Open Thread Friday
Hello friends, volunteered to come back at the keyboard to write a series of Open Thread diaries which hopefully ends with Funky Fridays returning.
Catch up on a few issues from in my previous OTs and comments. The plants and animals on the farm are doing well. Expanded the vegetable garden and now have a strawberry patch. Almost all preparations for winter are in place. I keep thinking of one more project to get done. Hoping for less snow than last year. The possibility of the highway being rerouted through the property appears to be very remote according to Transportation Department personnel at the public meeting last week.
Going to try and create conversations on individual health, healthcare business in general and government roles in healthcare.
My introduction into healthcare business was in high school working a year at a verinary clinic trying to figure out a career choice. The clinic treated large and small animals Responsibilities ranged from cleaning the kennels to assisting the vetrinarians with weekly surgies, performing white blood cell counts with the microscope, develope x-rays and. Settled on pharmacy as a career.
When I started pharmacies were divided into 3 categories Retail, Hospital and Nursing Home or sometimes called Institutional and I worked in all three. The division was based on special categories of pricing provided by the pharmaceutical companies based on the potential for the category of pharmacy to shift market share of a product. For example the cost of a bottle of 100 Tylenol at retail level $2.00, nursing home $1.25 and hospital $0.01. Remember the slogan "Tylenol the pain reliever hospital use most.". Nursing home and hospital pharmacies would use at least retail pricing for customers. Mail order pharmacy came a little later and received significant price breaks.
In the mid 1980's about 80% of the retail pharmacies in Oregon were independently owned. One of the pharmacists behind the counter was likely to be the owner and greeted you by name. Prescription records were filed manually, prescription labels hand typed, patient med profile manually checked for potential problems and insurance claims were filed by the customer. If you had a question on vitamin supplements, bandage types, cold meds we would walk out from behind the counter to answer and often select a product from the shelf. A high volume pharmacy might have a counter person to ring up sales at the register. A few pharmacies had installed mainframe computer systems with third party software and a few writing their own.
Hospital pharmacies were billing for individual use or consumption of a product and often the department creating the most profit. The other hospital departments were using flat fee for services. Many hospitals were writing their own software for mainframe computers.
Nursing home pharmacies were usually located inside retail stores and maintained a separate inventory for the products with special pricing. One of the unique services offered was medication review or consultation monthly for nursing home patients and quarterly for assisted living. This turned out to be my specialty. Eventually designing a software package for laptop computers used by consultants across the country.
A few core opinions I have developed over time
1) The body is designed to stay healthy and heal itself from injuries, infections, toxins and chronic illnesses.
2) Be responsible for maintaining and improving your own health or listen to the designated person in your family (often wife or mother). Which includes finding a new health practitioner occasionally. Respect and trust between you and the one providing healthcare treatment can be as important as the treatment.
3) Learn to listen to your body and learn to see the small changes and physical clues in others and yourself. It is easier to do a minor course adjustment before there is a major problem. Insulin resistance discussed in several diaries recently is a good example. This link for some additional signs of insulin resistance.
4) Everyone is a unique individual and there is not one answer or one problem universal to us all. I think in addition to profit our bouncing from one extreme medical idea for another is not believing there can be more than one truth at the same time. A person can be made sick with a high carb diet and a low carb diet - it depends on the person, their time of life and other environmental factors.
5) It is an important to know when to reduce or stop treatment as it is to start. Overtreatment is a significant risks to health, including medications and exercise.
Sport medicine is a profitable business segment.
6) I consider the foundations to effect health are food, physical activity, mental activity and air.
7) The physical body will die after it is born and does not always function perfectly. It is what we do within the beginning and end that is important. Working with people who knew they were dying and still enjoying life brought a level of peace and acceptance to mine I can't explain easily.
8) Most people will ignore advice if it requires them to make personal lifestyle changes, environmental changes or learn and apply a new skill. It is easier to pop a pill, inhale a substance, have a surgery, or live with degrading health. (Inhale a substance - I was thinking of asthma inhalers)
9) Modern medicine theories for treatment and health are based on our understanding chemistry and biology. We have barely began to apply any understanding of physics, mostly within the scope of how it effects chemistry and biology. Yet most of us instinctively know a good joke or music makes us feel better.
10) Technology is not always the best answer.