The Covid-19 pandemic has revolutionized the uptake, coverage, and sustainability of telehealth use. It is celebrated and, to many clinicians, a necessary acceleration that will optimize efficiency and outcomes in medicine.
Despite the positives seen with the telehealth transition, we are also seeing new avenues for inequities in care access to exacerbate and opportunities to improve the integration of telehealth within the greater healthcare ecosystem. These are pronounced in the chronic disease population. (1)
The barriers to telehealth are most evident in rural, old patients with chronic diseases who are racial or ethnic minorities, do not speak English, or are of low socioeconomic status. These individuals have been disproportionately affected by the Covid-19 pandemic in addition to having worse outcomes for their chronic diseases. …
Quarantine has been a time of dropping old habits and picking up new ones, of honing lifelong talents and developing new passions. I have always enjoyed cooking as an outlet, but not South Asian cooking (my ethnicity). Free time to make a meal at home left me preferring a delicious gnocchi allo genovese or some chocolate banana bread. But for the first time in my life, I have found enjoyment in preparing traditional Indian recipes and cooking up a South Asian storm for my family. 13-year-old me is shocked, given how disinterested I have always been in doing this. …
How biological clocks are affected in Parkinson’s disease patients
Parkinson’s disease is a neurodegenerative disorder characterized by the death of neurons. The disease progresses with the death of dopaminergic neurons located in in the pars compacta of the substantia nigra (SNpc), located in the midbrain. The substantia nigra is located within the basal ganglia, which is responsible for the motor control pathway. Along the course of the disease, neurons die in the olfactory bulb, locus coeruleus, vagus nerve, and cortex. One of the hallmarks of Parkinson’s disease is Lewy Bodies, which are aggregates of misfolded α-synuclein protein. These misfolded protein aggregates occur due to mutations in the SNCA gene, among others.(1) …
Over time electronic health records (EHR) systems and their usage have increased. From adoption among US office-based physicians to acute care hospitals, EHR system adoption has skyrocketed. However, it important to mention that the options for health care systems have much room to grow. There are several recommendations to be adopted in the realms of technology, process, and culture.
The electronic health systems must have the computing power, algorithm, and machine learning strength to perform the logistical functions that might traditionally be done on paper. The existing work processes of each health system need to be personalized in the electronic system. The culture of the organization has to be ready to accurately utilize the system and be invested in its benefits. It is not easy for physicians to learn how to use systems, undergo continuing education, and engage with it, and thus there must be the benefit of increased quality. …
Buddhist ideas of the social basis for happiness differ greatly from the Western perspective. Buddhism holds that happiness is not something measured as a qualitative comparison with others. Each and every individual’s desire to be happy is just as viable and true as the pursuit of anybody else’s (Ricard). In order to achieve true happiness, individuals must release themselves from the cycle of dukkha or suffering. In this context, it must be understood that the Buddhist idea of happiness it not related to the traditional “smiles and laughs notion”. It relates to the strengthening of the mind through constructive guidance.
According to tenets of Buddhism, the concept of a person as a distinct entity does not exist. The person is seen as a fluid progression of experiences and moments in time. While it is common and understandable to attribute aspects of personality and emotion to an entity, that entity does not exist. Even so, viewed from a vibrational or energy standpoint, the greatest disruption and disturbance that one can face is adherence to the idea of self. It promotes greed, and therefore clinging to the items that seem naturally attractive. This greed does not initially seem to be “greed-like”. It may lull individuals into a false belief that they are protected from sadness and suffering by retreating inside their personal wants and desires (Ricard). In actuality however, this internal retreat leads to greater upset and disconnect with the other dynamic entities of the world. This retreat does not work because of the impermanent nature of everything in a Buddhist perspective. …
Role models are incredibly important for all of us irrespective of our field. The term was coined by a sociologist Robert Merton, who suggested that comparing oneself to groups of people who are in the positions that one wishes to have creates an unconscious drive and motivation for imitation. A self-fulfilling prophecy can result that enables the individual with the role model to come closer to their aspirations.
Role models can be people we encounter in our everyday lives, like your 80-year-old who has been a volunteer firefighter for 50 years and reads to kids at an after-school care facility. …
Key considerations in deciding settings for care provision
When it comes to options for home care versus institutional care, there are several points to consider. The first that comes to mind is the patient’s family structure and the level of health of the patient who need long term care. If the senior is fairly independent and healthy, then home services could be helpful. If the family is far away, they can be more reassured by updates of providers who go to the individual’s home.
For their comfort, the senior may not want to have to take care of their home and may find comfort in moving to assisted living homes which have become much more popular over time (these are custodial and not necessarily institutional in nature). There are not many intense medical needs handled here, but rather a community of similar individuals who can receive help with daily activities and be provided food. …
Packing, prepping for a new state and city
Remembering the familiar in anticipation of the unfamiliar
Photo frames, tea bags
To facilitate the transition into the unknown
14 hour drives
Torrential rain, overcast skies
Analogous to the Wizard of Oz
Hoping for a smooth landing
Arriving, wanting to breathe the air
But constrained by tightly fitted masks
Watching tourists with their careless mask-less saunters
Do you even care?
Exhausting to move items into a shoe box-sized space
With a dainty window view of a Thai restaurant
Finally settling in, planting the picture frames in their new home
And brewing the familiar mango ginger…
Both historically and in the present day, behavioral health services are not covered and treated like other medical services are.
There has been a trend of non-parity, which means that there’s a double standard for mental health services and they are somehow separate from other care. Gradual recognition of the importance of mental health care that is accessible and affordable and effective has prompted mitigation of this disparity. But in order to truly establish parity, we need to recognize specific barriers to care that are more prevalent with behavioral health than other forms of health care.
These barriers include stigma, inequitable geographical distribution, financial limitations, misunderstanding about treatment, provider attitudes, substance abuse, and fear of relapsing. …
Everyone with two eyes receives two different stories about the world. For most of us, a structure called the optic chiasm crosses the nerves and helps make sense of these perspectives. I have anisometropia, which means that my eyes don’t “team” or work well together. For me, one eye sees only things that are close well, while the other sees only things that are far.
Although my vision is fraught with challenges, I’ve always felt that I was luckier than many others. I donated birthday money to charities that treat vision problems and received letters with names of the recipients. It was initially gratifying to conjure distant faces of the patients who benefited from improved vision. …