Today I was able to sit in on a presentation by Paul Farmer to a group of doctors at Harbor-UCLA (thanks to someone commenting on Payam's blog about Dr. Farmer's visit to Los Angeles and Farah posting the events on the discussion board).
Some things he mentioned:
- The importance of community health workers in not only developing countries (like Haiti, Rwanda, etc.) but also in the US (!!!!). He mentioned PACT (and here), a new project in Boston that provides DOT to HIV/AIDS patients that have a CD4 count below 150 and drug resistance.
- Applying community-based care to chronic disease(!!!).
- He couldn't seem to stop talking about community health workers and how important and successful they are in increasing treatment adherence (to greater than 90%!). Someone asked about family members providing DOT, and he said that they must be stipended regardless of relation, and that non-family members generally work better.
- (Concerning this week's discussion re Eastern European men) Having worked in Tomsk Oblast, Siberia treating MDR-TB, he said that progress in Russia has been due more to economic progress than anything else. Surprise surprise.
- Trying to make it easier for medical students to focus on global health rather than just having to tack it on to their residencies. A Global Health Equity and Internal Medicine residency program, initiated in 2004 at Harvard, is doing just this. He mentioned other schools that are interested in doing this (UCSF and University of Miami are the ones I remember).
It was so exciting listening to him discuss PUBLIC HEALTH to a room full of INTERNS and RESIDENTS! Talk about shifting the paradigm. Seeing all our theories actually being practiced was thrilling. I began having thoughts of DOT right here in LA. Is it happening right now? We need to find out! I could see it being its own program at AIDS Project Los Angeles. Possible?
All in all, totally worth losing the one participation point from leaving 501 thirty minutes early.
8 comments:
thanks so much for sharing that mana!! i think it's so important that he's not just lecturing on community-based health but that he's demonstrated how powerful it can be, and how it can be scaled up.
p.s. btw i was looking for articles he wrote online and found some audio bytes of his speeches on wikipedia (scroll to the way bottom): http://en.wikipedia.org/wiki/Paul_Farmer
how great! I wish I could have been there to see the puzzled looks of residents and attendings grapple over the idea of public health! Most of them have no idea! What a great treat for them to hear it from Paul Farmer!
This is such a good news Mana. It seems there has been a shift in U.S medical school system. I was really concerned when Dr. Cousineau mentioned how medical students only get 2 hours talk on public health during their education.
I hope that the A Global Health Equity and Internal Medicine residency will be available to more schools shortly. This sounds such a great field next to medicine.
Sounds Great! Wish I could have been there... I really need to read up on more of his stuff. Thanks for sharing this with us.
If Harvard's doing it, everyone will start doing it too... The only way this country is going to get anything done about its health issues is to get its physicians off their high pedestals and make them realize that they are not the only solution to every single medical issue.
"Have these numbers lost their ability to shock or even move us?"
So true... the impersonal nature of statistics makes it easy not to address the vast health disparities. To some extent, I think getting to know one community - one person - can have more of an ability to "shock" and "move" many individuals than the bulk of epidemiological data...
Just a thought...
That's so great that you got to go, wish I could have! I love that he has really promoting the use of community health workers. It makes a lot of sense since people tend to trust them more and have better access to people who are right there in the neighborhood.
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