It is not until I left the US, a nation of comfort I call home, that I realized the expanding world around me was not the pretty picture I imagined it to be. Arriving at the airport in Lima to aid as a medical volunteer was an opportunity I was excited to be apart of. However the city I stayed in, Miraflores, was an illusion to the crumbling healthcare system in Peru.
As they took us to a small village in the outskirts of Lima, I couldn’t help but notice the dwindling resources with every passing mile of the city. Roads were now dirt paths as buildings turned into shacks. Upon arrival in the small village of Cono Sur, we were greeted by the local physicians who helped us setup the medical aid tent where we would provide clinical services to the already growing line of locals waiting patiently outside. Setting up a medical tent feet away from dog feces was distasteful in itself, as I could point out more than a handful of HIPAA violations within the first half an hour of my volunteering. From improper sterilization to the questionably unsanitized patient chairs, the facility in itself was a harbinger for disease. I worked as an assistant to Dr. Sanchez, a young physician who tirelessly treated the assembly line of patients. From the many cases that came through the door, a common diagnosis of many villagers was a lungworm,as a result of bacterial infection. After scribbling a prescription to be taken to the pharmacy tent next door, Dr. Sanchez bid farewell with a cautionary “look out for your health”. In a village where young kids shared kisses with stray dogs and Inca Kola was more readily accessible than drinking water, looking out for one’s health was not much of an option. It was inevitable; there was only so much time before they would get sick again.
Leaving the village that evening to the sound of locals playing the pachango by the street corner and young children shimmying to the merengue under the faintly lit lights, the future health of these vibrant youths seemed just as dim. In a country where there was a clear divide between the haves and have nots, the wealthy would be healthy while the sick would get sicker. It is these health discrepancies that must be addressed for a community to move forward. Whether it is due to a lack of necessary resources or the inability of a government to provide basic healthcare for its people, sickness will continue progressing as improvement continues to stagnate. There is no use hiring a selfless physician to water the empty Peruvian soil. A seed of reform must first be planted in order for the villagers of Cono Sur to one day flourish.
We have all experienced going to a scheduled doctor’s appointment only to have to wait an eternity for the physician to see to us. It can be frustrating when we have a million other things to do that day, but the problem is actually much deeper than inconvenience—it is a sign of one of the biggest inherent flaws of our health-care system: the prevalence of the “15-minute appointment”.
Recently, I read an article in the Wall Street Journal condemning the briefness of the majority of appointments, and I thought it rose some valuable points that should be brought to attention so that the public is more aware of the problem. The biggest negative of the 15-minute appointment is, unsurprisingly, that the doctor is not allowed ample time to intimately discuss the patient’s issues, and as a result the patient does not get the care he or she needs. The resulting failure affects both parties: it can come in the form of misdiagnosis, wrongly prescribed medications, and burnout for the physician. In fact, the article states that in 2014, a full 54% of physicians met the criteria for burnout. The problem is also worsening, as only three years ago this figure was 10% lower. Doctors become more and more tired as they run around chasing their rigorous patient schedules, and then are not fully present and capable of treating the people they do see to the best of their abilities. Brilliant medical minds are being wasted if they are not provided time to think, and patients are suffering in the process.
What is the force propagating the 15-minute appointment, and why isn’t the problem obvious to everyone? Why are we allowing this to continue? If you asked me, I would say that it points to a systemic greed that is present in American health care. The incentive is to see as many patients in as short a time as possible, to write as many prescriptions and squeeze in as many co-pays. On the one hand, I do understand that health care is an industry. But on the other hand, delaying the instant gratification that comes from sheer numbers of payments will actually improve the economics of health care from the status quo. When patients are misdiagnosed because they barely had any time to explain the problem, they come back. Another or a different medication has to be prescribed. This costs more resources that didn’t need to be used, and it costs more valuable appointment time each time a patient has to return because they don’t feel any better.
I like to think that each doctor makes the choice to study and practice medicine because there is an empathy in them that leads them to believe that their calling is to care for others and provide the suffering with relief. Although this may be excessively idealistic, I think a good amount of physicians do possess this spirit, and so we should let them realize exactly that goal. Truly good doctors genuinely don’t want to halfheartedly care for patients, but there is not much of an alternative–they are not allowed to sit down, really talk to their patients as people, and help them feel better. This is why the 15-minute appointment should be done away with—for the health of our doctors, our patients, and our entire health care system.
What if I told you that there was a way to eliminate food insecurity while reducing our carbon footprint? That you could be boosting your protein intake with a healthier, more nutritious alternative to beef, chicken, pork, or even fish?
Eating insects will increase food and feed security and is beneficial to our health. The proteins that we’re eating right now are not viable for long-term sustainability. 1 lb of beef requires 10 lbs feed, 1000 gal water, 200 sq. ft. pasture (2 acres/cow). On the other hand, 1 lb of insects only requires 2 lbs feed, 1 gal water, and 2 cubic ft. land space. Additionally, cows cause desertification of land, loss of biodiversity from the land space, and 240 lbs methane/cow/year. Pigs and chicken also produce lots of manure which still has to be decomposed. In contrast, bugs don’t require much space or water. They’re also easy to produce (very fertile) and do not require special machinery. Moreover, bugs offer high nutrition, with an excellent protein to calorie ratio. According to Phil Torres, an entomologist, 100 g of crickets has around 13g protein but only 120 calories (100g chicken contains 24g protein but 219 cal). Ethical issues are also not a problem. By slowly freezing insects, they die by going to sleep. Because of this, many vegetarians are open to the idea of eating bugs.
Bosler, Cayte. “To Save the World, Eat Bugs.” The Atlantic. 25 Feb 2014. Web. 02 November 2015.
Cassimally, Khalil A. “Why Should We Eat Insects? It’s the Future of Food.” Nature. 06 June 2013. Web. 02 November 2015.
Martin, Daniella. Edible: An Adventure into the World of Eating Insects and the Last Great Hope to Save the Planet. New Harvest, 2014. Print
GBM #7 – Hemorrhage Control Event – John E. Locke
On Thursday, December 3rd, members of the UMD AMSA and Pre-Med Society gathered in the Benjamin Banneker Room in the Stamp Student Union for a presentation and hands on event presented in conjunction with local recruiters from US Army Medicine. The event started off with presentations from several different US Army Medical Officers, dressed with their medals proudly displayed on their uniforms. Their speeches involved the nature and benefits of attending medical school and becoming a physician through the United States Army system, with some personal background included for additional context and detail. If accepted to medical school through the United States Army system, tuition for medical school, normally ranging from thirty to sixty thousand dollars a year, is covered in full, as are books, supplies, and housing during the time as a medical student. In addition to this, stipends are often awarded to complete various projects, and a sign-up bonus further incentivizes the track. Pictures of the Army Medical facilities around the country added realness of this possibility, and the presenters told of their experiences within US Army Medicine. Discounts on health and life insurance, lower cost of living, tax deductions, streamlined payments, and a pension after twenty years of service were also mentioned as benefits of the system’s track. They also boasted a higher than average acceptance rate to residency programs. With tuition costs on the rise, and the debt of expenses accrued during medical school weighing on people’s minds, it is good to know that there are other options available. In exchange for these benefits, individuals who go through this system are expected to spend their summers serving at the Army facilities, and they are required to complete several years of service with the Army following their medical training, which can take many forms depending on the situation.
This service truly presents a wonderful opportunity for many people wishing to attend medical school, and can help those people realize their dream while serving their country and minimizing their financial debt. Anyone who is considering these programs should look further into the options available. http://www.goarmy.com/amedd.html In addition to the presentations, the representatives from the US Army Medicine gave a short clinic on hemorrhage and wound control while in the field, instructing the students on the various instruments and techniques utilized to minimize damage and preserve as much tissue as possible. This included hasty tourniquets, deliberate tourniquets, pressure techniques, gauze application, and wound wrapping. After the demonstration with a few volunteers, students were able to practice the techniques for themselves, with assistance and advice being given by the medical officers. This event truly represented a fantastic hands on experience and encouraged those involved to learn about a different field of medicine. Combined with the information presentations preceding the demonstration, this event was an incredible experience for all the students involved. The UMD AMSA and the Pre-Medical Society groups are very proud and grateful for this opportunity for their members.
At AMSA once, we had a guest speaker come in and talk about neuroscience. He had Tourette’s Syndrome, and spoke extensively about misconceptions about Tourette’s Syndrome. He even related the syndrome back to the infamous South Park episode which was praised for its accuracy. His presentation was absolutely fascinating, as he went to clear up many different thoughts people had on Tourette’s. I was able to learn so much from this lesson, such as the fact that there are different degrees of severity of Tourette’s. He showed us the different manifestations, and also told of how it has a hereditary disposition as well. I was especially fascinated at the public health and global health endeavors he was a part of. He showed us how he has been to many poor countries and has been able to treat people who would have lost their lives otherwise. Even so, he told us about the importance of not letting the harsh nature of the job influence our passion for helping people. He told us about burning out, and how not to let that happen, by constantly reminding ourselves that not every case should be taken personally. He reminded me a lot of a teacher figure because he sounded sincerely concerned for our success and our futures in medicine, and I do hope I have the privilege of working with him again in the future.
Full-tuition to medical school? Is that not the dream of every pre-medical student? The first step is to get accepted into medical school, and the second step is to worry about financial aid. In today’s modern world, medical students with M.D. /D.O. degrees often graduate with hundreds of thousands in debt. However, at AMSA’s recent meeting, I learned of an opportunity where I can be debt-free as a medical student while at the same time serve my country. And this opportunity is the Health Profession Scholarship Program. In this scholarship, 4-years of medical school are paid for by the US Army, including a stipend of almost $20,000. In return, the medical student has to complete residency at an army-based school and should also serve active duty time for a minimum of three years. This opportunity truly opened my eyes because I was not at all aware of this scholarship. I have heard the US Army gives financial aid to their medical students, however I was not aware that full-tuition worth almost half a million is all paid for. In fact, because of AMSA’s recent meeting, I learned of a significant and important opportunity where I do not worry about being in debit after medical school, while at the same time given an opportunity where I can serve my country in a profession that I am truly passionate about. It is opportunities like these that help me extend my connections, and also helps me truly pursue medicine with no worry of the financial burden that is almost inevitable for any medical school student.
Raising Drug Prices – Samantha DeSilva
In September of this year, Martin Shkekli, founder of Turing Pharmaceuticals, announced that his company would be raising the price of the drug Daraprim from $13.50 to $750. That’s more than a 5,000% increase. Daraprim is known for being the best treatment for preventing malaria, treating toxoplasmosis, and preventing other kinds of infections. Over the many years of its use, the drug has been a principle drug for AIDs patients or other patients with weakened immune systems. I was glad that we were able to discuss this issue during one of our AMSA meetings, where we watched clips of the issue from multiple news stations. It is appalling that this type of injustice can exist in our society.
Even today, after being seen as one of the most hated men in America, being called a “morally bankrupt scumbag,” and “everything that is wrong with capitalism,” Shkreli stands by the price increase and even claims they should have increased the price more. At the Forbes Healthcare Summit, Shkreli made it abundantly clear that his job was not to serve the patients, but to make the most money for his shareholders, after some time of claiming the reason for the price increase was to pour money into research. Instead of ceding to the critics, Shkreli blamed the capitalist system explaining, “No one wants to say it, no one’s proud of it, but this is a capitalist society, capitalist system and capitalist rules, and my investors expect to me to maximize profits, not to minimize them, or go half…”
Shkreli represents all that is wrong with pharmaceutical companies. Because of how disconnected drug companies are from the patients and how profitable they are due to their inherent necessity, they often do not work with the best interest of patients in mind. It goes without saying that what Turing Pharmaceuticals was morally deficient, but it does serve as a reminder, a reminder of what matters at the end of the day – the patients and their well being. As future doctors and even citizens of our world, we must remember the importance of working together as a community. We must never forget to think of others before we act.
Sources: http://www.forbes.com/sites/dandiamond/2015/12/03/what-martin-shkreli- says-now-i-shouldve-raised-prices-higher/ http://www.bbc.com/news/world-us-canada-34331761