Final Reflection

Shahadat Rahman

Professor Matyakubova

English 21003

7 December 2017

Final Reflection

While reviewing the work I have submitted this past semester, it is clear to me how much I have grown as a writer. In the first assignment, the informative report, I realized that I had moved on from grammatical and analytical errors to a much larger problem: local structure. The vast majority of my sentences in the first assignment were written using simple sentences of the same structure; this made my writing dull and boring. Adding on to the dullness of my paper, I repeated words throughout the essay without using synonyms to make my writing sound more attractive. When looking over my final paper I look at a piece of writing I can be proud of. Not only does it accomplish the analytical and grammatical standards I normally achieve, the local structure includes varied sentence format and a breadth of vocabulary which helps my writing be more vivid and appealing to read. By doing so I am one step closer to becoming the writer I hope to be.

But this class did not only help me become a better writer, it helped me become a better person. The people in this class came from all walks of life, each with their own set of struggles. These different point of views helped shape a diverse class with interesting — and occasionally heated— group discussions. It also helped that the professor did not impose her own views, but she left the discussion to the students: the class was not merely the professor lecturing, the bulk of the class relied on students discussing. I realized the perspectives of others and learned to consider them not only when approaching my writing, but when approaching life. I never thought I would learn as much as I did when I first entered this class: about writing and about life.

Interview Reflection

Shahadat Rahman
Professor Matyakubova
English 21003
14 November, 2017
 Research Paper Interview Reflection

This assignment required me to conduct an interview with a professional in the healthcare system. Conducting this interview helped me discover how to find professionals in a certain field and how to contact and interview them. I had to think of what information I wanted to extract from the interviewee ahead of time and simultaneously think of questions that they would be comfortable answering. It would be useless to conduct an interview where the interviewee is only comfortable answering one or two questions. This also helped me consider how I would use this information in my paper and helped me develop my paper further.

Not only that, but the interview helped me become more interested in my research topic. I was initially interested, but the personal interview provided an element of ethos I had not felt in my previous research. The feelings invoked in me during this interview gave me a sense of the feelings I want to invoke in my audience when they read my paper. This helped me realize how and when I should use the interviews and also how my paper should be written in terms of style. 

Interview

Shahadat Rahman

Professor Matyakubova 

English 21003 

 14 November, 2017

 Research Paper Interview

Interview: Does Medicine Really focus on the Patient?

            This paper seeks to discuss the plights of the current American healthcare system, primarily focusing on how insurance and hospital bureaucracy impede a doctor’s ability to treat patients. This interview was conducted with a pediatrician— who wished to remain anonymous in the event she said something controversial— at Bellevue Hospital. The pediatrician would be able to provide personal accounts of her day and specifically the struggles she faces as a doctor, particularly when treating patients. This could be used to provide ethos in the paper as well as provide a primary source that would expand on how the current healthcare system fails doctors, subsequently connecting that to how it fails patients. She could also explain her initial reasons for becoming a doctor and how these preconceived notions disappeared once she entered the medical field, highlighting the importance of not only teaching medical students about what being a doctor is truly like, but invoking a need to provide solutions to these problems.

Question 1: Why did you choose this career?

I wanted to help people. Although that seems like a generic answer, I thought being a doctor would be the best way to help others. There was this idyllic nature to being a doctor that I could never shake; I always thought it’s what I was meant to be. But being a doctor isn’t the only way to help people. I also fell in love with it because of how intellectually stimulating it was. I love biology and chemistry and I always excelled at it. So naturally, being a doctor was the only logical career choice.

Question 2: You said you thought being a doctor was the best way to help people. What changed?

Well, I became a doctor. I found out that there are a lot of factors that go into treating a patient, other than the diagnosis and a doctor deciding a treatment plan. Factors range from the patient’s insurance to the hospital’s willingness to pay. If a patient doesn’t have good insurance, it can seriously affect their level treatment. Often we see that problems with terminally ill diseases like Huntington’s. They max out their insurance plans and after that we just send them home. Some people’s insurance doesn’t even cover their medication, which can cost hundreds to thousands of dollars per refill. It also doesn’t help that I can only spend a certain amount of time with a patient per hospital regulations. 

Question 3: I shared my story of when I got cellulitis and asked for her thoughts.

That’s exactly what I mean. Hospitals, pharmacies, and insurance companies hardly communicate. I think it’s stupid that your insurance plan doesn’t cover doxocycline hyclate— it’s a simple medication to a common but extremely dangerous infection— but if they didn’t they should have made it clear to doctors so you wouldn’t be running around wasting your time. There’s too much red tape that’s hard to get around.

Question 4: So how does your typical day go, red tape and all.

Well typically I start my day around 6 am as I dreadfully get out of bed. I quickly put on scrubs and head to the hospital. At around 7 am I do rounds on newborn babies. It’s wonderful; nothing wakes you up like crying babies. I see all my patients and don’t spend too much time because of hospital regulations, and then I head to the practice. From about 8 am to 12 pm I have pediatric appointments, about 15 minutes each, regardless of the complexity of the problem, again due to hospital regulations. I usually run 30 minutes behind schedule because not all problems can be solved in 15 minutes. Then take an hour lunch and go back to the practice around 1 pm until 5 pm for afternoon appointments. From 5 pm to 7 pm I do follow ups where I take care of messages, lab results, X-rays, and prescription refill requests. It is critical and needs to get done every day, but I’m not reimbursed. And around 7 pm I leave the clinic and head home. I need to keep my pager on in case there is an emergency. There always is. In that case, I rush back to the hospital.

Question 5: Wow that’s 12 hours a day and a ridiculous amount of work. Do you think it was worth it after 8 years of education and 5 years of residency?

No, not really. In terms of compensation it’s ok but that’s about it. There are too many problems and too few doctors. The red tape just exacerbates the problem. Most of us doctors are overworked with no end in sight. I think if most of us had the opportunity we wouldn’t pick this career again. It’s just not what we thought it would be. It’s more paperwork and less personal care. We don’t even get to spend that much time with patients. Sometimes I feel more like a clerk than a physician.

Question 6: So how do you think the lives of doctors can be improved?

Well first of all the clerical work can be outsourced. Doctors should focus on patients and other people should focus on the clerical work. Most hospitals can definitely afford it. Also we should be able to spend time with patients. As I said before, not all problems can be solved in 15 minutes. Patient history—like if a patient has been feeling depressed and has started drinking a lot lately, or if they have recently taken up smoking—can really affect our diagnosis and how the patient is treated. We can’t talk about these in such a short amount of time. The solution isn’t always as simple as asking what’s wrong, doing a check up, and prescribing some pills.

Question 7: What about health insurance? How does that affect your day? What do you think of the new bill Trump is trying to pass?

I’d prefer not to answer. I know how it affects my day but I’m not exactly sure of the logistics a health insurance company goes through, so I’d sound asinine giving my opinion without understanding their [health insurance companies] side, especially considering Trump care. 

Question 8: How have you seen these problems affect doctors?

The time and energy consumed represents a dimension of health care that goes beyond technical competence. Insurers do not acknowledge the value of these services and rarely compensate primary care doctors for them. As a result, many of them cannot afford to take time off to rejuvenate their spirits. Others have suffered physical and psychological and marital problems trying to deal with the stresses and dissatisfaction of a career in primary care.

Question 9: Do you have kids? What do they think about you being a doctor?

I have kids but I know a lot of doctors make the conscious decision not to. My kids think it’s amazing that I’m a doctor and they love it. But I can tell sometimes they wished I could spend more time with them, and I wish the same too. I’ve missed graduations, dance recitals, school plays. I really miss a lot of things that happen in their lives. That’s why some people decide it’s easier not to have kids, to spare their children the trouble and neglect.

Question 10: If you could get a second chance at a career, would you choose medicine or the same specialty again?

I prefer not to answer.

Work Cited

Personal Interview, in discussion with the author, 5 November 2017

Research Paper Draft 1 Reflection

Shahadat Rahman

English 21003

Professor Nargiza Matyakubova

1 November, 2017

Reflection on Draft

This assignment allowed me to become more efficient in thinking about ethos, pathos, and logos when considering the value of research sources. There are a plethora of sources available on healthcare and its implications, but most of them provide only statistics. Although these are helpful and give a form of credibility, they provide little emotional appeal. That is why I turned to personal interviews. They are primary sources that provide credibility and they are also able to provide emotional appeal. Instead of reading obscenely long scientific articles filled with copious amounts of information, I am able to find the sections of articles I need. Indeed, I have become more efficient in reading scientific articles, as I now know where specific information can be found in specific parts of a report or other forms of scientific writing.

This paper also aided me in providing an emotional appeal without necessarily providing any bias. Healthcare is an important topic and affects everyone. I needed to emphasize this, especially emotionally, without providing any of my own opinions on the subject. This also includes minor adjectives that could sway an audience to perceive a term or event in a way it objectively is not. Instead I had to rely on evidence to provide this appeal, rather than my own style or writing. It highlights the difference in writing in a scientific format as opposed to other forms.

Research Paper Draft 1

Shahadat Rahman
English 21003
2 November, 2017
Research Paper Draft
Does Medicine Really Focus on the Patient?
This paper will provide an understanding of the current crisis regarding American healthcare and how it affects patients, slowly transitioning into how these problems can be remedied to help doctors. The paper will begin by providing statistics on how doctors view their profession — what percentage of doctors are dissatisfied with treating patients — and investigating why there is dissatisfaction within the medical field. The research will then delve deeper into how hospital administrations and insurance companies control patient care, ranging from investigations into hospital budgets and insurance policies to interviews with healthcare professionals. Even further, the new healthcare system proposed by Donald Trump will be dissected and the implications will be detailed. An amalgamation of all previous research will then lead to potential solutions, including reallocating funds within the federal budget and other methods of improving healthcare. 




When most medical students are asked why they chose to pursue medicine, most of them would give the same response: they want to save lives. Why else would one dedicate nearly 13 years of their life to higher education? Yet the American healthcare system poses a host of problems for doctors when treating patients. The idyllic perception posed by the idea of helping others is shattered when doctors face the bureaucracy established by hospital administrations and insurance companies: patients no longer receive the care they deserve, instead transforming a selfless profession into a game of money; and doctors are unable to fulfill the Hippocratic oath that defines them, as they are restricted to treating patients based on insurance policies that are heavily dependent on one’s wealth. It is crucial for those considering a career in medicine to realize the problems doctors face with the American healthcare system, as well as the responsibility of the American people to offer a solution to the disorganized system. The plight doctors face when treating patients accumulates into a burden that systematically diminishes patient care; in order to aid doctors who treat patients, these challenges must be rectified
Every year, nearly 20,000 students are accepted into a medical school; yet when they become doctors, studies state that approximately 63% of doctors are unhappy with the medical field (Adams 1). In fact, doctors have the lowest job satisfaction rate in America and only 54% of doctors would choose medicine again as a career (Adams 3). After committing nearly 13 years to higher education, why is it doctors do not realize their dissatisfaction with medicine sooner? The answer lies not within medicine itself, but in the way medicine is distributed. Doctors possess little control over how they can treat patients, with insurance companies playing the biggest role in dictating treatment plans. Given recent potential legislation regarding American healthcare, the way doctors help patients could deteriorate rapidly. 
The healthcare system has gotten to a point where the insurance determines patient care. Doctors are no longer able to treat patients the way they want or the way they were taught; instead treatment plans are dictated by insurance companies, and I have a personal story which exemplifies this. In August of 2017, I remember coming home one night and my mother noticing a huge bump on my face— I had not seen it. Being facetious I ignored until the next morning, when it had continued to swell until it covered my right eye. When I rushed to the emergency room I was stuck waiting for three hours in a hallway, as all the rooms were full. After the wait in the disease-ridden hallway, a doctor finally arrived to say I had something called cellulitis— a serious bacterial infection of the skin and tissues beneath the skin. They said that if I had waited even a few hours longer, I could have lost my eye. After giving me a dose, the doctors proceeded to prescribe me doxocycline hyclate, an antibiotic common in treating cellulitis as well as other bacterial infections; little did I know this would be a futile effort. When I had gone to the pharmacy I was told that this common medication was not covered by my insurance, a feat that had confused the pharmacist as well as all the doctors I proceeded to speak with. One doctor even claimed, “it’s stupid that they (the insurance companies) would keep such a crucial medicine from you, it’s so common.”  After hours of struggling I was finally given an answer by my insurance company, I was allowed to have a slightly modified version of the antibiotic called doxocyline mono. I then travelled back to the hospital to retrieve my new prescription, but had to wait until the next morning to get it fulfilled. If I had not received the initial dose of the antibiotic at the hospital, I would have lost my eye. What if there was someone with a more serious illness having this issue? The disconnect between hospitals and insurance companies has become so severe, that this miscommunication wastes hours and lives.  If the patient were wealthier and had a more accommodating insrance plan, this problem would not exist. But somehow, this problem plagues those who need the insurance the most: the poor. This, medicine has shifted from being a noble profession that serves everyone to a selective idea which only works for the wealthy.
Furthermore, doctor’s jobs are impeded by the mountains of paperwork they must complete every day. As mentioned earlier, there was a 3 hour wait time to see a doctor— and that was in the emergency room, the most vital part in a hospital. And this trend is common in other departments as well. “Every day I spend between 3 to 4 hours on paperwork” states         Dr. Lucy Chang, a pediatrician at Bellevue Hospital, “my day is split between medicine and clerical work to the point where sometimes I feel like an accountant rather than a doctor. But it needs to be filled out every day to keep medical records as accurate as possible” This causes doctors unnecessary stress and as a result impacts patient care. Doctors waste time on paperwork rather than treating patients, leading to long wait times. Furthermore, doctors become more stressed, affecting their mood and how they act around patients. Even something so simple as a doctor’s mood can have lasting effects on how patients heal.

Annotated Bibliography

Shahadat Rahman

English 21003

Professor Matyakubova

26 October, 2017

Annotated Bibliography

Medicine: The Ultimate Money Scheme

Chang, Lucy. Personal Interview. 17 Oct. 2017

This personal interview inquires about the lives of doctors and how they can be improved. Dr. Lucy Chang, a pediatrician at Bellevue Hospital, discusses her average day and how the solutions to the obstacles in her day. She explains various topics, including balancing work and family as well as the problems doctors face in treating patients. Dr. Chang then explains how these obstacles, both personal and professional, impact patient care. This interview provides subjective insight into the life of a doctor. This can be used to explain the relationship between the obstacles doctors face and their effects on patient care. For example, Dr. Chang explains that she spends about 3 hours after work doing paperwork— work that can easily be outsourced. If she spends about 12 hours at work every day and spends 3 additional hours of paperwork, that leaves only 9 hours to spend on rest and family; this often diminishes mood and patient care. This information can be used in tandem with sources that explain how demeanor affects patient care.

Hoque, Tanjila. Personal Interview. 17 Oct. 2017

Tanjila Hoque is currently an MD student at NYU Langone Medical School. In this interview, she discusses her aspirations as well as why she wants to become a doctor. She also explains what she thinks the average life a doctor looks like and what problems she believes doctors face. Hoque then goes on to argue against the high job dissatisfaction rates among physicians and explains why she believes being a physician is a fulfilling career. This interview will be used in tandem with the interview with Lucy Chang. The two sources will compare the views of a medical student on what the life of a doctor is like and what the actual life of a doctor is like. This information will then be used with the source, “Medical School Applicants, Enrollees Reach New Highs.” The discrepancies between the reality of doctors’ lives and what medical students believe it to be, along with the source “Medical School Applicants, Enrollees Reach New Highs,” will depict how the delusions of medical students are dangerous and how it is important to expose medical students to the pitfalls doctors face — as well as provide solutions to these problems — especially if the number of students attending medical school is increasing.

Mainous, Arch G., et al. “Impact of Insurance and Hospital Ownership on Hospital Length of Stay Among Patients With Ambulatory Care–Sensitive Conditions.” Annals of Family Medicine, American Academy of Family Physicians, Nov. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3252189/.

This study investigated the role of a patient’s insurance and how it impacted the length of stay of the patient in the hospital and the risk of mortality, especially in a for-profit environment. The method of investigation included analyzing those who were hospitalized with both ambulatory care and hospitalizations considered to be preventable; the mean length of stay was compared between patients of different forms of insurance. It was found that patients with no insurance had significantly shorter stays and higher mortality rates in both ambulatory and preventable care than their counterparts with insurance. This source provides an objective view and relevant statistical data as to how insurance impacts care. For example, it was found that in ambulatory care the average stay for a patient that had insurance was 5.05 days while the average length of stay for those without insurance was 2.92 days. These results provide concrete proof that those who have insurance receive better care than those who don’t, and it can be used to explain the disparity in care between those with insurance and those without it. It is different from other sources used because it provides statistics on patient care, rather than subjective views on the lives of doctors.

 “Medical School Applicants, Enrollees Reach New Highs.” Association of American Medical Colleges, www.aamc.org/newsroom/newsreleases/446400/applicant-and-enrollment data.html.

This article depicts the number of medical school applicants within the past 5 years. In fact, the number of applicants increased double the percentage from last year, from a 3.1% increase in 2016 to a 6.2% increase in 2017. The number of medical school applicants is also increasing across all minorities as well. By explaining this, the article hopes to incite lawmakers into proving increased federal support for residency training. This source provides an objective view and statistical data on how the number of medical school applicants is steadily increasing. This information can be used to explain the importance of the research done in this paper. If more people are interested in medicine, it is crucial they realize the obstacles doctors face when treating patients. It can also be used to incite funding for medical schools, which will be needed if the increased number of people attending hope to be properly trained.

Argumentative Essay Reflection

Shahadat Rahman
 Professor Matyakubova
English 21003
October 12, 2017
 Reflection to Argumentative Essay

Peer reviewing this paper allowed me to see the mistakes in other people’s papers. There some components of the paper that I was missing such as the abstract. Other than that, the peer review aspect was not very useful, as I did not receive many constructive comments on my paper. On the other hand, I did get to help other people with their papers and was reminded of common grammar errors that not only other people made in their papers, but that I made in my own paper.

This paper also allowed me to consider every aspect of an argument as well, from every counter claim t every claim. This became difficult when planning the structure of the paper, as it was hard to visualize a way to organize the claims and counter claims in a logical manner. I could not simply alternate between claim and counterclaim; I also had to choose which claim would precede which counterclaim in order to help my arguments flow better. By considering the global structure, this also helped me consider the local structure of each individual paragraphs. It made it easier to figure it which sequence the evidence would be in as well as how this would help transition from one piece of evidence to another, and eventually from one paragraph to the next.

This paper also helped me realize the significance of every single argument. I constantly questioned every single argument I made, trying to disprove them. Once I thought of ways I could disprove my arguments, this helped me strengthen those arguments. This way, I had succinct and powerful paragraphs that helped get my points across. This also helped me formulate counterclaims and refutations to those counterclaims.