Insurance and Health Care Reform Support Group
This community deals with health insurance issues and major health care policy creation or changes (for the most part, governmental policy). Communicate your ideas, problems, solutions, and experiences here.
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I recently attended a conference and had the honor and privilidge of listening to three young doctors who have graduated this program (Latin American School of Medicine). Among them, was a young man from Honduras who shared with us his vision of returning to Honduras and creating a health care infrastructure that meets the needs of the indigenous peoples of Honduras. He testified that the people of his village and region have not had health care of any type for the past 118 years. He talked at great length about the type of medicine he wants to establish as regular practice in his country. The following is a summay of an illustrative story he shared.
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A woman comes into the clinic complaining of severe back, neck and shoulder pain. She has this pain because she has to carry water and firewood great distances every day in order to feed her family. The doctors at the clinic examine her. They then prescribe a 5 days course of anti-inflammatory medication and order her to rest for 15 days so that her muscles can heal.
She returns two weeks later and requests more medicine because she has to be able to feed her family. The doctors realize that she took the pills that were prescribed, but did not take the 15 days of rest because if she did there would be no one to feed her family. They give her another prescription for anti-inflammatories and again tell her that she absolutely needs to rest. She returns again 15 days later in the same circumstance.
How then should we (as physicians) treat this problem? If we continue to give her anti-inflammatories, she will develop a whole host of problems including liver disease, kidney disease and stomach ulcers. If she takes the rest from hauling the water, her family will starve. If she takes the rest from hauling the firewood, she will not be able to cook the food anyway plus the water will not be purified and many diseases and medical conditions will arise from contamination.
We propose that if we instead provided this woman with a passive-solar oven instead of medicine and rest, she would be able to cook her food without having to carry wood. Additionally, she would be able to purify her water without having to carry wood. She also would not need the anti-inflammatory medications.
In this manner, we have eliminated all of the diseases, recognized the real illness this woman suffers from and treated the whole patient.
Other solutions: teaching the patient how to carry wood differently to make it therapeutic instead of damaging (it IS possible). Getting the village women organized so everyone collects wood together and walks it back on a wagon.
So many "medical" problems need help from social services.
Many problems need more than one solution and the whole community to become involved rather than just throwing a pill at them.
Diabetes is another good example. Type 2 was previously unheard of in youths and adolescents. Now, it may soon have potential social consequences that could eclipse those of smoking tobacco.
What happens when the trees are gone?
Check out my MS group post "Absorption Cycle" on the fisrt page of 25 posts or my MUCH longer "B12:Synthesis of Myelin" post about 12-13 pages in.
-Best Wishes
Small example: I once mentioned to a nurse that I hadn't been sleeping well the past two nights and she immediately told me to "get a prescription for Ambien," an addictive drug. It didn't even cross her mind that it might clear up by itself, which was my (correct) thought.
You go in with chronic heartburn, they say you have gastric reflux and order an upper GI series instead of telling you to lay off the meatball sandwiches with beer for breakfast.