Discrepancy in health care

I had an incredible meeting with an emergency medicine physician here who has joined our team. She is from Bangladesh, was trained outside of the country and came back here to work. She is like-minded in her pursuit of bettering the medical education and training here but unfortunately the field of emergency medicine, believe it or not Is still very very new here. Mostly patients are being triaged and theres a limit to how much treatment or resuscitation they are receiving. This is problematic because many disease processes require immediate attention and it's why ER physicians can do just about anything because they see such a variety of patients and they need to act right away. For example we know that the mortality of a patient with sepsis is improved if appropriate IV fluids and antibiotics are given in the first hour; And typically that first hour is when they are being evaluated by an emergency physician, and it is the ER doc who is providing those interventions first. 

Fast forward to my meeting today. I met up with this physician at one of the private hospitals where she works. A position she chose because it is one of few places that has an ER program.  The hospital itself is beautiful. As you pull in to the main driveway you are greeted by a sign advertising the availability of an on site PET scan (a type of CT scan often used when evaluating nodules or masses for their degree of metabolic activity which if high is most often concerning for malignancy though can be associated with other processes such as infections). As you walk in to the entrance of the building you see a sprawling lobby with a coffee kiosk. I thought I Star-Trek style teleported back to the US until the ever so familiar buzzing of a mosquito reminded me where I was. In my mind I pictured the entrance to Dhaka Medical (DMC) families and patients lining the halls because of a limitation of beds and space and again realized that the resources available at this private hospital will never reach the masses of people at DMC. And then my mind wandered to Bellevue in NYC where efforts are made to obtain the maximum amount of care  despite a patient's financial status. It occurs to me that no matter how flawed our health care system in the US it does allow for better access to care relative to how things work in so many other parts of the world. 

I can't save the world. I can't save health care and the limitation of resources in Bangladesh. But, here's what I can do: I can draw attention for those interested in doing the same kind of work and together we can spread medical training and education. And as we all know, education is the gift that keeps on giving. 

Inside DMC

 

Inside a private hospital