As I entered the room, the wafting odor of cheeseburgers and Funions floated in the air. I spotted the wrappers littering the floor next to the gargantuan patient filling the bed.
Doc: “What brings you into the ER today?”
Patient: (taking a long drag of Coke from his 96 oz trough) “Abdominal pain. Well, that, and my doctors seem to be having lots of trouble keeping my diabetes under control.”
Sometimes I wish I could just make these stories up. I don’t expect perfect adherence to a rigorous workout and diet schedule, however, I have some small requests, which have remained unachievable since I started working in the Emergency Department.
So, let me reflect.- I had a nice patient visiting from Ghana who informed me all she wanted was her antihypertensive medication, which seemed simple. However, for her, she could normally go to the pharmacy and pick up her medication. In the US, one must always have a prescription from the doctor.
I had a nice patient visiting from Ghana who informed me all she wanted was her antihypertensive medication, which seemed simple. Her blood pressure was high, she knew what medication and the dose that worked for her, but she had been out for three weeks. For her, she could normally go to the pharmacy and pick up her medication. In the US, one must always have a prescription from the doctor. Sure, many medications should require prescriptions, but if a proven responsible party needs preventative medications, well, why must we have so many hoops to jump through?
Later, the same shift, I had a patient who could not afford her insulin, thus, they came to the ER. Stop and think about that a second. Too expensive, so go to the most expensive location for treatment now that that preventable problem is out of control. Grrr…(and I’m not really angry at the patient for coming in, just frustrated for their predicament).
Then, after my shift, I found out that a close friend had to pay over $700 to get their child immunized.
So what’s the problem here?
In the US, we have amazing healthcare for when tragedy occurs, but often we do a terrible job of preventing the problems in the first place.
Preventative medicine is not the priority, reactive medicine is. This may seem odd coming from someone who works in the ER, but we need to stop the problems before they start if we are to make our healthcare better.
Vaccinations should be free.
Antihypertensives should be free.
Diabetic medications as well.
Oh, and the $600+ EpiPens… yeah, don’t get me started.
Then, we also need some accountability.
We should have some sort of system to reward individuals for staying healthy. Granted such systems would be a giant shift from the norm, but we NEED this. I don’t know the answer. Maybe get a tax refund if your BMI is <30. Or perhaps if you exercise three times per week you get $10 bucks. Somehow, we need to make being healthy a social norm and preventing disease before it happens to be emphasized. Otherwise, I will continue to see 530-pound patients who are confused about why their blood sugars are high while eating Funions and Coke.
We need to make being healthy a social norm and emphasize prevention. Otherwise, I will continue to see 530-pound patients who are confused about why their blood sugars are high while eating Funions and Coke. That, and they’ll still wonder why their doctor just can’t get their diabetes under control.