By Marlana Li, MD
I love to travel. I also love having a vocation in medicine, so the natural integration of the two is going on medical mission trips and polishing my knowledge of travel medicine. I enjoy meeting new people, learning history, immersing myself in new cultures, and sharing information via different means of communication. During my trip to Nicaragua last year, I realized that medicine has a language and culture of its own, which is difficult enough to interpret, but especially in another language, or if the patient has a different educational background or health literacy level. I also learned about cultural and economic factors that play into the spread of parasitic and other preventable diseases.
Medicine also is similar to travel in that it involves navigating complex systems and understanding monetary exchange. If only it were as easy as one US dollar being roughly 0.91 Euros. Instead, we have to determine how much a reasonable copay is, how many wRVUs we get for coding a 99214, and how many administrative hours, wrinkles and pulled hairs a prior authorization phone call creates. While all of this can be confusing, I do know that some aspects of medicine, travel, and life in general are priceless. Despite the challenges and costs of healthcare locally and internationally, it is worth the miracles of holding a baby after delivering her, or hearing that a patient quit smoking, or knowing that you helped a patient feel better after a surgery. I also find joy in making new relationships and developing established ones, which both medicine and travel afford the opportunity to do.
We are an increasingly global community. Countries and individual communities are no longer islands that do not need to worry about what is going on in other parts of the world. The recent Zika and Ebola pandemics made that very clear. It only takes one person to pass a virus that could cause serious illness, birth defects, and death. We are starting to recognize how crucial good public health programs are in preventing illnesses and their spread. If only people have clean water, proper nutrition, and basic health information (like how it is important to brush teeth, boil water, or wash scabies-infested blankets), innumerable diseases could be prevented and fewer health disparities would exist. The rapid advancement of technology has allowed us to develop more vaccines, antibiotics, antivirals, diagnostic tests, and educational materials, but just as rapidly, germs are learning how to mutate and spread, and people, and other vectors, are traveling all over the world.
Despite our natural tendencies to segregate and judge people different from ourselves, we need to reach out and help our neighbors, here and abroad. It is exciting to work together to discover “best practices” and find ways to improve quality of health care and to quickly diagnose and effectively treat diseases. And of course, it is important to determine cost-sensitive means to do all this in a manner that is translatable across nations.
Community and public health disasters have serious world-wide economic, political and ethical ramifications. Being a family medicine physician allows me to not only treat the patient, but take into consideration all the factors that may affect their health and quality of life. As a faculty at a medical school and residency program, I hope to prepare our future physicians to work effectively in areas with limited medical resources, unique diseases, and various other cultural and socioeconomic issues that might affect care or access.
I freely admit that I do not know everything, and that I cannot cure every illness. But I do humbly and honestly seek to learn more, and to partner with my patients, colleagues, university, and community at large to find ways to more effectively deliver healthcare. These are exciting times for Family Medicine and international medicine in general, and I am blessed to be part of it. I am excitedly awaiting my next trip; though of course will take the proper precautions!
Marlana Li, MD is an Assistant Professor (Clinical) in the Family Medicine Residency Program at the University of Utah School of Medicine.
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