Answers
Three Types of Medical Uncertainty - Answer 3 types of Medical Uncertainty.
Limitations of medicine (external).
Limitations of self/ability to learn all medical knowledge (internal).
Limitations in ability to distinguish between type 1 and type 2. Which leads to
Uncertainty and Death which makes the student/doctor feel like a failure.
Training for Medical Uncertainty - Answer Can't possibly learn all the material.
No "spoon feeding", lack of structured learning, lack of grades.
Inability to actually cure people who are sick/inevitability of death.
Physical Diagnosis/Cadaver experience is most central to dealing w/medical uncertainty.
Objectification and Rationalization - Answer Perhaps the most consistent theme that
recurred in these accounts was the scarcity of humane and caring encounters between
doctors and patients...Doctors' clinical perspectives focused almost entirely on the
disease rather than on the illness. Virtually all teaching emphasized the technical
aspects of doctoring: diagnosis, treatment, and intervention. Too often this approach
caused patients to become the disease: "the lymphoma in Room 304."
With the Cadaver Experience - Answer How do students deal with uncertainty?
Emotional and Physical Reactions.
Abstract Concerns.
Coping Mechanisms:
Objectification..
Rationalization.
, Intellectualize/Technicalize.
Curing/Competence versus Caring = loss of idealism and "emotional numbness".
Competence v Caring - Answer Practice of medicine entails "entering" human body.
Often framed as "entry into science."
Results in objectification of human body and patient.
Focus on technical over human concerns
Ironic that doc needs both!
"Today the medical industry has come to value what are traditionally regarded as
female qualities of empathy and good listening...Research shows female doctors spend
more time with patients, ask more personal questions, and do a better job of getting
patients to agree to treatment." (AAMC report)
Inverse Coverage Law - Answer Those patients most in need get less treatments and pay
more for health care.
Health Insurance in the US - Answer 46.6 million (15.9% )of US population lacks access
to health care (2005).
67.7% purchase private care.
Main barriers: "Race and Citizenship."
Education, low wages, job characteristics, citizenship status.
Why? Can't afford it; Fear legal consequence.
Rise of costs per year.
Community vs. Risk Rating - Answer Community rating, as a basis for premium
calculation, is fundamentally different from the usual method of determining insurance
premiums, i.e. risk rating. In a risk rated insurance market, an insurer calculates the
premium payable by a potential policy holder in order to enter into an insurance
contract on the basis of various factors particular to that individual, such as the risk of a