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Overview: Healthcare Ed

So much has been happening lately that I can't even come close to keeping up with my journal. This weekend I'm attending a conference at NCNM on "Transforming the Mind" and the presentations today were fascinating. I think the most interesting one for me was this wild mathematician guy who has decided to represent aspects of dynamic living systems in three dimensional moving lines as drawn by his computer. But I don't want to write about this too much now. There will be more of this conference, and I'll have more insight after I finish the whole thing.

Last weekend I saw The Business of Being Born. It's a documentary movie on modern medicine in the US, particularly on hospital childbirth as versus home birth and widwifery. Pretty interesting movie, and I want to post a bunch of factoids and gleaned from it.

I also have studying to do, so will be posting notes. Next week is lab finals (cadaver lab and palpation), takehome finals in clinical correlates and biochemistry tutorial are due, and a paper for honors in microbiology, which I am contemplating doing. I didn't expect to score well enough to get honors, considering that I've barely scraped by with averages between 70 and 80 percent so far. To get honors in micro you need a 90 or better. But he adjusted the scores on the midterm sufficiently that my miserable ignorance of the subject earned me a 94%. Many students scored well over 100% with his curve. Though he doesn't admit to having curved it. He says that he removed the questions that the most people got wrong. Not exactly the same as a curve, but the effect is the same.

The week after is finals week, one big exam each day. I'm not very well prepared, but then it seems I never am. Some students skipped the conference this weekend but are down in the library studying all day. They'll be the ones who deserve honors.

On Thursday the former governor of Oregon spoke at NCNM, and I thoroughly enjoyed his talk. Governor Kitzhauber spoke on our failing medical system. His talk was EXCELLENT. He immediately pointed out our 10 trillion dollar debt ceiling, and threw down the gauntlet to the baby boom generation. He spoke of the dire legacy that his generation will have, should there not be some dramatic change, and soon. In just a few years the Baby Boom generation will be retiring. He didn't bring up the numbers about medicare but I hear that expenditures under that program have increased by 25% in the last decade, and we already know that our government is in debt. The combination of our increasing national debt with the skyrocketing costs of healthcare for the boomers as they age could easily take us over the edge into financial collapse. And if you watch the news, bank failures are on the horizon.

Gov K highlighted our investment in the current medical system, using stats such as 1 in 11 jobs is in healthcare, 1 in 7 dollars is spent on healthcare, and 84% of US citizens have insurance, and receive most of the care. So transitioning to a new way of doing things won't be easy. People will lose jobs. Companies will fold. But if we can't all come to the table and create a new idea, a new plan, our citizenry will continue to die of chronic disease that is "managed" after it reaches crisis proportions. Governor K said that 70% of our current medical dollars are spent on people with chronic disease, yet our system is not well set up to actually treat chronic conditions. Each individual chronic condition is treated with a separate drug, instead of addressing the health of the whole person, and the overlapping nature of chronic diseases.

He pointed out the irony of even calling it "healthcare". It is sickcare. Insurance paid sickcare. If your condition improves, or you avoid getting ill, that is not billable, so our current system couldn't give a damn. A more functional system in his vision would have three levels, 1st the wellness system, which would govern environmental, social and behavioral factors that combine to create societal health (or illness). The second level would be the medicine, which would incorporate much of what we have now, and the third level would be the financial system, which needs to be rearranged substantially from the way we're doing it now.

Governor Kitzhauber has begun the process of attempting to create consensus and bring people together in the name of acting together for the greater good. It's a long shot, but I for one completely believe in what he is doing. He was an excellent speaker and he gives me hope. He said what I would say if I were a bolder speaker. Perhaps someday I will be able to light a fire under people the way he does.

Here's the website for Gov K's org, the Archimedies Movement: http://www.archimedesmovement.org/

On a totally other tangent, perhaps the last for the evening, I have noticed a couple of very interesting vocabulary items in this population where I have landed. I have heard more than one person use the work "grok" which comes from Robert A Heinlein's book Stranger in a Strange Land. Grok means to understand, comprehend, love and become one with. It's wonderful to hear this word used. I hope there is lots more grokking in all of our futures.

The other term which I have been surprised but pleased to hear is "transmogrify", which I learned from the cartoon Calvin and Hobbes, by Bill Watterson. One online dictionary lists the word has being first heard in the 1600's, and meaning "to change or alter greatly and often with grotesque or humorous effect".


( 6 comments — Leave a comment )
Mar. 16th, 2008 02:21 pm (UTC)
Love your topics. They make me think on a subject that I'm already percolating on. After getting my son knocked off of Blue Cross because he had taken Celexa (sigh -- the price of being ignorant that the insurance companies do not have your best interests at heart).

When I was in Europe I was amazed how much more I was walking around, and it dawned on me then that there were little pathways and people-friendly parks, and not the car-jammed, pollution reeking streets with my uncertainty of who was driving by that I found at home. In Holland, new areas had to provide these walkways and parks all done for the good of its people. Here in America we yell at people for not exercising and then make it difficult for it to happen. We gripe over people with chronic conditions, including obesity, when the society fosters it. I'm hoping somehow for a change in this. Glad to read your posts.
Mar. 16th, 2008 06:30 pm (UTC)
Interesting observations about Europe. It is true that our current infrastructure largely discourages foot traffic and bicycles too. Here in Portland it is better than in most cities, but there are parts of the city that it is very hard to get to, or around, without a vehicle. And frankly, it isn't that pleasant riding a bike in the area where I live (which is quite close in). But so far, I've survived.

I hope that we can "be the change that we seek". My pursuit of a respected degree in natural medicine is the beginning of my contribution along these lines. I have high hopes that the medical paradigm shift that we see in its initial phases will reach fruition for my profession while I am still practicing.
Mar. 16th, 2008 07:03 pm (UTC)
Me too. And I have to remember that this is the chaos at the beginning of the change as the old passes away but the new is not in place.
Mar. 17th, 2008 01:19 am (UTC)
Yes....we do indeed live in Interesting Times.
Mar. 17th, 2008 02:21 pm (UTC)
And that's a curse, isn't it.
Mar. 17th, 2008 05:52 pm (UTC)
Yes, it's one part of an ancient threefold Chinese curse....May you live in interesting times, may you get what you are looking for, and....I can't recall the 3rd part at this moment.
( 6 comments — Leave a comment )



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