I just finished watching the film, Resistance, on Netflix. Nearly 180K people die in the U.S. now due to drug resistant bacteria. Yet, we still allow farmers to use rampant antibiotics in farm animals that we eat, feeding the resistance even more. The EU banned antibiotic feed to animals a long time ago, yet, we haven’t. Shame on us.
This travesty aside, it got me thinking about the problems, challenges and (positive way of looking at it) opportunities that I think are probably the most pressing in public health now. So, I started looking up what other healthcare pros think are pressing issues. Sanjay Gupta’s are here. I just finished Atul Gawande’s Being Mortal, where he presents the argument that quality vs. quantity of life near the end should be considered, as well as cost. Of course, you can’t avoid the huge “EBOLA” banner right now over at CDC’s website, either.
It appears that over at the Indiana state’s website on public health–(other than our discriminatory lawmakers–yes, I went there), we suffer from and thus have initiatives around preventing the spread of HIV (mainly through Scott County’s Opana/dirty needles issue), HIP 2.0 and getting affordable healthcare plans on board, and the measles outbreak/getting vaccinated.
I’m now going to stop being Debbie Downer, and instead focus on the challenges that I think we’ll be facing in droves in healthcare over the coming years, that I think in turn could be opportunities for pharmacy and pharmacists. This could create win-win situations for patients and pharmacies…but only if we have a few pharmacists out there who dare to get out of the box and try some new services and ideas.
Affordable, sustainable communities – This one seems the most obvious, but often times I don’t know if lawmakers stop and think about ensuring that the community itself is sustainable, rather than putting bandaids on problems, like some listed above. This to me means good, close schools. This means affordable housing (like the tiny house movement – I still dream of the day living without a mortgage). This means affordable healthcare too. I still have friends who are willing to pay the penalties coming for not having healthcare insurance, because they simply cannot afford a healthcare plan (and I wish we could just get this burden off the backs of our employers). This also means walkable communities, which have healthy food choices within a walk to the local grocery store. This means designing houses in subdivisions where people can age in place too. Frankly, without this as a major public health concern, any state or local community is doomed.
Am I saying that big healthcare conglomerates should get into civic and community development? Yes. Where’s the big pharmacy chain Tiny House subdivision with the store in the center that sells healthy choices to consumers, and allows them to have care at variable levels in their tiny, mortgage free houses? If healthcare conglomerates really care about public health, they’d be right there with commercial builders to redesign what healthy living looks like from the ground up, rather than running to the latest street corner with a light on it to build a new drugstore.
Vaccinations – Pharmacists are already on this one – I just wish we could serve up the vaccines closer to home, rather than forcing customers to come to us for them.
Antibiotic-free protein sources – This was the idea that sparked this post. But seriously, if we continue to let farmers feed their animals antibiotics, scary bacteria like MRSA, and even resistant Salmonella are going to take out more of us in the population. Whole Foods vows to not sell antibiotic fed meat from animals. Here’s a list of plant-based protein sources. The pharmacists out there can do a lot of educating around this realm…but are we?
Services to keep the elderly happy and healthy at home – This one actually goes right back up to the first problem I outlined here, but each day, 10,000 people in the US now are turning 65. Harvard said we’re ill-prepared. Health care costs are going to go up for the elderly. They can’t make it to the drug store as easily (hopefully, the drones may help us out here). One should look at Aging in Place resources. Maybe Angie’s List or a pharmacy chain could get into an index of resources to help the elderly stay at home, and sell it like a subscription service? It would have to be cheaper than hospital stays and long term care! And yet, I don’t really see that many in healthcare stepping up into the aging in place phenomenon that’s coming…like it or not.
Shrinking # of Physicians - Sanjay is right about this one. Why should someone go to undergraduate, then med school, then work like a dog in a residency and/or fellowship, rack up tons of debt, only to get out and let insurance companies and everyone else (including the federal government) tell them what they’ll pay for their services? Frankly, I don’t know that medicine IS a wise choice for our best and brightest anymore.
The good news here is that mid level practitioners will have plenty of work to do if the # of physicians decreases as everyone predicts. However, governments are going to have to get flexible about scopes of practice for the midlevels if they want their populations cared for – otherwise, we’ll be even less healthy than we are now.
These are all opportunities for public health, healthcare in general, and pharmacy specifically.
Will we rise to the challenges?