Earlier this year I was sitting in the student lounge of UT Southwestern Medical School searching for health policy internships in DC. I was stunned by how many opportunities I came across, but few seemed like such a perfect match as the opportunity here at the New America Foundation. Part of the reason for this has to do with my own experience with "avoidable care”—an experience that sparked my interest in health policy and preventive medicine.
My high school anatomy and physiology class fascinated me. Whether it was dissecting a cow heart, learning about air exchange in the lung, or passing my skeletal examination, anatomy and physiology fueled my desire to become a doctor. In college I applied to a summer doctor shadowing program through the pre-med advisory office. When asked for my top preferences of physicians to shadow I chose all the "exciting" fields, like neurosurgery and cardiology. But since there weren't enough neurosurgeons or cardiologists to match my enthusiasm, I was instead paired with a doctor at the local Wound Care and Hyperbaric Medicine Clinic. Needless to say, I was disappointed. I had never even heard of a "wound care doctor." Besides, I wanted to see doctors performing lifesaving stroke interventions and cancer therapy—not taking care of some old guy's stinky foot sore. Grudgingly, I settled myself in for a long, boring summer.
Almost daily I watched the physicians at the clinic work with patients who presented with seemingly incurable open wounds, loss of feeling, amputations and other maladies. The vast majority of these wounds were due to poor circulation in the lower extremities. Many times we would send these patients for a "dive" in our hyperbaric chamber, where they would breathe 100% oxygen at high pressure. This would ensure that high levels of oxygen would percolate to every inch of their bodies, regardless of their poor circulation, and accelerate the healing process. These procedures, however, were costly and very time consuming—a typical prescription called for 20 to 30 ninety-minute sessions of hyperbaric therapy.
After a while I began to realize that many of these patients with the incurable wounds also had type II diabetes. While doing the rounds with the physicians one day I asked him about my discovery. He sadly explained to me that most of his patients could have their diabetes under control if they could eat healthy and lose weight. I was stunned! All of these visits to the doctor, negative pressure treatments, wound cultures, hyperbaric treatments, discomfort, amputations, prosthetics, and medicines (to name just a few of the discomforts these patients had to deal with) could largely be avoided with a healthy lifestyle.
My "boring" internship ignited a fire inside me that day. I finished with a whole different perspective on what medicine is—it became more than just scrubs and scalpels, more than a prescription pad and prostheses. It was now about empowering my future patients, about working through policy, public health and medicine to bring about changes that allow them to conquer the most costly, debilitating medical problem of my generation.