Traditional and Nontraditional Health Care

• Distinguish between traditional and nontraditional forms of health care and the associated risks/benefits.

• List types of home health tests.• Describe common medical exam procedures and medical

tests. • Relate oral health to overall health and discuss good oral

care.• List their rights as a medical consumer. • Describe the doctor-patient partnership, including

choosing/evaluating their primary care physician.• Compare and contrast the different types of health-care

practitioners and health-care facilities.• Evaluate their role in their own health care, including self-

care.

Chapter Learning Objectives

Personalizing Your Health Care

Your Family Health History

•Mapping your family medical history can help identify health risks you may face in the future.

Health-Care Consumers: Men vs. Women

• Women• More likely to see a

doctor, take prescription drugs, and to be hospitalized.

• Account for 75% of health care spending.

• More likely to suffer from migraines.

• Men• More likely wait to see a

doctor for problems.• More prone to back

problems, muscle problems, allergies, and digestive problems.

• Less likely to suffer from migraines.

The genders differ significantly in the way they use health-care services in the United States.

Despite differences, women and men spend similar proportions of their lifetimes— about 81 percent—free of disability.

Personalizing Your Health Care

Self-Care•Most people do treat themselves for minor problems.• Aspirin for a headache, chicken soup or orange juice

for a cold, or a weekend trip to unwind from stress.•100’s of home tests are available to help consumers monitor everything from fertility to blood pressure to cholesterol levels.• Examples: Pregnancy, fertility, blood pressure,

cholesterol, urinary tract infection, and HIV infection.

Personalizing Your Health Care

Oral HealthProper and regular brushing and flossing is the best way to prevent loosing teeth to decay and gum disease.Fact

• Research indicates links between chronic oral infection and:• Heart disease• Lung disease• Stroke• Low birthweight and premature births• Diabetes

Personalizing Your Health Care

Oral Health•Plaque• Sticky film of bacteria that forms on teeth.

•Gum, or Periodontal Disease• Inflammation (due to plaque) that attacks the gum and

bone that hold your teeth in place.

•Gingivitis• Inflammation of the gums.

•Periodontitis• Severe gum disease in which the tooth root becomes

infected.

Personalizing Your Health Care

Doctor-Patient Partnership•Because physicians have less time and less autonomy, patients today must do more.• Learn more about your body.• Learn more about medical conditions or

problems you develop.• Learn more about treatment options.

•Where can you find more information?• Online services, patient advocacy, and

support organizations.

Evaluating Online Health Sites

Check the Creator

Check Website Creation &

Updates

Look for Possible Bias

Consider theAuthor

Check the References

Primary Care Physician

• Your medical exam will include recording a medical history, any complaints you have, and your current lifestyle.

• Examinations may include: head, neck, chest, abdomen, rectum and genitals, pelvic region, extremities, and taking your pulse and blood pressure.

How Should I Choose My Primary Care Physician?

Did your physician take a comprehensive history? Was the physical examination thorough?

Did your physician explain what he or she was doing during the exam?

Did he or she spend enough time with you?

Did you feel free to ask questions? Did your physician give you straight answers? Did he or she reassure you when you

were worried?

Does your physician seem willing to admit that he or she doesn’t know the answers to some questions?

Does your physician hesitate to refer you to a specialist even when you have a complex problem that warrants such care?

Screening Tests and Recommendations

• Anemia• Beginning in adolescence, all non-pregnant

women should be screened every five to ten years until menopause.

• Clinical Breast Exam/Mammogram• Women age 20 to 39 should receive a clinical

breast exam every three years. Women age 40 and older should receive an annual clinical breast exam and a mammogram.

Screening Tests and Recommendations

• Cervical Cancer Screening (Pap Smear)• Three years after first sexual intercourse or by age 21,

whichever comes first, until age 30, women should receive an annual Pap smear. After age 30, the screening rate may decrease.

• Cholesterol and Lipids• Adults over age 20 should have a lipoprotein panel test

every five years.

• Colorectal Cancer Screening• Adults age 50 and older should receive an annual fecal

occult blood test and colonoscopy every ten years.

Screening Tests and Recommendations

• Type 2 Diabetes• Beginning at age 45, adults should have a fasting blood

glucose test every three years.

• Hypertension Screening• Adults age 18 and older should have an annual blood

pressure (BP) check. BP < 130/85 every two years. If BP is between 130–139/85–89 every year. After age 60, blood pressure should be checked annually.

• Osteoporosis• Women 65 and older should have a baseline bone mineral

density test.

Screening Tests and Recommendations

• Prostate Cancer Screening• Men age 50 and older should discuss potential benefits

and known harms of screening with PSA and digital rectal exam.

• Skin Cancer Screening• Adults should receive an annual skin exam.

• Visual Exam• Adults age 18 to 40 should have a complete visual

examination every two to three years; age 41 to 60, every two years; and age 61 and older, every year.

Your Medical Exam

• Medical history• Lifestyle habits• Standard Tests:

• Head (ophthalmoscope)• Neck• Chest (stethoscope)• Abdomen• Rectum and genitals• Pelvic examination

(speculum)• Extremities• Pulse and blood pressure

• Medical Tests:• Chest X-ray• Electrocardiogram• Urinalysis• Blood tests

• Elective Treatments:• Vision surgery• Cosmetic surgery

Three Basic Rights

Right to InformationYou must give your consent for hospitalization, surgery and other major treatments

Right to Privacy and Medical RecordsYou have a right to view and have a copy of your medical records and limit who else sees them

Right to Quality Health Care

Doctors must use reasonable care for all patients

Elective Treatments

• Basing diagnostic testing and treatments on solid evidence produced by rigorous research studies.

• Evidence-based medicine pays particular attention to outcomes.• Outcome: The impact that a specific

medication or treatment has on a patient’s condition, overall health, and quality of life.

Elective Treatments

• Elective treatments are procedures and products that are not medically necessary but that promise to enhance health or appearance • Cosmetic Surgery• Approximately a quarter of those receiving

plastic surgery are between the ages of 18 and 29, with liposuction, nose reshaping, and breast augmentation as the most common procedures.

• Vision Surgery• You should find a qualified surgeon who has

experience and who will also participate in pre- and post-operative surgery checkups.

Your Right to Privacy and Access to Medical Records

Access to

Medical Records

Notice of Privacy

Practices

Confidentiality

Prohibition

on

Marketing

Complementary and Alternative Medicine

Complementary and Alternative Medicine (CAM)

• CAM refers to various medical and health care systems, practices, and products that are not considered part of conventional medicine because there is not yet sufficient proof of their safety and effectiveness.

Types of CAM

• Mind-body medicine uses techniques designed to enhance the mind’s capacity to affect bodily function and symptoms and can have a positive effect on psychological functioning and quality of life.

• Biologically-based therapies include substances such as herbs, foods, and vitamins.

• Manipulative and body-based methods are those based on manipulation and/or movement of they body.• Chiropractic and Massage are examples

• Energy therapies focus on energy fields believed to exist in and around the body

What Should I Know Before I Try CAM?

• Is it safe?• Is it effective?• Will it interact with other

medications or conventional treatments?

• Is the practitioner qualified?• What has been the experience

of others?• Can you talk openly and easily

with the practitioner?• Are you comfortable with the

CAM care setting?

Acupuncture: An Alternative Medical System

Philosophy

Cycle of energy flows through body

Pain and disease disrupt cycle

Cycle can be restored by inserting needles along meridians

Use

Research shows effectiveness for:

• Chronic lower back pain

• Osteoarthritis of knee

• Relief of nausea in chemotherapy

Three Additional Alternative Medical Systems

Ayurveda

Traditional Indian medicine

Discipline of exercise, meditation, herbal medicine and proper nutrition to manage conditions

Homeopathy

3 Fundamental Principles:• Treatment must always be individual

• Less is more

• Like cures like

NaturopathyNatural remedies as disease treatment

Mind-Body Medicine

Examples

Meditation and prayer

Visual imagery

Creative outlets: dance, art, music

Yoga, T’ai Chi

Use

Visual imagery and biofeedback have been accepted into Western medicine

Especially effective for chronic illness• Epilepsy • Pain

• Asthma • Raynaud’s Disease

• Cancer

Chiropractic Medicine

Massage Therapy and Body Work

Osteopathic manipulation, Swedish massage, Alexander technique,

reflexology, Pilates, acupressure, and rolfing.

Unconventional

Physical TherapiesColonics, hydrotherapy, and light

and color therapies

Manipulative Mind-Body Medicine

Health-Care Practitioners

• Physicians• medical doctors from specialized schools who have undergone

premedical college courses and four or five years of medical school, and who have passed a national board examination and finished a one year internship, followed by a two to five year residency.

• Nurses • graduate from a school of nursing and pass a state board

examination.• Specialized and allied-health practitioners

• work with physicians and nurses, and include occupational therapists, clinical psychologist, psychiatrists, optometrists, ophthalmologists, and podiatrists.

• Dentists • complete a bachelor degree, followed by two more years of sciences

training, two years of clinical work, and a written and clinical exam.• Chiropractors

• have two years of college-level training, plus four years of specializing in chiropractic care.

Health-care facilities

• College health centers range in size from small dispensaries staffed by nurses to large-scale, multispecialty clinics that provide both inpatient and out patient care.

• Outpatient treatment centers can handle many common surgical procedures, and then allow the patient to recuperate at home to cut health-care costs.

• Hospitals and medical centers can be private, public, or academic.• Emergency services, or hospital emergency rooms, tend to be

understaffed, underfinanced, and more expensive.• Inpatient hospital care is the most expensive.

• Home health care includes equipment and services provided in the home to restore or maintain comfort, function, and health.

Paying for Health Care

• Traditional Health Insurance• Indemnity plans: A form of insurance that pays a

major portion of medical expenses after a deductible amount in paid by the insured person.

• Managed Care• Health care services and reimbursement predetermined

by third-party insurers.

• Health Maintenance Organizations (HMOs)• An organization that provides health services on a

fixed-contract basis.

Paying for Health Care

• Preferred Provider Organizations (PPOs)• A group of physicians contracted to provide

health care to members at a discounted price.• Government Financed Insurance Plans• Medicare: The federal government pays 80%

of most medical bills, after a deductible fee, for people over 65.• Medicaid: A federal and state insurance plan

that protects people with very low or no incomes/unemployed.

Paying for Health Care

• The Uninsured• More that 47 million Americans are uninsured, with the

primary reason being the high cost of health insurance.

Types Of Health Insurance

Managed Care

Predominant form of US health care

Preferred Provider OrganizationsThird-party contracts with providers to provide services

Medicare/Medicaid

Federal and State insurance plan for low-income

Health Maintenance Organizations

Managed care plan that emphasizes routine care

Taking Charge of Your Health

• Trust Your Instincts• Do your homework

• Find a good primary care physician who listens carefully and responds to your concerns

• See your doctor regularly• Get a second opinion

• Seek support• If your doctor cannot or will not respond to your

concerns, get another one• Speak up

• Bring your own advocate