Self-harm in Wayne County

Self-harm is a rising problem among young people all over and Wayne county NY is not immune.  In fact, I have known a handful of people from Wayne county, in my life, who have suffered this epidemic. Canandaigua, NY has even implemented some means of prevention in their schools. They have a prevention specialist who works with middle school students on issues such as this.  The Wayne Post recently had an article about self-harm that highlighted the stories of many young people and some adults who had battle this issue. The article points out that self-harm is a very multidimensional problem that can be driven by a number of different things. The common thread among the different stories in the article was the need for control. The article states, "Self-harming is actually a self-medicating coping mechanism that comes from a normal, good desire to feel better...For some, self-injury provides a way to manage intolerable feelings or a way to experience some sense of feeling, she said. It is also used as means of coping with anxiety or other negative feelings and to relieve stress or pressure." This is a very common issue that primary care physicians need to be equipped to handle. As we learned in our RMED article this week, mental health knowledge is lacking among primary care physicians, and this is one more reason that we need to fill in that gap.  

http://www.waynepost.com/article/20140216/NEWS/140219706?refresh=true

Drunk Driving in Wayne County

I came across an article about drunk driving in my hometown paper recently (http://www.waynetimes.com/news/why-are-they-still-drinking-and-driving/).  It got me thinking that alcoholism is a public health issue that I don't think gets enough attention. Alcoholism is rampant especially in rural areas. As we have learned through various RMED articles, certain street drugs are less available in rural areas and thus, rural people are limited in what they indulge in.  With the popularity of Breaking Bad and other mainstream media, crystal meth has been highlighted as a drug of choice in rural areas.  However, I think alcohol is a much bigger problem.  Alcoholism is a problem in urban areas too, but in rural areas, most bars requiring driving, which is not the case in urban areas.  Public transit is scarce in most of rural America, forcing the rural alcoholics and bar enthusiasts to drive to their bars and liquor stores. I think this is a dangerous combination that often ends in driving while intoxicated.

There is another problem with alcoholism, though.  How do doctors treat it? Alcohol consumption is a very sensitive subject for many who abuse it, and while a good physician can read between the lines and estimate alcohol consumption, many alcoholic patients underplay their intake. This is not just a problem of trust building between patient and physician, but also an issue of self-denial.  Therefore, how are we to deal with alcoholism when some alcoholics don't even believe they have a problem? This is an issue that rural physicians absolutely must face.

As a future rural physician, I believe that the best way to deal with this issue is to be completely honest with patients, as well as nonjudgmental.  With this approach, one can hope that patients will respond with trust and honesty, so as to open up conversation about solutions to alcoholism and drunk driving.

http://www.waynetimes.com/news/why-are-they-still-drinking-and-driving/

New Dialysis Centers Open In the Wayne County Area

 The first dialysis center in Wayne county has recently opened its doors in Newark, NY. This is a a wonderful thing for Wayne county.  The center, opened through the Rochester General Health System will fill a gap for those in Wayne county who had to travel to Monroe county for their dialysis services.  The new center includes 14 dialysis stations and is said to be state of the art, including heated chairs, personal televisions, and WiFi. I think this is a step forward for Wayne county medicine. Wayne county is a large county that includes extremely rural towns, quaint historical villages, and even a small "city" or two.  However, it is like many rural areas in the U.S. in that many residents must drive to neighboring counties for the medical services they require.  Therefore, I see this new center as not just good for the patients who require dialysis, but as a push for more services in rural areas.  Hopefully, this is the way of the future and under-served areas will continue to gain facilities and opportunities such as this.

http://www.waynetimes.com/community/rgh-opens-news-dialysis-center-in-newark/
http://www.waynepost.com/article/20130831/NEWS/130839996/10054/NEWS

Defining Environmental Hazards in Wayne County

While searching for articles about environmental hazards in Wayne county, my home county, I remembered the nuclear power plant located just one town away from my home.  I thought to myself, this is not a perfect match for the assignment - it isn't organophosphate poisoning, or Farmer's lung - but  it was always a very real potential hazard for the residents nearby.  I remember when I was growing up, there were always emergency drills preparing for the day when something would go wrong with the power plant.  The residents were issued iodine tablets which may help in minimizing damage from nuclear radiation.  The schools would do drills every couple of years, which usually entailed a few hours worth of herding students onto busses, driving them to the designated fallout location and then returning to school. So I thought to myself, this was a very real hazard that I faced in Wayne county, and it continues to be a potential hazard.  I started looking into the Ginna Nuclear Power Plant and found an article entitled, "The World's 10 Oldest Operating Nuclear Power Reactors." This was fairly concerning for me to read.  However, I cannot say whether the power plant being old is a good or a bad thing, because we all know things used to be made much sturdier than they are now. The article states that Ginna opened in 1970 and has been running largely without incident ever since.  However, in 1982 there was a break in a tube that leaked radioactive water, resulting in a temporary shutdown for the plant. Despite the fact that no one was hurt or evacuated, Ginna remains a potential hazard in Wayne county.

Now my curiosity is sparked to understand more about this power plant.  I found that it is a pressurized water reactor that is monitored through the Radiological Environmental Monitoring Program.  This program samples local water sources, food, air, and milk for detectable radiological activity. The results of the 2011 monitoring program indicate that there was no significant radiological impact from the operations at Ginna. So, this blog project may help me sleep at night knowing that so far, Ginna has not posed a huge threat to my home community. However, I still believe it has the potential to be a worrisome environmental hazard for Wayne county.  Let's hope it never lives up to that dangerous potential.

Childhood Obesity in Wayne County

 According to the Wayne County Public Health Department, the rates of childhood obesity are higher in Wayne County than the national rates. As obesity explodes as an epidemic in this nation and state, it is undeniably a problem encountered by school medical directors. This is typically a preventable condition in which the local experts are key for prevention.  As a local expert, education is the best means of prevention and intervention.  Organizing informational sessions on nutrition and fitness is a major means of impacting the community.  Furthermore, supporting fundraisers for various sports and activities may also help. Childhood impacts communities because obese children often become obese adults and are much more likely to develop comorbidities. As the level of health in the community declines, the healthcare costs increase.  None of this is good for communities. This is an epidemic in Wayne County and it is one in which the medical experts need to take seriously.


http://www.co.wayne.ny.us/departments/publichlth/Report%20Card%202009%20Wayne.pdf

Reflections on Medicine in Wayne County

As the academic year and Intro to Rural Medicine come to an end, I find that I have learned a great deal about medicine in  Wayne County.  I grew up in Wayne County and realized at a young age how difficult it can be to travel to receive healthcare.  However, there was much that I did not know about Wayne County's healthcare prior to the RMED blog and the research it entailed.  In the process, I found that while Wayne County ranked very poorly in terms of morbidity in NYS, there are a number of programs that indicate progress in bettering the delivery of healthcare. 

I was surprised to learn about NY Connects, a program which improves access to healthcare, has reached Wayne County. Furthermore, the Public Health department has some great programs in place for smoking awareness and education.  There is also a highly comprehensive substance abuse program in place.  It seems though, that Wayne County still needs to improve their health to reduce morbidity. 

Having lived in Wayne County for so long, I know that there is much to offer in terms of culture and history. However, I think that access to care will remain a problem. I think that one of the most important things a physician can offer, in addition to providing the best care, is to work in the community to improve access.  Technology will be one of the greatest tools in the future for allowing patients access to their information and care, and it is imperative that technology grow in rural areas like Wayne County.

Improving Access to Care in Wayne County with NY Connects

NY Connects is a statewide program that provides information and assistance about long term services and support.  Wayne County is one of many in NYS to implement this program.  NY Connects defines long term care as, "medical and non-medical support services needed to improve or maintain ones' health and/or daily function...[that]may be provided in individuals' homes or other community-based and residential settings."  

The program is available for people of all ages and is not limited by insurance carrier.  It is intended to help people who are might find accessing medical care confusing.  The local programs, including the program in Wayne County provide information and assistance specialists that personally counsel patients on making informed decisions about their medical care.  The specialists also assist patients in accessing long term services and supports for both existing and future healthcare needs.

The Wayne County NY Connects program is offered through the Wayne County Department of Aging and Youth.   Their specific program goal is to help people of all ages access reliable information regarding services and to assist in formulating a plan to ensure people can maintain as much independence as possible.

As a future practitioner, I see myself working within a patient centered medical home.  I think that this is the future of primary care overall, and I believe it will ensure better medical care to patients.  I think that NY Connects is a wonderful resource for people because navigating medical care can often be confusing and seemingly inaccessible. Therefore, in my practice I will encourage and promote such programs for patients. 

http://www.co.wayne.ny.us/Departments/AgeYouth/NYConnects.htm

http://www.nyconnects.ny.gov/nyprovider/consumer/indexNY.do