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13Consumer HealthLearning ObjectivesAfter studying this chapter in the text, the student should be able to:13.1Describe some ways the Affordable Care Act is affecting access to health care.13.2Identify three elements of personalized health care.13.3List some steps to becoming a better healthcare consumer.13.4Outline your rights as a health-care consumer.13.5Discuss the pros and cons of elective treatments to enhance health or appearance.13.6Identify ways to recognize health hoaxes and medical quackery.13.7Assess the value of complementary and alternative medicine (CAM).13.8Review the components of the health-care system, including types of practitioners and health-care facilities.13.9Explain how a health care plan can affect the health-care services a consumer receives.13.10List some of the choices college students have for health coverage.Chapter SummaryThis chapter will help you understand what it means to be a health-care consumer. Whether you are monitoring your blood pressure, taking medication, or deciding whether to try an alternative therapy, you need to gather information, ask questions, weigh advantages and disadvantages, and take charge of your health.Lecture OutlineA New Era in Consumer HealthIntroductionThe Affordable Care Act (ACA) ushers in new era of consumer health careAs a result, Medicaid has expanded and now covers 3.9 million more AmericansImproving Your Health LiteracyAbout one-third of the population in the U.S. has limited ability to understand health information and to use that information to make good decisions about health and medical care.Health literacy is the ability to understand health information and use it to make good decisions about health and medical care.Regardless of their literacy skills, college students do not seek out information on health concerns.Finding Good Advice OnlineTwo in three Internet users are “e-health” consumers who seek information or support, communicate with health-care providers, or buy medical products online.Guidelines for evaluating websites with medical information:Check the creator.Look for the latest research.Check the references.Consider the author.Look for possible bias.Getting Medical Facts StraightRather than putting your faith in the most recent report or the hottest trend, try to gather as much background information and as many opinions as you can.Look for answers to the following questions:Who are the researchers?Where did the researchers report their findings?Is the information based on personal observances?Does the article, report, or advertisement include words like amazing, secret, or quick?Is someone trying to sell you something?Does the information defy all common sense?Evidence-Based MedicineEvidence-based medicine is a way of improving and evaluating patient care by combining the best research evidence with the patient’s personal values.Practice guidelines can be developed by doctors who use evidence-based medicine.Outcomes ResearchOutcomes are the impact that a specific medication or treatment has on a patient’s condition, overall health, and quality of life.Outcomes research can help determine which of several therapies or approaches provides the best results at the most reasonable costs.Personalizing Your Health CarePersonalized medicine can alert your doctor to potential threats that might be prevented, delayed, or detected at an earlier, more treatable stage and, if you do develop a disease, pinpoint the medications that will do the most good and cause the least harm.Your Family Health HistoryMapping your family medical history can help identify health risks you may fact in the future.Gender DifferencesThe genders differ significantly in the way they use health-care services in the U.S.Many experts believe that the need for birth control and reproductive health services gets women into the habit of making regular visits to health-care professionals. There are no comparable specialists for men.Men tend to be more positive about their experiences of being hospitalized.The genders also differ in the symptoms and syndromes they develop.Health-Related AppsEmergency Medical Center LocatorGoodRxiTriageCook It Allergy FreeUMSkinCheckSelf-CareMost people do treat themselves.People should know their vital signs and how they compare against normal readings.Oral HealthOral health refers to the entire mouth, including all the structures that allow us to talk, bite, chew, taste, swallow, smile, scream, or scowl.Oral health is a critical part of overall health.Poor oral health can lead to a variety of health problems.Gum or periodontal disease, is an inflammation that attacks the gum and bone that hold teeth in place.Plaque is the sticky film of bacteria that forms on teeth.Gingivitis is the early stage of gum disease.Periodontitis is where plaque moves down the tooth to the roots, which then become infected.Gingivitis and periodontitis trigger an inflammatory response that eventually leads to an increase in the incidence of cardiovascular disease.Becoming a Savvy Health-Care ConsumerYour first step should be learning more about your body, any medical conditions or problems you develop, and your options for treatment.Choosing a Primary Care PhysicianYour rapport with your primary physician and the feelings of mutual trust and respect that develop between you can have as much of an impact on your well-being as your doctor’s technical expertise.Guidelines for talking with your doctor:Prepare in advance.Ask about a “question hour.”Go onlineInterrupt the interrupter.Ask for access to your medical record.Your Medical ExamAnalysts have not found evidence that an annual screening physical is warranted for health adults, primary care physicians feel differently.Medical history is health related information collected during the interview of a client by a health-care professional.Point out any pain or concerns you have during your physical as your physician examines your head, neck, chest, extremities, pulse and blood pressure, abdomen, and rectum and genitals.Medical TestsLaboratory tests may include; chest x-rays, urinalysis, blood tests.Specific tests and procedures that are often overused include those for low back pain, osteoporosis screening, cardiac screening, pap testing, and pelvic exams.Pap smear is a test in which cells removed from the cervix are examined under a microscope for signs of cancer; also called a Pap test.Preventing Medical ErrorsMore people die from medical errors than from motor vehicle accidents, breast cancer, or AIDS.The best defense against medical errors is information.Avoiding Medical MistakesBe sure to find out from your doctor and pharmacist the name of the drug, what it is supposed to do and how and when to take it and for how long.Ask if the drug causes any side effects and what you should do if any rm your doctor if you take any over-the-counter drugs.Follow the directions exactly.Other additional steps to take:Keep a record of all your medication.Always turn on the lights when you take medication.Never take someone else’ medication.Always check labels for warnings.Don’t take medicine with grapefruit juice.Don’t leave medicines in a car for prolonged periods.Your Medical RightsConsumers have basic rights that help ensure that you know about any potential dangers, receive competent diagnosis and treatment, and retain control and dignity in your interactions with health-care professionals.Your Right to InformationBy law, a patient must give consent for hospitalization, surgery, and other major rmed consent is a right, not a privilege.Your Right to Privacy and Access to Medical RecordsYour medical records are your property.Key provisions to the federal standards that protect the privacy of patients’ medical information include:Access to medical recordsNotice to privacy practicesProhibition on marketingConfidentialityYour Right to Quality Health CareThe essence of a malpractice suit is the claim that the physician failed to meet the standard of quality care required of a reasonably skilled and careful medical doctor.Elective TreatmentsIntroductionMedical technology has developed new treatments.Some treatments are new alternatives for correcting common problems, others offer the promise of looking younger or more attractive.Vision SurgeryLASIK (laser-assisted in situ keratomileusis) is the most common technique to correct vision.A surgeon uses a razor like instrument to life a flap of the cornea and then reshapes the exposed area.Prices have fallen, but ophthalmologists have warned consumers that some laser surgery centers have cut corners to cut prices, such as hiring inexperienced surgeons or using optometrists or technicians rather than MDs.Cosmetic SurgeryThe most common cosmetic operation is lipo-suction, the removal of fatty tissue by means of a vacuum device.Breast augmentation is another cosmetic procedure.Body Art PerilsAdverse reactions to inks, even henna, used for temporary body artHealth Hoaxes and Medical QuackeryQuackery is medical fakery; unproven practices claiming to cure diseases or solve health problems.Be suspicious when you see:Claims that a product is a “scientific breakthrough,” “miraculous cure,” “secret ingredient,” or “ancient remedy.”Claims that the product is an effective cure for a wide range of ailments.Claims that use impressive-sounding medical terms.Undocumented case histories of people who’ve had amazing results.Claims that the product is available from only one source and payment is required in advance.Claims of a “money-back” guarantee.Websites that fail to list the company’s name, physical address, phone number, or other contact information.To keep from risking your life on false hopes, follow these guidelines:Arm yourself with up-to-date information.Ask for a written explanation of what a treatment does and why it works.Don’t part with your money quickly.Don’t discontinue your current treatment without your physician’s approval.Nontraditional Health CareOverviewComplementary and alternative medicine (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.Holistic methods focus on the whole person and the physical, mental, emotional, and spiritual aspects of well-being.People use CAM to improve their overall health and well-being or to relieve the symptoms associated with chronic or terminal illnesses or the side effects of conventional treatments for diseases.Who Uses CAMThirty-eight percent of adults in the U.S. report use of CAM therapy in the previous 12 months.Populations most likely to use CAM are: women, adults between ages 30 and 69, cancer survivors, adults with higher levels of education, those who are physically active, people who have existing medical conditions or made frequent medical visits in the prior year, residents of Western states, former smokers, and people with private health insurance under age 65.Types of CAMAlternative Medical SystemsAcupuncture is an ancient Chinese form of medicine, based on the philosophy that a cycle of energy circulating through the body, controls health, .corrects pain and disease by inserting needles into meridians throughout the body.Long thin needles are inserted at specific points along longitudinal lines, or meridians, throughout the body.Research has found that acupuncture:Helps alleviate nausea in cancer patients undergoing chemotherapy.Relieves pain and improves function for some people with osteoarthritis of the knee.Helps in treating chronic lower back pain.May or may not be of value for many other conditions.Ayurveda is a traditional form of medical treatment in India.Ayurveda’s basic premise is that illness stems from incorrect mental attitudes, diet, and posture.Homeopathy is based on the idea that increasing dilution can increase efficacy.Naturopathy emphasizes natural remedies such as sun, water, heat, and air as the best treatments for disease.Mind–Body MedicineMind–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.Some of these therapies are now mainstream such as patient support groups and cognitive-behavior therapy. Some are still considered CAM such as prayer, yoga, t’ai chi, visual imager, mental healing, and creative outlets such as art, music, or dance.Other approaches that have won some acceptance include hypnosis, and biofeedback.Biologically-Based TherapiesBiologically-based therapies use substances such as herbs, foods, and vitamins.In the last ten years, sales of herbal supplements have skyrocketed by 100 percent.Most of the herbs tested have proven generally safe, although side effects such as headache and nausea can occur.Manipulative and Body-Based MethodsCAM therapies based on manipulation and/or movement of the body are divided into three subcategories:Chiropractic medicine is based on the theory that many diseases are caused by misalignment of the bones.Massage therapy and bodywork includes osteopathic manipulation, Swedish massage, Alexander technique, reflexology, Pilates, acupressure, and Rolfing.Unconventional physical therapies include colonics, hydrotherapy, and light and color therapy.Energy TherapiesEnergy therapies focus on energy fields believed to exist in and around the body, including the use of electromagnetic fields and even therapeutic touch.The Health-Care SystemHealth-Care PractitionersPhysicians – a medical doctor (M.D.) trained in American medical schools usually takes at least three years of premedical college courses and then completes four or five years at medical school.Nurses – a registered nurse (RN) graduates from a school of nursing approved by a state board and passes a state board examination. They may have bachelor degrees and may specialize in certain areas.Specialized and Allied-Health Practitioners – more than 60 types of health practitioners work with physicians and nurses providing medical services.Some examples include clinical psychiatrists, optometrists, ophthalmologists, and podiatrists.Dentists – (Doctor of Dental Surgery, D.D.S. or Doctor of Medical Dentistry D.M.D.)Chiropractors (Doctor of Chiropractic D.C.)Health Care FacilitiesPrimary Care is also referred to as ambulatory or outpatient care – is provided by a physician in an office, emergency room, or clinic.Secondary care is usually provided by specialists of subspecialists in either an outpatient or inpatient setting.Tertiary care is available at university-affiliated hospitals and regional referral centers, and includes special procedures.College Health Centers – institutions of higher learning provide direct health services.Outpatient Treatment Centers handle many common surgical procedures.Hospitals and Medical Centers offer different types of care.The most common hospital is a private, or community hospital, which may be run on a profit or nonprofit basis.After checking with your health insurance, also,Talk to your physician about recommended hospitals.Check with the local nursing association about the ratio of patients to nurses.Find out about room rates.Ask how many times in the past year the hospital has performed the procedure recommended for you.If possible, tour the hospital.Emergency Services should only be used in a true emergency.Inpatient Care remains the most expensive form of health care.Home Health Care is the provision of equipment and services to patients in the home to restore or maintain comfort, function, and health.Health Care FinancingYour health plan affects many things, including:Who will care for you?What kind of care you will receive?Where you will receive your care?How you will be cared for?How much you will pay?Managed CareA predominant form of health care in the United States that delivers care through a network of physicians, hospitals, and other health-care professionals who agree to provide services discounted or at a fixed rate.Health Maintenance Organizations (HMOs)HMOs are managed care plans that emphasize routine care and prevention by providing complete medical services for a predetermined monthly payment.Preferred Provider Organizations (PPOs)PPOs are third parties between a business or self-insured person, which contracts with a group of physicians and hospitals to treat its members at a discount.Medicare/MedicaidMedicare is how the government helps to pay a percentage of most medical bills after a deductible for people over age 65.Medicaid protects people with very low or no income.What You Need to Know about the Affordable Care ActOn March 23, 2010 the Patient Protection and Affordable Care Act was signed into law.The law mandates, among other things, that those under 26 can be covered by a parents’ health policy.Key WordsacupunctureAyurvedachiropracticcomplementary and alternativemedicine (CAM)evidence-based medicinegingivitisgum diseasehealth literacyhealth maintenanceorganization (HMO)herbal medicineholistichome health carehomeopathyinformed consentintegrative medicinemanaged caremedical historynaturopathyoutcomesPap smearperiodontitisplaquepractice guidelinespreferred provider organization(PPO)primary carequackeryself-carevital signsMindTap: Global Health Watch Questions and Suggested ResponsesThe following questions appear in MindTap. Though student responses will vary, the Suggested Reponses are examples of correct answers.A new study reports that adult diabetes patients who have limited health literacy are less likely to continue taking prescribed antidepressant medication.Why do you think it is important for diabetes patients to take antidepressant medications as prescribed?Suggested Response:Diabetic adults often suffer from chronic depression, requiring long-term medical treatment. Patients who do not take depression medication as prescribed may experience a relapse or recurrence of their depression.How can healthcare providers better equip patients with limited health literacy to control chronic medical conditions?Suggested Response:Patients with limited health literacy may need more in-depth counseling from health care providers regarding their treatment. Clear explanations about treatment, closer follow-up, and simplified information from health care providers will help patients to become more health literate and to take control of their health care needs.Reference:Poor 'Health Literacy' Keeps Patients From Taking Meds; In Study, Adults with Diabetes Who Didn't Grasp Health Info Often Skipped Needed Drugs. (2013, March 27).?Consumer Health News?[English]. Retrieved from ................
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