My naive dream

It's no secret that the health care system here in the US benefits little. With the advent of Obamacare, yes more people have health insurance but is that truly helping them? Today I was listening to Marketplace on 88.5 on my commute home and they talked about health care and this insurance company in Oregon called CareOregon that has this program called "Health Resilience Program." From Marketplace's website: The idea is that healthcare providers leave the exam room and spend more time developing relationships with patients in their kitchens and living rooms.

I was reminded of my naive dream. Back when I wanted to be an MD or DO my dream was to get my degree in primary care and work in urban or rural areas... basically places where people either can't afford health care or have their state Medicaid insurance. My naive dream? To open my own clinic where, yes I would take insurance, but I would have the people that I served pay me in what they could as well... Mainly I thought about food. I'll do your yearly (or however often exam) and you can make me a lasagna, enchiladas... whatever you're good at making.

When I first developed this dream, I was an undergrad student studying abroad in Oaxaca, Mexico in 2006. I was fortunate enough to have a rotating internship at different kinds of clinics in the city and also in Puerto Escondido. I know the health system in Mexico is different from the US but there are similarities as well. People still suffer from the same diseases and also can have the same financial difficulties. My passion for practicing medicine grew and matured. 

Unfortunately, according to the standards of the medical schools here in the US, I do not have what it takes to become a physician. So what am I doing now? Applying to become something 100% better. A nurse practitioner. Why do I think it's better? From what I've seen, nurse practitioners get more time with their patients and still have autonomy. They're not forced just just churn patients and their in and out during the day.  (off the soapbox now)

Back to the dream and the program I listened to today. Some economist from Harvard said that "so many things we do in American health care because we think that they must work....But every time we looked, we’ve found the answer has been a big giant zero." I think/hope he wasn't including primary and preventative care. Because time and time again studies have shown that those two things are actually cost effective. Even this article, http://www.ncbi.nlm.nih.gov/books/NBK53914/, says findings show "mixed results" but aren't mixed results better than billions of dollars being spent on unnecessary treatment? Also, I understand that health care workers need to be compensated for their knowledge at time but goodness gracious.... At the cost of people dying because they can't afford treatment? Where is the Hippocratic oath in that? How can someone feel okay with not treating someone because that someone feels that they won't get compensated justly? You're going to let that person's morbidity continue to decrease?

Okay sorry apparently I climbed back on the soapbox again. Anywho. I know my dream will never come true but maybe one day, I can help bring back the concept of a doctor's (or nurse practitioner) house call so I can be closer to my dream.

(btw here's the article from Marketplace if you want to actually read it: http://www.marketplace.org/topics/health-care/challenge-pairing-sick-social-services)