We all owe our individual and collective health not just to ourselves but to any army of Samaritans — our friends, families, colleagues, caregivers, and the many medical professionals who practice at the highest levels of skill and compassion.
It’s tempting, especially when immersed in the ways that health care in this nation falls short, to turn from healthy skepticism to corrosive cynicism. But for this holiday in particular, let’s all give special thanks for those who practice the healing arts. Many of them will leave loved ones and work long hours over Thanksgiving, and not just because of a fee or a charge but to improve the lives of the sick and needy.
With all the adverse, if not hostile reaction Americans are showing in recent days to people beyond our shores, it’s also worth reminding ourselves that the call to help humanity truly is deep and universal. We can learn and be humbled by what others accomplish, including in health and medicine, with resources so much more spare than we can marshal, spending as we do, and, as the Organization for Economic Cooperation and Development notes, at the pinnacle for healthcare and not always seeing equivalent, positive outcomes.
But what if the money just wasn’t there? In Nepal, as New York Times columnist Nicholas Kristof has reported recently, an eye doctor improvises and ends up with a cheap, fast way to restore the sight to tens of thousands of blind people. Western practitioners derided Dr. Sanduk Ruit until his cataract microsurgery was subjected to a randomized trial whose results were published and showed his outcomes, with a 98 percent success rate, were the equal or better of Western counterparts. Further, his procedure costs $25 or so, while published data on cataract surgeries, without costly machines, run more than $3,400 per eye. Ruit has expanded his pioneering technique into a broad practice and it treats more than 30,000 poor across the region, people who otherwise would be doomed to darkness and even greater economic depredation; he charges a small fee to half the patients but treats the others for free.
Meantime, Dr. Devi Shetti also merits mention: He’s an Indian cardiologist who has built a large-scale heart care system that seeks to provide services to those in most dire need but least able to pay with what National Public Radio terms “cardiac care Henry Ford style.” He left a $350,000-a-year practice in Miami to return to his native land, where he tussles with vendors, especially those from the industrial west, about every cost, knowing his patients may be selling their homes or sole source of sustenance (a cow) to cover a loved one’s care. He has shown that prices can be driven substantially lower. He and his five dozen colleagues perform more than 14,000 procedures annually and at a fraction of the cost. Their break even number now, the doctor says, is $1,200 per patient, though he thinks it can go lower; compare that with the United States, where, for example, a bypass procedure in 2013 in the Midwest cost more than $100,000. Those who can pay do but more than half his patients receive cost-free care. Recognizing a huge inequity in a land he clearly loves, the doctor never even discusses payment for girls who are his patients; he knows their parents might otherwise neglect such children solely because of their gender.
Here’s hoping that practitioners like Ruit and Shetti advance their work in helping the needy and poor even more and that their Western counterparts, our caregivers, find due inspiration in their accomplishment.
I’m grateful for the time and consideration my family, friends, colleagues, and clients give to me, my practice and our collective health. Thank you to all on this special holiday.