Training Activist Physicians: Problems, Solutions, and Resources - PowerPoint PPT Presentation

Loading...

PPT – Training Activist Physicians: Problems, Solutions, and Resources PowerPoint presentation | free to download - id: 5579c8-ZDMyM



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Training Activist Physicians: Problems, Solutions, and Resources

Description:

Training Activist Physicians: Problems, Solutions, and Resources Martin Donohoe Solutions Research-based health activism courses Social medicine residencies Websites ... – PowerPoint PPT presentation

Number of Views:70
Avg rating:3.0/5.0
Slides: 74
Provided by: Own2136
Learn more at: http://phsj.org
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Training Activist Physicians: Problems, Solutions, and Resources


1
Training Activist Physicians Problems,
Solutions, and Resources
  • Martin Donohoe

2
Am I Stoned?
  • A 1999 Utah anti-drug pamphlet warns
  • Danger signs that your child may be smoking
    marijuana include excessive preoccupation with
    social causes, race relations, and environmental
    issues

3
Impediments to Public Health and Social Justice
  • Medical education
  • Failures of health care system
  • Actions of academic medical centers
  • Scientific Ignorance and Pseudoscience

4
Impediments to Public Health and Social Justice
  • Exploitation
  • Maldistribution of wealth and resources
  • Corporations
  • Environmental Destruction
  • War
  • Lack of international cooperation

5
Voltaire
  • The comfort of the rich rests upon an abundance
    of the poor

6
Hudson River, 2009
7
The State of U.S. Health Care
  • 51 million uninsured patients
  • Millions more underinsured
  • Remain in dead-end jobs
  • Go without needed prescriptions due to
    skyrocketing drug prices
  • Est. 51,000 deaths/year due to lack of health
    insurance

8
Headline from The Onion
  • Uninsured Man Hopes His Symptoms Diagnosed This
    Week On House

9
Rudolph Virchow
  • Doctors are natural attorneys for the poor If
    medicine is to really accomplish its great task,
    it must intervene in political and social life

10
Care for the Poor
  • Doctors are natural attorneys for the poor If
    medicine is to really accomplish its great task,
    it must intervene in political and social life
  • - Rudolph Virchow

11
Problems with Medical Education
  • Social, economic and cultural contributors to
    health of individuals and populations important
    but under-emphasized in medical (and other health
    professions) curricula
  • Students idealistic/motivated, but grow
    increasingly cynical and develop
    negative/defeatist attitudes as training
    progresses

12
Schism between medical schools and schools of
public health
  • Medical schools more focused on biochemical
    mechanisms of disease and drug therapies
  • Public health focused on populations and societal
    issues

13
Social Factors Responsible for Illness and Death
  • Deaths in 2000 attributable to
  • Low education 245,000
  • Racial segregation 176,000
  • Low social support 162,000
  • Individual-level poverty 133,000
  • AJPH 20111011456-1465

14
Social Factors Responsible for Illness and Death
  • Deaths in 2000 attributable to
  • Income inequality 119,000 (population-attributabl
    e mortality 5.1)
  • Area-level poverty 39,000 (population-attributabl
    e mortality 1.7)
  • AJPH 20111011456-1465

15
Social Factors Responsible for Illness and Death
  • Deaths in 2000 attributable to
  • AMI 193,000
  • CVD 168,000
  • Lung CA 156,000
  • AJPH 20111011456-1465

16
Harvey Cushing
  • A physician is obligated to consider more than
    a diseased organ, more even than the whole man.
    He must view the man in his world.

17
Medical Ethics
  • Overemphasizes individual conflicts and
    fascinating dilemmas involving expensive
    technologies (e.g., gene therapy, cloning, face
    transplants)
  • Underemphasizes psychological, cultural,
    socioeconomic, occupational, and environmental
    contributors to health

18
Minimal Training re
  • Environmental health
  • AMA guidelines prohibiting physician
    participation in capital punishment
  • War and peace issues (e.g., Geneva Conventions)

19
World Health Organization
  • The role of the physician in the preservation
    and promotion of peace is the most significant
    factor for the attainment of health for all.

20
Other Problems
  • Patient and physician dissatisfaction with
    current fragmented health care system is growing
  • Cynicism and burnout common
  • Interest in primary care low/inadequate

21
Ethical Distortions to Help Patients
  • Doctors offering varying levels of testing and
    treatment based on patients ability to pay
  • Physicians gaming the system by manipulating
    reimbursement rules so patients can receive
    necessary care

22
Charity Care and Volunteerism
  • Almost half of US medical schools sponsor
    student-run health clinics for the indigent
  • However, the proportion of physicians providing
    charity care has declined over the last decade

23
Approaches to Teaching Activism
  • History
  • Literature
  • Photography
  • Other

24
Important Historical Figures in Medicine/Public
Health and Social Justice
  • Florence Nightingale
  • Rudolph Virchow
  • Margaret Sanger
  • Thomas Hodgkin
  • Albert Schweitzer
  • Charles Dickens
  • Upton Sinclair

25
The Role of Literature
  • Promotes empathy, critical/creative thinking,
    flexibility, non-dogmatism, self-knowledge
  • Encourages ethical thinking
  • Allows for group discussion/debate Identification
    with doctor authors (e.g., Keats, Chekhov,
    Maugham, Williams)

26
Homelessness
  • Doris Lessing
  • An Old Woman and Her Cat
  • From the Doris Lessing Reader (New York Knopf,
    1988)

27
Poverty
  • Orwell, George. How the Poor Die. In Sonia Orwell
    and Ian Angus, eds. The Collected Essays,
    Journalism and Letter of George Orwell, IV In
    Front of Your Nose, 1945-1950. New York
    Harcourt, Brace and World, Inc pp.223-233.
  • Eighner, Lars. Phlebitis At the Public Hospital.
    In Travels with Lizbeth. New York St. Martins
    Press, 1993.

28
Race and Access to Care
  • Ernest J Gaines
  • The Sky is Gray
  • in Gray, Marion Secundy, ed. Trials,Tribulations,
    and Celebrations African American Perspectives
    on Health, Illness, Aging and Loss. Yarmouth,
    Maine Intercultural Press, 1992

29
The Native American Experience
  • Christopher Columbus, upon meeting the Arawaks
    of the Bahamas
  • Theybrought usmanythingsThey willingly
    traded everything they ownedThey do not bear
    armsThey would make fine servantsWith fifty men
    we could subjugate them all and make them do
    whatever we want.

30
The Native American Experience
  • Smallpox
  • Forced migrations
  • Wars
  • Loss of land and autonomy
  • Broken promises
  • Genocide
  • Worse health outcomes high rates of alcohol
    abuse, obesity, psychiatric disorders, violence,
    suicide

31
The African-American Experience
  • Slavery
  • Drapetomania
  • Tuskegee Syphilis Study
  • Ongoing discrimination, impaired access to health
    care, worse outcomes
  • Persistent suspicion of health care enterprise

32
Racial Disparities in Health Care African-America
ns
  • Equalizing the mortality rates of whites and
    African-Americans would have averted 686,202
    deaths between 1991 and 2000
  • Whereas medical advances averted 176,633 deaths
  • AJPH 2004942078-2081

33
Photography
  • Nurse Midwives
  • And
  • Country Doctors

34
(No Transcript)
35
(No Transcript)
36
(No Transcript)
37
(No Transcript)
38
(No Transcript)
39
Photography
  • Poverty, Hunger, and Homelessness

40
Jacob Riis
41
Dorothea Lange
42
Rachel Adams
43
James Nachtwey
44
Photography
  • Environmental Degradation

45
W Eugene Smith Minamata Disease
46
W Eugene Smith Minamata Disease
47
W Eugene Smith Minamata Disease
48
Sebastiao Salgado Mining
49
Sebastiao Salgado Mining
50
Sebastiao Salgado Mining
51
Sebastiao Salgado Mining
52
Photography
  • War

53
Robert Capa
54
(No Transcript)
55
(No Transcript)
56
(No Transcript)
57
(No Transcript)
58
(No Transcript)
59
(No Transcript)
60
W Eugene Smith
61
James Nachtwey
62
Solutions
  • ? public health education
  • ? emphasis on global bioethics and social justice
  • ?use of history, literature, photography, and art
    in curriculum

63
Solutions
  • Interdisciplinary education
  • Community partnerships
  • Work with the underserved (locally and globally)

64
Solutions
  • Read activist journals
  • AJPH, Mother Jones, Dollars and Sense, The
    Progressive, Harpers, Z Magazine, The
    Progressive, In These Times, Bulletin of Atomic
    Scientists, Hightower Lowdown
  • Join activist groups
  • PSR, PNHP, PHR, UCS, AI, PP, Greenpeace, etc.

65
Political Solutions
  • Vote (physician voter turnout low)
  • Run for office (physician-legislators rare)
  • Lobby legislators
  • Shift focus from reimbursement rates to social
    justice issues

66
Solutions
  • Research-based health activism courses
  • Social medicine residencies
  • Websites/Blogs

67
Websites/Blogs
  • Social Medicine Portal http//www.socialmedicine.
    org/
  • Medicine and Social Justice Blog
    http//medicinesocialjustice.blogspot.com/
  • Public Health and Social Justice
    http//www.publichealthandsocialjustice.org or
    http//www.phsj.org

68
Additional Resources
  • NYU Literature, Arts, and Medicine Database
    http//litmed.med.nyu.edu/Main?actionnew
  • Public Citizens Health Research-Based Health
    Activism courses http//www.citizen.org/hrg/activ
    istcour/index.cfm

69
First they came for the Jews by Pastor Niemoller
  • First they came for the Jews, and I did not
    speak up, for I was not a Jew.
  • Then they came for the communists, and I did not
    speak up for I was not a communist.
  • Then they came for the trade unionists, and I did
    not speak up, for I was not a trade unionist.
  • Then they came for me, and there was no one left
    to speak up for me.

70
Günter Grass
  • The first job of a citizen is to keep your mouth
    open.

71
African Proverb
  • "If you think you are too small to have an
    impact, try going to bed with a mosquito in your
    tent"

72
(No Transcript)
73
Contact Information
  • Public Health and Social Justice Website
  • http//www.publichealthandsocialjustice.org
  • http//www.phsj.org
  • martindonohoe_at_phsj.org
About PowerShow.com