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Showing posts from March, 2011

Haiti and the conundrum of being merciful without enabling dependency

I just got back from 2 weeks on the Haitian island of La Gonave. We have a longstanding exchange established between our community in Idaho and several communities there.  Last year, a few months after their earthquake, I visited for the first time, carrying medical supplies and planning on delivering care to the injured and ill. In fact there were very few injured and ill, partly due to the fact that La Gonave is very rural and few houses were occupied at the time of the quake. The other important fact was that this part of Haiti, with few if any medical providers, does not support sick or injured people very well and so they either die or recover.

This visit was primarily to study their medical resources, beliefs, health concerns, and to advocate for better sanitation practices and water antisepsis. I was unable to resist bringing medications and supplies, and also stuffed my suitcase with condoms to hand out like candy.

Community organizing around effective ways to use their medi…

Practicing good medicine by paying attention to the patient

I just read an article in the New England Journal of Medicine by Sean Palfrey MD, a professor at Boston University School of Medicine in the department of pediatrics.  Dr. Palfrey dares to state the obvious, in a world in which the telling it like it is can be the kiss of death.  Dr. Palfrey writes:

Every participant in our health care system must focus on ways to optimize health while decreasing cost, at every step of the process. We need to change the financial incentives currently embedded in health care reimbursement systems that reward the use of tests, procedures, consultations, and high-cost therapies. And finally, the legal system needs to be more restrained about pursuing lawsuits when a difficult diagnosis is missed or a treatment fails, to diminish the pressure on health care providers to practice expensive, defensive medicine at every turn. These are major changes, but today we are far from providing good care for all our citizens and far from achieving health care…