Medical Sociology

Unit 4 Journal Entry

Healthcare and Sicko

Imagine your fictional character is in need of medical care. Consider their social and economic situation and the likelihood of them having insurance. Be very specific as you determine not only whether they have medical insurance but also what that coverage encompasses. Think back to the movie as well as the lecture on healthcare delivery… does insurance guarantee that one can access medical care? What about rising copayments, employer and employee contributions? As you think about your character trying to access care, consider, too, their experience of healthcare in the United States.

Now imagine your character is visiting another country, or perhaps they even live there. You may choose any country to focus on… preferably one showcased in the film. What is your experience? How does it differ from your experience in the United States?

                Sam has already had some experiences with the issues of the high cost and availability of healthcare. He has seen how the high cost of health care has affected his family. His mother had been diagnosed with leukemia about five years ago. She had received chemotherapy at that time and had been in remission for almost three years. Sam’s family had significant struggles to obtain coverage for many of the treatments his mother had received and they are still paying for co-payments and fees that were charged at that time. During a doctor’s visit about a year ago it had been found that her cancer had returned. She is receiving more chemotherapy and she is on the waiting list for bone marrow treatments. Sam had health care coverage from his father’s health plan through his father’s small business. When the costs of his mother’s care became to great his father had to drop Sam’s coverage. Sam had to pick up coverage under the ACA program.

Under the ACA Sam has some basic health care coverage. He has however found that he had to change his primary care provider (PCP) as the doctor he had previously been seeing had changed to a managed care system and would not accept patients with ACA insurance. Sam did find it difficult to get an initial visit with a PCP as many offices that he called were booked a few months ahead.  Sam is also struggling to pay his portion of the costs for the ACA coverage. He works part time so his earnings don’t always meet all of his expenses. His employer does not provide any health care benefits to people who work less than 30 hours per week. Sam is required to have health care coverage though in order to attend classes at the community college.

Sam has been able to have a routine checkup through his current PCP and his overall health has generally been good. He did recently seek treatment from a practitioner of acupuncture for some chronic headaches. This treatment was recommended by his PCP after Sam had experienced some side effects from taking medications. Sam had also talked about this option as he had a good experience with trying acupuncture during a college health fair that he had attended. Sam does have to pay out of pocket for the acupuncture as this service id not covered under his ACA plan.

            About a year ago Sam had been visiting a college friend in Canada. The friend had a minor bicycle accident while they were out riding on a trail near where the friend lives. Sam had helped his friend to get to the hospital and had waited there with him. Sam was surprised that the care there was, from what he saw very efficient. His friend was seen in the emergency room after about a half hour wait, he received an x-ray for his ankle injury, he had been evaluated by the doctor and had received an ankle support and a prescription for some pain medication. When Sam talked with his friend afterward, he asked what it would cost for the friend’s hospital bills. His friend explained that everything was covered under the national health plan. Sam was a bit shocked that it was so easy for his friend to get the care he needed, as his personal experiences were quite different.

Unit 3

Journal Entry

Francis DeMers

Imagine that you are a patient being treated by Dr. House. Consider an illness that your fictional character is likely to have, and outline House’s approach in treating it. Does he listen, is he interested in you, do you think he considers some of the limitations associated with biomedicine? Given DTC advertising what are your expectations around treatment?

Sam has booked an appointment at the hospital’s free clinic. He has been having chronic headaches and neck pain, he is starting to get tingling and numbness down both of his arms. He has had some trouble sleeping, although he is not sure if it is due to the headaches. Sam is examined by Dr. House. Sam is somewhat offended by House’s brusque manner and apparent lack of empathy.

Dr. House conducts a routine exam and has bloodwork drawn for analysis. He asks several somewhat obscure questions, asking if Sam has been out of the country recently “No, I can’t afford to travel is Sam’s reply.” Has anyone you live or work with traveled out of the country? “Not that I know of? “Have you been swimming in the last several weeks?  “I swam in a friend’s pool about two weeks ago.”  Was the water clean?  “As far as I could tell, there was a lot of chlorine in the water.” Dr. House continues to ask questions, but doesn’t really seem to pay much attention to Sam’s answers. He does examine Sam’s skin very closely, but he gives no indication of his findings. 

                Dr. House tells Sam that he would like to admit him to the hospital for further testing. He is recommending a CT scan and an MRI along with other tests. He tells him that he believes Sam might possibly have picked up a viral infection from the pool water. Sam tries to explain that he really can’t afford to take time off from school or work right now and he asks, “Can’t you just give me some pills for the pain?”  Dr. House responds “When did you get your medical degree and what makes you think I’m going to give you pills, when I don’t know what’s wrong.”  Once again Sam is taken back by Dr. House’s manner and he asks if he can be seen by another doctor. Dr. House replies: “Oh of course you know better than I do what is wrong with you!” Sam is now offended and he says that he is going to leave and go somewhere else.

                This is my interpretation of how I anticipate a visit with Dr. House would go based upon the way I saw the character portrayed in the show. Dr. House is portrayed as a very competent physician but he is generally lacking in “people skills” and his “bedside manner” is not his strongest skill.

                The show does portray the use of often invasive and at times excessive testing and diagnostic procedures. Dr. House works with a team that tries to determine the cause, of difficult to diagnose illnesses. He does have a tendency to look for unusual or unique causes for the illnesses that he sees. I do think though that Dr. House also has a certain distrust for the “medical system” as he was a victim of a medical error. His brusque and offensive manner is also due in part to both his expertise and his personal experiences. He may have some good reasons for his typically rude behavior but he shouldn’t allow it to interfere with his treatment of his patients. Dr. House is also jaded by his work and he often allows his ego to interfere with his practice of medicine.

                As portrayed on the show Dr. House does generally follow the typical procedures of the biomedical model. He does frequently use some rather unconventional methods but he doesn’t appear to embrace any form of alternative medicine.

                I do think that Sam would expect an easy solution to his headaches, DTC advertising sells us on the answers to all of our problems being contained in a pill. Sam would probably leave the appointment feeling disappointed with his treatment and without an actual solution to his medical issues.

Unit 2 Journal

Medical Sociology

Frank DeMers

For this entry consider the social sources of morbidity and mortality. You may consider the following questions:

1. How are you (your fictional character) affected by the distribution of food? In other words, is food plentiful in your society, do you have the wealth needed to buy a healthy diet?
2. How are you (your fictional character) affected by the distribution of food? In other words, is food plentiful in your society, do you have the wealth needed to buy a healthy diet? How do cultural forces affect how you consume food? For example, how does nationality, social class, ethnic group, age, gender, and more affect how you consume food?
3. Consider a day in your life… what transport is available to you, if you’re employed what are the conditions of your working environment? At home, what sort of proximate environmental factors affect you?
4. As you consider all these points, be sure to reflect on how these material factors affect your health… are you affected in adverse or positive ways?

When considering this from Sam’s point of view, I find that he has access to sufficient sources of food. He does however face some social challenges that may cause some difficulties with obtaining food that would support a healthy diet. Sam is working part time at a grocery store so the supply of food is readily available. His income and current social status are probable contributing causes of issues with access to food.

Sam as a white twenty – year old male from a middle – class background had good nutrition through his early youth and until he had moved out from his family home. He currently has no health issues related to malnutrition or insufficient access to food.

When Sam was attending college full time, he had access to food at the cafeteria. There were many food options, but as often the case Sam would choose the foods that were readily available. He would often select food that was quick to grab so that he didn’t have to wait in long lines. In many cases this consisted of fried and fatty foods. Sam did notice that he had started to gain some weight during his freshman year so he did make an effort to increase his exercise routine and to be more selective with his food choices. Sam’s current challenges though may start to influence his health. He has a high level of stress. His income has currently been impacted by the relatively low wages he is paid and the fact that he is working part time.

            Sam is experiencing economic challenges as his part time work doesn’t cover his expenses. He has to pay rent and part of the utilities for his shared apartment, he has to pay for fuel, maintenance and other costs for his vehicle. He also has to pay for his tuition costs and when he can, he tries to help his family with bills. With all of these expenses he doesn’t have much money available for food. His roommates do sometimes go in together to buy food, but that usually consists of pizza or takeout /delivery of fast food. As with many young males of this age group alcohol consumption is also a factor. One of Sam’s roommates is over twenty -one and they all “party” at times with their peers. Sam does enjoy spending time with his friends but he really is not into the party scene.

            When Sam is working he will often pick up some food before he leaves work. He does sometimes have time concerns due to classes or when he has scheduled time to drive for Lyft. Although he is aware of healthier eating options, he does find that fresh produce, lower fat foods and healthier food options are often more expensive than prepared foods. He has also found that his roommates will sometimes grab some of his food if he leaves it. The roommates are supposed to share but they tend to buy fast food meals that are not very nutritious.

            Sam has his own car and has ready access to sources of food. His working environment is generally safe, he does stocking work, some general cleanup in the store and he is sometimes assigned to the checkout area of the store. He does have some current concerns at work due to the current Covid -19 pandemic. He is exposed to a large number of people every day. He has been taking appropriate precautions whenever possible. He wears a face mask, tries to maintain social distancing, and to follow other preventative measures.

            As Sam is now twenty he is becoming more aware of some of the current and future life challenges he may be facing. His mother’s relapse and the financial challenges his family has faced recently have both made him more conscious of his spending habits. He is trying to save money to pay for his previous student loans and to cover his community college tuition. Although Sam’s father had a steady income from his business, current circumstances have made that more uncertain. His mother had worked part time as a medical receptionist, she is currently on leave due to her illness.

            Sam has tried to be more aware of his health and of his eating habits, his level of stress though is a potential contributing factor that could begin to effect his health.

Speech 6 Outline:

The secret to my success in this class has been the input, support and feedback that I received from my classmates.

Body:

A. Shared experiences

1. Introverted personality

2. Knowing others were introverted made the environment more comfortable

3. Other students experienced the same challenges as I did

B. Practice

1.Opportunity to post dry run speeches

2. Practice and feedback from classmates helped me improve my speeches

3. Growth and progress of my classmates was encouraging, made me feel better about my own progress

C. E-portfolio and Course Materials

1. Setting up and working with the portfolio was challenging

2. Tutorials helped explain the process, as well as seeing other students’ efforts

3. Course materials were effective and informative, and kept the class interesting

Conclusion:

A. Better speech preparation skills

1. More thorough understanding of the technical aspects of different types of speeches

2. Gained a better sense of how rehearsal, feedback, and revision can help improve my speeches

Journal # 10 Entry

                I feel that the most improvement that I saw was between my dry run of speech number four and my final speech number four.

            From previous feedback that I have received I wanted to try and make my speech livelier and I do feel that I accomplished this overall.  I did note however upon reviewing the speech that Imight have gone a little too far with adding in hand gestures. This will be an area that I can still work on.

            Specific feedback that I received included adding to the time of the speech.  When I had written my draft of the “dry run” I had several pages and I hadn’t had a chance to actually try out the speech. It turned out a little short so I did add some additional content for the original speech.

I do feel that this was probably my best improvement, based bothupon feedback and upon looking at the two speeches.

My biggest Strides:

1:04: I had a glitch with pronuciation and I just tried to remain focused on the speech and work through it

1:41: Use of hand gestures to emphasize points in the speech. Although I do have some criticism for the overuse of hand gestures in this speech. I also feel that this was a point where I used hand gestures effectively.

3:12 – 3:24: When I was talking about the values that my father taught me and my hope thatI have passed them on to my son, I feel that I effectively conveyed the emotions that I felt here.

Conclusion: I felt that the wording of my conclusion and the expression of the speech gave a good emphasis of the importance of my father to me personally.

Overall, I think that the feedback I received and the continued practice have helped me to improve. I have also become more comfortable with the mechanics of giving a speech and I think that my public speaking skills have improved.

Journal # 9 Entry

            In chapter twenty – three we look at ways in which we create and organize a persuasive speech. As the title describes the purpose of these types of speeches is to present facts or information to an audience and to attempt to either change their point of view, present an informed opinion or to make an effort to change the audience’s views regarding a specific topic.

            This chapter provides examples of goals that we can use to organize persuasive speeches and to help a speaker to deliver the speech in a way that will have the desired impact. One of the first goals is to establish credibility. The speaker should establish their qualifications or expertise regarding the subject. This goal is intended to give the audience an understanding of why or how the speaker has a basis of knowledge about the topic. Another important goal is to make the speech personally relevant to the audience. By creating a connection to the speech and involving the audience we can begin to engage in the persuasive appeals.

            There are three forms of persuasive appeals, in many cases a persuasive speech will touch upon all of these appeals. The first is “logos” in which we try to present an appeal based upon logic. The second is “pathos” in which we are appealing to the emotions. The final appeal is to “ethos” in which we attempt to appeal to the ethical nature of a topic. These three forms of appeal are the basis of a persuasive speech and we will build upon them when we look at the next chapter.

            In chapter twenty – four we continue to look at persuasive speeches and we delve into ways that we can structure a persuasive argument. The beginning of the chapter introduces the claim, evidence and warrant as the basic elements we will use to construct these speeches.

            The claim is our entry point into the persuasive argument. It is a thesis upon which we will build our argument. We need to establish though that the claim has some validity.

            The evidence is the facts and information that we will draw upon to attempt to prove the claim. Through research of the subject matter and through careful presentation of our findings we can try to show that the “evidence” supports our claim. We may also want to introduce counter arguments that go against our claim. This gives us an opportunity to refute or disprove these counter claims.

            Finally, we should establish that our claim is warranted. We can show either through established facts, supporting evidence, establishment of a sound theory, logical argument or by showing that recent advances in theories have established previous claims, that our claim is valid and proven.

            The chapter gives us several means through which we can determine the nature of our claim and ways that we can prove certain types of claims. It also addresses the counterargument and ways that we can refute or disprove a counterargument. Finally, the chapter gives us guidance regarding patterns that we can use to construct a persuasive speech in the best way that it will engage an audience and fulfill the goals of the speech.

Journal # 8

SPC 100

Frank DeMers

            I felt more comfortable with this speech generally. I’m not sure if this was due to the fact that my speaking abilities may be improving or if it was due to the nature and contents of the speech.

            I can say though that some of the feedback I received was very helpful. I was able to incorporate some of the feedback into my final speech. I also found that having a chance to view other people’s speeches helped me. To be able to see how others had approached the speech and to see that others had shown improvement was actually very encouraging.

            The nature and purpose of this speech made it easier for me to connect with it on a personal level. Reading in the chapter helped me to see that there is a “set formula” that I could use to develop the framework of the speech. This doesn’t prevent me from being creative or from including my feelings, emotions and passion into the final speech. This was for me another example of how having a process to create the speech, makes it easier to develop the speech.

            I found the process of creating this speech to be easier. I think that I am becoming more confident and comfortable with presenting as I gain more practice. I can see that there is still work to do and areas where I can improve, but I am also enthusiastic to see the progress I’ve made so far.

Journal # 7

SPC -100

Frank DeMers

            Chapter twenty-five gives us an introduction to speeches that we might deliver on special occasions. One aspect that I found interesting about this chapter is that there are general formats that apply to the different types of speeches. Since these types of speeches have a particular purpose or goal, they also have some rules that help us to determine the specific nature of the speech.

Although special occasion speeches may function, as do many other speeches, to inform or persuade an audience. Special occasion speeches are more often meant to entertain, celebrate, commemorate, inspire or to set a social agenda. To fulfil these particular roles, we may need to tailor the speech more carefully, in order to fit the needs of the special occasion.

Some events that might call for an entertaining speech include, banquets, award ceremonies and in some cases an introductory speech might benefit from some levity.

If a speech is given to commemorate a particular event or to honor a person, the audience would expect the speaker to pay tribute to, or offer a remembrance of the event or the person.

We should include some humor in a roast and depending upon the circumstances humor may be a part of a celebratory speech.

These are just a few examples of the rules that may apply to the speeches that we would give on special occasions. I found it helpful to see, that there may be a framework that can help us to construct these speeches. It also helps me to understand that there may be rules that I can apply when organizing and formatting other speeches.

Journal # 6

SPC -100

Frank DeMers

            Some of the things that I have learned so far trough this class include. The idea that there can be an actual process to the creation of a speech and that this process can improve the speech.

It has also become clearer to me that there are several elements of a “speech” that have no direct relationship to verbal communication, the contents of the speech and in some cases the purpose or intent of the speech.

            When we first began the class, I know that I needed to work on overcoming some “stage fright.” I have had opportunities to do public speaking before, and I know that this is usually a challenge that many people face. The first video by Joe Kowan pointed out that this is a common issue and that it is something that we can take on and overcome. Preparation, rehearsal, feedback and revision can definitely help us to work through these challenges. Though as Joe Kowan points out a bit of levity and allowing ourselves to find a personal comfort level can also be important.

            As we moved on to the second week and with the reading that we did as well as the second video it started to be more apparent to me that you could have a more formal process for creating and formulating a speech. The readings introduced ways in which we can organize the speech and set a purpose and direction for the speech. The video talked about ways that we can improve the process of giving and receiving feedback. I know that I learned from the feedback that I received from my peers, I tried to use the feedback to improve my final version of the second speech.             Going into speech three, I did try to incorporate the feedback I have received from my peers and from Mr. Miller. I know that looking at the speech, there is still room for improvement. I do however now fell more comfortable with my public speaking skills and I plan to continue to use the skills I have learned and the new skills I will learn, to improve my abilities through the rest of the class.

Journal #5

SPC-100

Frank DeMers

Chapter Thirteen

Chapter Thirteen was actually very helpful for me.  When we were doing speech number two, I initially struggled with how you would create an outline for a speech.  I’m pretty comfortable with writing a narrative (story).  The idea of creating an outline from the narrative, though, almost seemed to be the reverse of what I am used to.  Reading Chapter Thirteen and seeing the examples helped me to better understand this concept.  You start with the narrative and then break that into the essential components of the speech.  In this case, “less is more”.

By breaking the speech out into its main points, subordinate/supporting points, and organizing the pattern that we will use to present those points, we can build both the structure and the content of the speech.  From this working outline we can then create our speaking outline.  Here again we try to narrow the focus, without losing the essential information that we want to convey.  This process and preparation will help us to deliver a speech that connects with our audience and relates the message we are trying to communicate.