Tag: Sana Durvesh

0

Health Care Dilemma | Who is Responsible?

Many physicians believe that demanding patients are the reason they are delivering so much unnecessary care. Patients insist on getting a prescription for a drug they saw advertised on TV, or on getting an unnecessary and pricey imaging test, such as a CT scan. Doctors fear that the patient will leave them for another physician or because explaining why a drug or a test is unnecessary takes too much time. You have a patient who comes in with hearing loss. It might be an acoustic neuroma, a very rare [slow-growing] tumor. Some doctors order an MRI for every patient who walks in the door complaining of hearing loss. But a more rational approach is to explain to the patient that there is only a small chance of a tumor. The doctor should say, “Let’s check your hearing in six months.” But many doctors don’t do that, because they worry the patient will go to a physician down the street, who will find a tumor, and the patient will turn around and curse the doctor who suggested waiting. There are other hidden forces pushing over treatment. In many private facilities there are more specialists and more hospital beds than necessary, and the doctors tend to practice more-aggressive care, hospitalizing patients unnecessarily and referring their patients to other specialists, who then perform more unneeded procedures and tests. Sometimes, providers deliver unneeded care because they get paid more when they do more. Most of our caregivers are still paid through a system known as fee for service. They are reimbursed for each office visit, each day a patient spends in the hospital, and each test or surgery performed. This means that health care providers have every incentive to give patients more care, not better care. In our part of the world doctors are the professionals devoting most of their lives to service but they are not getting fair economic returns and privileges. Their minds are being polluted by the corporate culture of pharmaceutical industry and the deprived doctors find them a last resort to maintain a respectable lifestyle for themselves and their families. The insensitivity of our system towards health care has also increased the cost of health care and the doctors find themselves sandwiched among health managers and consumers.

0

Health Care Dilemma | Cost & Quality

Every day, people die due to lack of access to sufficient medical care. Health care costs have soared in the past several years, posing a dilemma for everyone, especially those who have financial difficulties. Why does basic health care cost so much? What do we get for all that money? Let’s look at a few facts as an example:

Infant and maternal mortality rate in Pakistan is the highest among SAARC countries and one child dies in the country every minute from EPI disease, diarrhea and acute respiratory infections.

The World Health Organization (WHO) has estimated that the out-of-pocket health expenditure in Pakistan stands at 71 per cent — the highest in the Eastern Mediterranean region — and a burden for the poor.

The unregulated private sector delivers a high proportion of health services and there is a great discrepancy in the quality of services.

Those who can only afford to pay a little usually get the poorest quality of the services, says a World Health Organization review on health inequalities in Pakistan.

In rural areas, the very poor women and men avail government services as they can afford only those.

3

Seasonal Affective Disorder (SAD)

Seasonal Affective Disorder (SAD), also known as winter depression or winter blues, is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or, less frequently, in the summer, spring or autumn, repeatedly, year after year. SAD is not a unique mood disorder, but is "a specifier of major depression". People with SAD tend to experience some of the following symptoms:

• Desire to sleep more
• Overeating
• Withdrawing from social activities
• Feeling anxious
• Being unusually irritable
• Feeling a lack of energy
• Headaches
• Craving of sweets
• Loss of desire for physical activity
• Weight gain

If you think this sound like depression, you are right. SAD is a form of depression, but it is caused by the reduction of daylight during the winter months. In addition, even if you are inside in artificial light most of the day, you can still suffer from a lack of daylight. Mental health professionals diagnose a person as having SAD if they have these symptoms for two consecutive winters, and do not have the symptoms in the spring and summer. SAD tends to be more common among women and young people, so you should be watching for symptoms in your partners and daughters. Doctors think there may be a connection between SAD and lower serotonin levels, which in more cases that are serious can result in clinical depression.

What To Do if You Think SAD is an Issue

First, if you think you or someone in your family is experiencing Seasonal Affective Disorder, you may want to consult your family physician or mental health provider. Your health professional will want to ask a number of questions to identify SAD and rule out other causes of the symptoms. Your physician may want you to try using a light box, which tends to have beneficial effects on about 75% of SAD patients. Spending 15-120 minutes per day in front of the light box can make a big difference. Your doctor may prescribe antidepressant drug therapy if serotonin levels are low. Make sure, if you take antidepressants that, you follow your doctor's instructions explicitly to be safe. Psychotherapy may also help. Sometimes talking with a counselor or social worker can help you focus on changing behaviors that contribute to SAD. Daily exercise outdoors is one inexpensive way of self-treating SAD. The fresh air, exposure to daylight and the endorphins you release through exercise can have a major positive effect on SAD sufferers. A 30-60 minute daily regimen has many positive health effects. Paying attention to the behavior of your family members can help you recognize the symptoms and effects of Seasonal Affective Disorder. When you see symptoms like these that cause you concern, get help and work with your loved one to get additional daylight and exercise.