REFLECT
Model stories written by young professionals/students.
The Screaming Speeding Metal Box in Which the Injured Ride
A parody of the inefficiencies of emergency medicine
On my third week visiting the United States of America, a rather traumatizing event occurred. The Americans have rather intriguing metal “A” frame rack that allow them to reach higher places, and while I was climbing upon one to access the roof of the expertly designed shanty I was staying in, the physical genius of the climbing device failed me. I realize now after reviewing the physical properties that this device exploits that it fails once standing on the tip top, which is something valuable to note. Anyways, after my some thirty hands or so of plummeting, I hit the ground with quite a force. I would like to pretend that with all my manliness I got right back up to continue my research, but as my body smacked the ground I let out a large yelp that drew the attention of many of the Americans taking their personal furry mammals out for exercise. These Americans graciously contacted the medicine man for me.
However, to my surprise, a rolling metal box screaming to the heavens was the result of this phone call. Two people got out of the metal box that were clearly not medicine men. Instead of checking on my health status, they instantly put my neck in a contraption that prevented me from viewing anything that was done to me. I was then strapped to a flat plank to further restrict my movements and shoved into the wailing metal box. At this point I was no longer worried about my injuries; I was simply in terror as to why these men would restrict me, then shove me into this metal box. Then, I received the pleasure of being tossed back and forth as the metal box screeched all the way to the medicine man. Once I was there, the medicine man only had to perform a few simple tests to insure that no major damage had been done to my body and I was free to go.
Just as Miner did in his paper "Body Ritual Among the Nacirema," I analyzed a common artifact of medicine in today's world and took it out of the context (Miner,1956 ). I took a look at how an ambulance service is designed to serve those in emergency situations, yet it would be much simpler and less traumatizing to the patient if a doctor came to the patient. I believe that in the current big business mindset of medicine says this practice is not economically efficient.
With an ambulatory service, a patient that could be critically injured is placed in the ambulance, which transports them to the closest hospital to get the medical attention they need. I would like to argue that on many fronts, having essentially a mobile doctor unit makes much more sense. Firstly, economics: the average cost varies greatly by location but often costs over $1,500 for less than half an hour of service (Rosenthal, 2013). While Ambulatory services are thought of as emergency services, they often are used for non-life threatening conditions as well. I believe that a doctor and a mobile clinic that could be rapidly prepped to serve the specific scenario phoned in could be cost competitive to ambulatory services. The transportation fee typically provided by ambulances could be used to offset the doctors’ smaller number of patients due to travel times.
A system designed like this would also be more effective for the speed of treatment for a patient. If there truly was an emergency, the mobile clinic could be prepped to serve the situation rapidly, and the doctor could start saving the patient as soon as they get there. This would eliminate the time it takes for an ambulance to travel to the patient retrieve them and bring them back, only then for the patient to receive care. There is also the potential for extreme situations where surgery would be required, and in this instance the doctor could be prepping the patient during the drive back and planning for the surgery. This would prevent the time it takes for a doctor to get up to speed on patients in the current system. These could be the minutes required to save a patient's life, and, on the other hand, if it were a non-life threatening situation it would save them a lengthy trip to the hospital.
As shown, it is important to question traditions and current systems set in place to evaluate their effectiveness. Sometimes it is important to take an extreme step out of the box, to observe these practices without context. This allows one to see the oddities that we have grown accustomed to over time and is important to improving and moving forward in medicine and many other aspects of life. This is also a reason to value my background of non-medically employed parents, and my first generation bachelor's degree status. I should value the diversity that I have been exposed to and use it to learn medicine with an eye of scrutiny.
— Ross Owen
Reference:
Horace Miner, “Body Ritual Among the Nacirema,” American Anthropologist, 58, no. 3 (1956), 503-507.
Rosenthal, Elisabeth. "Think the E.R Is Expensive? Look at How Much It Costs to Get There" The New York Times. Dec 4, 2013.