America, the land of plenty! Did I just say that?
As much as I want to tell a story about how my first three months of the fellowship year has been exciting, enlightening and rewarding with inspiring experiences, I will defer that and tell a startling tale.
Coming to America, as a physician trained in Africa, I would literally assume the healthcare system is void of a lot of discrepancies that we face in my home country Nigeria. As fate would have it, I happened to be my own case study.
My ordeal with the healthcare system started when I found out I needed to get health screening to work at one of my programs site but my insurance would not pay for preventive services and I needed to be ill to use the insurance I was provided. I sought a solution, but obviously this was a situation beyond me or anyone that may have tried to intervene. It was a societal menace. It is one of the ills the average American has to deal with whenever such medical needs are warranted. This is one of the wrongs of the health system I as an American fellow was supposed to identify and work with others to alleviate.
As awkward as I felt at that time, I decided to press on and get through that part of my requirements. Little did I know that I just went through the first stage of my case study of the health system!
Once I found a practice, my tests were ordered and as expected, since I live in America now, the results came in quicker than what I was used to and I scheduled an appointment to see my new physician. On review, one of the tests was of concern and I was told I needed treatment for the condition to my utter surprise! I had just taken the test less than a year ago and I got cleared for it. It was not a condition I needed to be tested yearly or regularly for but because this was a new job and I am African, it was necessary. I looked at the report but doubted what was documented by the reporting laboratory and requested for further evaluation or another clinician’s opinion since I don’t have signs or symptoms of the diagnosis. My physician decided that I needed to be treated still, but I maintained I won’t get treated for a condition I don’t have. The laboratory clinician declined further review and made it clear the result was final and the test she reported from would not be provided as it will seem normal if anybody else looked at it. This is the same hospital that my demographics were erroneously recorded as a 66year old man on the same day despite been there physically. My physician sensed some foul play and decided I should take a repeat test which I may have to pay for out of pocket because my insurance may question the request. I was given a prescription to another practice for a repeat test for comparison. The comparison test came out negative and with evidence for a third review of the result which also was negative.
First lesson from this is, to never think any system is perfect! There are a lot of holes and issues in the American health system that needs to be identified and require a multilevel collaboration to mend. Secondly, when I looked at my circumstance and the challenges I encountered while navigating the system, it brings to light the predicament of the underserved and minority populations whom we serve, who are uninsured or under-insured, homeless, can’t afford healthcare, not equipped with health information, not able to challenge the status quo and are constantly at the mercy of the system.Thirdly, the financial burden and psychological effect of the laxity and inefficiencies in the health system to the population is immense.
This drives home the reason the work my co-fellow and I are doing with the Children’s health fund is necessary. Our organization provides comprehensive health care to the nation’s most medically underserved children through the promotion of guaranteed access to “appropriate health care” for all children and homeless youths through mobile medical units and collaboration of medical doctors, nurses, psychologists, social workers, IT specialist, managers and communications specialists. We also serve as advocates for our population through research and advocacy to stakeholders.
The true definition of health inequities is revealed to me on a daily basis and clarity of purpose as a Global health corp fellow is being gained continually. I am also delighted to be a part of a movement to foster equity and mitigate the manifestation of inequities. It seems a lot to do, but I know we can do it! With collaborations and a vision for change “Little drops of water, little grains of sand, make the mighty ocean and the beauteous land.” Yes we can!