Not sure how many of you read this New York Times Magazine article from a few months back but it has stuck with me and I have been reminded of it several times since starting school. SO, I thought I would share it with you.
One way in which I found this article interesting was the way it addressed the issue of community health workers and ancillary providers, and how in developing countries they are relied upon to bridge the gap between the abundance of patients and the few doctors often available to care for lage populations. It is a way to address the issues of cost and access, among others.
In the US we also have a great need for this sort of "gap" care which for many people could be in place of the majority of their primary care and if provided in a proactive way, could not only eliminate unnecessary hospitalizations and reduce healthcare costs, but could improve the quality of life for many people. I think Americans tend to be very closed minded to the idea of someone other than a doctor providing medical care, exhibited by many peoples' reluctance to see nurse practitioners, etc. Our healthcare system doesn't put enough emphasis on the "medical team" approach, although there have been several attempts to bring this to the forefront with managed care, etc. I think more people would get the care they need if more resources were put into programs like the one profiled in this article.
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Great article, thanks for sharing Noemi. The concept that we would be comparing the state of health care in Mississippi to that in Iran is striking—even more striking to say that the system in Iran is more effective. I was particularly struck by the themes of medical mistrust and cultural competence that are weaved throughout this article. But these are not just symptoms of the American South; these are issues that are rampant right here in the Bay Area. In West Oakland I worked very closely with a retired physician who has spent his golden years attempting to make residents healthier—including the implementation of a very ambitious asthma management program in public schools. Despite these innovative solutions, parents routinely miss appointments. They do not take advantage of these services. What could be the explanation for this? The program is free to all patients, so neither insurance nor money is the issue. The program takes place on school grounds, where children must be taken every school day, so transportation doesn’t seem to be the issue. One likely culprit is simply the fact, highlighted very bluntly in this article, that the health care professionals involved in this program do not look like the residents of West Oakland. This seemingly trivial issue could very well be the reason that health disparities are so great in low-income communities and rural communities. These observations just go to show the importance of understanding the human aspects of health care—aspects that, according to this article, seem to be more fully realized in Iran than in the U.S.
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