Hak Pak Sak

Stephen Lewis on Infrastructure, Identity, Communication, and Change

VRM and Health: A Country Without Databases, Individual-Oriented Medicine, and “Tasty!”

Posted by Stephen Lewis on July 30, 2008

Further to yesterday’s entry on VRM (Vendor Relations Management) and health care

In The Evidence Gap: A Call for a Warning System on Artificial Joints the New York Times reports that a plethora of unsuccessful joint replacement operations could have been avoided in the United States had there been, as there are in most other industrialized countries, national data bases of patients’ experiences.  Application of VRM to health issues not only has the potential to ensure delivery of properly individualized health care but also to assess and address the needs of groups of individuals and to broadcast the results back to policy makers and the medical industry at large (sadly, medicine is an industry in the US rather than part of a social net or service delivery infrastructure).

Two Health-Related Footnotes:

1. Individual-Oriented Medicine: Two days ago, I visited a “Park Avenue” (i.e. top-draw, high-priced) eye doctor for diagnosis and treatment of what I thought was damage to my right eye.  After a 20-minute examination for which I was changed US$ 395.00, the doctor said my eyes were fine but that I should see a dermatologist and have a general physical exam.  That evening I described my symptoms to a friend who for years works on-and-off as a translator at the office of a Russian-born Brooklyn eye doctor with a primarily Russian immigrant clientele.  Over the phone, my friend was able to diagnose what ailed me as a minor but persistent virus-related affair and suggest interim treatment.   He pointed out that even while functioning in the midst of the US insurance pyramid, some physicians in Russian immigrant neighborhoods still manage to respond to the situation of the patient rather than artificial distinctions between medical disciplines.

2. Tasty!  A recent posting on the New York Times’s Well Blog reported an overturn of the common-wisdom of the last decades re:eggs and cholesterol and also reported that alcohol is good for one not only because of cardiac benefits of red wine but also because drinking enhances quality of life.  Several years ago, over lunch in a restaurant garden in Sofia, Bulgaria, I asked my fellow-diner, an overweight hard-drinking ex-journalist suffering from high-blood-pressure and high-cholesterol, why he had ordered tripe-fried-in-butter, sausage, and feta cheese for lunch.  His answer: “Because it is tasty!” (Zashto e vkusno!)”  After I lectured him pedantically on the evils of cholesterol and sodium, he stared at the plate of sliced tomatoes and cucumbers that comprised my lunch and replied: “You will die of too little ‘tasty’ long before I die of too much cholesterol!”


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