Wednesday, April 2, 2008

I have an idea

So I was watching Dr. Phil yesterday, and he was talking about MRSA - the super scary "superbug" that is probably going to kill "more people than AIDS," according to the show. What scares me the most is that a minor skin injury, just a regular cut, can let MRSA (which is an antibiotic resistant strain of staph) into your body. Once it's there, it's really hard to kill (antibiotic resistant). This 19 year old girl (who appeared healthy and strong) had been living with it for a year. A young boy who was immune compromised died of it extremely quickly when he caught it at the age of 13.

I got to thinking about how devastating it would be to take my healthy kid to the doctor for something totally routine, like the removal of a mole or something, and have them come out with MRSA. It kind of reminded me of when we took MG for her 18 month well-baby visit, and we came home with rotavirus. I thought, "Boy, wouldn't it cut down on these sorts of infections if we could return to the days of house calls?"

But I thought, "No, doctors need all their stuff. They wouldn't want to visit sick people, and then find out that they need some important equipment that they don't have in their car..."

But what about those well baby visits?

Shots are portable. Scales and tape measures are portable. There is nothing that they do in a well baby visit that they couldn't do in the baby's home. This would surely prevent well babies (like MG) from getting (and then spreading) common illnesses like rotavirus (and the flu, and every cold that goes around all winter, and so on...). It would protect the members of our population with the least mature immune systems from contracting illnesses. That would, one would think, prevent the spread of those illnesses in the general population (how many times have you caught a cold from a kid?). Then we'd need fewer antibiotics to begin with, because disease would spread less. That would not only protect kids from getting things like MRSA in the doctor's office, it would also prevent the creation of these "super bugs" (or at least postpone it) in the first place.

And, as a side-effect, how many cases of abuse and neglect would be caught if the doctors were visiting people in their homes, instead of the people coming to doctors' offices? I also think that parents would be more likely to really talk to their doctors about issues if they hadn't just spent 30 minutes sitting in the waiting room next to the person who was waiting for them to finish their kid's appointment so they could get their sick kid home.

I recently read an article (can't remember where, can't find it) about maternal mortality in the U.S., and how many cases go unreported (because death certificates in many states don't ask if the woman was pregnant immediately prior to or at the time of death). More to the point, it said that many of these deaths could have been prevented if someone had visited the woman's home in the weeks immediately following birth. One particularly sad case was of a single mother, whose family lived in another state, who died of a postpartum hemorrhage. The baby starved to death. They were found much too late when her family hadn't heard from her.

Home visits after birth are standard in many European countries (where the maternal mortality rate is much lower). The article suggested that if we adopt this model in the U.S., we could prevent a lot of death and suffering.

I think we need to return to a home-based model of medical care in this country. Yes, I know that time is money to doctors. Yes, I know they need their equipment. Yes, I know that it would cost more. But I think it's worth considering. I just wish I could figure out who to write to or talk to about my suggestions (besides you all, of course).


Shawna said...

I don't feel like I know enough about the current U.S. system to offer much of an opinion on how it should change (other than giving you guys a decent maternity leave!), but you might find it interesting to know that here in Ontario, Canada a public health nurse does come by the home after mom and baby have been released from the hospital. It's generally only once unless there are problems, but they are supposed to contact the mother within 24 hours of being released from the hospital to arrange that visit.

As well, I had a midwife for my first (I had complications on that go-round so they recommended an OB this time), and they made house calls for the last couple of visits before the birth and the first few weeks post-partum. They even did the heel-prick blood sampling (there are a few things screened for routinely here) at our house. It was really nice not to have to leave the house, especially since I'd ended up with a c-section and was still recovering.

Can I also mention that it was predicted that "superbugs" were going to be the result of overuse of antibacterial soaps, etc. when those products started to come on the market? Something to think about.

kelseyma said...

Amy I am with you on the well baby visits. We come home with the rota virus at Morgans 9 month appt. It landed her 2 days in the hospital and IV fluids for Kelsey.

Morgan just had her one year appt (does not weigh enough so lucky us get to go back in 2 weeks) and both girls now have fever and tons of green crap coming out every place.

kelseyma said...


I am with you on the well baby visit as my girls are never well within one week of a visit. We have also gottten the rota virus--resulted in 2 days for miss morgan in the hospital and IV fluid for Kelsey and mommy.

Morgan just had her 12 month well baby visit(does not weigh enough so back in 3 weeks) and they both have fantastic green crap coming out of noses and fevers.