For those of you who are at all interested in medicine, public health, or health economics, Atul Gawande wrote a really interesting and (I think) inspiring article in the New Yorker last month about caring for socially and medically complex patients. (http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=all)
His article does a great job of describing the rationale behind much of the work we do at my fellowship organization, the Primary Care Coalition of Montgomery County (PCC). One of the biggest weaknesses of the American health care system today is that it often fails to adequately address the needs of “medically complex patients” – patients with multiple chronic illnesses, for example – particularly when they are uninsured or publicly insured. PCC aims to fill in the gaps for low-income uninsured patients in Montgomery County, Maryland by connecting them to comprehensive primary care services at safety-net clinics and subsidizing their access to medications and specialty care services as needed.
Working here has definitely changed my perspective on health care. I’ve recognized that when patients come to the emergency room with uncontrolled hypertension or diabetes, it indicates not only that their bodies have failed to appropriately regulate their blood pressure or insulin levels, but also that our health care system has failed to provide them with the treatment, guidance, and support that they need to appropriately manage their disease. My fellowship experience has helped me decide that I’d like to eventually work at the intersection of medicine and public health so that I can both treat patients directly and work to address larger systemic factors affecting their health.
In addition to my work at PCC, I’ve also been enjoying the unseasonably warm weather here in DC. Hope those of you on the east coast are also enjoying this early taste of spring, and hope everyone has a great long weekend!
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