Health Screening and History of an Adolescent or Young Adult Client Essay

Health Screening and History of an Adolescent or Young Adult Client - Essay Example She reports some over-exertion on occasion while training, and some periods over vacations where she does little exercise, while on vacation, for example. She considers herself fit and strong for the most part, and evidence to support this is clear from her physical appearance. She is well-toned, and proportioned, with a good energy and open demeanor. Her ability to sustain high levels of mental and physical activity, particularly in the academic year, and during her training cycle, is further indication that she is healthy, overall. Primarily her health is maintained through her exercise programs. However, she does not always ensure that her nutrition is suitable to this kind of exercise program. While aware of the connection between good health and lifestyle, she acknowledges that she does eat fast foods regularly, and does not always maintain regular meal intervals. The family has comprehensive health insurance, and she is covered well for any medical eventuality. The client has e xperienced no serious illnesses in her past, except for some childhood illnesses, and has torn an ankle ligament during training in the past, and ripped a thigh muscle, also during training. Recovery was complete and within reasonable time. She does not suffer from any chronic condition, and has only incidental experience of influenza, or colds, not in any regular or ongoing pattern. Occasionally she does use over-the counter pain medication for infrequent headaches, and describes these as being due to heavy exercise routines, or intense academic work periods, when she does not sleep enough, or has strained her body and endurance. No allergies are evident. Family history does include cancer – the maternal grandmother succumbed to initial breast cancer. Awareness in the client is heightened and supported by her mother, and they are checked by a physician regularly, together. Balance is lacking in her food intake. Despite her apparent physical strength and stamina, the maintena nce of this condition is due to large intakes of fats and carbohydrates, with relatively lower intake of protein and vegetable matter. This may imply lower than acceptable mineral and vitamin intake (RDA, 2011, website), but her youth does tend to mask the lacking elements in an overall picture of health. She has access to good nutrition at home, but excuses poor food choices by insisting that she has no time and needs to eat fast foods, so that she has time to complete all her activities. Her parents are busy, too, she reports, and thus the family seems not to consider their food too carefully. Fluid intake is reported to be high during training sessions, and consistent and regular during non-training. The client uses water only and does not use energy drinks, or supplement drinks, stating that she does not like them. The client is taking in approximately 2200 calories daily, but it is likely from her reported meals’ composition that she is taking in too much fat, too much f atty acid, too much total carbohydrate and not enough protein and fiber (RDA, 2011, website). Nutrients are also likely to be below Recommended Daily Intake, especially given her training and exercise regime. She may in fact be in need of supplements in some form or another and be at risk for unstable blood glucose. The client is fairly regular in her sleep/wake patterns – she tends to be asleep by 10:30 p.m. and awakes no later than 7:30 a.m. On occasion, she reports, on the weekends, she may go to bed later, and

A Joint Venture Agreement and Central Park Medical Group Essay

A Joint Venture Agreement and Central Park Medical Group - Essay Example This is essentially what I am being asked to do; I am being asked to pay "monthly bonuses" to the Central Park Medical Group in order to form a business arrangement in which patients of the Central Park Medical Group are sent to my establishment, Sundown Community Hospital. In addition, it seems that the board, as well as myself, are fully aware of the fact that 60% of the Central Park Medical Group patients are covered by government health coverage. This is obviously why the board is eager to seal this deal with the medical group. The fact that this is a joint venture agreement makes some of the facts a bit subject to interpretation as the Board of Medical Directors has implemented certain rules depending on the state. Anti-kickback statutes specifically state that income that may surface from joint venture activities must be compensation for services rendered. The "bonuses" given to physicians in the joint venture agreement between my organization and the medical group in question is very clearly not for any purpose but a referral incentive. The Medicare and Medicaid Protection Act of 1987 clearly states that the type of actions described by the board to me as the administrator would qualify as a federal offense punishable with fines of up to $25,000 as well as other possible sentencing. I absolutely would make this clear to the board, that the terms under which they would like to issue the joint venture agreement are not only unethical but also illegal and could result in criminal prosecutions of not only board members but the members of the Central Park Medical group and myself. My suggestions would follow a more legal and ethical approach. I would suggest to the board that first of all, each and every board member refresh their reading on anti-kickback statutes and laws. I would remind the board that although certain allowances are made in these statutes, the terms which they have decided on regarding the medical group in question are specifically why the statutes are in place, to begin with. I would resubmit to the board a legal revision of the arrangement. It would include the merger between the Central Park Medical Group and the Sundown Community Hospital as one that promoted a helpful liaison to the patients, regardless of their insurance type. This would under no circumstances include any type of monetary gain from Sundown to the medical group, in the form of bonuses or perks. By definition of a joint venture agreement, the compensation received by the medical group would be limited to shared profit as well as losses. This is simply the only legal and ethical way to enter into such an agreement under these circumstances. I would also stress to everyone involved that since we are dealing with a medical group that has made us aware of their 60% Medicare patients, that we as the Sundown Community Health Center should be that much more concerned for the how the legality of this union appears. There should be careful measures taken to ensure that no one is receiving any type of kickback of any sort. I would also emphasize that since we are indeed a community center, we should be focused on the needs and best interest of the community and not our personal gains from the members of that community. In addition, I would remind everyone involved of the case of Feldstein M.D. vs Nash Community Health Services Inc.