Case Study: Public Health Versus Individual Focus of Care
Kevin O’Brien is studying for his Master of Science Degree in Public Health (MSPH). As part of his clinical practicum he works with patients in the tuberculosis (TB) clinic. Patients with active TB are instructed not to work handling food (among other restrictions), to prevent contagion, until they have completed a full course of treatment and are medically cleared. One evening, Kevin and his roommate order a pizza to be delivered. Much to his surprise, the pizza is delivered by one of the patients who Kevin knows from the TB clinic. The patient recognizes him as well. Kevin says, “You know, you’re not supposed to work with food.” The patient says, “I know, but I don’t handle the food directly. I just deliver it. Hey man, don’t say anything to the clinic, okay? I really need this job, I have a family to feed.” Kevin says nothing in response, pays for the pizza, and tips the “patient/delivery man.” Kevin wonders whether he should even eat the pizza, and whether he should communicate his concern to his roommate. He is also conflicted about whether to report the incident to his instructor or preceptor at the clinic, or both. Kevin also was unsure whether “handling food” includes delivery, or what is involved in the patient’s job.
Discussion Questions
- Which should be the main consideration in this case, the potential for the public’s exposure to a contagious disease or the patient’s need for a job? Explain your decision.
- Should Kevin O’Brien share his concern about the possible contamination of the pizza with his roommate? Why or why not?
- Should Kevin report the incident to his instructor and/or the clinic staff? Why or why not?
- Should Kevin enter into a more direct discussion with the patient/delivery man?
- In this case, the main consideration should be the potential for the public’s exposure to a contagious disease. Tuberculosis (TB) is an infectious disease that can be transmitted through the air, and it is crucial to minimize the risk of transmission to protect public health. While it’s empathetic to consider the patient’s need for a job, the primary responsibility of public health professionals like Kevin is to ensure the safety and health of the broader community. Public health measures exist to prevent the spread of diseases like TB, and these measures should be upheld to protect the public.
- Kevin O’Brien should share his concern about the possible contamination of the pizza with his roommate. This is important because it directly affects his roommate’s health, and his roommate has a right to know about any potential risks to their well-being. By sharing this information, Kevin’s roommate can make an informed decision about whether to consume the pizza or take precautions.
- Kevin should report the incident to his instructor and/or the clinic staff. Reporting is essential in this case to ensure that proper public health protocols are followed. If the patient who is supposed to be under treatment for active TB is working in a job that may expose others to the disease, it is a clear breach of public health guidelines. The clinic staff need to be aware of this situation so they can take appropriate action to prevent further potential exposure and ensure the patient receives the necessary support and treatment.
- Kevin should enter into a more direct discussion with the patient/delivery man. It’s important for Kevin to communicate his concerns to the patient and explain the potential risks associated with his job. Kevin can express empathy for the patient’s financial situation but also emphasize the importance of following public health guidelines to prevent the spread of TB. Encouraging the patient to discuss the situation with their healthcare provider and explore alternative employment options that do not pose a risk to public health would be a responsible course of action. Ultimately, open communication may help the patient understand the gravity of the situation and make informed decisions regarding their employment.