As my fellowship is winding down and my summer comes to an end, I can't help but think back on what I have accomplished (or failed to). I started out enthusiastically insisting that I could make an impact with the 2 1/2 months I had to work with. This enthusiasm has slowly waned from existence as roadblocks in the form of IRB approvals, HIPAA regulations and financing issues slowed my project to a crawl. But this is the reality of trying to change the world. Nothing is ever an easy fix, and if it was it probably isn't worth fixing. It became clear to me that my summer was just the tip of the iceberg for this project, and that many more months/summers/years would be necessary to achieve the results I am looking for.
With this realization, I began to understand that it wasn't me who was necessarily making an impact, and I wasn't going to change the world in 2 months. But instead I soon discovered that a more important event was occurring: the impact was being made on me. I may not have accomplished much this summer on paper, but I am now a firm believer in working towards improving health care. One of my new favorite quotes is from the revered Atul Gawande: "New laboratory science is not the key to saving lives. The infant science of improving performance-of implementing our existing know-how--is"
How true this is. So much of NIH's money has been invested into the basic sciences that historically there has been little interest in changing the current practice of medicine. Not to undermine the importance of basic scientific research, there have been many life-saving discoveries that have been essential to current medical practices. However, much of this research never makes it to the patient - and is forever stuck in the purgatory of research known as translation. Furthermore, if we continue to focus on discovering new techniques and technologies, the cost of medicine will only continue to sky rocket. Anywho - I digress but my point is: focusing on changing our current system of practicing medicine has the potential to make an immediate and significant difference both in the general health of the population and in reducing the cost of health care.
The stories behind each patient I have seen with Dr. Fangman has encouraged me to continue working towards improving care for disadvantaged populations. The disparities in care are truly staggering and almost left untold in medical school! That's not to say there aren't those in the medical community who are talking on this subject. In fact, each physician/NP/PhD/community worker involved with public health I have spoken to are some of the most devoted and inspirational people I have ever met. I recently sat down with Dr. Meurer, the Director of the new Urban and Community Health Program at MCW, and we ended talking for 2 hours about the projects we were involved in and bouncing ideas off one another. It's events like this that has encouraged me to continue working on this project throughout my medical school tenure.
Alrighty, so hopefully you made all the way through my ranting and raving. What does the future hold for this project? We are currently in the process of meeting with key individuals involved with the Wisconsin Health Information Exchange program and the IRB board and have a proposal in the making to finally make this project a reality. The proposal does not have the same objectives as our original due to HIPAA regulations, but still has the potential to provide valuable information regarding ARCW patient's visits to Emergency Departments.
I will continue working on this project as school starts up again, so stay tuned!
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