BECOME THE BEST YOU POSSIBLE: THE PURSUIT OF MEDICINE
“The art of healing comes from nature, not from the physician. Therefore the physician must start from nature, with an open mind….” - Paracelsus

By Dan Hong
FCIQ Collins
W04
Assignment due Tuesday 4/26/2016

The Pursuit of Medicine:

Table of Contents

Introduction to myself……………………………………………………..3
Career Profile………………………………………………………………..4
Anthropology ………………………………………………………………..7
Sociology………………………………………………………………………..13
Psychology…………………………………………………………………….16
Political Science…………………………………………………………….20
Economics……………………………………………………………………….26
History……………………………………………………………………………32
Philosophy………………………………………………………………………38
Conclusion………………………………………………………………………..43
Bibliography/works cited…………………………………………………..45

The Start of a Journey:
Introduction of myself

If there’s a will, there’s a way. And if there is a way, Dan Hong has the will. Ever since I was born, I was curious about the world. I always said yes to trying new foods, taking mental and physical risks, and learning new skills when possible. I was born and raised in Queens, New York where I hustled on the daily; interacted with people of all kinds and developed a New Yorker mentality of “time is money” and acquired a taste for Italian, Korean, and Indian food. Then, I moved to the Great Neck bubble where I felt as if my development was being stagnated because of the lack of diversity and opportunities. But that didn’t stop me—I traveled to new locations such as California, West Virginia, and Guatemala to free my soul. These trips inspired me to take more risks not only elsewhere but at home such as shadowing physical therapy offices and ultimately volunteering as an EMT for my local fire department. By volunteering to help others in need of an emergency, I developed not only a passion in emergency care, but a specific love for medicine. And so the journey begins at NYIT—a new chapter in my ongoing journey...

Career Profile:

My lifelong dream is to become a doctor—more specifically, an osteopathic doctor. I am currently in the Bachelor of Science/Doctor of Osteopathy (3+4 year) program at New York Institute of Technology where I hope to graduate through NYCOM in 2022. The national average of a general practice physician is around $175,000 a year. In Great Neck, the physician average is much higher—almost $200,000
(link: http://swz.salary.com/SalaryWizard/Physician-Generalist-Salary-Details-11020-Great-Neck-NY.aspx )
3 Questions related to a Physician Interview:
What are your weaknesses?
-My weaknesses are the ability to think of new options and decisions when under extreme stress, and the ability to understand how different people may feel emotionally when it comes to treating them for my lacking of understanding cultural values of others. But through lots of new practice and experimenting under tight restrictions, I can slowly learn my way through becoming a veteran who flourishes under pressure. By studying other cultures and their way of lives, I am also better at understanding the mixed emotions when dealing with new people.

What are your goals?
-I think this is a very good question not only relating to physicians but also to most jobs in general because one has to feel happy and both productive in a day to day basis. There has to be some sort of learning process when working on the job, and as an aspiring physician I want to become a better well-rounded person who can live with the satisfaction that I saved the lives of many. My end goal is to change the way people fight cancer and instill a fighting spirit in every patient that even the terminally ill can depart with a sense of victory.
What salary are you seeking?
-This is a big one for both the physicians and young aspiring physicians themselves. In order to live happily and serve patients with the upmost regard of respect and care, there has to be a line of certain values. Money can only satisfy so much of a person’s reward system. It may be good to earn lots of money because most doctors do, but the stress caused by being a physician can take its tolls; in the end, thinking of just money won’t make a happy doctor. There has to be pro-social aspects such as the actual satisfaction of helping and saving lives because that’s what I think all these years of hard studying, clinical rotations, and brutal residencies are meant for.
Full-time Oncologist at Elmhurst Hospital by Mount Sinai Icahn School of Medicine in Manhattan, New York http://www.monster.com/jobs/c-icahn-school-of-medicine-at-mount-sinai---mount-sinai-services-affiliates.aspx Full-time Psychiatrist at Queens Hospital Center in Jamaica, Queens http://jobview.monster.com/Psychiatrist-Job-Jamaica-NY-US-165629188.aspx?mescoid=2900468001001&jobPosition=3 Internal Medicine Physician at Company Confidential at Midtown Manhattan http://jobview.monster.com/Internal-Medicine-Family-Practice-Physician-Job-New-York-City-NY-US-166026473.aspx?mescoid=2900464001001&jobPosition=2 What is Anthropology?

Anthropology is the study of humans from the past of evolutionary times all the way to the present modern society. This includes the interaction of human individuals not just within small encounters, but also as groups and also through cross-cultural ties. This study can also help anthropologists teach us humans how we can solve universal problems without creating problems for others.

Humanities Education
Debates over the proper place of humanities, STEM (science, technology, engineering and math) and career-skills courses in education are not new. All three curriculum areas were discussed in one of Western philosophy's founding documents — the Greek philosopher Plato's masterwork, The Republic, written nearly 2,400 years ago. After two millennia of discussion, however, debates about the relative value of the big-three curriculum areas continue, as lively as ever.
In the West, the idea of formal schooling as the backbone of civilized society began with the Greeks, around the fifth century B.C. In The Republic, the philosopher describes the schooling that educated citizens of his ideal republic would receive in terms that echo through the history of higher education.27
After completing elementary school, young men of Plato's ideal republic's ruling classes would study mathematical reasoning in the form of arithmetic, geometry, astronomy and music (included because harmonious music is produced by strings whose lengths form precise, small-number mathematical ratios). These four subjects — the ancient Greek equivalent of STEM — “lead toward truth,” Plato observed through his literary mouthpiece and real-life teacher, Socrates.28
Nevertheless, the primary purpose of mathematics is as a stepping stone to a higher field of study — the arts of abstract reasoning and discussion, Plato said. Only these high-level and widely applicable skills — similar to the cornerstone humanities disciplines of philosophy and logic — would enable the republic's leaders to grasp “by thought alone the real nature of good itself,” he wrote.29
Specific career-oriented professional skills such as navigation, carpentry, architecture, farming and medicine also were to be taught in Plato's republic. However, no matter how highly trained such practical artisans became, they were barred from leadership roles. Those were reserved for upper-class men with philosophical training.
Other ancient Greek, as well as Roman, philosophers continued developing Plato's vision of what came to be known as the “liberal arts” curriculum — studies intended to develop broad skills vital to functioning as a free citizen, such as analyzing and debating public issues.
During the early Christian era, liberal arts study formed the core curriculum in schools established across Europe by monks and nuns. It included a three-part, skills-focused humanities portion — the so-called trivium of grammar, rhetoric and logic — and the four-part quadrivium of arithmetic, geometry, astronomy and music.
“Those to whom the system of the trivium has disclosed the significance of all words … do not need the help of a teacher … to understand the meaning of books and to find the solutions of questions,” wrote 12th-century English educator and bishop John of Salisbury. Cultivation of these broadly applicable intellectual disciplines was well in line with Christian practice, since reason is not only the mother of knowledge but of virtue, he declared.30
The term “humanities” — studia humanitatis, or “study of human things” — was first applied to thetrivium in 15th-century Italy, where scholars added a new element: reading Greek and Roman books in their original languages. Meanwhile, liberal arts study was still confined mainly to males in the ruling classes. Humanities study was deemed “unsuitable for women because it was intended to form the minds of civic and political leaders,” said Mary Ann Frese Witt, a professor emerita of foreign languages and literature at North Carolina State University in Raleigh.31
In the 17th and 18th centuries, colleges and schools sprang up in colonial America, with Harvard University established in 1636, Virginia's College of William and Mary in 1693, and others to follow. Struggling to survive, the young colleges generally admitted any boy who could pay tuition, and few stayed to graduate. When the College of Rhode Island — now Brown University — opened in 1765, it had one student; in 1767, it had 10. Yale, founded in 1701, had awarded 18 degrees by 1707.
These colleges “ratified and perpetuated an elite that would inherit positions of influence in communities,” wrote John Thelin, a professor at the University of Kentucky College of Education, in Lexington. At their core were the humanities, especially the skills of the trivium as applied to public speaking, a vital skill for both church and political leaders. A college education was not considered a prerequisite for professions such as law or medicine. In 1800 only about 0.6 percent of American males age 16 through 25 were in college.
Technology Rising
By the mid-19th century, “the argument was being made that the sciences will take us into the future,” says Caroline Winterer, a professor of history and director of the Humanities Center at Stanford University, in Palo Alto, Calif. “Suddenly the classics” — long considered the pinnacle of leadership education — “didn't seem so useful anymore.”
Colleges began adding humanities courses that promised more contemporary relevance, replacing the reading of Latin classics with study of literature originally written in English and other modern languages, for example.32 And in a bid to reassert their dominance, humanitiesscholars “began arguing that humanities serve a cause higher than utility because they address the soul,” says Winterer. This tactic played into the hands of science faculty, however, who were “happy to agree that humanities had no utility,” she quips.
The growing prestige of science also boosted what Plato had dubbed the practical arts — vocational studies — and spurred a new wave of college construction. The Cincinnati College of Agriculture opened in 1851. Planning for the Massachusetts Institute of Technology began the same year. Existing colleges added technical classes.
Meanwhile, skilled workers as well as medical and other professionals were leery about colleges moving into career-oriented education. They feared that college degrees — still generally available only to the rich — might eventually become a prerequisite for careers such as law, surveying, medicine and mechanical engineering and for career training that members of the professions and skilled trades had formerly handled themselves.
Related questions of whether post-secondary education should reinforce or help bypass barriers of class, wealth and race played into the post-Civil-War founding of colleges for freed blacks across the South. Established mainly by Northern philanthropists, these new colleges primarily turned out to be “segregated black institutes … whose curricula offered preparation for skilled crafts and trades,” wrote the University of Kentucky's Thelin. The anti-egalitarian result: “Black higher education was not preparing alumni for … fields associated with leadership and genuine power.”33
Business Influence
In the late 19th and early 20th centuries, American philanthropists poured huge sums into college and university coffers. Ironically, though, many industrialists donating the cash were neither college educated nor, it seems, terribly impressed with still mainly liberal-arts-focused colleges.
Said Clarence Birdseye, an inventor and the founder of the Birds Eye frozen-food brand: “Our colleges have become a part of the business and commercial machinery of our country, and must therefore be measured by somewhat the same standard.” But liberal-arts education, Birdseye groused, rendered most graduates unfit for business.34
Well into the 20th century, however, most American colleges offered broad liberal arts educationthrough survey courses and other classes aimed at acquainting freshman and sophomores, especially, with the basics of disciplines such as philosophy and history. Furthermore, U.S. elementary and secondary schools provided “a very good public education that belonged to everybody,” focused on humanities disciplines such as civics, history and grammar, says Matthew Santirocco, a professor of classics and senior vice provost for undergraduate academic affairs at New York University, in New York City.
The 20th century brought changes that diminished the dominance of liberal arts in college curricula.
Graduate school became a prerequisite for college teaching, and professors became specialists who preferred to teach their specialized research rather than more general subject matter. In fact, “graduate schools are antithetical to liberal education,” because they “reward narrowness, not breadth,” argued former Beloit College President Ferrall.35 |
Meanwhile, much as Birdseye may have hoped, colleges and universities took on more of the structure of businesses, employing more top- and mid-level managers such as vice presidents and deans, and filling their governing boards with business executives and financiers.
Over the past 40 years, governing boards dominated by CEOs and hedge-fund managers “with a bottom-line mentality” have “steadily but relentlessly” displaced faculty from decision-making, including about curriculum, says Jay of Loyola University Chicago.
In some cases, the bottom-line approach has clashed with support for liberal arts andhumanities. In early June 2012, the University of Virginia's (UVA) Board of Visitors, led by real estate developer Helen Dragas, abruptly ousted university President Teresa Sullivan, a sociologist. Sullivan was reinstated less than three weeks later after a high-profile revolt by faculty.36
In a May 2012 analysis, Sullivan had acknowledged that UVA's commitment to humanities and liberal arts education posed dilemmas. “Some … fields that bring us the greatest distinction are not those in which most people would today invest (e.g., Spanish, English, religious studies),” and hiring faculty can be difficult because while “every institution says that it prizes teaching, … the University really does,” she wrote. Rather than suggesting that the university jettison its priorities, however, Sullivan proposed ways to improve finances while maintaining UVA's commitment tohumanities and liberal arts, a plan that may have precipitated the board's initial decision to replace her.37
The conservative editorial board of the business-oriented Wall Street Journal accused the professors who fought to get Sullivan reinstated of trying to create an “academic Green Zone separated from economic reality.”38
Meanwhile, the past century has seen exponential expansion in the percentage of people seeking higher education, a trend that has boosted interest in a broad variety of majors, including career-oriented disciplines. In 1900, only one in 400 — 0.25 percent of Americans, primarily the economic elite — attended college.39 By 2011, 42 percent of 18- to 24-year-olds were enrolled in either a two- or four-year college.40
Changing Curricula
Given the pace of social change, it's little wonder that college curricula have changed over a century. Whether those changes constitute a crisis for humanities is less clear, however.
Some data do indicate a long-term decline in interest and support. So-called liberal arts colleges — which do not offer graduate degrees or career-oriented majors, have substantial humanitiesand other general-education requirements and feature small classes and high student engagement — have steadily declined in numbers, from 212 in 1990 to 130 in 2012.41
In addition, a prominent mid-1990s study found that during the 20th century, liberal arts requirements decreased substantially at 50 of the nation's most selective colleges. In 1914, for example, 76 percent of schools required at least one philosophy course, but in 1996 only 4 percent did. And while 90 percent of the schools had a foreign language requirement in 1964, only 64 percent did by 1993.42
Nevertheless, “the data are mixed. We don't know that it merits being called a ‘crisis,’” says Santirocco of New York University. For one thing, over the past two decades, many schools have recommitted themselves to “robust core” and “humanities-infused” curricula, he says.
In 2005, for example, the American Association of Colleges and Universities (AACU) launched its Liberal Education for American Progress (LEAP) initiative to challenge the practice “of providing liberal education to some students and narrow training to others.” To date, nine state college systems and some 340 schools have joined the initiative to offer broad-based liberal arts-style intellectual training to all students, the AACU says.43
Today, while the percentage of students majoring in humanities has dropped, it remains close to the average level of the past 65 years or so.44 Furthermore, because the number of Americans earning college degrees soared over the same period, the proportion of the population withhumanities degrees has remained about the same, even after the collapse of the temporary bubble in humanities majors that occurred in the late 1960s, according to journalist and statistical analyst Nate Silver, of the Five Thirty Eight blog.
In 1971, only 26.7 percent of 21-year-olds earned bachelor's degrees, while by 2011 43.4 percent did. Thus, even though the percentage of graduates who were English majors, for example, dropped from a high of 7.6 percent to 3.1 percent, the percentage of the U.S. population holding English degrees remained close to the same level it was in the bubble years, Silver said.

The message of the article is to reveal that the humanities field in colleges is a dying art and that something needs to be done about it. The reason for this lack of emphasis on sociology, history, and yes, anthropology, is that people are more inclined for career-oriented majors and to save tuition money. It makes sense, as our fragile economy continues to waver while our schools become super expensive. It makes the parents and students think: aren’t we wasting our time if we spend on useless liberal arts majors? But on the other hand, a point is made in which our very essence of education is being deprived if we continue to look down upon such foundations of schooling that include math, science, and the liberal arts. By taking this away, our cognition of creativity starts to disintegrate also. In a time where our society has been so improved through so much innovation and creativity, we are going to eventually enter a black hole of stagnation because instead of looking for purpose and reasoning, we will only rely on numbers and facts. If Y2K did happen, the technology-reliant human race will lose all order. This is an interesting article because it helps me appreciate classes such as this one more (FCIQ) and that we shouldn’t just focus solely on technology and career based knowledge.

What is sociology?

Sociology is the study of human relationships. Personally, I think sociology is really important because it is very diverse since humans have a wide range of emotions and mental capabilities. As we become more complicated regarding our activities, development, and our accomplishments in society, we need to become much more aware of such humanistic relationships. By studying sociology we will be better at communicating with each other and be able to create large mutual networks that expedite the success of humanity.

A Developmental Model of Ethno sensitivity in Family Practice Training

Family physicians are one of the first medical professionals the public contact when concerned about their health care. As most societies in North America have a diverse cultural population, the patient walking into the doctor's office could be from any number of ethnic backgrounds. Research in the United States, Canada, United Kingdom, and New Zealand has shown that the visible minority population receives a lower standard of health care than that of the western Caucasian population. Borkan and Neher ask why that is the case and what can be done from a family physician's training point of view.
Language barriers, spiritual beliefs, cultural differences, income, residential situation and location, are all cited as being challenges to receiving appropriate medical care. Borkan and Neher assert that cross-cultural medicine is a natural and important part of family practice.
It is not possible to anticipate every cultural exposure a physician will incur during the life of his or her practice. …

This very interesting article matches perfectly with my career path in life. This article also touches well not only with my FCIQ class and BS/DO major but also with my Psychology class. We recently learned about the cross-cultural psychology subfield and how it is important when it comes to approaching patients and communicating with their ethno cultural values. The alarming message revealed here is that ethno sensitivity and cross cultural medicine is not being appreciated enough in the world of family medicine. Medical schools, although trying to achieve some type of ethno cultural exposure, fails to uphold the importance of cross-cultural communication. Western medicine especially adheres to traditional methods and shames itself away from unorthodox methods such as patient’s experience of the illness and bio psychological model. What amazes me is that Osteopathic doctors on the other hand, are taught very well in this aspect of “whole-some treatment” and are veterans to various approaches such as cross-cultural ones. Osteopathic doctors are somewhat capable of accepting a large standard of traditions and are educated to keep an open mind at all times, which simultaneously reinforces the skill of doctor-patient communication. Lastly, the best part about having a great exposure to cross cultural medicine and overall ethno sensitivity is learning more about human relationships and surprisingly creating an introspection towards oneself and uplift a sense of humility and shame which create more humanistic factors that turn a doctor into a patient’s friend.

What is psychology?
Psychology is the scientific study of the human processes in the mind. It is a very interesting study because the mind has the capability to store immeasurable amounts of memory, evoke different ranges of emotions, and ignite the creativity that drives our innovations and inventions in society. There are also many subfields of psychology that include but are not limited to: clinical, cognitive, developmental, experimental, and social psych. An example of clinical psych would be the analysis of clinical depression and bipolar disorders in mentally ill patients. These psychologists and psychiatrists study to help alleviate such symptoms or try to cure entirely. An example of cognitive psych relates to human processing, memory, and thinking. What relates to this is a vague yet exciting field in discovering how humans perceive reality and feel like independent selves. Lastly, an example of social psych varies largely from small person to person interactions to big group experiments such as a large-scale survey that targets the entire human population. Getting large statistical data helps greatly with companies and corporations that want to know about the buyers’ consumption and behavior. The two opposing motivations that drive how much people cheat or steal is the fact that they are aware of their morals as to not become too extreme in their misdeeds but also be able to win as much as they can for what they are doing without getting caught. This paradox is extremely detrimental to our human society and values because the majority of our population thinks they can get away with something by doing a little of it but since this is the case, a large-scale minimal cheating becomes a much bigger problem that some outlier who cheats at an extreme and obvious case.
TREATING ADHD
The total number of drug prescriptions written for U.S. children and teens has dropped for the past several years, but the rate of ADHD prescriptions continues to climb, according to the Food and Drug Administration.
ADHD prescriptions rose 46 percent between 2002 and 2010 (the latest year examined), the second-highest increase of any category. Contraceptive prescriptions increased 93 percent, while prescriptions for antibiotics and some cough medicines dropped, after new medical guidelines recommended limiting their use.44
Driving the increase in ADHD prescriptions has been a steady rise in the number of young people under age 18 diagnosed with the disorder. It grew 66 percent between 2000 and 2010, according to a study this year by researchers at Northwestern University. By 2010, doctors had diagnosed 10.4 million U.S. children and teens, up from 6.2 million in 2000, according to the analysis.45 (The number of Americans ages 5 through 17 — the prime ages for an ADHD diagnosis — hovered between 53 and 54 million in both years.)46
“The magnitude and speed of this shift in one decade is likely due to an increased awareness of ADHD,” said study author Craig Garfield, an assistant professor of pediatrics at the Northwestern University Feinberg School of Medicine.47
Changing Policies
Late last year, the American Academy of Pediatrics expanded its ADHD diagnosis guidelines to cover children and teens from ages 4 to 18; earlier guidelines had covered only children between 6 and 12. New medical findings about ADHD make it possible to diagnose and treat the broader group, says the academy.
“Treating children at a young age” may “increase their chances of succeeding in school,” said Mark Wolraich, lead author of the guidelines and a researcher on neural development at the University of Oklahoma Health Sciences Center, in Oklahoma City.48
As for teens, “it's been known for a while” that stopping ADHD drugs at puberty — as recommended in the past — “was a mistake” and that attention problems, in particular, still plague teenagers, says the University of Illinois' Stein.
In the past year, the supply of several ADHD drugs has fallen short of demand. Besides the growing legitimate market, demand is swelling for stimulants as performance enhancers or recreational drugs. Because stimulants are “controlled substances,” the Drug Enforcement Agency (DEA) caps the amount that companies can produce, and the combined legitimate and illegal demand has outstripped supply.49
“The DEA is tasked with making sure there is enough for legitimate need without making so much [that] it is diverted for illicit purposes,” said agency spokesperson Barbara Carreno. This year, DEA has raised the cap for methylphenidate, the basis for such drugs as Ritalin and Concerta, from 50,000 to 56,000 kilograms per year and the cap for amphetamine, used in drugs such as Adderall, from 18,600 to 25,300 kilograms per year.50
Meanwhile, implementing school procedures that assist both ADHD students and their teachers continues to be difficult.
Federal legislation is pending to limit schools' leeway in using physical restraints and seclusion to control students, often those with ADHD-related traits. The bills — sponsored by Sen. Tom Harkin, D-Iowa, and Rep. George Miller, D-Calif. — would prohibit schools that receive federal funds from physically restraining a student unless the behavior poses immediate physical harm to the student or others. Restraints can be used only if they allow the student to communicate, and if other means of controlling the behavior have been tried and failed.51
Many advocates for the disabled support the bills, but schools are leery. The legislation proposes “an extremely high threshold” that schools must meet before restraints are allowed, said the National School Boards Association. For example, a student whose behavior threatens “to destroy a classroom” — a costly consequence — would not be eligible for restraint under the bills as currently drafted, the group said.52
A recent study by the Chicago Tribune points to serious inequities between schools in high- and low-income neighborhoods when it comes to making accommodations to help ADHD sufferers and other disabled students. Federal law authorizes schools to make certain adjustments — such as allowing seating in the front of the classroom or providing more time to take tests — to create a level playing field for all students. However, the Tribune found that Illinois students who live in higher-income districts got the lion's share of such help.53
Statewide, only about 1 percent of public-school students had accommodations in the 2009–2010 school year, according to the paper. But in some wealthy districts near Chicago, 4 to 5 percent of students got accommodations. The 20 school districts with the highest percentages of students with accommodations had student bodies that were 76 percent white and poverty rates well below the state average of 45 percent; the 20 districts with the fewest accommodations were 19 percent white, and the “vast majority had far higher poverty than the state average,” theTribune reported.

In this article, we learn about a certain common mental disorder called ADHD. One of the most prevalent mental illnesses in the US, ADHD affects about one in ten children ages four to 17. This relates greatly to psychology and my major as a BS/DO because the future of psychiatric medicine depends on common disorders like ADHD, which vary in diagnoses and require powerful drugs such as Adderall. We need to be aware of long-term consequences that these amphetamine drugs can have on developing children and adults who are diagnosed with such cases, because it proves to be more ultimately detrimental than alleviating. In other cases, there are times when adults and children do not need such powerful prescriptions because their cases are minimal and comfortable to live with. As an aspiring physician, my goal is to uphold the patient’s mental states and to diagnose patients who need or don’t need such powerful drugs. All in all, the patient’s mental status is just as important, if not more, than their physical status.

What is Political Science?

Political science is the study of governments and more specifically, the way in which human societies can possibly run at the upmost efficiency. In other words, humans use political science to discover the most efficient way of running a productive society. We study political science because it makes us more aware of our surroundings and the way people act towards each other. Unlike philosophy and sociology, political science takes into account the respect of higher authority, power, and social equality. Without a balance in this, there will only be jealousy and through jealousy the roots of hate and anger will grow. With balance, people can prosper together and live harmoniously. Political science is very important when it comes to determining a social and political structure of a group of people. For example, we can study the Rwandan genocide as a sort of political collapse because of ethnic tensions that arose when one group wanted more power than the other. In order to avoid savage atrocities like these, political science needs to be studied well and applied in government policies to prevent such events from ever happening again.
Reforming Veterans Health Care
Current Situation
Reforms Unveiled
The Department of Veterans Affairs is entering the first stage of a reorganization designed to avoid repeating recent scandals by focusing on and listening to the veterans it serves. Secretary McDonald unveiled the effort on Nov. 10 and said it was informed by his summer and fall travels to meet with veterans, employees and others associated with the department.
In addition to creating the post of chief customer-service officer “to drive VA culture and practices to understand and respond to the expectations of our veteran customers,” McDonald announced plans to: * Simplify the VA's structure so veterans have a single point of contact. * Implement management reforms to improve efficiency, such as by having VA components share internal services. * Establish “community veteran advisory councils” to coordinate with state and local organizations that also serve veterans. * Create an online suggestion box — called My VA Idea House — by which employees can offer suggestions and vote on one another's ideas.64
“Please keep in mind that this is a long-term process and we are just beginning to plan how this will all unfold,” McDonald said.65 But he vowed that “we will deliver.”66
The announcement was greeted with support and skepticism.
“We think it is a good step forward, but it is only one of a marathon of steps that are going to be required to turn this around,” said Paul Rieckhoff, founder and chief executive of Iraq and Afghanistan Veterans of America. “Having a plan is easy in Washington; executing that plan is hard. We'll see over the next few years if he can make it happen.”
Garry J. Augustine, Washington executive director of the Disabled American Veterans, praised McDonald's plan to simplify the department's bureaucracy. “In the old system, there were a lot of layers, and one concern was that none of the bad news got up to the secretary because of all those layers,” he said.
House Veterans' Affairs Committee Chairman Miller says McDonald isn't firing people fast enough. “New plans, initiatives and organizational structures are all well and good, but they will not produce their intended results until VA rids itself of the employees who have shaken veterans' trust in the system,” he said. “So far VA hasn't done that.”67
Others complained the department has been too slow to wield the enhanced firing powers contained in the reform law passed last summer. For instance, Sen. John McCain and Rep. Jeff Flake, both Arizona Republicans, jointly charged that the new provisions are “being ignored.”68
The department said it has proposed disciplinary action against more than 40 employees.69Plus, “well over 1,000” employees face investigations that could lead to sanctions that range from admonishment to termination, according to McDonald.70 And the FBI, Justice Department and U.S. Office of Special Counsel are conducting about 100 investigations that could lead to criminal charges.71
The first to be fired under the new procedures was James Talton. The department announced in late October that it had ended his tenure as director of the Central Alabama Veterans Health Care System, which had been plagued by fraudulent appointment records, unread X-rays and even an employee helping a patient buy crack cocaine. Earlier, the department announced termination proceedings against Cliff Robinson, Talton's chief of staff, hailing the action as evidence of the department's “commitment to hold leaders accountable.”
Besides Talton's dismissal, the department announced on Oct. 6 that it planned to fire three other executives for misconduct or failing to manage their facilities effectively.72 But two — Susan Taylor, deputy chief of procurement for the Veterans Health Administration, and John Goldman, director of the VA medical center in Dublin, Ga., — retired before they could be fired. Taylor was accused, among other things, of improperly steering VA business to her lover. Goldman was accused of allowing employees to produce fraudulent records showing inaccurate wait times for appointments.73
Terry Gerigk Wolf — director of the Pittsburgh VA Health Care System, where Legionnaires' disease killed at least six patients and sickened 16 others between February 2011 and November 2012 — was fired Nov. 13 after being given extra time to argue why she should not be dismissed.74
VA spokeswoman Kerry Meeker pointed out that “federal employees, including VA senior executives, are entitled to a meaningful opportunity to reply to the charges and evidence supporting a proposed removal.”75
“We are as impatient as you are,” McDonald said. “But while investigations are going on, we are not allowed to take definitive action.”76
He also defended allowing executives to retire before they're fired. “It's very common in the private sector,” he said. “When I was head of Procter & Gamble, it happened all the time, and it's not a bad thing — it saves us time and rules out the possibility that these people could win an appeal and stick around.”77
McDonald's record at P&G — a giant global business with annual sales of $83 billion, 127,000 employees and 300 brands sold in more than 180 countries — has been cited as a qualification for running the VA and as a liability.78
“His management skills as a former CEO make him a good fit to run the department, which has been plagued by mismanagement for years,” Miller said when McDonald was appointed.”
“With the big business mindset,” Iraq and Afghanistan Veterans' Hansman says, “hopefully he can bring some quality and timeliness changes to the VA and operate it more like a business than a bureaucracy.”
However, McDonald's lack of health care and government experience drew criticism from others. The New America Foundation's Longman, for instance, described McDonald as “a Republican soap and toothpaste salesman — a man with no experience whatsoever in running a health care or social services organization.”
In addition, McDonald left P&G amid criticisms similar to those leveled recently at the VA: He moved too slowly to solve problems in a company with a “convoluted” organizational structure, said hedge fund executive William Ackman, who owned 29 million shares of P&G stock. McDonald's supporters said recalcitrant managers and a complacent corporate culture did him in — similar to what he could face within the VA bureaucracy and from members of Congress.79
Progress So Far
A few days before announcing its reorganization plans, the VA released a report about progress it already had made addressing the shortcomings revealed by the scandals.80 Among other things, the VA said it had: * Kept its clinics open longer. * Solicited comments from veterans and the public at town hall meetings in every medical center and benefits office. The meetings will be repeated every three months.81 * Completed 1.2 million more appointments in July through October than in the same period in 2013. * Made 98 percent of appointments within 30 days of either the date the patient requested or the date a VA provider said was “clinically appropriate.”
The 30-day period is a new standard adopted after an audit determined that the previous two-week goal was unrealistic. The VA will pay for private care to keep a veteran from waiting longer. VA employees Kristen Ruell and Ronald Robinson and fired worker Javier Soto, right, told a House hearing on July 14, 2014, about reprisals against them after they reported mismanagement at VA facilities. The VA is now moving to protect such whistleblowers, and the department has reached settlements with three, two of whom were promoted. (Getty Images/Chip Somodevilla) |
Undersecretary Clancy says what's important is that the wait meet the patient's needs and expectations, rather than the specific number of days. “If I'm worried and extremely anxious [the need] might be today or in the next day or two,” she explains. “If it's just some checkup that I've got to get sometime, all I need is a predictable date.”
The VA has steadily reduced wait times for new patients' first primary-care appointments — the heart of the appointment scandals — from an average of 51.23 days in mid-May to 42.08 days on Sept. 1. However, the Sept. 1 waits differed widely at individual facilities, from 82.89 days in Fayetteville, N.C., to 15.66 in Bedford, Mass. Waits for existing patients increased during that time period, but they were low to begin with — averaging 3.56 days in May and 5.83 in September.82
By comparison, a 15-city survey last year found average waits of 19.5 days for first appointments with private family physicians. The survey, by Merritt Hawkins, a Texas-headquartered consulting firm that recruits health care personnel, also found a wide range of wait times to see a family physician, from 66 days in Boston to five in Dallas.83
The department is moving to protect whistleblowers attempting to reveal VA problems. In October the U.S. Office of Special Counsel certified the VA's whistleblower protection program. And the department reached settlements with three whistleblowers, two of whom were promoted, underscoring McDonald's pledge to encourage and reward those who call attention to shortcomings.

My article name is Reforming Veterans’ Health Care. This article describes the current state of health care system right now and how it pertains to the benefits of veterans nationwide. Robert McDonald, the head of the Department of Veteran Affairs, is seeking to make changes in the way veterans are currently being treated. In our political system where American veterans should be treated with the highest honor and a privilege to health care benefits and prestige appointment scheduling, there are still thousands of veterans who are not receiving their benefits because of the severe shortage of health care professionals. In addition, the government pay for such health care professionals are statistically lower than those for private patients since these health providers must serve every veteran regardless of his or her health care plan. As someone who plans to be a health care provider myself, I must be aware of the government shortage of health care providers and the need for service of veterans who risked their lives. On the other hand, I must also serve the general public who may be willing to pay more than the government-protected veterans. In regards to political science, it comes down to serving those who we should respect or to gain much more money. At our proud and patriotic society, we have to balance working for our customers and those who preserve our government, freedoms, and general way of life.

What is Economics?
Economics is the study of the entire market system which includes consumption, production, and the transaction of goods and services. Economics are broken down into two different subjects: macroeconomics and microeconomics. Macroeconomics relates to the study of the market at a grand-scale such as the national market and the Stock Market. Microeconomics, on the other hand is a study based on individual behavior of consumers and producers. One of the famous schools of teaching are Keynesian that describes different outcomes of economy turns. An amenity is a property that its features can be used to greatly increase its value. Diversity is the act of diversifying one’s spending and investments to buffer losses. Human capital is the stock of human value that provides valuable application of knowledge and labor. High-technology industry is the increase in efficiency of products with use of high-tech devices. We study economics because it teaches us to be more communicative with each other and help build society up. By studying economics and creating smart transactions, we are able to build our resources, create connections, and accomplish our goals. Goals don’t need to be financial just because it is economics because if affects other studies in complex ways that are both direct and indirect. It helps us survive, it helps us thrive. Economics is important because it builds upon human connections and moves toward a more complicated level of complex connectivity. One example is controlling taxes for a general population.

Marijuana Industry
Legal Issues
Colorado, as the nation's leader in legalizing recreational use, is now a legal battleground between the cannabis industry and those who would halt, restrict or even reverse its growth. The future of the legal marijuana industry could hinge on the outcome of several suits challenging a state's right to enact a law that conflicts with federal law.
In a case pending before the U.S. Supreme Court, Nebraska and Oklahoma, which do not allow recreational marijuana use, have asked the justices to invalidate Colorado's legalization. Colorado marijuana crosses into Nebraska and Oklahoma, the lawsuit argues, straining their police and judicial resources and undermining their own marijuana-control efforts.74
“If our law gets killed, the black market will be back and the Sinaloans [a Mexican drug cartel] will be back in business,” says Colorado Sheriff Masters. “I think the other states need to pass some reasonable legislation, and that way they'll torpedo this problem.”
In a case filed in Colorado federal district court in March, six Colorado sheriffs are suing to strike down Colorado's marijuana statutes, saying the discrepancy between federal and state laws causes the sheriffs to violate their oath of office, which requires them to uphold both state and federal laws. Six plaintiffs from neighboring Kansas and Nebraska joined the suit on the grounds that Colorado's marijuana laws placed extra stress on their law enforcement resources, causing them “direct and significant harm.”75
But Masters says the right to possess and sell marijuana “is part of the Colorado constitution. I'm bound to uphold the constitution, and I have to protect those constitutional rights.” The high court has not yet agreed to hear the case.
And the Safe Streets Alliance, a Washington, D.C.-based organization opposed to marijuanalegalization, has filed two suits in Colorado federal district court claiming that Colorado's legalization violates the U.S. Constitution's “supremacy clause,” which holds that federal law supersedes state law.76 The court has not yet ruled on whether it will hear the cases.
The disparity between state and federal laws creates “a very awkward problem,” says Stuart Taylor, a Washington, D.C-area journalist and author and a nonresident senior fellow at the Brookings Institution think tank. “The conflict between federal and state law means that any state that legalizes [marijuana] is in violation of federal law,” Taylor says. “It looks like a form of lawlessness.
“The feds don't have nearly enough people in the DEA or related positions to enforce federal law rigorously everywhere all the time,” he says. “If they take down the [state-] regulated marijuanabusinesses, it leaves the entire [illegal] market much harder to control and more likely to lead to all the problems that the federal law is designed to prevent — transport across state lines, distribution to minors, stuff with dangerous concentrations of THC — all the things the state regulations are designed to prevent.”
Cannabis Business
Despite marijuana's legal uncertainties, the industry is beginning to attract big money. Kris Krane, a co-founder and managing partner of 4Front Advisors, a cannabis industry consulting firm in Phoenix, says startup costs vary from state to state but can be daunting.
In New York, which legalized medical marijuana in 2014 and awarded its first business licenses on July 31, 2015, “groups were spending on average a million and a half dollars or so just to get through the licensing process,” says Krane. Getting the business up and running, he says, could cost “upwards of $25 or $30 million.”
That's partly because in New York, a dispensary must grow and process the marijuana it sells. And each licensee — the state has granted five so far — must operate four dispensaries.77“There are only going to be 20 stores in a state of 20 million people,” Krane says. “The capacity … to meet demand has to be really large.”
Although New York is “a bit of an outlier,” Krane says, “it's hard to start an operation in any state for under a million dollars.”
Some predict large companies, particularly in the tobacco industry, will enter the cannabis market. Researchers from the University of California, San Francisco, and Finland's University of Helsinki reviewed archived tobacco industry documents which revealed that since 1970 three multinational companies — Philip Morris, Brown & Williamson, and RJ Reynolds — have all considered manufacturing cigarettes containing cannabis. “The documents demonstrate the tobacco industry's willingness and preparedness to enter legalized marijuana markets, which the companies believed to have a large sales potential,” the researchers said.78
Spokespersons for Altria Group, which manufactures Philip Morris cigarettes and other tobacco products, and Reynolds American (Camel, Pall Mall and other brands), say their companies are not planning to enter the commercial marijuana market. “Marijuana remains illegal under federal law, and Altria's companies have no plans to sell marijuana-based products,” says Altria spokesman Jeff Caldwell.
But some legalization advocates are skeptical. “My concern is the Marlboro-ization or Budweiser-ization of marijuana,” said Ethan Nadelmann, executive director of the pro-legalization Drug Policy Alliance. “That's not what I'm fighting for.”79
Shenandoah University's Gettman says, “Certainly, the tobacco industry knows how to take a plant, turn it into cigarettes and sell it to people.” But there are many differences betweenmarijuana and tobacco, he says. For instance, modern cigarettes contain “all sorts of additives and flavors,” while “I can go out in my backyard, grow a marijuana plant, dry the flowers and smoke that product, and be quite happy with it.”
The ease of producing marijuana plants means the market will be very competitive, he says. “The idea of six or seven firms collectively controlling the entire industry — that's going to be hard to do.”
Retailer Ode of the Seattle Cannabis Co. isn't bothered either way. “I don't anticipate that big tobacco moving in would have a huge advantage,” he says. “But if they offered a good product at a good price, I'd love to have them in the store.”
2016 Elections
The outcome of upcoming elections could determine whether the legal marijuana market continues its robust growth — or whether the market may already have peaked.
Ohioans vote Nov. 3 on an amendment to the state constitution that would legalize both recreational and medical marijuana. If it succeeds, it would mark the first time a state will have legalized recreational marijuana without first establishing a medical marijuana program.80
In 15 states legalization advocates are organizing petitions to put initiatives on next year's ballot on whether recreational use of marijuana should be legal. As of September, only Nevada had put the question on the 2016 ballot.81 But legalization advocates are confident more states will vote on the issue in November 2016, and that at least five may choose to end prohibition. Journalist Philip Smith wrote that public opinion surveys in Arizona, California, Massachusetts, Michigan and Nevada show a majority of those polled favoring legalization, and in 2013 a survey in Maine had a pro-legalization plurality of 48 percent to 39 percent.82
Paul Armentano, deputy director of the pro-legalization National Organization for the Reform ofMarijuana Laws (NORML), says if California votes to legalize recreational marijuana next year, “It would be regulating and legalizing the largest market in the country for cannabis production, use and sale.”83 In addition, he says, “California often sets a trend for the rest of the country and for national politics and voter sentiment in general,” so passage of legalization or regulation in California “would be a harbinger of national changes in the fairly immediate future.”
A March poll by the Public Policy Institute of California showed 55 percent of likely California voters support legalization, but Republican political consultant Rob Stutzman said, “I don't think it's a slam dunk to pass. There's a lot of opposition to it. There will be a lot of concern about unintended consequences.”84
Bipartisan measures are pending in Congress that would affect the future of the industry. In the Senate, the CARERS Act, sponsored by Sen. Cory Booker, D-N.J., would downgrade marijuanafrom a Schedule I to a Schedule II drug, acknowledging that it has an accepted “medical use” or a “medical use with severe restrictions.”85 It would end enforcement of federal marijuana laws in jurisdictions where it is legal and allow banks to provide services to legitimate marijuana-related businesses.86 A companion bill, introduced by Reps. Steve Cohen, D-Tenn., and Don Young, R-Alaska, has bipartisan co-sponsorship in the House.
GovTrack.us, which follows legislation through Congress, has given the bills almost no chance of passage during this Congress. Michael Correia, director of government relations for the National Cannabis Industry Association, says members of Congress represent their own state interests, and if legalization is not happening in their state, it's harder for them to get involved. But as more states legalize recreational use of the drug, he says, it will get on the “radar screens” of more members of Congress.
However, congressional approval is not required to reschedule marijuana under the CSA. If the administration wanted to push for rescheduling, the attorney general, in conjunction with the DEA and the Department of Health and Human Services, could change the drug's schedule or even remove it from CSA scheduling altogether. However, the “notoriously cumbersome procedure” would require “months if not years of formal hearings,” said Vanderbilt University law professor Robert Mikos, and it would not affect the laws in states where marijuana is still illegal.87
Nationwide, a Harris poll in May found that 81 percent of American adults favor legalizing medicalmarijuana in their home states, while 49 percent support legalizing it for recreational use.88
As for the 2016 presidential election, Rep. Blumenauer says, “I don't think there's any question” but that marijuana legalization will be a factor. “This is … being considered across the country, and when you get into the home stretch of the 2016 election, it's not going to be something that [candidates] will be able to ignore,” he says. “They're either going to be for it or against it, or they're going to look like they're waffling.”
But Sabet of Smart Approaches to Marijuana says legalizing marijuana “is “one of those issues candidates don't want to talk about. I think they're on the fence about where they want to go,” but they are also aware of public opinion on the issue.
Hudak at Brookings said legalization will “absolutely” be an issue in 2016 because “states are very blatantly violating federal law, and it is an absolute presidential consideration about what to do about this. It's an issue that candidates won't be able to be silent about.
“But the question is not just about marijuana,” Hudak continues. “It is about public policy experimentation; states' rights; small business; medical marijuana and health care; privacy; and access to medicine. A 2016 candidate's views on marijuana are part of a broader public policy worldview or set of values that really reveals who that candidate is.”

This is quite an interesting article because the national rage with marijuana creates a whole lot of revenue for the government. Since it has become legalized and used for “medicinal use” for over 25 states, profound knowledge on the dry herb still is unfound. As an aspiring physician, although we may provide prescriptions for medical marijuana and THC for future patients dealing with cancer and all other illnesses, we have to be careful and acknowledge the fact that we still don’t know everything about marijuana regarding its long-term effects. This article relates well to the economics being studied because as a drug, marijuana is gaining considerable attention and forces doctors to take into account giving out medical licenses and prescriptions to patients who may or may not abuse the drug. Abusing on this highly profitable drug is bound to set up bigger consequences such as marijuana production companies to fit the demands of the consumers, some who may not even need the drug and abuse its recreation. As a doctor, I want to be fully sure I am not giving away wrong diagnosis and increase the consumption of marijuana just for the sake of it and drastically support the expediting economy in marijuana sales. It’s easy to just prescribe a drug to someone, it’s another when the drug becomes used recreationally throughout the entire nation.

What is History?
History can be defined in many ways; but most importantly, it describes the study of the collective memory. What this means is that we are studying the knowledge, ideas, ventures, attempts, failures, and accomplishments provided to us by the passage of the human mind onto script and oral telling. Collectively, the accounts of what happened during that time period provide profound wisdom that provides our dying curiosity of questions like: how did we get here? How did we become this? We study history because we want to be more aware of our surroundings and in addition, to become more creative. History accounts of attempts and failures help us save time because they provide the insight and actual situation of whatever choices we make which include good ones, bad ones, and horrible ones like the Jewish Genocide. We use history to make good events happen and not repeat bad ones, so it forces us to become creative in a new light. A rich history lets us become more creative by being better, and never going backwards. Historians like to study through the eyes, ears, and mouths of the primary accounts of that time period. By relying on first-hand perspectives, they are able to immerse themselves in the history of those before them.

Doctor Shortage
At his medical office in Milford, Neb., American Academy of Family Physicians president Wergin works with a physician assistant. There are eight other doctors in his group practice, who work at two other locations in the area. Together, they reflect several trends in 21st-century American medicine that are helping the country address current and projected physician shortages.
Wergin and most of his colleagues earned their medical degrees or served their residencies — or both — in Nebraska. When they recruit other doctors and physician assistants into their practice, they find their most promising prospects grew up in small towns or rural areas.
Scholars and health care executives are seeking to reduce doctor shortages in underserved areas by increasing medical school slots and residencies in those areas. They are encouraging residents of underserved areas to take up health care careers. And they are seeking efficiencies through group practices like Wergin's. In another reflection of a contemporary trend, Wergin and his colleagues are employed by Seward's Memorial Hospital, which owns their practice.
Federal lawmakers in both chambers introduced legislation this year to increase the number of Medicare-funded residencies by 3,000 annually from 2017 to 2021 — thus supporting 42,000 residencies a year starting in 2021. Introduced by Democratic Sen. Bill Nelson of Florida and Democratic Rep. Joseph Crowley of New York, the bills give preference to residencies in states with physician shortages and to residents training in disciplines that are in short supply, such as primary-care and general surgery.83
Nevada, for instance, has enough residencies to accommodate only 15 percent of the state's medical school graduates, said Dr. Mitchell Forman, founding dean of the Touro University Nevada College of Osteopathic Medicine. “The majority of graduates … leave the state, never to return here to practice.”84
The primary cause of the shortage of residency slots is the growth in the number of medical students in Nevada, coupled with the Medicare freeze, says Shelley Berkley, the university's CEO and senior provost. Federal funds tend to go to the hospitals that have traditionally received residency funds. It's not just the number of residencies but the type, Berkley adds. “If you want to specialize in cardiology and there's no cardiology residency, you have to leave,” she says.
The Nevada Legislature this year allocated $10 million in state funds to increase support for residencies, she says.
Residencies based in community clinics and health centers in underserved areas — called “teaching health centers” — are among the most promising efforts to channel primary-care physicians to where they're most needed, wrote Dr. Barbara Ross-Lee, vice president for health sciences and medical affairs at the New York Institute of Technology.85 Residencies in traditional teaching hospitals — the vast majority — do not prepare physicians for outpatient primary care in underserved communities, she said. But teaching health centers do, by placing residents under the tutelage of primary-care doctors. Similarly, she said, osteopathic schools have created partnerships with smaller hospitals, community health centers and ambulatory clinics to give residents “real-world experience.”
Eight of 10 residents in teaching health centers practice within 40 miles of where they trained, Wergin says. Ross-Lee also pointed out that 40 percent of osteopathic residents enter primary-care practice, compared with 30 percent of residents in more traditional programs.86
States are seeking to address residency shortages by increasing medical school slots and targeting them to students likely to remain in the state to practice. The Utah State Legislature, for instance, funded 40 additional slots at the University of Utah Medical School, which admitted the largest class in its history this year. Admission preference is given to Utah residents who commit to practicing in rural areas.87
In Minnesota, state legislators in May increased University of Minnesota Medical School spending by $30 million over the next two years to fund more teachers and students and beef up the school's Rural Physician Associate Program, which supports rural internships for third-year students, half of whom go on to practice in rural areas.88 Lawmakers also expanded a loan forgiveness program for health care workers who practice for two to four years in rural and other underserved areas. Of doctors receiving the assistance since 1991, three-quarters still practice in rural areas. A majority of dentists and nurses also stayed beyond their initial commitments.89
The Washington State Legislature this year restored similar loan assistance, which had been cut substantially in 2011.90
In western New York, doctors themselves are moving to deal with shortages by funding scholarships to the University at Buffalo School of Medicine and Biological Sciences. Recipients must graduate from high school in western New York and pledge to practice there.91
Health care professionals are volunteering to fill gaps in isolated communities and other underserved places. Remote Area Medical — founded in 1985 by Stan Brock, onetime host of the “Wild Kingdom” television nature show — operates free clinics in the United States and around the world. Volunteer health care workers, supported by other volunteers, provide medical, dental, vision and preventive care, as well as health education.92
Increasing Diversity
Medical schools are trying to recruit more diverse student bodies, because doctors with rural, minority or disadvantaged backgrounds are most likely to practice in underserved areas.
Students whose families are in the highest socioeconomic bracket have made up an increasingly large proportion of medical school matriculates, said Dr. Scott Shipman, director of primary-care affairs and workforce analysis at the Association of American Medical Colleges.93
Only about 9 percent of U.S. physicians are minorities, including 5 percent who are black. Blacks represent only 7 percent of medical school students.94
Medical schools and health care-related organizations such as the AMA award scholarships to minority students to study medicine. Other programs recruit and support minority and economically disadvantaged students even before they enter college.
A dozen medical and dental schools participate in the free Summer Medical and Dental Education Program, for instance. Sponsored by the Association of American Medical Colleges, it offers six weeks of preparation for medical and dental school to college freshmen and sophomores, primarily with rural, minority or disadvantaged backgrounds.95
Since 1979, the state-sponsored Chicago Area Health and Medical Careers Program has recruited almost 5,000 middle- and high-school students — mostly minorities — into premedical studies and then supported them throughout their education and into their careers. The students are steered into rigorous science and math classes and paired with professional mentors who counsel them for years.96
A Minnesota initiative addresses another underrepresented group — foreign-educated doctors who are not credentialed to practice in the United States. Recent legislation gave the state health department $1 million to explore ways of moving them into the health care workforce.97
While the initiative might fill a U.S. health need, some physicians and scholars warn it may harm health care overseas. “It wouldn't be good to take needed doctors from other countries and leave those countries in a worse shortage,” family physician Wergin says.
Increasing Efficiency
The federal government and big insurers are seeking to make medicine more efficient by changing how health care providers are compensated. U.S. medical care traditionally has been reimbursed on a “fee-for-service” basis, which means the provider is paid separately for each exam, inoculation, lab test and so forth. Many scholars contend this drives up health care costs and the demand for doctors by paying providers more for providing sometimes unnecessary services.
Medicare has begun transitioning to what often are called “bundled” payments — flat fees for treating a particular illness or for meeting all of a patient's health needs for a specific period of time. Providers are paid more for patients with complex medical problems. Some services, such as emergency surgery and after-hours calls, are paid separately.
Medicare has been bundling payments to Medicare Advantage providers, such as health maintenance organizations, since the late 1990s; it hopes to shift half of current fee-for-service payments to bundles before 2019. Blue Cross bundles about 20 percent of its payments; Aetna bundles 28 percent and plans to bundle three-quarters by 2020.98
Advocates of bundling argue that it encourages providers to focus on keeping patients healthy because providers can keep more of their flat fee if they do less treatment.
Patients shouldn't worry that bundling encourages providers to withhold needed treatment, says Phillip Longman, a health care-policy scholar at the New America Foundation think tank and Johns Hopkins University. “Most people think undertreatment is the problem, but overtreatment is the No. 1 problem in health care,” he says.
Health care experts expect bundling to drive other changes in health care. Providers will be more likely to form groups to address all of a patient's needs. Telemedicine and other innovations will become more economical.
“With fee for service, you have to justify every time you use a remote stethoscope” to listen to the breathing and heartbeat of a patient through a telemedicine link, says Jonathan Linkous, chief executive officer of the American Telemedicine Association. With bundled payments, telemedicine becomes “just part of the service. If it works — if it makes sense — you can use it.”
Wergin says bundled payments might allow him to budget for “the infrastructure to do telehealth or to hire a nurse to look through the records and call patients who haven't had a mammogram in five years.”
Bundling payments isn't the only thing driving providers to group practices. Doctors are finding they can become more productive by joining forces with other providers. And being part of a group practice — as a partner or an employee — can promise a more attractive lifestyle. “Only a small percentage of residents go into single practice now,” says Grover of the medical colleges association. “People now want a predictable schedule. They want to spend time with their families.”
Wergin says about 70 percent of his academy's members are employees of group practices, hospitals or other health care organizations. New doctors “aren't looking for more debts to open a single practice” or to buy into a group partnership. “They say, ‘I'd like to have a steady income for a while.’”
Joining a group enables a physician to leave record-keeping to a clerk, says Fifer, of the Healthcare Financial Management Association. “I hear it all the time: ‘I just want to practice medicine.’ They want to take care of people. Nobody wants to sit around doing paperwork.”

This article is about the statistics and history behind what people may assume to be “the shortage of doctors.” Although the article appears to emphasize the importance of the number of doctors that are necessary, it seems to constantly correct the false findings of history that indicate that new supportive occupations like physician assistants and nurses can provide more and take over some work of physician providers. It is very meaningful to me because it explains the situation I am in regarding occupation availability and the future of physicians. It pertains to me greatly regarding the different kinds of job networks that work together in order to provide the best care for a patient possible and not just the doctors themselves doing all the work. This article also relates to the study of history because it explains the trends in doctor scarcity and explains what has been done in the past. I can use this article to learn about the future of doctors and the paths that future physicians would go through. Historical methods include statistical data using surveys and the national census. The national census is especially important in determining how many people would usually need health care and the percentage of the old who may most likely need the most treatments. This information have to be of primary recognition.

What is Philosophy?

Philosophy is the study of the wisdom as said in the Greek pre and suffixes - the love for wisdom. Having wisdom is powerful because unlike knowledge of many factual things that can be proven by mathematics, science, and observation, the strength of wisdom rests within perspective and the abstracts of ethics. Philosophy is also the study of how humans can become better people, and increase the understanding of themselves, their friends, relationships, and ultimately – the world. We study philosophy because we want to be more knowledgeable about our surroundings and be more open-minded about different perspectives. This state of open-mindedness and constant thinking helps us create new options that may have not existed before and therefore allow us to better innovate ourselves and society. Specifically, we study philosophy in order to create the best knowledgeable environment to do our work correctly and make huge contributions to society.
Miracles at a Price
THE BABY DOCTORS
Probing the Limits of Fetal Medicine.
By Gina Kolata.
213 pp. New York:
Delacorte Press. $18.95.
The baby doctors of Gina Kolata's book are not your ordinary obstetricians or pediatricians but a group of physicians who, since the mid-1970's, have been extending the practice of medicine to babies not yet born, to fetuses in the womb. They have by now established the idea that the fetus can and should be treated as a patient. And like so many other medical pioneers, they have also enlarged our powers over life and death, delivering familial benefactions and posing wrenching ethical problems.
Ms. Kolata, a skilled and experienced science reporter for The New York Times, provides a lucid and accessible account of the technical innovations that have made fetal doctoring a regular branch of medicine. She also brings a special sensibility to the subject. The mother of two children, she was drawn to the story of the fetal physicians partly because she also lost two infants in the 1970's, one by miscarriage, the other - a ''perfectly formed'' baby, she was told -to stillbirth. She wonders whether that stillborn baby could have been saved by fetal surgery. And her wondering makes ''The Baby Doctors'' an absorbing, often moving, book, an empathic rendering of the physicians who created fetal medicine and of the pregnant women, carrying fetuses in trouble, who have come to the doctors desperate for help.
Ms. Kolata notes that when the baby doctors invented fetal medicine in the 1970's, most of them were in the early stages of their careers, professionally ambitious and disinclined to spend their lives in conventional obstetrics. At the time, it just so happened that a variety of new methods and technologies for prenatal analysis were making unconventional obstetrics possible: amniocentesis, which allowed genetic and biochemical diagnosis of fetal tissue; fetoscopy, which permitted visual inspection of small regions of the fetus through a tiny fiber-optic device; and, perhaps most important, ultrasound, which displayed an image of the whole fetus on a screen. ''If we could see inside,'' says Richard Berkowitz, a fetal physician at Mt. Sinai Medical Center in New York City, ''there was the potential to alter what we found there.''
The baby doctors, Ms. Kolata writes, are exuberant pioneers of alteration, ''single-minded, aggressive, and self-confident,'' each one ever eager ''for the challenging new case, the time when his skill and daring can come into play to save a fetus.'' In 1979, some of them organized themselves into what they formally called the Fetoscopy Study Group and informally dubbed the Fetal Invaders. Even today, says Mitchell Golbus, one of the earliest invaders and a member of the medical faculty of the University of California at San Francisco, they devote part of their annual meetings to asking each other, ''What have you done in the past year that is totally outrageous?''
Such medical swashbuckling appears to be more of a pose than a practice, perhaps even a way of sustaining morale in the face of a national policy that prohibits the use of Federal money for fetal research. Nothing medically outrageous is uncovered as Ms. Kolata relays the doctors' accounts of how they have employed or invented the major procedures that constitute current fetal medicine.
Several of the doctors in the book improved chorionic villus sampling - a technique, imported from China via Britain, that permits fetal diagnosis earlier in a pregnancy than amniocentesis does. Michael Harrison, the chief of pediatric surgery at the University of California Medical Center in San Francisco, devised two key techniques: a surgical procedure to close a hole in the fetus's diaphragm so that the abdominal organs can't push through the chest cavity and crowd the lungs; and a therapeutic procedure in which a shunt is inserted into the fetal bladder to bypass a blocked urinary tract, so that the fetus can develop normally until birth, after which the blockage can be surgically repaired. Richard Berkowitz contributed to the development of the procedure called ''selective termination'' or ''pregnancy reduction.'' This technique is usually applied to women who have taken fertility drugs and find themselves pregnant with so many fetuses (four or more) that all of them are at risk of dying. Some of the fetuses are selectively terminated - that is, killed with an injection of potassium chloride into their hearts - so the rest can live.
Pregnancy reductions pointedly expose the painful predicaments that arise in fetal medicine. Physicians who do not wish to perform abortions are torn between, on the one hand, violating their convictions to save a few of the multiple fetuses and, on the other, honoring their beliefs at the cost of dooming all the fetuses. Many women with multiple fetuses anguish over terminating the lives of any of them. One woman consulted her Bible but found no guidance. The Bible speaks about ''God's plans for even the fetus in the womb,'' Ms. Kolata writes, ''but if not having a reduction meant that none of those fetuses would live, what did that do to God's plans?''
Some ethicists contend that a multiple pregnancy should not be reduced to less than twins, because most mothers can carry and deliver two healthy babies. Yet some women, pregnant with multiple fetuses but wanting only one child, fail to see the difference in principle between selective termination of an unwanted twin and an ordinary abortion. Indeed, if the abortion rights position is that a woman has a right to opt for no children, it would certainly seem to include her right to choose only one child. However, Dr. Berkowitz and his colleagues refuse to reduce multiple pregnancies down to a single fetus, not only for ethical reasons but also because they fear anti-abortionists will attack their practice of prenatal diagnosis in general.
Ms. Kolata never comes to grips with the ethical issues, the tremendous costs or the self-interest of the doctors that her accounts of the fetal invaders expose. Nevertheless, what the book lacks in analytical scrutiny is made up in reportorial immediacy. Here are doctors struggling to reconcile ambition with conscience; pregnant women coping anxiously with the uncertainties of experimental medicine; and women who have suffered through failed fetal procedures declaring they would do it again to give their babies a chance. Here, too, are new parents, speaking gratefully of the successes of fetal medicine - their ''miracle'' babies.

This is a very interesting article because it relates to a new branch of medicine called fetal medicine – a new branch that serves to the unborn. This provides not only new questions but also enlarged power to determine the fate of an unborn baby’s life. As technology expedites in the amount of capabilities and exact calculations in regards to evaluating the lives of fetuses, new questions arise. An interesting point is that this article gives further reasoning for old-end traditions such as abortion which seem to be one of the hottest ethical issues. As an aspiring doctor, I want to make sure that I take a stand on the issue of abortion as such technology becomes better and it makes it harder to not abort when people know that efficient and safe abortions becomes possible. I want to be able to be strong in my opinion and provide the best care simultaneously. It is a difficult topic as I think about it now and I hope to be strong in my passion of the future.

Conclusion: the end of a journey…and a start of a new one
As someone who loves history, I was always aware of the constant need for physicians in suburban and rural areas all over the United States. In essence, this article is important to me because it raises not only the scarcity of physician help but also my motivation to help those who really need it, especially the rural areas (even when there are an overabundance of providers in urban areas who charge unreasonable fees to their advantage). In addition it helped teach me about how doctors made up for such scarcities and the lifestyles they chose helped themselves and the needing environment around them.
On the other hand, I learned a lot about these other subjects that gave me a new perspective in both the new and old things that I come to challenge every day. In sociology, I learned that being culturally aware is just as important as having good manners during practice. In anthropology, the emphasis of humanities is important in developing a larger sense of one’s environment and well-being. Psychology, one of my favorite subjects, taught me about the complex processes of the brain along with the disorders I must learn about in the future. In political science, I have become more aware of special priorities that I must serve to such as veterans and the poor. In addition, political science helped me learn about things such as Medicare and political bills that will affect my future career. In the world of economics, medical marijuana and other drugs have blown up and the expediting prescriptions from doctors doesn’t seem to cease any time soon. Philosophy surprisingly came up as a huge aspect also with regards to the new issues of ethics that blow up headlines in this century like abortion and stem cell research. Thanks to this foundation class, I took each of these subjects seriously; some, like anthropology surprised me with its relevance to my career. Ultimately, I want to be able to study these subjects together with my medical courses in order to full a well-rounded career.
After learning the word “wisdom” throughout one of the lectures, I learned that there is newfound potential when it came to understanding all of these foreign subjects. This portfolio helped me reflect on the diverse knowledge that can be used to affect my future career. The crazy part is how everything relates; the sum of these subjects come together to unite into a working portfolio or rather say, mass of “wisdom”. Unfortunately, all innovating and inspiring courses must come to an end, and I must say I am thankful for this course. It provided a kindle of fire where it made life so much more interesting than the relentless load of science courses, research, and clinical work I was expecting. I only hoped we could learn and apply more per subject, but time can only fly when the thirst for knowledge soars with it. Now it appears that more work and more knowledge is to be known, to not only provide as the best physician I can be, but also the best ME possible. Thank you for reading, and I hope you and I can both take that “wisdom” out of this portfolio and apply it to our ongoing journey.

Works Cited Bibliography

Anthropology
Clemmitt, M. (2013, December 6). Humanities education. CQ Researcher, 23, 1029-1052.

Sociology
"A Developmental Model of Ethnosensitivity in Family Practice Training." Medicine, Health, and Bioethics: Essential Primary Sources. Ed. K. Lee Lerner and Brenda Wilmoth Lerner. Detroit: Gale, 2006. 136-139. Opposing Viewpoints in Context. Web. 8 Mar. 2016
Psychology
Clemmitt, M. (2012, August 3). Treating ADHD. CQ Researcher, 22, 669-692.
Political Science Price, T. (2014, November 21). Reforming veterans' health care. CQ Researcher, 24, 985-1008.
Economics
Wanlund, W. (2015, October 16). Marijuana industry. CQ Researcher, 25, 865-888.
History
Price, T. (2015, August 28). Doctor shortage. CQ Researcher, 25, 697-720.
Philosophy
Kevles, D. J. (1990, September 30). Miracles at a Price. New York TImes. Retrieved April 10, 2016.