Greetings from Ecuador!
Tomorrow we are meeting with university staff to plan a fellowship in Family Medicine Obstetrics---Obstetricia con Medicina Familiar.
The family medicine project here has really taken off. Naturally they are covering all of things we did in rural Tennessee[Fam Med 1998, 2010]. Family physicians staff the ER and images are sent for interpretation as needed by internet. Point of care interpretation for ultrasound is the rule, and the impact is impressive.. Yesterday I saw another example of a community family medicine center with its own delivery room.
Basically the line between a well equipped family medicine center and a micro hospital is disappearing. The Venezuela program should start soon. Note the micro hospitals being established in Texas.
This is a very disruptive technology which has implications for Medicos' motto regarding twice the service at half the cost. Here in Santo Domingo Hesburgh hospital with 70 beds has been constructed and equipped for $ 3.2 million. In Florida the equivalent cost over $ 45 million. This savings is more than significant even after you make allowances for the Ecuador--USA $ gradient.
My dream is that we will use the foundation of Ecuador/Venezuela certifications in family medicine plus one year of obstetrics/ultrasound/surgery to create a meaningful OB certificate for community hospitals here as they have done in Africa. These regions will never have the resources to fund separate call systems in Obstetrics, Ortho, and pediatrics, so family medicine+OB is the logical solution. Curriculum accountability requires further study, however the outcome data for OB, ER and sports medicine is strong.
A member of our group is currently President at SUNY downstate medical school. This indicates how far reaching this concept is proving to be..
Mejor humillarse con los oprimidos que compartir el botin con los orgullossos. Proverbios 16
Wm. MacMillan Rodney MD
Professor Family Medicine Obstetrics
Chair, Medicos para la Familia
Memphis, Maracaibo, Mississippi
