Management is the process of dealing with or controlling things or people to accomplish selected aims. You manage all the time. Managing time is likely at the top of your list, along with managing personal finances. Parents help their children managed behaviors as do classroom teachers. That's classroom management. Personal trainers and nutritional coaches help clients manage their weight. That's weight management. With the title of Manager, a person could manage people and all processes. That's team or project management. Hello, my name is Dr. Bob Miller. I'm an internal medicine physician and a clinical assistant professor at the University of Houston College of Medicine and the Department of Clinical Sciences. My name's Dr. Frene' LaCour-Chestnut, an internist and pediatrician and clinical associate professor here at University of Houston College. Hello, I'm Kimberly Pilkinton and I'm an OB-GYN physician, which means I practice obstetrics and gynecology. I'm here at the University of Houston College of Medicine. I not only have my doctor of medicine degree, but a Master of Public Health, which is one of the reasons why I came to the University of Houston because they are so dedicated not only to teaching our students individual patient care, but also how to take care of the population better. Population health to me, is not just treating acute disease in an individual patient or a chronic condition in one patient. But also looking at the population from which that patient is coming and trying to make their community and their population that they're around better in their health as well. In medicine, a lot of what we do is about patient health and it's one of the things that doctors are really good at, and what the United States puts a lot of emphasis into, because if we have a heart attack and we can treat it, that's amazing, right? But we also need to worry about doing more to prevent that heart attack from getting to that point. Prevention is probably one of the most important things that we need to concentrate more on in the education of medical students, in social work, community health work, nutritionist, and beyond. There's so many people that impact the health of a community in a society. Prevention is one of the areas where if you put funding and policy and education into that, you reap amazing rewards in the end. I would offer them unlimited health education resources at their literacy level and what I would like to call just-in-time. The availability of being able to understand and what's going on with their health and educate patients about their medical problems as well as ways to prevent and manage those I think is key to maintaining their best health and achieving their best health. There are so many people with misconceptions who think that myths are truths in terms of their disease, who don't understand the basic building blocks of how you maintain your health, especially in chronic disease management such as diabetes or high blood pressure, what those diseases actually mean and how it can impact their health long term. I think providing some of that education and ways that they can manage those diseases. Whether it's with food or medication or weight loss or activity, having that basic education. In a way that patients would understand would go a long way to maintaining their health. Not everyone has the same resources and being able to access that information. Providing some of those resources to patients rather than them just seeking them out. Having an active partnership with maybe community health workers, social workers, or others who can bring those resources to our patients where they are in their neighborhoods, in their schools, in their environment, at our doctors offices as well providing that information. Sometimes we need to think about technology and how we can push that information to our patients and have it readily available when they go looking health information. That we don't have so much misinformation being pushed towards them that we have actual reliable resources that are available. I would reach out to communities in Houston by actually having them find groups of people that they feel comfortable being around, and say, "This is what we need to do to help them approach health literacy." Somebody has cancer and they can't get access to treatment. We need to figure out, "What are the barriers?". I think you cannot approach a patient's care without understanding the barriers to care. There might be a woman that is so fearful that her husband will be deported from this country, that she refuses to come to the clinic. There might be a woman that is so scared to actually have a cancer diagnosis that she refuses to get a mammogram because her mother died of cancer and she doesn't want to go through the same thing. There's many things that we need to understand before we actually say, "Okay, this person is just not taking care of themselves." We need to actually have a community behind them and help them understand why it's important to access care. I'm going to bring this back to the COVID-19 pandemic that we're a part of right now because it is the most pressing thing in the world. There is so much that is being unpacked in this pandemic, that is just glaring at us in the face, that has been there for years, yet we never saw it in this light. I think right now, a medical student has so much they could do, because they can actually approach the patient with an understanding of the biases that they come from, and the cultural backgrounds, and their ethnicities, and the upbringing of these patients as well, that have impacted their health. Because it is not just that their clinical diagnosis, just all of a sudden happen. COVID-19 didn't just happen to that 350-pound man with untreated hypertension, untreated high cholesterol, untreated diabetes. That person may have not known that they had high blood pressure, never got screened, didn't have access to care, didn't have access to good food, and didn't have access to education that would help him understand why he has high blood pressure and what he needs to fix it. I think there's many things a medical student can do. This is the time to really make an impact for medical students. One way that the environment can really impact health is, for instance, I know of a little boy who frequently was in and out of the emergency room and inpatient care for acute exacerbations of asthma. A non-profit was able to go into this child's home with his parents and realize that there were some things in the environment in his home that could impact his health. For instance, there was old carpet, there was an old mattress, he had an old pillow. They spent approximately $1200 to put tile fluorine in with the permission of the landlord, as well as they were able to get him a new mattress and pillow. In the year following that, instead of him being seen every 3-6 weeks for an acute exacerbation, he only was seen one or two times or not at all for the next couple of years thereafter. A little bit of funding to treat an underlying problem made health so much better. But as a doctor, I can't prescribe a pillow, I can't prescribe a mattress, I can't prescribe a tile floor. I can't make the apartment complex put tile in. In a perfect world, again, we would all work together so that I can prescribe the best medication for when they do get a little bit of wheezing, but prevent the wheezing by making their environment better. Health care management is precisely what the name implies. The overall management of a health care system, facility, or network. Across the health care industry, the management focus of providers to help patients achieve, manage, and maintain their best health. In the video, you probably heard some familiar themes regarding population health that you explored in the previous module including, patients must be seen and treated as a whole person rather than as the presenting symptom. Perhaps you start a doctor's visit by asking patients a few simple questions about their physical environment. Good health outcomes can't be achieved without addressing the social and behavioral determinants of health. It's important to connect patients to non-medical services as part of their medical treatment, especially if addressing specific non-medical issues might help to mitigate or solve the medical need. We know that physicians don't want to screen if they don't know where to refer patients. We also know that patients often don't follow up on the referrals. So ensuring providers have the resources to refer and work to close the loop on the referrals with physicians, so we know what happens outside the doctor's office is critical. It's important to build community partnerships to address community level and individual health care needs. All of these are a function of management, dealing with or controlling things or people to accomplish select aims, which in this case is to improve patient health outcomes.
