Ellen
08-14-2007, 08:37 PM
Watch the video here:
http://www.medscape.com/viewarticle/560228
From Medscape General Medicine (http://medgenmed.medscape.com/medgenmed)
Webcast Video Editorials (http://www.medscape.com/px/viewindex/more?Bucket=columns&SectionId=2054)
Community-Based Solutions for Chronic Disease
Posted 08/03/2007
Anne Peters, MD
Author Information
I am a physician who tries to help the poor, but the gap between my reality and theirs often poses a barrier to my delivery of medical care. My patients are respectful of the treatment I give them, tell me the things I want to hear, but often don't improve. The disconnect in our realities came into focus for me when I hired a local woman to administer lifestyle questionnaires. Patients would often cry when asked questions about their diet. Why? Because we taught them too well. They knew what to eat but had no access to the appropriate foods.[1] In the poor neighborhoods of Los Angeles, there is 1 supermarket per every 19,000 people, compared to 1 for every 7000 in mine. Fresh fruits and vegetables are often bruised and wilted. Lean meats are nonexistent. The streets are too dangerous for exercise. I have had 4 patients shot while they exercised, one in his own living room. My patients run out of food and can't feed their families and consider fast food more of a treat than empty calories.
This information and more about the communities that surround our clinic has changed my life.[2,3] I have a newfound empathy that has allowed me to heal my patients more effectively. It has also taught me to become a community activist because we must help repair these toxic environments. We don't know all the answers, but our patients have an idea.
So go out into the areas where you work; hold meetings in churches, schools, and community centers. Find out what is needed. Our communities wanted farmers markets, communal gardens, and healthier school environments. We helped achieve this and more. I have been criticized for my lack of evidence-based data supporting my "feel-good" programs, but I would argue that rarely has anyone suffered because fresh produce is more available.[4] And although it is easier to prescribe a pill than to change a neighborhood, we should never forget that both are a part of healing a patient.
That's my opinion. I'm Dr Anne Peters, Professor of Medicine at the University of Southern California, Keck School of Medicine.
Readers are encouraged to respond to the author at momofmax@mac.com (momofmax@mac.com) or to Paul Blumenthal, MD, Deputy Editor of MedGenMed, for the editor's eyes only or for possible publication via email: pblumen@stanford.edu (pblumen@stanford.edu)
http://www.medscape.com/viewarticle/560228
From Medscape General Medicine (http://medgenmed.medscape.com/medgenmed)
Webcast Video Editorials (http://www.medscape.com/px/viewindex/more?Bucket=columns&SectionId=2054)
Community-Based Solutions for Chronic Disease
Posted 08/03/2007
Anne Peters, MD
Author Information
I am a physician who tries to help the poor, but the gap between my reality and theirs often poses a barrier to my delivery of medical care. My patients are respectful of the treatment I give them, tell me the things I want to hear, but often don't improve. The disconnect in our realities came into focus for me when I hired a local woman to administer lifestyle questionnaires. Patients would often cry when asked questions about their diet. Why? Because we taught them too well. They knew what to eat but had no access to the appropriate foods.[1] In the poor neighborhoods of Los Angeles, there is 1 supermarket per every 19,000 people, compared to 1 for every 7000 in mine. Fresh fruits and vegetables are often bruised and wilted. Lean meats are nonexistent. The streets are too dangerous for exercise. I have had 4 patients shot while they exercised, one in his own living room. My patients run out of food and can't feed their families and consider fast food more of a treat than empty calories.
This information and more about the communities that surround our clinic has changed my life.[2,3] I have a newfound empathy that has allowed me to heal my patients more effectively. It has also taught me to become a community activist because we must help repair these toxic environments. We don't know all the answers, but our patients have an idea.
So go out into the areas where you work; hold meetings in churches, schools, and community centers. Find out what is needed. Our communities wanted farmers markets, communal gardens, and healthier school environments. We helped achieve this and more. I have been criticized for my lack of evidence-based data supporting my "feel-good" programs, but I would argue that rarely has anyone suffered because fresh produce is more available.[4] And although it is easier to prescribe a pill than to change a neighborhood, we should never forget that both are a part of healing a patient.
That's my opinion. I'm Dr Anne Peters, Professor of Medicine at the University of Southern California, Keck School of Medicine.
Readers are encouraged to respond to the author at momofmax@mac.com (momofmax@mac.com) or to Paul Blumenthal, MD, Deputy Editor of MedGenMed, for the editor's eyes only or for possible publication via email: pblumen@stanford.edu (pblumen@stanford.edu)