I don’t know why that isn’t the default in email clients. I always send all my bulk emails to BC recipients. Even if they all know each other, including my relatives, why should anyone know what I think you are interested in? So, apart from work stuff, if there is more than one recipient they are all blind copied.
That’s really interesting. I remember reading about an Italian man in the US who was feeling sick and went to a doctor. When the doctor asked him what was wrong, he said that a witch had put a curse on him. Apparently, in his village in Italy, belief in witches and curses was common, and the cure was something like a couple of aspirin or antibiotics or whatever. But in the US, his complaint landed him in some serious observation for a few days. Sane in Italy, crazy in the US.
I stopped using a pharmacy (Duane Reade) because of the way they treated customers. They were so bad they’re worthy of a pit thread of their own, but what the heck, here I am, so. . .
First, they attempt to make the customer deal only with the cashiers at the pharmacy counter. And Duane Reade seems to hire the slowest, stupidest, most unpleasant cashiers that they can find. So you’ve got to present your prescription to the cashier, who will put it in a box or something where the pharmacist will eventually look at it. When you return to pick up your prescription, the cashier will fish it out of another box, hand it to you, and handle the transaction. If you’ve got any questions about the medication, you must ask the cashier, who will obviously not be able to answer the question (although she will often attempt to answer it), and the pharmacist will respond to the casher, who will respond to the customer.
Now, I shouldn’t have to give the prescription to a cashier in the first place. I should be able to give it to an actual pharmacist, who will understand it, and who can ask me any questions (you know, like “this stuff can kill you if you’re taking [other medication]. Are you? Does your doctor know about it?”).
I have no problem with the cashier handling payment – there’s no reason a pharmacist should spend his or her time at the cash register – but I should have had the opportunity to speak with the pharmacist. I should not have to ask questions at the cash register, in front of everyone else on line, most of whom are just there to buy basic drugstore stuff - soap and shampoo and the like - and (because of this particular Duane Reade’s proximity to my office) many of whom work at my company. And I shouldn’t have to receive an answer to what might be a crucial question (like “it says three on the prescription. Does that mean three times a day, or three pills at one time?”), to which a wrong answer might kill me. And there’s a good chance that the idiot cashier will garble either my question to the pharmacist or the pharmacist’s answer to me.
But it’s the privacy thing that bugs me the most. When the cashier digs through the box, she will often conduct a conversation with me at more than audible volume. “[Saintly] (it’s always “Saintly,” never “Mr. Loser”), is this yours? The herpes medication?”
I got fed up with Duane Reade. I even complained, in writing, to whatever agency it is that regulates pharmacies in New York (can’t remember at the moment). They, of course, responded that they’d investigated my complaint and found it to be unfounded. It wasn’t.
There was recently an article in the New York Times which involved different manifestations of anorexia - the doctor was talking about how in Hong Kong, young women would stop eating and report feeling gassy and bloated all of the time, and if left untreated, they would starve themselves to death. They did not report feeling fat, or thinking that they looked fat. They thought they were perfectly attractive women, but gassy and uncomfortable and unwilling to eat. It seems like this is probably the same underlying disorder (anorexia), but it manifested completely differently in a different cultural context.
Oh hell… 11 years ago, my internist once left a message for me that I had just been diagnosed as hypothyroid.
She left this WITH MY BOSS! (we shared an office at the client site)
I got a phone call at home, from said boss, with the news.
Now, it wasn’t anything more “serious” (AIDS/pregnancy/cancer/psychological issues etc.) but still.
I brought this up to her at the next visit and she apologized profusely, it was the end of a very long work day for her.
And it was prior to HIPAA being enacted, IIRC.
The doc has since proven herself to be a very good diagnostician, and we work very well together, so while I’m still the eensiest bit annoyed, I can live with it.
Heh… I wish the “mouth” meds were OTC> I once had it “coming and going” after a round of antibiotics, and called the doctor. On the phone with her, in a cubicle farm, mumbled a brief description of the problem.
She heard me wrong. She said “well can’t you just pick up some Monistat at the drugstore?”.
I had to say “it’s the other end!”. I’m sure people nearby were wondering what the hell I was talking about.
HIPAA was enacted in 1996.
Many psychological disorders manifest themselves differently depending on cultural context, including depression, anxiety, and even schizophrenia. (In fact, schizophrenics tend to do much better in undeveloped countries than Westernized countries. Societal perception of schizophrenia varies widely, which affects treatment outcomes… one study (I believe in southern Africa) found that it wasn’t the hallucinations and disorganized speech that was viewed as problematic, but rather the self isolation that is characteristic of the disorder.) A recent study found that Latino schizophrenics did much worse with case management intervention than no intervention at all. It is hypothesized that the case management intervention was too intrusive to the family system to effectively treat the problem.
Latinos, African Americans, and other minorities tend to have different mental health needs as psychological disorders manifest themselves in different ways. Also, because of the special social issues minorities face, misdiagnoses are very common. African Americans, for example, may be diagnosed with borderline personalty disorder because of legitimate stressors in their lives caused by oppressive social conditions. Another study found that general practioners are much less likely to diagnose depression in African Americans when compared to whites who exhibited the exact same symptoms. This suggests not only that cultural context is important in understanding mental illness, but also that cultural competency is also fundamental to accurate diagnosis and treatment.
For Latinos in particular, depression is often manifested as physical discomfort, stomach aches, head aches, etc. This might be due to culturally bound expectations about how to deal with personal issues. Another common culture-bound disorder is ‘‘attaque de nervios’’ (nervous attack) which is something like a panic attack but manifests itself very differently, perhaps as a screaming outburst.
The DSM is a very useful tool, but it is a tool that grew out of a Western/European conceptualization fo mental illness, and most of the research that has been done on psych disorders in the U.S. has been done on middle-class white people. A LOT of research still needs to be done on different populations to determine how culture impacts mental health, but it is CERTAINLY a legitimate endeavor, indeed, giving the changing demographics of the United States, I would argue that it should be an issue at the forefront of mental health research.
It was enacted in 1996 but the details weren’t worked out and we weren’t required to adhere to it until 2002.