Comp1_unit3_discuss_key.doc - Lane Community College



Introduction to Healthcare and Public Health in the US: Delivering Healthcare (Part 2)

Discussion Questions with Expected Outcomes

Discussion questions (for individual assignments or small group discussion):

1. What is outpatient care?

Expected Outcome: Outpatient care refers to care that is not provided in hospitals, in outpatient facilities

Outcome of discussion: student should be able to define outpatient care and contrast with other types of care such as inpatient care.

Objective(s): 1

Lecture(s)/Slide(s): a3

2. Discuss the important characteristics of primary care. In your opinion, which is the feature of primary care that most appeals to you?

Expected Outcomes: Primary care is the provision of integrated, accessible healthcare services by clinicians who are accountable for addressing a large majority of personal healthcare needs, developing a sustained partnership with patients, and practicing in the context of family and community

Outcome of discussion: student should be able to select a characteristic of primary care and defend their selection.

Objective(s): 1

Lecture(s)/Slide(s): a5-7, a9-10

3. What do you think are the main factors that foster the clinician-patient relationship?

Expected Outcomes: Sustained partnership, meeting mutual expectations, mutual respect, mutual trust

Objective(s): 1, 3

Lecture(s)/Slide(s): a14-15

4. What is the primary difference between internal medicine and family practice physicians?

Expected Outcomes: Family practice physicians see patients of all ages, and some of them provide obstetric care while internal medicine physicians only see adults and they do not provide obstetric services.

Objective(s): 3

Lecture(s)/Slide(s): b4-5

5. Do you think primary care is in crisis? Defend your position.

Expected Outcomes: Issues include an increasing number of older patients with complex medical issues, imperfect coverage of preventive care services, an emphasis on documentation, a complex billing and compensation system, decreasing number of physicians practicing primary care leading to a supply-demand imbalance, a greater dependence on after-hours acre, and the increasing cost of healthcare delivery

Outcome of discussion: The weight of medical literature suggests that there is a supply-demand imbalance in primary care. The student should be able to identify that there is a need for a greater number of primary care providers, and justify their logic during the discussion.

Objective(s): 1, 2, 3

Lecture(s)/Slide(s): b14-17

6. If you had the necessary authority, how will you solve the primary care crisis?

Expected Outcomes: Options include health reform and federal stimulus funds, training, grants for training and educational innovation, recruitment, loan forgiveness and other financial inducements, international medical graduates in positions that are not filled by US trained graduates

Outcome of discussion: the class should be encouraged to approach the problem from different perspectives.

Objective(s): 1, 2, 3

Lecture(s)/Slide(s): b18

7. What are the differences between urgent care centers and emergency departments?

Expected Outcomes: level of care, urgent care centers not intended to treat life-threatening emergencies.

Objective(s): 1, 2

Lecture(s)/Slide(s): c4-7

8. What is the best setting to treat the following conditions (choose between primary care clinic, urgent care center, and emergency room):

a. A 24 year old male with a sore throat, cough, without fever, wheezing, rash or other constitutional symptoms.

Expected Outcomes: in the primary care clinic (acute, limited, but not life-threatening condition) or in a retail clinic

Objective(s): 1, 3

Lecture(s)/Slide(s): b3, c3

b. A 46 year old female who twisted her ankle and now has some swelling and bruising around the inner aspect of her ankle.

Expected Outcomes: in an urgent care center (needs acute diagnosis but not life-threatening, alternatively patient may be seen in a primary care clinic, if a same day appointment is available and X ray facilities are convenient)

Objective(s): 1, 3

Lecture(s)/Slide(s): b3, c4-5

c. A 68 year old male with a one hour history of severe chest pain, accompanied by sweating, palpitations, and a sensation that he is going to pass out.

Expected Outcomes: in the emergency room (urgent, serious, potentially life-threatening condition)

Objective(s): 1, 3

Lecture(s)/Slide(s): c7

9. Why do you think the number of ER visits increased from 90.3 million in 1996 to 119.2 million in 2006?

Expected Outcomes: Amongst others, some reasons include the increasing US population, decreasing number of primary care providers and options for care, increasing number of patients who use ERs for non-emergency primary care, state of the national and local economy (decreased jobs, decreased number of patients with health insurance)

Objective(s): 1, 2

Lecture(s)/Slide(s): c7, c9

10. Discuss strategies to reduce inappropriate ER visits in your community.

Expected Outcomes: Patient education, establish medical homes, use telephone triage systems, improve after hours care availability, increase enrollment in safety net programs, simplify health information for patients.

Outcome of discussion: This topic could be led by the instructor, who will have significant knowledge about the local healthcare landscape.

Objective(s): 1, 3

Lecture(s)/Slide(s): c11

11. What are some of the branches of pathology and how do these fields help clinicians manage their patients?

Expected Outcomes: Anatomical pathology, surgical pathology, chemical pathology, hematopathology, blood banking, cytogenetics, microbiology, forensic pathology, molecular pathology. Diagnostic role of pathology helps clinician manage patient’s medical issues.

Objective(s): 1, 2

Lecture(s)/Slide(s): d4-6

12. Discuss some of the advances in radiology from the time of Wilhelm Röntgen to the present day. Do you think that the advances in radiologic technology have improved patient care?

Expected Outcomes: X-rays, ultrasound, advanced imaging techniques such as CT, MRI and PET scans, nuclear medicine scans, preventive screening such as mammograms and bone density tests (DEXA scan), angiography and invasive radiology.

Objective(s): 1, 2

Lecture(s)/Slide(s): d8-9

13. How does a multidisciplinary approach help hospice patients?

Expected Outcomes: Involvement of multiple disciplines such as a physician, a social worker, nurses, home health aides, pain management specialists and a chaplain help to provided integrated medical, psychosocial, and spiritual care in a collaborative fashion that alleviates the patients’ suffering, controls pain and other noxious symptoms, and improves the quality of their life.

Objective(s): 2, 3

Slide(s): d12

14. Have you ever been to a primary care office, either for your own health needs or for the needs of your family? Describe the people you met at the office during your visit, your perception of their role, and how you feel they fit into the organization structure of the clinic. Do you think some roles are more essential than others?

Expected Outcomes: Front office, clinical team, back office role. The clinician is key to the visit, but during the discussion emphasize the importance of interdisciplinary teams in healthcare.

Outcome of discussion: Encourage students to recount their own experiences and discuss it in class. Avoid letting students mention protected health information, the focus should be on the setting and the workflow, rather than on the disease, diagnosis and treatment.

Objective(s): 1, 2, 3

Slide(s): e3-12

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