Traveling to a 3rd world country is an eye opening experience. Rarely in the US do you see the clinical manifestations of disease such as Kaposi Sarcoma, or corneal scaring with Vit A deficiency. However, the educational value needs to be shared by both visiting and local physicians. In addition to equipment, physical resources, and technology which are hard to come by in terms of donations, what else can be given to improve the capabilities of local physicians? This is a difficult issue at the core of the debate surrounding medical tourism.
The power of research and evidence based medicine has lead to countless improvements in healthcare in the US. A US physician from Philadelphia collected data on childhood mortality in the ER in Port Au Prince and presented her findings back to the team of local residents. They were fascinated by her findings on what was and wasn’t working. The Haitian physicians were not trained in statistics or evidence based medicine, and the hospital was far from being able to provide additional staff for this purpose. This US physician used her training, time, and expertise to provide a valuable and lasting service to the hospital. She also gave examples of ways other hospitals in various locations around the world had approached a similar problem. Providing analyzed data back to the local physicians gave them the big picture ammunition they needed to be able to critically evaluate and improve their own practices in an efficient, and most importantly- sustainable, and resource possible, fashion.
As I saw the discussion going on amongst the local physicians after being given statistics on the effectiveness of their care, I thought about the potential a massive, nationwide database could have. Our President contends that one of the benefits of a largely utilized Public Option would be the creation of a comprehensive database, similar to the information gathered by Medicare and Medicaid. I thought about this cited benefit and pondered the limits, if any, such a data bank could have on the evaluation of healthcare in my own country.