By James W. Walton, D.O.
Dallas, TX – Three patients have solidified my intuition that the definition of "health" is something other than the absence of infirmity. Imagine the chances that all three would be accidentally injured in the same year with almost identical injuries and admitted to the same hospital: Carlos was shot in the neck; Martin struck his head while diving into a swimming pool; and Santos was involved in a motor vehicle accident. All three suffered an injury to their cervical spinal cord rendering them paralyzed from the neck down, yet all have partial movement of their arms.
They have a decidedly challenging future in front of them. Each finds themselves far away from their home countries, living in a land whose language they haven't been able to master. They have injuries that might cause them to come into contact with less-than-receptive healthcare systems. Additionally, their level of vulnerability (uninsured and poor) could cause one to question God's divine justice and fairness.
What Philip Yancey called the "curious law of reversal" came into play as each one of my new patients became my teacher. By extending myself to these three men, which on the surface is considered charity, I get caught in the unusual position of receiving. Instead of being expended, I receive from them a profound and strange sense that my life is somehow more significant.
Curiously, recent reports show that fewer doctors are providing charity care. Is this a sign of tough economic pressure on practicing physicians or a withdrawal from civic involvement? In an affluent society, where roughly 58 million neighbors are uninsured or live with a family member who has no health insurance - many being children living in poverty - we must challenge ourselves to greater civic engagement and responsibility. Increasingly, social science research indicates that community health is affected by the degree of civic involvement. From this evidence it is just a short leap to conclude that doctors and other healthcare providers may have a larger role in community health improvement than simply providing healthcare services.
During this period of unprecedented focus on healthcare's bottom line, I submit that the bottom line desperately needs to shift from financial success (relabeled as "survival") to significance. Somewhere in the clamor to meet overhead, we are missing the opportunity to learn important and time-sensitive lessons from our patients.
One lesson I have learned from these patients is that it is more important to experience them than to simply define them by a diagnosis and particular payer class or managed care contract. When and if this happens at a critical mass, I am confident we may begin to witness a greater healing in our community, particularly for those of us called "providers."
Jim Walton, D.O. works with Baylor Health Care System's physician organization, HealthTexas Provider Network, and he volunteers in community service efforts of the Dallas County Medical Society.