Rant 3

It seems like I've written too many positive entries lately, There is a disturbance in the Ying Yang forces in my blog. Therefore, I will now attempt to balance it out with the most emo-depressing, hipster-negative, hitler-angry post that will rectify the ying of my blog for years to come. Just kidding, but there is an issue that's been floating around my mind for a while now and I think I just need to pin them down with words to help me reassess the situation a bit better.

I resumed shadowing Josh a while ago, and it was one of those things where you feel like you are just repeating the same thing you are doing over and over again and start to wonder what you could possibly gain from repetition. Patients change every time, but the process seems to be the same. Patient comes through the ER, usually due to headache, pain, or mini-stroke (not kidding). He reads about the patients' background, goes and talks to them about their problems, give treatment, and spend twice as long dictating that whole process to a phone and documenting what he did in case anyone tries to sue him. Lately, we've been doing rounds on the psych ward, which is my favorite since I've studied so much about psychological problems from my neuroscience classes. Plus, I love seeing all the crazy people sitting in a circle and being lectured by a psychiatrist, it reminded me of One Flew Over the Cuckoo's Nest. Josh hates the psych ward because he thinks people there are creepy as fuck, and with good reasoning. Yesterday a patient handed him a note that said "Dear Doctor, my life is in your hands. When you get home, please find a way to contact my parents at XXX-XXX-XXXX and let them know that I am Ok". Clearly delusional, but to see this in real life is so different from reading about it in books. What I get out of repetition is that I am able to see past the treatment of individual patients, and assess the trend of patients coming in, as well as the working environments that family doctors face. It is starting to make me question the foundation of medicine in America.

Josh is a hospitalist, who basically acts as a family physician in a hospital setting. He generally sees all types of patients and runs around different parts of the hospital constantly. From the ER to ICU to Psych etc... Which is cool because he only needs a general knowledge of all diseases and will never really be as bored as family physicians, who probably spend most of their days listening to old people talk about their grandkids. The problem is that this country favors so heavily on specialists that family doctors aren't as focused on as before. Yes, it is sometimes really boring to listen to people who don't have problems pretend like it's the end of the world. But family doctors are really the frontline of preventing people from getting so ill in the first place. If people focused more on preventative care, we wouldn't have so many people coming through the ER with chest pain, blindness from diabetes, strokes, these are so preventative yet so prevalent, that they just drive up the cost of health care which our country is scrambling to find a solution to. Word of advice to the government - If you want to solve healthcare problems, The most effective thing to do would be to reform what kind of food you subsidize. I am not against fast food, but I am against our food choices being controlled by the four giant corporations. Our country spends the least amount of money with our disposable income on food than all other industrialized countries. Here's how I see America's screw up with food and health happens, Our tax money goes towards subsidizing corn, soy, rice, wheat, and cotton --> These products are able to sell for cheaper so more people buy those products over unsubsidized variety of foods --> People eat too much of the same thing and along with sedentary lifestyle get too unhealthy --> Pay for medical bills for their diabetes, cardiovascular disease, high cholesterol. These companies are externalizing their cost and we are forced to pay them. Every patient we see is taking at least 5 different types of drugs, and among those, there's almost always medication for hypertension, cholesterol, blood thinners, and antidepressants (mostly women).

In my ideal world, the ER would be reserved for people with knives in their head and gunshot wounds to their crotch. But that's not really the case in Boulder, and certainly not in the rest of the country. Specialists tend to do what they want, and I've seen Josh being told to assess the patient because the specialists don't want to deal with talking to patients. They just want to know if you need to do a procedure or not. More and more people want to become specialists because 1) There is no money in being a family doctor. 2) Old people talk a lot. 3) You have to take crap from specialists. Wake up America, you shouldn't deteriorate your health so bad that only specialists can freaking save you. Why is there no government subsidies for increasing the compensation for family doctors? Why is it taking so long to recognize the importance of preventative medicine? Why do they continue to subsidize foods that are killing us? These are all things that I've read in papers and textbooks before, but to experience it in real life has finally hit me hard. I think understand why many competent physicians like Josh, have such an apathetic view on the world. This profession is noble in nature, but to keep that mindset, you have to fight the tide of everything that stacks against you. You can give medication to 100 patients with diabetes and it won't change the fact that they're unlikely to change their lifestyle, and tomorrow, there will always be 100 more.