Rishi Manchanda: What makes us get sick? Look upstream
Rishi Manchanda: 疾病从何而来?从源头找起。
Rishi Manchanda is an "upstreamist." A physician and public health innovator, he aims to reinvigorate primary care by teaching doctors to think about—and treat—the social and environmental conditions that often underly sickness. Full bio
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live and work in conditions
息息相关的地方,
是怎样的呢?
approach to healthcare look like,
改善我们的健康?
说说Veronica的故事。
拜访我们的三周前,
emergency room in Los Angeles.
你可以先吃些头疼药,
here's some pain medication,
但仍以失败告终。
with healthcare professionals,
we tried a different approach.
我们尝试了一种不同的方法。
(持有普通教育发展证书),
居住在洛杉矶南部的病人
是肯定的:
to three of those things:
从头至尾又看了一遍,
the privilege of caring for,
却经历着超出常人的痛苦。
who have chronic allergies.
one's nose up and down,
一位成年女性身上,
我问了Veronica一些问题,
Veronica some questions,
我想我知道是怎么回事了。
headaches and some sinus congestion,
related to where you live."
都和你住的地方有关。”
talk about your treatment.
现在让我们来谈谈你的治疗方案。
medications for your symptoms,
我想为你介绍一位专家。”
a specialist, if that's okay."
就像在说:“真的吗?”
the specialist I'm talking about
我说的专家
call a public interest lawyer,
我们称之为公益律师,
had improved by 90 percent.
她的症状已经改善了90%。
the emergency rooms of Los Angeles.
急诊室来回奔波的时间。
这说明了什么呢?
地区健康问题
(upstream approach)。
但却被一个孩子的哭声打破了,
shattered by the cries of a child,
都掉进了河里,亟待营救。
in need of rescue in the water.
那我去造只筏子。
I'm going to build a raft.
他们成功救起一些人,
当他们终于抬起头时,
让这些孩子掉进了水里。”
我们有第一个朋友——
有负责重症监护的护士,
when you're in dire straits.
最需要的人。
很重要也十分必要的是,
在他们的诊所里、医院里
a very obvious question
about transportation and housing?
交通和住房的问题?
如果我们有科学的方法做指导,
were to use science as our guide,
approach is absolutely necessary.
是绝对必要的。
这个工作和
of death from heart disease."
对其有极大的影响。
space was a powerful influence.
公共健康领域的朋友
at those molecular mechanisms,
复杂的方式,
our DNA is literally shaped,
应该在这方面有所作为。
should do something about it.
all sorts of people in healthcare,
找过医疗卫生中心所有类别的医师,
说三个主要的,
for volume and not value.
根据”数量“而非”质量“来支付报酬。
live and where you work,
these are important issues.
of where they live and work,
遇到的问题,
做提供的帮助,
下一个问题,那就是:
第三个答案。
让这些孩子掉进了水里的人。
别的卫生工作者、
他们就进入“第二步”,
then move on to that second step,
“让我们找到问题的根源。”
“好吧,让我们看看你的基因,
这种治疗就起不到什么作用。
问题根源分析是这样的:
那里空气污染严重,
freeway with major air pollution
调集资源去解决的,
mobilize our resources to address,
这个过程中的“第三步”,
that third part of the process,
关键步骤。
设计一个有效的解决方案,
actually have clinical problems
逆流而上者做出的
nearly enough of them out there.
这样的逆流而上者还是不够多。
in the healthcare system.
数来数去只有这么多,
out there right now, by all accounts,
几年前我和我的同事会说:
that we use for our success,
“别问,别说”现象。
不再来来回回地折腾你,
bouncing you back and forth
that we can all do to get there.
还因为这代表着更高水准的医疗方式。
找出一些端倪,
in our data about our patients' lives
逆流而上者来帮助我们。
next generation of upstreamists.
需要很多这样的人,
in the healthcare system
作为患者该应该怎么做?
影响我健康的细节?
如果真的存在一些问题,
我无法听从你的建议,
responsibility or phenomenon.
”逆流而上“地
ABOUT THE SPEAKER
Rishi Manchanda - PhysicianRishi Manchanda is an "upstreamist." A physician and public health innovator, he aims to reinvigorate primary care by teaching doctors to think about—and treat—the social and environmental conditions that often underly sickness.
Why you should listen
For a decade, Rishi Manchanda has worked as a doctor in South Central Los Angeles, treating patients who live and work in harsh conditions. He has worked at the Venice Family Clinic, one of the largest free clinics in the United States. He was the first director of social medicine at the St. John’s Well Child and Family Center in Compton, where he and his team provided high quality primary care to low-income families in the area. Currently, he is the medical director of a veterans’ clinic within the Greater Los Angeles Healthcare System, which he refers to as an “intensive caring unit.” He tells the National Health Corps Services, “The moment when a patient switches from despair to hopefulness is the greatest part of my service.”
Manchanda is the author of the TED Book The Upstream Doctors, in which he looks at how health begins at home and in the workplace, with the social and environmental factors of our everyday lives. He shows how the future of our healthcare system depends on “upstreamists,” the doctors, nurses and other healthcare practitioners who look for the root cause of illness rather than just treating the symptoms.
Manchanda is the president and founder of Health Begins, a social network that teaches and empowers clinicians to improve health where it begins—in patients’ home and work environments. He also founded RxDemocracy, a nonpartisan coalition created to register voters in healthcare clinics. He serves on the board of the National Physicians Alliance, as well as on the board of Physicians for Social Responsibility in Los Angeles.
Rishi Manchanda | Speaker | TED.com