Med School Interview

So I was asked "What do you think the problem is with the health care system?" in my medical school interview last week. I looked across the table at the 65+ year old gentleman who had just laughed at my desire to become the surgeon general of the united states and earlier noted that "Muslims" keep to them selves here, and I replied "you are." Not quit like that, but I expressed my notion that cynical old doctors (which he was clearly one of) are what continue to maintain the status quo in this country and only when the next generation take control of important positions will things actually change. I guess I won't be going there for medical school. I wonder if I still want to become a doctor? Do I? It feels like I'm jumping into pool of acid, with the direction that things are happening in the medical world. Can I make a difference? Will I come out with the same mindset as I went in? Will $200,000+ in loans change my views regarding public health and helping the under served? Are doctors a possible source for a solution, or is modern medicine and its reliance on high cost intervention and delaying death at any cost (if you can afford it) actually a problem in itself?

I don't know the answer but a potential solution will be to force admissions committees at medical schools to find a true way to assess the the goals and desires of those potentially attending their medical schools. And if they can find good people society should ensure that once finished with medicine these people will be allowed to follow their dreams, rather than being buried under the oppression of debt.

Private Health

Would you ever think that IBM would come up with the most forward thinking and reasonable solution to the health care crisis in this country? If your interested pleas read the executive summary for their health care initiative and see what you think. What's interesting to me is the language they use, compared to what we're used to reading in Public Health. Have we ever read an article that mentions the consumer? Do we even know what the definition of a health consumer is? I really don't think we do. We've talked extensively about public-private partnerships, but our education is so tailored for a career in the public sector that it makes it difficult to bridge the gap from our end. We demonize the private sector as the root of most health problems, and expect to be able to find functional solutions to work together to solve problems.

Regarding the issue that private enterprise somehow devalues or diminishes culture I don't think KFC is the problem in China, and I definitely don't think McDonalds is the problem in America. These companies are a part of Modernity which is an inevitability throughout the world, and fast food and fast lives is a part of this modernity. To argue that this is taking away from a traditional culture is like saying the transition to not eating human flesh took away from cannibalistic cultures. In a post modern world its easy to look reverently at "traditional" culture but we need to understand that those people living in traditional societies look at our lives with even more reverence. Should we deny them what they want? Should we force them to live a "traditional" life because we think its healthier even if they don't want it?
I think there's an inherent fallacy in referring to traditional as somehow better than modern, especially from our perspective, and we need to take care in recognizing this.
With all the horrible fast foods and private companies disregarding our health to make a profit, life expectancy and quality of life indicators have grown steadily in the west, while more traditional societies have stayed stagnant in these indicators. Clearly its a complicated issue that deals with economics, politics, and other issues, but its easy to overlook these statistics when we're constantly bombarded with the negative data in Public health.