2/21/2012 Midterm

While composing my webtext and discussion posts this semester my main goal has been to create an academic, objective tone.  I have been striving to create an unbiased webtext that examines the two issues fully without letting my personal opinions get in the way.  Thus far, my biggest challenge is writing with an objective, informative tone, rather than a persuasive tone.  I am examining studies that have been done as well as other evidence and drawing my conclusions off of this research.  I am tempted to explain my personal views, so my biggest challenge has been to objectively provide information and logical conclusions based of off accepted sources.  Before completing any research, my only knowledge on this topic was personal opinions that I learned from family and friends.  However, after conducting research I have learned a substantial amount more than I started with.  I am overcoming the challenge of writing objectively by fully reading articles to understand the author's main points and then analyzing their information to comprehend how it relates to my topic.  I feel that I have learned a lot about my topic as well as how to analyze and use various sources.

Another obstacle that I have encountered has been writing in a professional tone.  I have never used a blog before, and I have discovered that writing online is different than writing on paper.  At first it was tempting to write similar to styles on social networking sites, without proper English or grammar.  I have learned to utilize links and anchor texts.  

I have also learned a lot about using proper sources.   Before completing research on my topic, I was tempted to use any source that seemed reliable on first glance.  Now, I look at the author and their credibility, as well as the objectiveness of the site.  I now only use sites that contain unbiased, reliable information to add credibility to my own webtext.  I feel as though learning to properly analyze other websites allows me to find faults more easily in my own.  This has allowed me to think about what effect my writing styles and choices provide and the effect on my writing as a whole.

I have also been trying to write with a more sophisticated writing style in order to convey an academic tone to my webtext.  It has been challenging to use a wider variety of words and sentence structures, but I know variety will increase a readers' interest in my webtext.  Also, I have based my font choices and colors on my academic tone.  I have chosen dark font colors on a white background, which allows for easier reading.  I have also opted for plain fonts, rather than swirly fonts.  I have also been looking at images that will add credibility to my site, such as scientific images and images with neutral colors.   In order to overcome this challenge, I have examined other webtexts and scholarly articles for inspiration.  I learned what color choices are harder to read, and I have analyzed images to understand their effect on the overall webtext.  I have also learned techniques such as breaking up my writing into sections to make reading easier.

Overall, I feel that my writing journal and webtext have provided me with a greater understanding of online writing.  I have learned to adapt my previous writing style to suit the needs of writing on a website.  Also, I have learned the importance of providing objective information and analyses to enhance my argument.

Abraham, J.M., Hofner, A.N., Moscovice, I., (2011). Expansion of coverage under the Patient Protection and Affordable Care Act and primary care utilization.  The Millbank Quarterly, 89.1, pg. 69-89.

Summary: This article considers the effects of the PPACA on primary care, such as visits to the emergency room.  The authors also discuss the shortage of primary care physicians that may result from the bill.  They also utilize research to determine how often people visit emergency rooms and how much that number will increase once the bill is in full effect.

Assessment: The authors of this article seem very credible and the information they provide seems reliable and useful. All of their information is backed up with statistics and various studies, and there are several charts included that summarize their data.  The information is very objective and does not seem to be biased.

Reflection: The information I learned while reading this article was very relevant to my topic and I will use this information in my project. It helps support one of my main ideas and provides a lot of statistics I could utilize. It further enhanced my understanding of the act.

Berger, E. (2011).  Emergency physicians face uncertainty in accountable care organizations: Health care megatrend brings threats, opportunities for emergency medicine.  Annals of Emergency Medicine, 57.4, A13-A15.  

Summary: This article introduces the topic of accountable care organizations and the changes that the PPACA can bring about.  The author discusses the benefits that may come about from creating accountable care organizations, such as increased uniformity of patient’s records.  He also discusses the potential downfalls for care in emergency rooms, such as expensive care that may be unnecessary.

Assessment: The information in this article seems to be really objective and unbiased.  The author discusses both sides of the argument and backs up all of the claims with evidence.  He uses a lot of credible sources.  The information in this article provided an interesting viewpoint for my topic.

Reflection: This article provided an interesting topic that I would like to use in my project.  It gave me a new topic to support my argument and provided insight on something I wasn’t familiar with about the PPACA.  It caused me to think about the varying affects that accountable care organizations can have on emergency medicine.

Bisgaier, J., Rhodes, K.V., (2011).Cumulative adverse financial circumstances: Associations with patient health status and behaviors. National Association of Social Workers, 36.2, pg. 129-137. 

Summary: The authors of this article completed a study of patients in emergency rooms and their differing financial backgrounds.  The polled random people to discover what effects their finances had on things such as food and physician care in emergency rooms.  They then analyzed all of their data and created tables listing numerous factors of their experiment.

Assessment: This article was a well-written analysis of the experiment.  The authors gathered a lot of data from varying social and economic groups to compose their analysis.  There is an unbiased, objective tone to this article, and they rely on the data to back up their findings.  The information provided seems relevant and reliable.

Reflection: While the information provided in this article is interesting and reliable, I will not use this source because it isn’t really relevant to my topic.  It will not enhance my argument at all and does not seem necessary. The article really didn’t discuss the PPACA at all.

Goldsmith, J. (2011). Accountable care organizations: The case for flexible partnerships between health plans and providers. Health Affairs. 30.1, pg. 32-40.

Summary: This author discusses the affects that accountable care organizations can have on hospitals.  He emphasizes the Medicare program and how physicians could receive rewards for using accountable care organizations, in an attempt to reduce Medicare spending.  He also analyzes the flaws in this plan. The author also discusses flexible contracting as an alternative to accountable care organizations.

Assessment: The information in this article seems reliable and is backed up by evidence.  However, the author seems slightly biased because he only discusses the flaws of doctors participating in accountable care organizations. The article includes several references and the author has a credible background on the topic.

Reflection: This article is objectively written and contains information that enhances my topic concerning the PPACA.  This information could help back up my argument.  Also, this article provided me with new information about my topic that helped change my understanding of how the bill will work.

Goodson, J.D. (2010). Patient Protection and Affordable Care Act: Promise and peril for primary care. Annals of Internal Medicine. Volume 152.

Summary: This article begins by stating the basic components of the act, and then gives statistics about physicians in the US and other countries around the world.  The author then explains the different promises of the act, and then analyzes their flaws.  Topics such as physician payment and  the increasing need for workers are covered.

Assessment: This article seems useful because it explains aspects of the bill and then analyzes the potential adverse effects.  However, it appears slightly biased because it only finds the flaws in the bill and not the benefits.  The information seems to be reliable, and references are listed at the bottom of the article.

Reflection: This source was very interesting to read, and holds some benefits for my research.  I will likely not use this source in my paper because it could be considered biased.  However, it did offer some ideas that are similar to other articles that I have read.

Knickman, J.R., Martinez, J., Powell, W., Ro, M., & Villa, N.W. (2011). Transforming the delivery of care in the post–health reform era: what role will community health workers play? American Journal of Public Health. Volume 101, No. 12.

Summary: This article considers the changes that the PPACA will bring to the medical field and the changing roles that community health workers will play.  They discuss the roles that community health workers can play in primary care and caring for people with chronic diseases.

Assessment: This article contains objective, reliable information.  Numerous sources are used, and there are references throughout the article.  The article was also written by a team of medical professionals. The information seems relevant to the topic.

Reflection: While the information in this article is accurate, I will not use it because it does not relate to emergency medicine.  The effects of the PPACA are accurately analyzed, but not for the emergency medicine aspect.  However, it was interesting to read about the changes that are taking place in other fields as well. 

2/7 In Class Research

Goodson, J.D. (2010). Patient protection and affordable care act: promise and peril for primary care. Annals of Internal Medicine. Volume 152.


Knickman, J.R., Martinez, J., Powell, W., Ro, M., & Villa, N.W. (2011). Transforming the delivery of care in the post–health reform era: what role will community health workers play? American Journal of Public Health. Volume 101, No. 12.

Bracht, F., Jolivette, G., Martin, S., Murawski, L., & Wurden, M. (2010). The patient protection and affordable care act: an overview of its potential impact on state health programs. Retrieved from: http://www.lao.ca.gov/reports/2010/hlth/fed_healthcare/fed_healthcare_051310.pdf

Summary:
This report offers a great summary of the Patient Protection and Affordable Care Act, providing information about the key provisions of the law.  The mandates are listed and explained in a way that is easy to comprehend.  Also, the estimated effects on state health programs are described in detail, as well as the possible consequences.  At the end of the document the broad, overall effects that the bill could cause are examined in great detail.
Assessment: This document provides an objective, unbiased report on the possible effects of the new bill.  All aspects are assessed in great detail.  The authors provide several figures throughout the document that include statistics to back up all of their key points. This sources seems reliable and provides useful information.
Reflection: I will use this source for my project because it provides objective information that could supplement my research.  It provides some evidence that I could use to further enhance my argument. This source was very useful by not only providing background information about the bill, but by providing insight into the possible consequences.

Foster, R.S., (2010). Estimated financial effects of "patient protection and affordable care act" as amended.  Retrieved from: https://www.cms.gov/ActuarialStudies/downloads/PPACA_2010-04-22.pdf
Summary: This report examines the financial impact that the bill will cause. It analyzes the costs verses savings that will result several areas, as well as the impact of the federal expenditure. The document also examines how the bill will cause a spike in health care costs.  The national increase in health expenditure is also analyzed.  At the end of the document is a conclusion, which neatly sums up the expected impact of the bill from a financial aspect.
Assessment: This is a long document that provides a great deal of information, but the information seems reliable.  All of the claims are backed up with financial data, and several graphs are used to emphasize the key points and provide credibility to the author. The information provided in this document is unbiased and very objective.
Reflection:I will most likely utilize this source because it provides useful facts and statistics that could help me support my arguments. The financial effects help enhance some of my key points, and this data is from a reliable and trustworthy source.  This source was very helpful because it not only provided raw data but examined the financial effects of this bill in all areas that will be affected.

The Patient Protection and Affordable Care was passed in 2010 in an attempt to provide all Americans with health insurance. On the surface, this seems to be a noble idea that has the potential to help millions of people. However, I believe that the Patient Protection and Affordable Care Act could have a potentially negative impact on emergency medicine. 

Millions of people will soon have health insurance, which means millions of people visiting hospitals and emergency rooms.  The number of individuals eligible for Medicaid will also increase, allowing even more people to visit doctors.  Overcrowding will inevitably occur, and a shortage of medical professionals will soon result.  Also, because of the increased demand for emergency care, the level of care that patients receive could be significantly lowered.  The Patient Protection and Affordable Care Act will affect everyone with health insurance because they face changes in their current insurance, as well as individuals who lack health insurance, because it will soon be required by law.  All of these individuals will be interested in the effects of the bill on the care they will receive. I believe that this topic is extremely important because it has the potential to change emergency medicine as we know it.  In addition, I plan to become a doctor and I am very interested in emergency medicine and the changes that could come about.   I believe that emergency health care workers such as doctors and nurses will be especially interested in this topic because their work environment could change drastically in the future.  The passing of this act could have a huge impact on the field of emergency medicine.

In conclusion, I believe that the Patient Protection and Affordable Care Act could have a detrimental effect on emergency medicine.  Several consequences could result that have the potential to lower the standards of patient care. 

Laxmaiah Manchikanti, MD, David Caraway, MD, Allan T. Parr, MD, Bert Fellows, MA and Joshua A. Hirsch, MD.  2011. Pain Physician 2011.  Patient Protection and Affordable Care Act of 2010: 
Reforming the Health Care Reform for the New Decade. Retrieved from: http://www.painphysicianjournal.com/2011/january/2011;14;E35-E67.pdf


Harry A. Sultz and Kristina M. Young. 2010. Health Care USA. Jones and Bartlett Learning, Boston,  Retrieved from: http://books.google.com/booksid=r1ASWbMugj4C&pg=PA60&dq=patient+protection+and+affordable+care+act&hl=en&sa=X&ei=yMgqTWsHZC5twef0M34Dw&ved=0CFsQ6AEwBw#v=onepage&q=patient%20protection%20and%20affordable%20care%20act&f=false