However, where the rubber meets the road, in my view, is in the inescapable conclusion that our medical care system is driving our country into bankruptcy (in part because we have to treat diseases that are the result of inadequate investments in public health). So, I still must ask, “Are we physicians part of the problem or part of the solution?”
And what is the problem, exactly? John C. Nelson, president of the American Medical Association, very specifically pointed out the problem in a commencement address to the School of Public Health at the University of Utah last year. He said our nation continues to be ravaged by eight preventable conditions. The eight scourges are:
- Alcohol and drug abuse that one study claims costs society upwards of $240 billion a year.
- Violence that another study claims adds $300 billion to our health care costs.
- Accidents, another $275 billion.
- Tobacco addiction, $75 billion in medical costs and $80 billion in lost productivity every year.
- Obesity, from $50 billion to $75 billion, according to yet other studies.
- Youth suicide, sexually transmitted disease and teen pregnancy, $12 billion
These numbers are approximate, but most Hopkins doctors could recite this list from memory because of the impact on their medical practice, especially so because of our location in the inner city. Because we are “benefiting” from these scourges by having a steady stream of patients requiring treatment, we de facto have become part of the problem.
I believe there are actions that physicians can take to highlight these problems if we are really serious about improving health, not simply treating disease. The AMA, for example, could take on obesity by running a national ad campaign and lobbying corporations that contribute to the obesity problem to change their ways. Difficult? Yes. Impossible? No.
We can make a difference. Let’s be part of the solution.
