Cross-posted to the blog.
I’m going on some smaller and longer trips over the next weeks, which put the topic of health disparities in comparative contexts. Disparities is the scientific term for health inequities. In short: everyone should get the same healthcare, but not everyone does. You get worse care if you’re black, or poor (unfortunately, those are obvious). What about if you are older, or LGBT, or speak a language other than English, or live in a rural area, or have a chronic illness, a disability, or a mental health issue? Probably. But the question is not just yes or no, obviously, but how, why, and what the solutions are.
Next Friday, October 24th, is the most local of the events. I’ll be giving a 400-second talk, that’s 20 slides in 20 seconds each, at PechaKucha Baltimore, the first local rendering of the speedy-talk format that has already been done in a number of other cities. My topic will be Talking Heals. And, while I won’t be mentioning specific health statistics about Baltimore inequalities (400 seconds isn’t enough for statistics!) I will certainly have in mind the great, abiding fact of Baltimore life. “The rich are different from you and me,” as F. Scott Fitzgerald said in another context: yes, they have more money (as Hemingway is supposed to have responded), and thus more health. How can we bridge the gap? Part is access (the poor in Baltimore can’t get in to see doctors, there’s a shortage of internists), part is cost (for obvious reasons) – but part is also quality. And part of that quality piece is to make sure that doctors and patients can communicate across lines of race, class, and origin.
On the preceding Sunday (I’m discussing these events out of their chronological order), October 20th, I’m giving a talk at the National Physicians Alliance: how do we make our doctor-centered system into patient-centered care? You might not be surprised to hear that the solution I proffer is neither all one thing (patient centrism, the advice of the doctor be damned!) nor all the other (status quo and to heck with EMRs!) but something in between: investing in and maintaining relationships.
Finally, in December, I am heading to Peking Union Medical College Hospital in Beijing, at their kind invitation. I hope to acquaint myself with their system and China’s system at large, which I am sure demonstrates some inequities unique to the Middle Kingdom and some shared with the US as well. From what little I know about the current Chinese socioeconomic climate, there is rapid and thoroughgoing social change – which I hope has not swallowed up previous governmental plans to provide better primary care access to millions of Chinese.
Through these multiple dimensions of care, quality, and access, applied across various regions, we can aspire to great change. Lots to do!