“You don’t train someone for all of those years of medical school and residency, particularly people who want to help others optimize their physical and psychological health, and then have them run a claims-processing operation for insurance companies.”

 — Malcolm Gladwell, from Forbes’ "Tell People What it’s Really Like to be a Physician"

It was really hard picking one section to quote because I loved almost every line of this article. <3 Malcolm Gladwell. Is he married?? Lol, joking.

The world is copying me

Just kidding.

But still, I thought I was unique...

• Secretary Clinton's Remarks on Global Health Initiative: "The United States is investing $63 billion - first, to sustain and strengthen our existing health programs, and second, to build upon those programs and take their work to the next level by collaborating with governments, organizations, civil society groups, and individuals to help broaden the improvements in public health that we can expect. We're shifting our focus from solving problems, one at a time, to serving people, by considering more fully the circumstances of their lives and ensuring they can get the care they need most over the course of their lifetimes. ..." (Btw, this speech was actually at the Johns Hopkins SAIS in DC. Crazy. Hopkins represent!)
  
• And this dude...who started a public health education and training program for rural Haitian youth: "I'm striving to be more than just a physician. I want to be an advocate for human rights, a voice for those whose voice goes unheard and a face for the poorest of the poor. I don't imagine myself in a hospital or in a lab. I'm interested in political medicine, changing policy, the way medicine is practiced, the way it is distributed, and how it is defined."
  
• And this other Dr. Francis Collin dude too: "The aim of the [NIH/PEPFAR $130 million global health initiative], Collins told Nature in an interview in July, is 'to build research capacity in African institutions to enable them to begin to play a larger role in studying their own health needs, in providing solutions, because I think the era of the developed world swooping in, doing the research, saying 'here's what you should do' and leaving is not the era we want anymore.'"
• And this dude Nicholas D. Kristof, this chick Maggie Doyne, this dude Professor Peter Singer: "Many people want to connect to a cause larger than themselves, but they are busy and juggling priorities, have limited time and don't know quite what to do. There's a market failure there; so many people who would like to help, and so many people who would benefit from that help, but there's a shortage of channels to connect them...The challenge is to cultivate an ideology of altruism, to spread a culture of engagement - and then figure out what people can do at a practical level."

23-year old Maggie Doyne with her kids at the Kopila Valley Primary School, which she is the founder and principal of.

• And this mere commentator dude on Kristof's article: "I am sad to say that I am afraid you are correct, and Americans will turn back inwards. After 911, it was fear that motivated many, I believe. I think the only way to hope for us to really get it would be for us to learn the real links between our own prosperity and the poverty of so many worldwide..."
  

Poo. :(

Oh well, on the bright side, and the only side that matters, other people are already acting on good ideas and doing good. How awesome is that?

Malpractice litigation + health insurance + Atul Gawande's Better

I've been working my way through Atul Gawande's Better, and as I'm writing this, I realize that I'm more than halfway through, which surprises me a little. I don't feel like I've read that much...sign of a good writer?

I loved his debut, Complications. My boyfriend asked the other day, so is the 2nd book really better? Ha. I'd say it's more serious. By this, I don't mean that Complications dealt with fluff, but the topics that he chose to cover in Better (litigation, health insurance, patient privacy) definitely reflect the years that has passed--and its requisite experiences, feelings, growing bitterness?, definitely growing disillusionment--since his residency, when he wrote his debut.

There are many passages of the book that has stuck with me, but the most recent one pertains to malpractice litigation:

The one defense of our malpractice system is that it has civilized the passions that arise when a doctor has done a devastating wrong. It may not be a rational system, but it does give people with the most heartbreaking injuries a means to fight...And although it does nothing for plaintiffs, people whose loved ones have suffered complications do not then riot in hospital hallways, as clans have done in some countries

When I read that, I thought, Ha, that's what happens in China. Where do I begin? The doctors who get ambushed publicly when loved ones day? The reporters who get maimed for investigating doctor misconduct? The lack of respect and satisfaction doctors in China feel? Reading that passage above made me suddenly wondering, would a better justice/legal system not only help human rights and other areas but also the health system? Just a thought.

Gawande then goes on to talk about health insurance: insurance considerations start from the moment someone calls to make an appointment. Making sure they have insurance, making sure you as the doctor falls in their insurance's network, making sure the insurance covers the visit or service, making sure the patient is aware that he/she has to bring in money for the copay, entering in the right referral number, preapproval numbers, insurance-plan numbers, diagnosis codes, procedure codes, visit codes, tax ID number, etc. etc. Reading it just makes my head spin, I don't want to think about actually doing all of that...Just like Gawande, I've heard from doctors, almost-doctors, and potential doctors alike that insurance is/was their biggest concern. And I can kind of get a feel for that. No wonder concierge practices are getting more popular. More on this later. (I'm shadowing a concierge doctor now.)

Dr. Abraham Verghese

This man is amazing. Another hero to me. Up there with Jim Yong Kim and Suzanne Farrell...he gives me hope and inspiration for pursuing medicine and arts at the same time and finding unexpected but welcome connections between the two.

At Stanford, he is on a mission to bring back something he considers a lost art: the physical exam. The old-fashioned touching, looking and listening — the once prized, almost magical skills of the doctor who missed nothing and could swiftly diagnose a peculiar walk, sluggish thyroid or leaky heart valve using just keen eyes, practiced hands and a stethoscope.

Art and medicine may seem disparate worlds, but Dr. Verghese insists that for him they are one. Doctors and writers are both collectors of stories, and he says his two careers have the same joy and the same prerequisite: “infinite curiosity about other people.” He cannot help secretly diagnosing ailments in strangers, or wondering about the lives his patients lead outside the hospital.

Physician Revives a Dying Art: The Physical