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WHO CARES: Chronic Illness in America
WHO CARES: Chronic Illness in America

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Jose Pedro Greer, MD
Miami, FL


To be a physician, to heal the sick, to serve the infirmed, it all seemed so simple and straightforward. A son of a physician, I knew about the emergencies, the days we couldn't be with Dad because he was tending to the ill, the Christmas mornings that were cut short by a phone call from the hospital, the long days and nights; that was all OK, for those sacrifices were for the benefit of the patient. I entered medical school with those memories in tow and the simple desire to save the world. To treat the sick, to serve all kind would be an honor; the world was mine to make better.

I trained to become an Internist, Gastroenterologist and Hepatologist. I worked with the poor, homeless and undocumented in Miami, setting up clinics in the heart of the city. I left the university and went to work in private practice with my mentor, my father. It would be easy, I thought. Treat all people, rich or poor, insured or not.

BAM!!! Healthcare reform explodes on America with hope and possibly a way to a healthier nation. Well, it brought change, just in the wrong direction -- 33 million uninsured in 1992, 44 million in 2001, and those with insurance today have less coverage than before. From a policy perspective, the wrong question was asked: "How do we make healthcare cheaper?" The question should have been "How do we make those living in our great nation healthier?" America's elderly really suffered, as evidenced by current debate on prescription drug coverage and the inability of the health system to effectively address the challenges of chronic illnesses. Paradoxically, as our population grows older, requiring more time and support from health care providers, the elderly are being dropped by both large and small HMO programs.

The job of a physician in the new millennium is not simply to battle the illnesses of patients but also to navigate a system that makes it difficult to diagnose or treat the patient. The lack of support systems for patients, the hassle of diagnostic testing for the patient, the referrals, the authorizations, and the denials that so often follow are the simplest examples of America's medical system today.

As a physician, I see and feel the problems our insured patients have; we hire more staff, one for referrals and authorizations, another to deal with all the different formularies HMOs have, and install more phone lines to deal with all the patients' hassles. To top it off, we have less time to spend with our patients - time that is invaluable for making diagnoses and building relationships with patients and their families, time for explaining, consoling, or just reassuring. These problems are multiplied ten fold for the uninsured, the majority of whom are employed and still without health insurance. Something is wrong and we need to right it.

Well, I took an oath and will honor it, for it is a privilege to treat the sick and an honor to work with the poor. My undergraduate education, medical school, post-doctoral training and fellowships should be applied to patient care and healing, not to traversing the obstacles presented by our health care system. Let us fight for the patients, be smart enough to prepare for the onslaught of chronic illnesses that this country has to deal with, and treat all our patients with dignity - let's just do it right.

YOUR STORIES
Zoe Albright, Stroke
Betty Bennett, Kidney Disease
Roxanne Bedford-Curbow, Seizures
Valerie Brekke, Fibromyalgia
Lily Casura, Chronic Fatigue
Billie Davis, Peripheral Neuropathy
Penny Day, Chronic Obstructive Pulmonary Disease
Julia DeJesus, Seizure Disorder
MS Patient, Fairfax, VA
Charisse Farmer, Hydrocephalus
Katherine Fielder, Chronic Pain
Zoe Francis, Juvenile Diabetes
James Hines, Hemochromatosis
William Holford, Emphysema
Nancy K, Chronic Fatigue Syndrome
Patricia Lawson, Natural Rubber Latex Allergy
James Locke, Crohn's Disease
Gary Maslow, various
Kathy Matthews, Parkinson's
Andrea Meyer, MS
Gina Owens, Chronic Fatigue Immune Dysfunction Syndrome
Alicia Salas, Chronic Pain
Allison Scott, Chronic Pain
Deborah Serrano, Stroke
Becky Shively, Phenylketonuria
Jennifer Smallin, Type I Diabetes
Joanna Southerland, Diabetes
Alina Valdes, Cystic Fibrosis
Elizabeth Wertz, Seizures

WHAT WOULD YOU DO?
Jose Pedro Greer, Physician
W.F. Nagle, Physician
Ronda Riebman, Exercise
Cathleen Schilling, Case Manager
Jim Sykes

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