Honors Service Learning

Zaber Malik
Sociology 2000
Professor Brewster
December 4, 2016

Entry 1Background Information

I am going to volunteer at Carpenter Pharmacy under the supervision of pharmacist, Hien
Ha. My goal at the pharmacy is to identify if the income level of the patients has to deal directly
with their healthcare. While determining the income levels of each individual patient I should
have a better understanding of how it affects their personal health, beliefs, their actions, and how
they interact. For example, some patients that enroll in this particular pharmacy are way under
the poverty line. On the contrary, there are patients that have better health insurance and thus,
having better health in total. During my volunteering experience, I will identify what economic
factors play a role in the patients overall welfare. Lifestyle choices, income level, certain
government programs, and what medication they receive can affect their health greatly. In the
class, we were taught to think as a sociologist; someone who studies human society and the
interests that humans have. Understanding where each patient stands socioeconomically can help
reveal what is causing more or less people to be sick or not sick. The pharmacy I am going to
volunteer at is located in Hamtramck, Michigan. The population is currently around 25,000
according to the U.S Census Bureau. At the end of the essay, I will identify what organizations
can help lower income patients afford better healthcare and better inform patients on what they
are taking that affects their health. Health insurances cover some medications based on their
formulary, which is a list of medications they will cover the cost of. Income inequality is
prevalent in today's society and it shows in the lifestyle we choose.

10/08/2016 Entry 2 Volunteering Experience

The first day I volunteered at the pharmacy I noticed that most of the patients are
below the poverty line. Most of the patients at this pharmacy have state provided insurance
because they are below the poverty line. The patient would approach the counter to pick up their
medicine once it was finished; a pharmacy technician would sign the medicine out and then give
it to the patient. The patient would look at their medicine and realize that some of the medication
they used to get prior to this visit was missing. The patient would be surprised and question the
pharmacist about why the medicine is not in their bag anymore. The pharmacist then explained
to the patient that their insurance did not cover the cost of the medication. Soon after, the patient
explains to the pharmacist that they need their diabetic test strips to test their blood sugar. Now,
the problem is the patient needs the medication but the insurance does not cover it. The patient
left after a moment of debate. Through the rest of the day, the normal routine of a pharmacy
occurred. A few patients would come in with scripts, and the pharmacist would fill them. Close
to the end of the day, a particular patient came in that had prescriptions for diabetic tests strips
and syringes. When I seen the preescription, I assumed it was not going to be covered because
most of the state provided insurances, such as Medicaid do not cover it usually. However, I
became surprised when the pharmacist processed it through insurance and it was covered. I
questioned the patient on what insurance that they have, they patient explained to me that they
have work insurance which covers more medications then regular state provided insurance. After
the last patient, the pharmacist counted the inventory and cleaned up around the pharmacy and
then closed it for the next day.

10/08/2016 Entry 3 Reflection

As said in class, social class is a large group of people who rank closely to one
another in the amount of property owned how much power they have in the society, and
prestige. This idea was developed by Max Weber, who invented the term "Social Class".
When applying this concept to the patients at the pharmacy, I realized that most of the patients
are below the poverty line. This identification made me understand where they stand in society
economically. A small percent of Americans own the most wealth in the country. The first patient
that entered the pharmacy for the diabetic test strips was charged an expensive price because the
insurance did not cover the cost of the medication. The second patient brought in the prescription
for diabetic test strips and syringes and they were both covered by the patients workers
insurance. In class, we identified wealth as the value of the property owned subtracted by
the persons individual debt. The wealth of the first patient was lower than the second patient.
The problem I have with this situation is that a patient that is less fortunate cannot receive
medication that they need vitally because of the insurance that they have. This proves inequality
is still substantial in the United State because the poor are not offered certain vital resources and
the wealthier are better well off. Karl Mar's ideas we discussed in class on health portray just
that. "As you go up the social class ladder your health improves while going down the social
class ladder your health decreases as well" (Brewster). Many patients that have Medicaid are
lower on the social class ladder from my observations. It is also possible to move up and down
the social ladder and the movement correlates to increase in wealth or property. The higher you
go up the more perks you have, in a sense.

10/14/2016 Entry 4 Volunteering Experience

During my second volunteering experience, I met new patients at the pharmacy and
explained to them what my one my goals were with volunteering at this specific site. I wanted to
help patients and inform them on certain medications and see if they can make any changes in
their personal lifestyle. When the pharmacist checks the basket, he then asks the patient if they
have any questions that way they can help inform them more. This particular day I noticed that
the patients that are enrolled in this pharmacy are primarily, African-American and Bangladeshi.
I made the observation that about 40% of the patients that day are regular smokers. I asked 20
patients if they smoke cigarettes 8 out of 20 them said they smoke cigarettes. After asking, each
of the 8 patients why they smoke, they would explain to me it is because of the stress they have,
usually from bills. The patients would wait for their medication and during that time they would
smoke a cigarette outside the pharmacy then come pick up their medication. I found that each
patient that smokes is on an inhaler of some sort, such as Ventolin or Symbicort. The patients
would leave and usually start coughing after smoking. I did not understand why some patients
smoke if they are asthmatic but then it might be because of the lifestyle that they live. Not every
patient is properly informed on some of the consequences of smoking. Lifestyle choices affect
our health and many of our choices are influenced by society or aspects of society. The smokers
that are enrolled in the pharmacy tend to be more dependent on certain medications based on
their lifestyle choices.

10/14/2016 Entry 5 Reflection

In class, we discussed factors that influence our health such as income, lifestyle
choices, and stress. Each one of these factors plays significant role because it can decrease or
increase the length of our life span. During this day, I met patients that are regular smokers. By
regular smokers, I define them by smoking at least one cigarette a day consistently. Our income
affects our health because the higher the income the more affordable health care coverage is.
Income separates people and what they participate in. Our lifestyle choices are shaped by our
income because we can only act a certain a way or partake in certain activities with a limited
amount of capital. Lifestyle choices can either be positive or negative to our health. Also, since
the patients feel stress about the bills they have tend to smoke more or just smoke period rather
than a person with a higher income. I can conclude that the patients that smoke are smoking
because of the stress they have due to the bills they have. The smoking then has negative effects
on their health which can lead to diseases such as lung and heart cancer or chronic obstructive
pulmonary disease. I asked myself, why so many patients smoke cigarettes and then use inhalers
as if it will cure their problem? It may be because the patients that are less fortunate are less
informed versus patients that have more wealth then them. In class, we discussed about
causation and what triggers it. Having stress and bills can constitute for negative effects on
someones life. The reason some smoke is because they were around others who smoked
prior to them. Unfortunately, being socially integrated with other smokers will tend to
increase the likelihood of someone smoking a cigarette.

10/15/2016 Entry 6 Volunteering Experience

Volunteering this day was interesting to say the least. I began to learn what medications
treat what diseases. I would ask patients what medications they are on and if they are physically
active in their life. The patients that came in that were on diabetic medication were either
overweight or considered obese. Physical fitness is a major key in keeping a healthy life. The
pharmacist tried to explain to the patients that obesity is a common killer in today's society and
how not changing your lifestyle could have an adverse effect on your health. The patients I
observed all agreed that they just take medication the doctor prescribes as a solution to their
diseases or ailments. However, also keeping exercise as a value instead of a hobby could greatly
increase your health. A patient came from the doctor and wanted to find an alternative solution
instead of taking a medication called; adipex, which helps patient lose weight. The problem the
patient had was is that the insurance company did not cover it because the patient is older than a
certain age which does not stand by the formulary of the insurance. The patient used to be
covered by their formulary before the age of 18, but the age limit was stopped 18 for this
medication. The patient then explained to the pharmacist that they need this medication and there
is no way for them to lose weight without it. At the end of the day I asked the pharmacist about
ways patients can lose weight by exercising and if it is easily accessible. Most of the patients are
not wealthy, so the pharmacist said just walking or jogging around the neighborhood can help
decrease your weight. At the end of the day, I restocked the toothpaste and other dental items in
the front and threw away the trash.

10/15/2016 Entry 7 Reflection

In class, we discussed about value clusters and how Americans have a list of values
that they find important to them. Some of the values that Americans rank high are physical
fitness and youthfulness; however, some do not value them the same. At the pharmacy, the
patients that were overweight seemed as if they did not care about their physical image. Most of
the patients that were overweight looked to medication to solve their obesity, instead of actually
being physically active. We identified 10 core values; achievement and success,
individualism, hard work, efficiency, technology, material comfort, freedom, democracy,
equality, and group superiority. Value contradictions are prevalent in today's society because
some people value other ideas more. For example, ideal culture is a person's values and norms
or the goals they accept to obtain. However, real culture is the norms and values that people
actually follow; as opposed to the ideal culture. The ideal culture is for patients to want to
exercise and be physically active. The real culture is that not every patient has enough time or
money to be physically active. The patients that are overweight tend to rely more on medication
to solve their obesity problems rather than being physically active. They would rather spend their
leisure time on doing things that they find entertaining even if it is not increasing their health. In
the reading, "Culture or Fear", Glasner talks about unfounded fears. Patients do not
understand that taking these prescription medications can potentially harm you rather
than taking illicit drugs. So the assumption that medication can help you is not always true,
sometimes there are alternatives such as exercising.

10/29/2016 Entry 8 Volunteering Experience

I came into the pharmacy today and was excited to come to work to experience another
day in the life of a volunteer. A young male came in today with a prescription for condoms; at
first I was surprised, because I did not know insurances covered condoms. When the pharmacy
technician processed the prescription it went through and then the pharmacist checked it and then
they took the patient out. Later on in the afternoon, a female patient came in with a prescription
and asked if tampons were covered through insurance. The pharmacist then replied that they are
not covered because it is not in the formulary of her insurance. The patient was furious because
she knows the male patients are covered for condoms. She felt like she was being treated unfairly
and she still kept questioning why the insurances would not cover it. The pharmacist explained
that condoms are a way to have safe sex and that it helps keep sexually transmitted diseases
contained. Also, the pharmacist explained that tampons are not covered because the insurance
companies see it as not a necessity and more of a luxury. The patient felt that the pharmacist was
acting based on their gender; but the pharmacist assured the patient that there is no bias when it
comes to patients medicine. I explained to the patient that tampons are not covered through
insurance because they do not have it listed on their formulary. A formulary is a list of drugs that
insurance companies compile in order to illustrate to people what costs of medicine they will and
will not cover. The patient asked for the formulary and I told her that she would be able to find
all the information on the internet. Most insurance companies have their formulary posted online
that way it is easily accessible for the patient. At the end of the day, I took the trash out and
cleaned up around the pharmacy, so the place can be ready for the next day.

10/29/2016 Entry 9 Reflection

In class, we learned about sex and gender and how society there are problems related to
gender inequality. At the pharmacy, the female patient noticed a male patient fill a prescription
for condoms and assumed she would be covered for tampons. The patient did not know that
condoms are part of the formulary for the other patients insurance. Tampons are not covered by
insurance companies in the United States. Gender inequality was not showcased here because
there was nothing further the pharmacist could do, unless the patient would purchase it
themselves. Gender inequality is when a male or female are treated differently because of the
biological parts they are born with. The female patient is experiencing ascribed status because
you are usually placed into it involuntary. For example, being female is an ascribed status in
this situation even though gender inequality was not showcased. Todays incident was more
so, miscommunication between the pharmacist and the patient about the condoms and tampons.
The patient assumes the pharmacist will play his role, which is the behaviors, obligations, and
privileges attached to a certain status. She wants the pharmacist to find a way for her tampons
to be covered; however, the pharmacist explained to the patient that it is not part of the insurance
company formulary. The difference between role and status is that you occupy a status and
roles let people know what for them to expect of you. In this case, the pharmacist let the
patient know that if they had prescriptions for other medications that are covered by her
insurance company, then he would be more than glad to fill them. After the patient finally
understood, she bought the tampons and went on her way.

11/12/2016 Entry 10 Volunteering Experience

When I volunteered today, the pharmacist told me to pay attention to the front of the store
and if something was missing, and then restock it. He also wanted me to pay attention to the
pharmacy technicians and how they operate as a whole. One technician would pull out the
medication and the other technician would count the medication and then have the pharmacist
either double count the medication and to verify that it is the right medication. Each cog in the
chain is dependent on the person previous to them. The technician would service the patient and
take their prescription. After the pharmacist would type up the prescription the technicians would
then proceed to pull the medication and count the correct amount. At the end, the pharmacist
would sign the patients medication out and ask them if they have any questions. The patient
checked the medication to make sure everything is there that they need and then leave. I was
very impressed with the way the workplace conducted them, as if they are one machine. I would
restock the plastic bags and ask patients if they needed any water or if I could make their visit to
the pharmacy more enjoyable. The wait time was relatively minimal the way the pharmacist and
the technicians processed and distributed medication. Each person kept certain a distance away
from each other while they were working as if they were marking their territory of work. Close
to the end of the day, I swept up the floor and helped move empty capsule bottles to the other
side of the pharmacy that way it could open up space for others to walk. Once the floor was
swept up and the windows were wiped down we were all able to leave. I took into consideration
the teamwork the workers portrayed as if they all had a common goal in mind. This reminded me
of organic solidarity.

11/12/2016 Entry 11 Reflection

In class, we discussed a concept called organic solidarity, which means the
interdependence those results from the division of labor; as part of the same unit and
depend on the person previous to them to fulfill their task. This portrays the pharmacy setting
because the each one of the workers acts like a cog in the machine. If one cog gets clogged then
the machine will not be able work; hence, patients will not receive their medication on time and
will have to wait. Division of labor helps because it does not place all the tasks on one sole
person, it would be much more efficient to distribute the tasks between the workers that way the
time spent is productive. Each worker tried to keep their own personal space, a personal
bubble that we try to protect to a certain extent. Each technician needed their own work space
that way they can get their task done and help increase the speed of the process. The goal I have
is to use personal space to my advantage and make the patient smile, or even use body language
such as waving good bye or thanking someone. I play the role as the helper in the pharmacy,
whether that is a patient or doing something for the pharmacist such as restock the inventory on
the outside. The pharmacist wears a badge on his chest that is titled with the word pharmacist;
this is an example of a status symbol. For example, the status is being a pharmacist and the
role that they have is to count and check medication, to inform patients, and to process insurance
claims for patients. Being a pharmacist is also considered an achieved status because it takes
a long schooling to become and is a very well respected profession in healthcare.

11/19/2016 Entry 12 Volunteering Experience

During today, it was a very busy day for the pharmacy we could barely eat lunch. I had to
cash people out when they were buying over the counter products such as diapers and
mouthwash. I had to restock inventory again today, however, then a particular patient came in
with a prescription for his blood pressure medication. When the pharmacist received the
prescription, he tried to run the claim through insurance but it did not progress. The insurance
company denied the claim because the patient already has been given this medication a week and
a half ago. The pharmacist then explained to the patient that they cannot receive their monthly
refills today because they have already received it recently. The insurance companies let us know
what we are able to process and what we are not able to process. They provide us with guidelines
that we have to follow in order to maintain the professionalism and order in the pharmacy. The
insurance companies give rules, and within the confines of these rules we are able to either
charge this patient which means they have co-pays or we are able make a claim through
insurance, which would be covered. The laws are upheld by everyone in the community from the
police, which are law enforcement to the citizens of the community. There are certain rules,
guidelines, and protocols that people/workers have to follow in order to maintain order. This
gives us support and lets us identify what is right and what is wrong. Some actions we are
capable of doing another we are not. For example, running a prescription through an insurance
claim is something a pharmacist can do. However, when the pharmacist processes the
prescription he has to follow the proper guidelines when he does.

11/19/2016 Entry 13 Reflection

In class, we discussed the functions of structure and institutions. Structures are related
to which in the way society is organized and how people meet certain needs. Institutions are
either educational, religion based or economic and they act by enforcing structure. In this
case, the structure is the protocol and guidelines, such as the formulary that insurance companies
have and the institution that upholds this are insurance companies. Social structure guides our
behavior because it gives a certain way to act or to do things. The pharmacist has to obey and
practice the laws upheld by the government and he has to comply with the rules of the insurance
companies. A taboo refers to a norm so strongly ingrained in our society that even the
thought of its violation is entertained with revulsion. A mores are norms that are strictly
enforced because they are thought as essentials to core values or the well-being of a certain
group. It would be considered a mores if the pharmacist processed a prescription and forgets to
signature it with his or her initials. Practicing norms such as following rules and guidelines is
a norm itself, it uphold the values that people define as good or bad. If the institution is
notified that the structure is not being followed then sanctions will be applied. A sanction is the
reaction people will receive for either following or breaking a norm. In this case, the
pharmacist upheld the structure with guidelines by the institution which will result in a positive
sanction rather than a negative one. A negative sanction would be for the pharmacist to do
something out of his authority that does not comply with the insurance companies rules.
Sanctions let people understand if what they are doing or not doing is correct or incorrect.

11/26/2016 Entry 14 Volunteering Experience

This was my last day of volunteering at the pharmacy and I cherished every single minute
of it. I restocked the shelves how I am normally would and wipe down the windows and chairs. I
greeted patients and see if they needed anything or if they needed help. Patients would come in
pick up their medication and I would escort them out and give them a wave good bye. I made eye
contact with the patient and smiled as I would walk each one of them out. I would even open the
door for patients when they were entering and exiting. The patients would pleasantly smile at me
and thank me for my service. Later on in the day, more patients came and picked up their
medication and then left. Close to the end of the day, a patient entered the pharmacy and the
clothes they were wearing I have never seen before. The patient was clothed in a burka, in Arabic
it means to cover the full body from head to toe with only the eyes visible to others. Furthermore,
I attempted to greet the patient with a smile and a friendly hello but I still was shocked about the
clothes she was wearing. I asked her where did she get this outfit from and she responded from
the local clothing store in Hamtramck. Before today, I never really noticed what people were
wearing because it would generally be the same clothes. Today, I was more shocked than ever
because it felt like I was disoriented. I proceeded to ask the patient more questions on her
clothing and she responded to me that it was part of her belief to cover up her body from others
in order to stay modest. I listened and relied that not everyone is the same and people have their
own right to eat, say, and wear what they want too. The clothing that people wear is part of the
material culture because the items are physical things such as clothes, paintings, or even jewelry.

1126/2016 Entry 15 Reflection

In class, we discussed different cultures and how everyone is different because of the
beliefs and values they practice. The patient that entered the pharmacy today was wearing
clothing I have never seen before. At first, I experienced culture shock because clothing of
this nature was never showcased to me before. However, I asked the patient why she wears
this specific type of clothing and she explained to me it is for her religion. Culture relativism is
when a person is trying to understand someone elses upbringing by looking at that culture
without judging it based on your own views. The quote, A last thing a fish would ever notice
is water (Ralph Linton). The burka the patient was wearing is considered material culture but it
also has aspects of non-material culture because the clothing has meaning in practicing her
religion. Robin Williams identified freedom as one of the core values that people consider
important. For example, the patient is able to express her freedom of religion by wearing
symbolic clothing. Individualism is also another core value identified by Williams that
Americans consider important. If I experienced ethnocentrism instead of cultural relativism,
then I would have made assumptions on the patients religion based on my own beliefs.
The customs, beliefs, and traditions we do not notice are because it is where a way of
growing up so we thought for it to be normal. Ethnocentrism usually ends in a negative way;
however, it can also have a positive effect as well. This concept was developed by William
Sumner (1906). Having an open mind can help you understand the world as it is for everyone as
well as for yourself.

Reference

Henslins Sociology: A Down to Earth Approach REVEL

Glassner, Barry. The Culture of Fear: Why Americans Are Afraid of the Wrong Things. New
York, NY: Basic, 1999. Print.
Lecture from Class (Professor Brewster)