Monday, January 14, 2008

Primary Care for Internally Displaced People

I did medical consultations in one of the nearby refugee camps today. The work was different than my usual daily activities as technical reference/supervisor for the HIV/AIDS clinic. The work today had more in common with my old job in NYC:

Most common chief complaint in Kenyan refugee camp: back pain.
Most common chief complaint in Upper Manhattan primary care practice: back pain.

Biggest challenge in Kenyan refugee camp: skin rash in the under-five crowd.
Biggest challenge in Upper Manhattan primary care practice: multiorgan failure in the over-80 crowd.

Medicine most commonly dispensed in Kenyan refugee camp: Acetaminophen.
Medicine most commonly dispensed in my upper Manhattan primary care practice: Acetaminophen.

Average documentation per consult in Kenyan refugee camp: one line (hand-written).
Average documentation per consult in Upper Manhattan primary care practice: two pages (typed, 10-point font).

Average number of medicines dispensed per patient in Kenyan refugee camp: one.
Average number of prescriptions per patient in Upper Manhattan primary care clinic: seven (likely a gross underestimate in my clinic, aka Polypharmacy Central).


Anonymous said...

Come back, you know you loved pushing tylenol, lipitor, and paxil!

Anonymous said...

Most common request by patients in your old Upper Manhattan Private Practice: "mas horas" to clean their house and cook for them.
Most common request by your patients in Kenya: house, food, and clinics to which they are willing to walk 20km.

-yu mee

audra said...

Glad you're safe. And still keeping me interested in medicine. And still laughing out loud in front of strangers in foreign internet cafes!

Anonymous said...

tomorrow in CP, students are leading small group discussions on Disparities in Health and Health Care. This follows one lecture from Ariel Pablos-Mendes on Global Health, and one other one from Olveen Carrasquillo on Racial and Ethnic Disparities in Health and Health Care in the U.S.
Since you're comparing care in Kenya to 168th Street...any other thoughts you'd like to pass along to first-year medical students?
We miss you, Nell

nomad said...

I'll leave that to you. They are so lucky to have you leading the course! Hopefully some of them will work on improving our US health care system, rather than just complaining about it and running away like I did...I miss you too. love to your family.

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