MHST 601 Final Reflection- Putting it all together

Learning, Reflection, & Future Professional Directions

Throughout this course I have learned about various health system policies, and issues. I have been able to reflect on these learning opportunities and take time to develop a well-informed professional identity. As a healthcare practitioner it is important to stay informed and practice evidence-based medicine. This course has allowed me to build foundational knowledge in policy, determinants of health, vulnerability, and disparities. What I have learned has made me a better Radiation Therapist with a broadened perspective about characteristics that affect patients' health. I have related the different topics of learning in this course to my profession in cancer care to become more educated on issues surrounding oncology patients. I have learned about programs, social supports, and current research in areas regarding the patient population I am in direct contact with every day. This has allowed me to provide more informed holistic care to each of my patients and to aid in the professional growth of my colleagues. My overall goal with gaining a Masters degree was to expand my professional knowledge and gain invaluable leadership skills. This course has been a great start to achieving this goal and becoming a stronger healthcare professional.

Assessment of Rural Health Care In Canada- Putting the Learning Together

Growing up in a remote area of Alberta has given me insights about the struggles and lack of access to sufficient healthcare in rural areas. I have seen and experienced first hand the issues of rural healthcare in Canada which include lack of resources and funding, limited physician availability, insufficient specialized care and diminished end of life care means. The Canada Health Act Annual report recognizes some of these challenges and is working to provide more educational opportunities for medical students in rural areas and attempting to attract and retain more physicians by developing monetary and other initiatives to aid in closing these care gaps (Health Canada, 2021). Wilson et al., (2020), has created a Rural Road Map (RRM) which is a guiding framework of addressing rural healthcare needs in a Pan-Canadian approach. The RRM focuses on the lack of physician availability and indigenous health needs. This article acknowledged that, “Almost one-fifth (18%) of Canadians live in rural communities but they are only served by 8% of the physicians practising in Canada” (Wilson et al., 2020). This RRM development has started necessary conversations about steps that need to be taken to improve rural healthcare but even with this framework it will take an investment of both time and resources to make it a reality. Despite the Universality and Accessibility principles of the Canada Health Act, Canadians living in rural areas do not have equitable healthcare services. Although this new Canada Health Act report published does address access to care there is still a lot of work to be done to ensure health equity between urban and rural areas in Canada (Health Canada, 2021). Furthermore, Comprehensiveness still remains to be addressed in rural areas. Particularly in the area of specialized care such as oncology and palliative care. Patients in rural areas face limited access to oncology providers, very long travel times to receive care, and diminished enrollment in clinical trials, all of which affect health outcomes and quality of care (Levit et al., 2020). As a Radiation Therapist many of our patients who receive treatment head back to their rural homes with little to no support for follow up or side effect care. Without access to specialized care many patients have long wait times for follow-up scans or may even get lost in the system without receiving the necessary long term care. Remote areas have both lower preventative care and screening rates which contribute to poorer health (Levit et al., 2020). Both the areas of screening, and specialized follow-up care are essential in improving rural patients' health. One possible way to address the follow-up care is to introduce cancer care navigation in which an individual follows up with patients to ensure they are getting necessary appointments and are aware of screening policies to keep up on. This could help with cancer patients in rural areas who do not have a consistent family physician and could increase their health outcomes and increase continuity of care. These issues need to be resolved to prevent poorer health outcomes in rural areas. More in depth research needs to be done in these areas as well to create a more clear picture of the issues and the possible resolutions moving forward.

Research Interests- Future Direction of Professional Growth

My research interests lie in rural healthcare and palliative care needs. I am passionate about addressing these health disparities in rural and remote areas as I know this affects so many. Currently in my career I get the opportunity to care for cancer patients and this has sparked my interest in ensuring their care in rural areas become more optimal. Not only does a cancer diagnosis make these patients vulnerable but the majority of patients with advanced cancer are over the age of 65 which creates more vulnerability within this population of patients (Duggleby et al., 2010). These vulnerable patients need access to specialized care whether that be follow-up, screening procedures, or end of life/hospice care. Most rural communities currently do not possess the funding nor the infrastructure to provide these services to patients. Studies continually show that patients living further from metropolitan areas are less likely to be in good health or have access to the essential care they need (Lavergne & Kephart, 2012). Social, economic, and geographic determinants play a prominent role in creating barriers to providing healthcare in rural areas. Assessing and understanding each of these determinants will allow for a more thorough plan to resolve the gap in care services for the Canadian rural population. More research in rural and remote areas needs to be conducted to gain more insight into what is working well and what care gaps need to be addressed immediately. Moving forward in my professional career I want to expand my research knowledge and capabilities and play a part in enhancing health equity across the country.

References:

Duggleby, W.D., Penz, K.L., Goodridge, D.M., Wilson, D., Leipert, B., Berry, P., Keall, S., & Justice C. (2010). The Transition of rural Older persons with advanced cancer and their families: a grounded theory study. BMC Palliative Care. https://doi.org/10.1186/1472-684X-9-5

Health Canada. (2021). Canada Health Act Annual Report 2019-2020. Retrieved from: https://www.canada.ca/en/health-canada/services/publications/health-system-services/canada-health-act-annual-report-2019-2020.html

Lavergne, M. R., & Kephart, G. (2012). Examining variations in health within rural Canada. Rural and Remote Health, 12(1), [34]–[46]. https://search.informit.org/doi/10.3316/INFORMIT.330008572580432

Levit, L.A., Byatt, L., Lyss, A.P., Paskett, E.D., Levit, K., Kirkwood, K., Schenkel, C., & Schlisky, R. (2020). Closing the Rural Cancer Care Gap: Three Institutional Approaches. JCO Oncology Practice 16:7, 422-430. DOI: 10.1200/OP.20.00174

Wilson, C.R., Rourke, J., Oandasan, I., & Bosco, C. (2020). Progress made on access to rural health care in Canada. Canadian Family Physician, 66 (1) 31-36.