Re: India’s “health camps”: the drug rep will see you now
Dear Mr. Patil,
My article is not about health camps per se. But since you brought up the issue, here are my two cents: I think it remains an open question whether or not the one-off camps are an effective way of dealing with the health challenges facing India today, and I’ve heard arguments both ways.
Pragmatists say the camps offer a modicum of medical care to people who might otherwise fall through the cracks -- and the cracks are certainly wide and plentiful.
That may be true to some extent. However, I don’t think there is any research assessing what effect health camps actually have on people’s health (there is this study showing they don’t boost use of public health insurance schemes: http://dx.doi.org/10.2139/ssrn.1873269). As you are no doubt aware, there have been many problems with the quality of care offered at the events. For instance, people have been left blind after botched cataract surgeries on several occasions.
Perhaps the bigger problem is that many camps focus on testing for chronic conditions. Yet in most cases we don’t know if screening does more harm than good. Here is one recent paper questioning the value of community-based diabetes screening in India, for example: bit.ly/1VSOv98. (1)
The concern is compounded by the fact that there is usually no follow-up testing or monitoring, because many people who go to health camps are not in regular contact with health providers. They just get a prescription and leave.
That’s particularly problematic when you are dealing with chronic conditions. At Dr. Khan’s camp, I talked to a day laborer who had screened positive for diabetes the previous year. He had been taking medicine ever since without once going back to see a doctor or having his blood sugar measured again!
And then there is the economic challenge: Who is going to pay for the drugs needed by people found to suffer from chronic disease at the camps? If they can't afford treatment, all they get is a diagnosis and the accompanying anxiety.
These are just a few of the basic problems that should probably be addressed before it makes sense to talk about “streamlining” the conduct of health camps.
Rapid Response:
Re: India’s “health camps”: the drug rep will see you now
Dear Mr. Patil,
My article is not about health camps per se. But since you brought up the issue, here are my two cents: I think it remains an open question whether or not the one-off camps are an effective way of dealing with the health challenges facing India today, and I’ve heard arguments both ways.
Pragmatists say the camps offer a modicum of medical care to people who might otherwise fall through the cracks -- and the cracks are certainly wide and plentiful.
That may be true to some extent. However, I don’t think there is any research assessing what effect health camps actually have on people’s health (there is this study showing they don’t boost use of public health insurance schemes: http://dx.doi.org/10.2139/ssrn.1873269). As you are no doubt aware, there have been many problems with the quality of care offered at the events. For instance, people have been left blind after botched cataract surgeries on several occasions.
Perhaps the bigger problem is that many camps focus on testing for chronic conditions. Yet in most cases we don’t know if screening does more harm than good. Here is one recent paper questioning the value of community-based diabetes screening in India, for example: bit.ly/1VSOv98. (1)
The concern is compounded by the fact that there is usually no follow-up testing or monitoring, because many people who go to health camps are not in regular contact with health providers. They just get a prescription and leave.
That’s particularly problematic when you are dealing with chronic conditions. At Dr. Khan’s camp, I talked to a day laborer who had screened positive for diabetes the previous year. He had been taking medicine ever since without once going back to see a doctor or having his blood sugar measured again!
And then there is the economic challenge: Who is going to pay for the drugs needed by people found to suffer from chronic disease at the camps? If they can't afford treatment, all they get is a diagnosis and the accompanying anxiety.
These are just a few of the basic problems that should probably be addressed before it makes sense to talk about “streamlining” the conduct of health camps.
Sincerely,
Frederik Joelving
1 http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.10...
Competing interests: No competing interests