When to see a Doctor?

"An apple a day keeps the doctor away” – proverb

The media has had a field day with Swine Flu and the number of health related stories is up - way up! Swedish researcher, Hans Rosling (of Gapminder.org), published a video last month comparing Google news of Swine Flu versus Tuberculosis. For each Swine Flu death there were 8176 stories published between April 24 and May 6. For each Tuberculosis death there was one tenth (0.1) of a story. So while the flu is being overhyped there is a silver lining – this is a great time to find articles on health care.

When fighting a pandemic, the best weapon is quarantine; i.e. keep away from sick people. And where are you most likely to find sick people? The Hospital! You might visit the hospital for an injury and pick up the flu in the waiting room or emergency room. I read a story today by an EMT worker who was told if they carried a person with signs of the flu, the vehicle had to be completely scrubbed and disinfected and allowed to air dry for three hours before they could pick up another patient. During a pandemic the EMS fleet would be largely grounded (at most 8 passengers a day per vehicle) if this disinfection rule were maintained. In cases of large-scale emergencies like an earthquake or hurricane, 50% of the regional hospitals may be knocked out of service when needed most.

So what happens if you need medical care during a pandemic or disaster? Many sites promote being your own doctor and stocking up now for a first rate medical supply. But do not carry this to extremes. Certainly you can do more first aid and even advanced first aid at home. Many emergency rooms visits are for minor injuries or illnesses that don’t require a doctor or for which a doctor can do nothing (You paid good money to hear, “take two aspirin and get some rest”?).

My newest commuting CD is about the history of Medicine and disc one is about Hippocrates who started modern western medicine. The instructor points out that it was not easy convincing people that natural causes, not the gods, were responsible for illness. “Faith healers”, priests of Apollo, sacrifices, etc had an excellent reputation because 90% of the time a patient will recover regardless of what is done. The human body is very resilient.

Sadly our schools don’t teach the public how to distinguish the 9 times you’ll recover on your own from the 1 time profession help is required. “Doctors cannot give set guidelines for when to see a doctor and when it is unnecessary because symptoms with the same cause vary too much and symptoms with different causes overlap too much.” [Merck] Many people play it safe and see the doctor every time or for every sniffle. When SARs hit the world in 2002-2003, there were just 208 officially reported cases in the US but the number of calls to 911 and the number of EMS runs increased by 10%. In Maryland this meant an additional 60,000 EMS calls by those who thought they might have SARS. [Based on 2002 call volume of 600,000]

Here are some sites about when to see a doctor:

About.com: Cold & Flu
Merck.com
WebMD
MyDr.com.au

Bottom Line

We can all do more to be our own doctor at home. Yet don’t over do it. Don’t bleed to death from a serious injury or attempt surgery at home because you might catch the flu in an ambulance or at the hospital. During a pandemic or disaster you will most likely need to drive yourself the hospital (ambulances and EMS being overwhelmed). And once there, the hospital staff will be overwhelmed so bring your own facemasks, water, food, and be prepared for a long wait.

Here are some sites for stocking your medicine cabinet and learning advanced first aid:

How to Maintain a Good First Aid Kit
Stocking Up on Prescription Medicines (amazing details of what to buy)
Advanced Trauma Care First Aid Kit

Wilderness First Responder
Wilderness Medicine-Beyond First Aid
Where There Is No Doctor - (html)