Hiatus

I haven't been able to volunteer for the past two weeks because I was out of town during Spring Break and had to leave for the Tri-Beta regional conference last Friday. Unfortunately, San Jose is closed for Easter break this Friday, but hopefully I will be able to volunteer on Wednesday afternoon.

In other news, the Tri-Beta regional conference went really well. The drive up there took 6 hours during Friday rush hour in Houston and Dallas but only 4 1/2 hours coming back. Shh, I tend to speed...

I gave my chapter presentation on the activities of the Nu Beta Chapter at UST for the past year. Going in, I had only heard that many other small schools were avidly involved in Tri-Beta, so I thought every other chapter would blow us out of the water. However, I was pleasantly surprised to find that we're one of the most active and productive chapters.

April is going to be one incredibly hectic month, so we'll see how much time I have to actually volunteer and blog. One thing that has been on my mind is how San Jose Clinic is reacting to all the health care reform going on. Typically, negative reactions have come from the right-winged, upper classes. San Jose Clinic though caters to the uninsured and low-income patients, so I was curious as to whether they are having a very positive reaction to the extension of coverage to roughly 32 million more Americans and the penalties involved for not having health insurance. I'll have to ask Sam about this next time I see her.

Another Random Musing

I was not able to volunteer on Friday because taking pictures of our transfections took much longer than expected. It actually took up almost the entire time I usually go to volunteer, so I decided to head home since I already had plans for that evening. However, as always, I constantly have random musings about health care, and I thought I'd make today's blog entry lab-themed due to the aforementioned circumstances.

With health care's status quo, there is a struggle between the morality of managed care and defensive medicine. Also called the "shotgun approach" to diagnosis, defensive medicine caters more toward the middle class and upper economic, insured brackets. Doctors issue an extraneous amount of lab tests and scans in order to remove any legal liability of neglect should an incorrect diagnosis occur.

On the other end of the spectrum, managed care happens mostly with HMO's when insurance companies and doctors are looking to save as much money as possible and issue the minimum amount of lab tests and scans. There is also usually a financial incentive for the doctor if they save money by "undertreating." Sometimes, this results in cutting corners by outrightly refusing some test the doctor may deem "unnecessary" at the moment.

Where in this range does an underserved institution like San Jose Clinic stand? The majority of their patients do not have insurance. Hence, that is why they are a charitable institution catering to the underserved and uninsured. However, as a doctor volunteering one's time at the clinic, how does this affect what tests you recommend to the patient? Do you err on the side of caution and more defensive-type medicine, or do you only inform only about tests within the financial reach of the patient? What can be done should a low-income, uninsured patient require an expensive procedure? Do the doctors and administration at San Jose take the time to petition for lowering the cost of costly medical procedures?

Medicine faces an infinite number of moral quandaries in its practice, and San Jose Clinic and other institutions of that type have their own sector of medical ethics to contend with. It's the side of the ethical debate you don't hear much about, and it takes musings like this to actually stand up and take notice of that exact lack of attention.

Day 3

It's been a hectic week, so this post is a bit late in coming. Being a second semester senior is no picnic, but the glorious end is near! =)

Anyways, last Friday, Rachel Chacko and I were assigned again to several different tasks that we carried out in the volunteer office on the first floor. First, we had to type up several documents of instructions for San Jose Clinic to be put on the database. Mine were specifically about bleach baths, the application of retinol A, and how to care for skin after blistering agents are used. Since Rachel and I are both fast typers, this task was completed rather quickly.

Our next task took us on a journey back to our childhood as we had to prepare little coloring bags for kids for Easter at San Jose. We had to put three crayons in each of seventy bags, and we had to cut out paper butterflies and lady bugs for them to color in. A tongue depressor and either a butterfly or a lady bug were put into the bag, and the child would glue the bug on the end of the tongue depressor. As a child, I always preferred colored pencils. They were just neater and easier to color with. I had the technique down where you do the dark, bold outline and shade in the shape lightly. It worked wonders on my geography maps in high school.

The last random task made it feel like Christmas. We were given a box of children's books that were wrapped and donated to San Jose for Christmas, and our task was to unwrap them so that they could be wrapped again in different paper for Easter to be given to children. It was actually fun just opening the presents and see what book was inside because many of them took us back to our childhood. I was definitely a voracious reader as a child, always carrying a book everywhere I went. I read while I ate, rode in the car, went grocery shopping, ran on the elliptical machine, etc.

Definitely a day of reconnecting with our youth, it was another week of small tasks for San Jose. However, without volunteer help, I wonder how they could accomplish all that we contribute to along with all of their other more prominent work. Every little bit counts, and that's what matters.

An Afternoon of Fast Tasks

Our second week at San Jose Clinic, Sam decided to take the day off, so Rachel Chacko and I were under the direction of Jeff. First, he had us making tags for all of the art that will be in the Art with Heart auction fundraiser. We had to put a square piece of masking tape centered on the end of a yellow 5 X 7 in. index card, and then we had to punch a hole in the middle of the taped area. After that, we had to loop some wire through the hole so that the card could later be labeled and attached to the art. Needless to say, we did the same as last week and had a smooth assembly line-like system down where Rachel cut and placed the tape, and I punched holes and looped wire. We ran out of wire early, so we went through another stack of 100 index cards with Rachel cutting tape while I placed tape and punched holes. Yes, it was as exciting as it sounds, but we're happy to do whatever we can to help.

After we finished that task, Jeff had us move a bunch of boxes and some artwork from one storage cage to another. Rachel and I again worked surprisingly quickly and in an organized manner, and we had that done in no time. Also, strangely enough, none of the boxes were too heavy for us to move. It was pretty interesting to see the random Christmas decorations San Jose Clinic had as well as some of the artwork that was either not sold at the auction last year or will be auctioned at the upcoming Art with Heart.

Once done with the moving, Jeff asked us to set up two laptops in one of the first floor offices. We hooked the laptop up to the wall outlets and ethernet connection and got them ready to eventually be logged into. Upon finishing that, we then had to create an Excel spreadsheet of the names of all the health care providers in their Downtown doctor directory. That took about two minutes with my speedy typing skills, so Jeff ended up letting us go twenty minutes early. Another afternoon small tasks is another afternoon of small contributions that help to get things done at San Jose.

On a side note, I should work on quickening the pace of my verbal communication in Spanish. A Spanish dental patient lost her way in the clinic, and she asked us for directions to the dental office. I was surprised I understood exactly what she was looking for, but it took me a while to think of the vocabulary as to how to direct her to the dental office. Luckily, a receptionist overheard her and directed her toward it. After a summer of shadowing an Argentinian medical oncologist, my Spanish listening and comprehension skills are sharp, but my speaking skills need more practice. Perhaps I'll have time to crack open some Spanish books during Spring Break.

First Day of Intensity

Yes, the title is made in sarcastic jest, but I still very much enjoyed my first day volunteering again at San Jose.

I arrived at the clinic at 12:20p.m., and the first thing I noticed about the new location is how much better the parking is. There was plenty of space whereas previously, there were times when you couldn't find a space whatsoever, or your car may become blocked-in or immovable once other cars parked around you. However, you must now pay for parking, so I wonder how the patients are responding to that change. Hopefully they provide free parking for low-income patients that cannot afford even those minor fees. The outside of the building also looks very fresh and modern with large plate glass windows in a pale aqua/sky blue for walls. San Jose Clinic now looks better than many regular clinics I've been to, so I'm incredibly happy for their upgrades.

I entered the building and managed to catch Sam and Rachel Chacko just as they were starting the tour of the new building. The first floor is just for volunteer offices, and the second floor is the medical clinic for adults and children as well as the pharmacy. The medical clinic now has four pods in each wing, and each pod has four exam rooms. This is a huge change from before when they only had two exam rooms total and one prep room for all medical patients. Also, the pharmacy now has a lot more room for organization and storage. The third floor is the optometry clinic run by UH Optomoetry school four days a week and the dental office where they have six chairs on each side of the wing, giving twelve chairs total. This has also been a major upgrade since they used to only have seven chairs total in the last building. Also, the old optometry clinic was a rather small, dark room. All of the wings are painted in bright colors, and each area has its own waiting room. In addition, each floor has a common area waiting room with the large glass windows facing to the street. There were also beautiful additions of large, stained glass squares that hung from the ceilings. San Jose has truly turned things around, and it's an amazing sight to behold.

After our tour, Sam sat down to talk to us, asking what we were doing after college and what we wanted to get out of our experience at San Jose. I told her I would be attending Baylor College of Medicine (yay! =D) and that I really wanted to get to observe the most prevalent conditions at San Jose. From experience, I knew they would be diabetes and hypertension amongst adults and childhood obesity amongst the child patients, but in Medical Microbiology, we had to focus specifically on infectious diseases. The most common infectious disease at San Jose, aside from the common cold, would be TB I believe.

Following the chat, Rachel and I were assigned to Sue and Debbie, who had us working on putting an address sticker on envelopes and folding them into RSVP cards to be sent out for the Art with Heart auction on May 15th. I thought it would be most efficient if we each took a job, so I did the labels while Rachel did the folding. It was relaxing after a long and hectic week to just sit and and talk about every random thing in life as we contributed toward the success of San Jose Clinic in even the smallest ways. We talked about fashion (of course), weddings (we're such girls), cars, life post-college, current events (Tiger Woods and other such seriousness), art, penguins, and everything in between. Yeah, we're strangely talkative.

Two hours flew by, and we finished our time for the day at San Jose Clinic. The clinic was pretty empty since they were about to have their monthly Saturday clinic where seven doctors come in and see a large number of patients. It was time to go and sign out, and we both left to enjoy the rest of our Friday afternoon. We may not have spent our time immunizing patients, diagnosing diseases, or even taking vitals, but we still helped San Jose Clinic in a direct way, knowing the end results. Rachel and I both helped Tri-Beta volunteer at the Art with Heart auction fundraiser last year, so we know how important it is to the clinic. I was happy to contribute in any way I possibly could.

Here's some exciting things that will happen in the upcoming week until I blog again!

- Auditioning for UST Idol (I'm nervous!)

- Cooking and serving dinner at Hospitality Apartments, free housing for cancer patients

- Writing my Bioethics paper

- Finishing my Cell project outline

- Writing my Cell lab report

- Writing my Summa articles and laying out the Entertainment Section for the March issue

- Whatever exciting things also pop up in my life!

Random Musing

My first volunteer day will be this Friday from 12:30 - 2p.m., so until I have more to write on what I'm actually doing this semester at San Jose Clinic, I thought I would write briefly about a random musing related to health care.

With health care reform, many changes are already being felt within clinics today, ranging from EMR's to stimulus packages. Community health care centers have received some additional funding, but with this, there has been an influx of patients. Often, a high capacity of patients pushes resources to the limit. Yes, underserved clinics may hire more employees and upgrade technology with stimulus package funding, but what do they do when they cannot provide for rapidly increasing demand?

In addition, with the requirement for all Americans to be insured, lower income patients will turn increasingly to community health centers for the lowest cost. Will lower income patients be able to afford this new mandatory health insurance? Also, if they do still turn to these underserved clinics for low-cost health care, how will community health centers across the nation compensate for this? Other clinics will begin seeing them as competition for insured patients, and health care may face more capitalistic issues than necessary.

Also, even with government funding of implementation of services such as Electronic Medical Records, will community health centers have the funding to cover the maintenance of such systems? Well, the better question is, will such upgrades continue to be costly after initial setup? They are essentially meant to cut the costs of health care by removing paper fees, but then they run the risk of rapidly decreasing patient confidentiality with so many access points to EMR's.

Yes, these musings have been mostly financially-focused, but in this economic climate, it's sensible to ponder on these things, even in the case of low income health care and underserved clinics.

Volunteering Setup

A quick update: I'll be starting at San Jose Clinic next Friday, volunteering from 12:30 - 2:00p.m. This week, they are finishing up their move, so they will not be ready for volunteers yet. I'm interested to see what I'll be doing!

_____________________________

I emailed Samantha Sherman at the beginning of the week about volunteering again at San Jose, and she replied today that they'd be happy to have me back. I sent her my weekly availability to see which times work best for me to work. Hopefully, I will be volunteering on either Monday, Wednesday, or Friday afternoons.

Last spring, I volunteered Monday or Wednesday mornings because the morning hours are always the best times to get the most patient interaction. However, my morning classes this semester do not permit me to work the same hours.

Since I will be there in the afternoons when it is a lot slower, I expect to see more of the paperwork and everyday work away from the patients. Also, San Jose will be moving locations, so I don't doubt a lot of work will be geared toward that major event. I am incredibly excited to see the new facilities built for San Jose, a fully deserving institution.

This is just a quick update on my status quo, but I am definitely eager to get back to spending time at San Jose Clinic!