Year 25+

A recent speech at Boston University by Dr. Jim Kim of Partners in Health, as well as the recent illness of my parents, has made me realize how much of health care delivery is about people. This may sound ridiculously obvious, naive, or just plain obtuse. But often when we think of health care we think of drugs, technology, and highly skilled doctors and nurses. All of those things are necessary but not sufficient. When it comes down to it, taking care of the sick is about spending time with someone who is sick. It may just involve checking on someone to see if they are taking their medicines, or having their meals prepared, or just talking. This is not high tech stuff. It does take time, and it does take lots of willing and concerned people. Community health workers, friends, family and other non-physicians can provide much of this care. But medical care does get complicated, and does require referral to more highly skilled providers. As Dr. Kim pointed out, community health worker programs are vital, but left alone, without doctors and nurses to back them up, they can be disastrous. Any discussion of the future of global health care must include the question of health care delivery, and any discussion of health care delivery must include the question of creating such a network of both physicians and non physicians. One without the other is unrealistic.