How the setting in which you see the patient may impact your recommendations for medications

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Address the following questions: Consider how the setting in which you see the patient may impact your recommendations for medications, treatments, or follow-up care. How would your recommendations have changed for this patient if she was underinsured? What about if the encounter had occurred at a mobile clinic for unhoused clients?   Include the following components:
I. answer all questions in the reflection prompt
II. demonstrate clinical judgment appropriate to the patient scenario
III. cite at least one relevant scholarly source as defined by program expectations. Must be APA within 5 years
IV. communicate with minimal errors in English grammar, spelling, syntax, and punctuation

The patient you are referring to is a 65-year-old female that presented with lower back pain for two weeks to the emergency room. An MRI of the lumbar spine and Xray. The conclusion is that she has sciatica. So the treatment would include an NSAIDs or Tylenol. Refer to physical therapy, pain management doctor, and or consider an epidural steroid injection.

You are to read the scenario above and answer the questions asked appropriately. You are to answer this question as if you are a medical professional treating this patient.

 

Sample Solution

Impact of Setting on Recommendations

The setting in which a patient is seen can significantly impact recommendations for medications, treatments, and follow-up care. In the case of a 65-year-old female with lower back pain presenting to the emergency room, the following factors may influence treatment decisions:

  • Resource Availability: If the emergency room has limited resources or a long wait time, the initial treatment may focus on pain management and referral to a specialist for further evaluation.
  • Social Determinants of Health: The patient’s socioeconomic status, access to healthcare, and living situation can affect treatment adherence and outcomes. For example, if the patient is unhoused, access to medications and follow-up care may be challenging.

Recommendations for Underinsured Patients

If the patient were underinsured, the following adjustments could be made to the treatment plan:

  • Generic Medications: Prescribe generic alternatives to brand-name medications to reduce costs.
  • Cost-Effective Treatments: Consider less expensive treatment options, such as physical therapy or over-the-counter pain relievers, if appropriate.
  • Patient Assistance Programs: Explore patient assistance programs offered by pharmaceutical companies to help reduce medication costs.
  • Community Resources: Refer the patient to community resources that can provide financial assistance or support services.

Recommendations for a Mobile Clinic

If the encounter had occurred at a mobile clinic for unhoused clients, the following considerations would be relevant:

  • Limited Resources: The mobile clinic may have limited access to diagnostic imaging and specialized care. Therefore, the initial assessment and treatment may be more focused on pain management and symptom relief.
  • Social Determinants of Health: Address the patient’s social needs, such as housing, food, and transportation, as these factors can significantly impact their health outcomes.
  • Follow-Up: Develop a plan for follow-up care, considering the patient’s mobility and access to healthcare resources.

Clinical Judgment and Evidence-Based Practice

In this scenario, clinical judgment is essential to determine the most appropriate treatment plan for the patient. The decision to prescribe NSAIDs or Tylenol, refer to physical therapy, or consider an epidural steroid injection should be based on the patient’s individual circumstances, medical history, and symptom severity.

It is important to consult with relevant guidelines and evidence-based research to ensure that treatment recommendations are appropriate and effective. For example, the National Institutes of Health (NIH) provides guidelines on the management of low back pain, which can inform treatment decisions in this case.

 

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