Posted By Monique Dever On April 8, 2015
Our Guest – Dr. Stephanie Bailey, Dean and Director of Public Health Initiatives, College of Health Sciences, TN State University
Over the years, physicians and healthcare providers have played a role in addressing many of the non-medical issues – absolutely! Doctors are educated – you learn to take the history, you learn to do the physical and then you confirm with the laboratory. The history is the key piece of the “art of medicine.” You talk about social issues: where the patient has traveled, how they were raised, where they live, what they eat, how they go about their day – that’s all part of the review of systems as I go from head to toe, but it takes time. By the time I finish the history, oh my, I should be clued in on my diagnosis. You then have the laboratory and the physical exam to confirm that diagnosis. So really, the art of medicine is the story.
We’ve gotten away from that for so many reasons: because of litigation, because of how things are reimbursed; and then how most of your money – 17% of our GDP – goes to healthcare but only less than 2% is for public health. In today’s practice, the perfect system of health would be a health system like we first talked about when I was at CDC. In general, people are born basically healthy. People then go through a period while aging, or as environments or events impose on them, where you move from a safer, healthier people to vulnerable people; then people become affected without complications, and then affected people with complications. Right now, most of our GDP dollars are spent around the affected people with complications.
We’re not very good at reversing things. When a person is born there are things you can put in place that make you less vulnerable to disease and things: immunization is a good one, eating right is another one to affect chronic disease; not smoking, or creating an environment which is healthy. All these actions can prevent people from moving into a vulnerable state or back to a safer and healthier environment. Unfortunately, the least amount of money is spent at this end of the spectrum, where the core of the public health system lies. If we could put these two ends of the spectrum in equal balance, than we would have a health “system”. That’s protection for life, and that’s where I’d like to see us get to over time.
This blog is an excerpt from our interview conducted with Dr. Bailey. For more of Dr. Bailey’s Q&A, read her full Expert Interview.