his father and his hobbies included fixing cars and playing guitar. I learned that his prisoner status was not his defining characteristic and that he was like any other patient. Though initially I perceived him as someone to fear, he was just another person who needed help. During this time, I appreciated the opportunity I was given as a medical student to learn about the human body and to have this rare window into someone else’s life.

When I decided to pursue medicine, I was the first in my family to attempt a medical career. My only experience with doctors was conducting research with them or shadowing in college. Still, there were certain qualities I admired about physicians and their practices that drew me toward medicine. I found these were best exemplified in internal medicine. Firstly, I enjoyed the idea of a life-long relationship with patients and pursuing a career with the main principle of helping others. Next, I found the challenging and detective-like process of interrogation (history taking), scene investigation (physical exam), and forensics (labs and imaging) to be thrilling and satisfying. Finally, it appealed to my love of organization and details since everyday I would write notes, make lists, and constantly adjust my patients’ plans until the mystery was solved and a life had been saved.

My extracurricular activities, work experiences, and research further contributed to my interest in internal medicine. Before entering medical school, I had conducted cardiac/radiology research at the Los Angeles Biomedical Institute. I enjoyed viewing the human body through CT imaging and was fascinated by the complexities and inner workings of the heart. In my first and second year of medical school, I worked with a medical oncologist and was able to see the varied manifestations of breast cancer and how medications can become a lifesaver. Then once I started surgery rotations, I found the most interesting and intellectually challenging moments were during pre-rounds and morning rounds where I formulated differentials and interacted with patients. Out of all the avenues of medicine I had explored, I found that internists spent the most time with their patients and provided healing physically, emotionally and socially. I have come to believe internal medicine is the foundation and home base where patients are cared for from the beginning to the end of their hospital stays. I want to become this anchor and support for my patients.

As a future physician, I envision myself as not only an efficient and comprehensive clinician, but also as a caring patient advocate. My ideal practice would focus mainly on clinical practice with some research and teaching opportunities. During my free time I envision myself volunteering in free clinics or participating in medical mission trips to help those in need. So who am I? Simply, I am a doctor-to-be who wants to be a friend and guide for my patients through this ever-changing healthcare system.