The essay will contextualize the personal viewpoint of Pierre Elias ‘experience of health, disease and healthcare in the contemporary American society. The essay will use a personal essay “Insensible Losses: When the Medical Community Forgets the Family” by Pierre Elias from Health Affairs. The essay will discuss and explain how the main issues raised by your Pierre Elias relate to the broader historical context in American current culture, including a comparison to a relevant past historical context. The paper will also have a political, socio-economic, cultural theme that recognizes the social determinants of health. The insensible loss of the patients’ family by the medical community is rampant in many healthcare facilities.
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The article “Insensible Losses: When the Medical Community Forgets the Family” was authored by Pierre Elias. The author who is a medical student at Duke University School of Medicine is a scholar who has also served as a TEDMED researcher. Currently, Pierre Elias is a visiting researcher at the University of California, Division of hospitality Medicine, San Francisco (Elias 707-710).
Authors viewpoints and main themes
There are several viewpoints and themes presented by the author in this article. To begin, the author indicates that the family of the patients are always respectful and patient with the doctor when their family members are in the doctor’s care. This patience and respect are also accompanied by trust since the families of the patients believe that the physicians or the health care workers know best on the condition affecting their family member
Under the subtopic, “telling Laura,” many themes and viewpoints come forth. To begin, the theme of neglect of the patient’s family is evident. The author narrates how after the condition of Steve, the patient, had deteriorated; he was rushed to the ICU where new doctors working in the ICU section took over. As the initial doctors assigned to take care of Steve, they had no responsibility over him. However, everybody has returned to their normal duties of attending to other patients and forgetting about Laura, a wife of 40 years to Steve. No healthcare worker considered informing Laura about the developments and the status of her husband for over six hours; she sat apprehensively with her other relatives waiting (Elias 707-710). Pierre states that their clinical team went through their afternoon to-do-list, and they no longer saw Steve as their patient, nor his family as their concern. This is because a new team had assumed the responsibility for his care. Similarly, at the ICU unit, the senior ICU resident on duty only knew the basics about Steve, did not know about the wife of Steve leave alone that she was patiently waiting in the waiting room. Moreover, she had planned to talk to the wife only when she had a new report. This implies that if there will be no new report, then the relatives of Steve would have waited longer to know about the condition of Steve (Elias 707-710).
Another theme evident in the article is a lack of systematic approach to communicating with families to the family members about the condition of their relative who is hospitalized, or when their health deteriorates unexpectedly and requires a change of healthcare providers. The author states that he realized that someone was needed to inform Laura about the condition of her husband, but it was unclear on who to do that. Steve was their patient, but he has been handed over to the neurological unit in other doctor’s care. The unclear protocol is seen on who to inform the family; the previous doctors or the current physicians handling him at the ICU. Lack of proper protocol also saw Pierre, the student physician, taking the responsibility of talking with the family of Steve. A responsibility that should be taken by the doctor in charge of the patient (Elias 707-710).
The theme of lack of emotional care to the families of the patients is also evident. The patient was facing an uncertain and long recovery from stroke and was to go for cancer treatment, and yet the wife with other family members sitting few meters away had no clue about it. Leaving the families of the patients in the dark for longer hours is less a mental torture to the families. Laura was kept for over six hours in darkness about the condition of her husband with no doctor caring to attend to them. Moreover, there was no senior physician to deliver the cancer news to the family, comfort with them, and explain about the condition. That was a blatant lack of emotional care for the families of the patients (Elias 707-710).
Lack of proper policies in place to handle communication with the families or attend to them is also highlighted by the author. Pierre elaborates that most hospitals lack properly instituted handoffs. Handoffs are defined as the care transition that involves transferring responsibility, information and authority amongst clinicians, and it is always risky. Moreover, the author pointed out that even in hospitals with properly instituted handoffs procedures, families are left out (Elias 707-710).
From my personal viewpoints, I believe that the author highlighted some important issues that are evident in many hospitals. Neglect of the families is common in many hospitals especially when the patients have been admitted to hospital units that do not authorize non-staff members. Similarly, lack of systematic communication to the families’ leaves may family members in darkness since they do not understand who to ask about their relative. Furthermore, lack of emotional care to the families is also rampant. Psychologists majorly deal with patients with psychological problems and forgetting that families to the patients also have emotional problems when kept waiting for doctors communication.
Contextualization of the article
Many aspects of the article show that it was written in the present day. For instance, the hospital set up with functional ICU, different departments and working schedules for doctor’s shows that it is of the present day modern hospital.
The article also tells a lot about the current culture in terms of health policy. To begin, the healthcare policies does not focus on implementing policies for preventive checkups and screening to determine some health condition. Also, they do not cover emotional care and how to respond to questions from the families (Goodnough 1).
The article also has highlighted many public health issues, the healthcare system, and healthcare professionals. Many healthcare professionals have not been taught about emotional family care, proper communication, and reporting (para 4). The Pierre pointed out that in a proposed curriculum for the residency program, interns were proposed to be taught about handoffs. Lastly, in the 21st century in America, there are many emergent diseases like cancer, stroke, among others that need proper mechanisms of breaking the bad news to the families (Dower 1).
Comparison this viewpoint with a past period
Comparing the viewpoints in this article to the past time period, I believe there are some improvements in healthcare delivery. Medicine is a changing field with improvements day by day. In the past time period, the proper mechanisms proposed and instituted currently may not have been available in the decade. For instance proper procedure of handoffs. Similarly, an inclusive medication where the family and the healthcare providers are involved in the care and treatment of a patient may not be available in the past, but is being encouraged in the 21st century (Dower 2).
Elias, Pierre. ‘Insensible Losses: When The Medical Community Forgets The Family’. Health Affairs 34.4 (2015): 707-710. Web. 18 Oct. 2015.< http://dx.doi.org/10.1377/hlthaff.2014.0536>
Goodnough, Abby. ‘Success Of Kentucky’S Health Plan Comes With New Obstacles’. Nytimes.com. N.p., 2014. Web. 18 Oct. 2015.< http://www.nytimes.com/2014/12/30/us/kentucky-health-plan-is-flooded-with-the-poorest-and-sickest.html?partner=rss&emc=rss&_r=0>
Dower, Catherine, and et al. ”Health Policy Brief: Health Gaps. Among Different Populations Across The United States, Substantial Disparities In Health And Health Care Persist”. N.p., 2013. Web. 18 Oct. 2015. < http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_98.pdf>
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