This week's New York Review of Books features an article by Jerome Groopman, MD, author of one of my favorite books on the practice of medicine, How Doctors Think.  In the article, Dr. Groopman explores the idea of "comparative effectiveness research" and the role it might play in our health care system if a reform bill passes.  He also points out that many politicians leading the push for reform believe that doctors should be forced to follow certain "standards of care" or "best practices" as determined by government panels and commissions.  Dr. Groopman brilliantly explains why forcing these government-mandated protocols on physicians will harm patients.  Read the article here.
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This week on House Calls Dr. Fisher guides you through the challenging decision of staying home vs. moving to senior living.  If you or a loved one are facing this challenging issue, don't miss this important show!  Rick Banas of BMA Management joins Dr. Fisher to share the insights he has gleaned from over 20 years experience in the world of senior living.  Plus, as always, Dr. Fisher will update you on the latest health headlines and take your phone calls live!  Join me Friday for the most intelligent health show on the radio, House Calls on AM 560 WIND.

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No one knows for sure what will happen, but those in Haiti who survived the earthquake are still at tremendous risk, for several reasons.

1) Infrastructure was very poor to begin with, now it is virtually nonexistent.  Prior to the earthquake, even the larger cities could not supply electricity and running water to its citizens.  Only the wealtheir Haitians could afford such "luxuries."  Now, what infrastructure was established has been decimated.  There is no backup system when the primary system was sparse.

2) This means that transporting supplies to the people is going to be extremely difficult.  Already reports from Haiti describe a "bottleneck" at the Port-au-Prince airport.  It is the only airport that can accomodate jetliners in the entire country, so almost the supplies will come through PAP.  Even the ports in other cities are very makeshift, so goods that are shipped will also need to go through PAP.  Unfortunately, when there are damaged roads and no access to gasoline, it is next to impossible to coordinate a process for transporting all the supplies to the 1.2 million people in the city, not to mention the almost 10 million Haitians throught the country.  There is little structure to oversee what we would consider routine, like traffic control or emergency services, so to expect a nation to suddenly implement a coordinated, efficient disaster response is unrealistic.

3) The factor that will impact people most over the next week is access to clean water, which was already limited.  The multileveled, makeshift housing structures throughout PAP do not have running water, nor do the shantytowns surrounding the city.  People in the city depend on shipments of clean water while those living in rural areas utilize wells, sometimes walking for miles every day to reach them.  Since we cannot survive for more than a few days without water, people will begin to turn to whatever source they can find.  No adequate sewage system exists, so pools of rainwater are likely to be contaminated.  Within 1-2 days of drinking this water, which contains shigella, cholera, giardia, E. coli, or any number of other organisms that grow in sewage, people will develop a severe diarrhea.  They will become further dehydrated, and without access to antibiotics, they will be at risk for death.  This is especially true among children.

4) Injuries cannot be adequately treated and will become complicated.  Many people are likely to have suffered open fractures, when the bone protrudes through the skin.  This creates an entry point for bacteria to infect the bone and the bloodstream.  Without proper antibiotics and surgery to close the wound, an overwhelming infection called sepsis usually results, and death occurs within 2-3 days of becoming septic unless IV antibiotics can be delivered.  Other wounds are also likely to develop infection that could become life-threatening if not treated.

5) Long-term disability is going to affect many victims because they have fractures that need to be repaired right now, but there is no access to X-rays or other diagnostic tools, not to mention orthopedic surgeons who may be able to repair a fracture pelvis or other serious injury.  The bones will heal, but in a deformed manner, leading to permanent disability in many cases.

Please consider giving today.

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On Saturday Jan 16th I will appear on Talking It Over with Janet Parshall a nationally syndicated radio program on the Moody Radio Network.  We will discuss the earthquake in Haiti and also talk about health care reform.  Tune in at 12:30pm Central Time on 90.1FM in Chicago and on stations across the country.  Visit the link above to find a station near you.

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IMG_0275It is hard to imagine the devastation happening this very moment in Haiti.  I visited in 2009 and it was my first experience with true poverty.  I knew that Haiti was the poorest nation in the Western Hemisphere, but only after seeing the country with my own eyes did I understand what that really means.  Electricity and running water are luxuries.  Shelters are constructed with whatever materials can be found, leaving their fragile structures vulnerable to storms and hurricanes, not to mention earthquakes.  Children who enter orphanages feel blessed to receive 2 meals per day.  There is no established medical or emergency response system because there are no resources.  Even in good times, rolling blackouts made hospital surgeries impossible, unless the patient or family could pay for the generator to supply electric power to the lights and instruments.  Now there will likely be no electricity to hospitals or clinics.

I had the privilege of working with a Haitian doctor during my trip.  I asked her what she thought of Americans.  Her response- "Americans give."  It is true- the number one source of income for the country of Haiti is American aid.  Most comes through private donations.  Now more than ever, Haiti needs our help.  Please donate to a relief organization that is rushing to help the people who are victims of this disaster.  Here are a few ways to help:

  • Text “HAITI” to “90999″ and a donation of $10 will be given automatically to the Red Cross.  The charge will go on your phone bill.
  • Donate to any relief organization- most are mobilizing their efforts toward Haiti right now.  A few suggestions:
    • ESMI- the organization I worked with when I visited- they are small but care for more than 2000 of Haiti's orphans-
    • Samaritan's Purse does an excellent job with relief efforts-
    • MAP International is an outstanding medical relief organization-

I learned in Haiti that even gifts that seem small to us go a long way.  American dollars have great power- please use what you have to make a difference.

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