A ra'ayi na, tsarin kiwon lafiya a kasar nan a halin yanzu yana kan tallafin rayuwa. Matsayin amana ya yi ƙasa da abin da ya kasance cikin aƙalla shekaru 50 kuma ya cancanci haka. Duk da yake da yawa tabbas sun yi imanin cewa mummunan tasirin tsarin kiwon lafiya ya dogara ne akan martanin Covid na al'umma, zan yi ƙoƙari na samar, daga hangen likitan da haƙuri mai ritaya, taswirar hanya wacce ta haɗu da duk abubuwan da ke cikin tsarin kiwon lafiya tare don bayyana yadda martanin Covid kawai ya haskaka ruɓar, maimakon zama sanadin sa. Duk da yake ina da masaniya game da sojojin da ke wajen tsarin kiwon lafiya waɗanda suka taka muhimmiyar rawa a cikin wannan wasan kwaikwayo, don wannan labarin, zan tsaya tare da kowane abu na likita.
Ana iya raba masana'antar kiwon lafiya zuwa fannoni huɗu masu alaƙa: 1) Masu ba da kulawa ta hannu; 2) Masu bincike; 3) Masana kiwon lafiyar jama'a; da 4) Masu tsarawa da masu kula da kayan aikin tsarin kiwon lafiya. Babban Umarnin (naku magoya bayan Star Trek) na kowane ɗayan waɗannan fannonin ya bambanta. Ga masu ba da kulawa ta hannu, shine: 'Na farko kada ku cutar da ku.' Ga mai binciken, shine: 'Nemi wani abu/gano wani abu.' Ga ƙwararren lafiyar jama'a, shine: 'Yi wani abu' (yawanci ana magana da babbar murya); kuma ga masu zane-zane da masu kula da kayan aikin tsarin kiwon lafiya, abin tashi ne a kan fim din, "Field of Dreams:" 'Idan kun gina shi, marasa lafiya za su zo.'
Abin da ya kamata a bayyane shi ne cewa waɗannan umarnin Firayim Minista guda huɗu na iya yin rikici da juna, don haka sai dai idan ba a sami haɗin gwiwa tsakanin ma'aikatan su ba, hargitsi na iya faruwa, wanda ya dogara da sarkar gaggawar lafiya. Game da martanin Covid na al'umma, hargitsi ya yi mulki, aƙalla saboda ƙaramin ƙwararrun ƙwararrun ƙwararrun kiwon lafiyar jama'a da Big Pharma sun karɓi ragamar aiki, yayin da aka kori masu aikin hannu da ƙwararrun ababen more rayuwa a gefe tare da ba da umarnin tafiyarsu. A cikin yanayin masu aikin hannu, an yi amfani da barazanar, idan ya cancanta, don samun yarda.
Abin da ya fi muni shi ne, yadda na kara koyo, na kara fahimtar cewa rudani ta hanyar zane ne, don kawar da hankalin al’umma daga fahimtar cewa ba a samu hadin gwiwar kwararru da ke wakiltar dukkan fannoni hudu ba. Muhimmancin wannan shine dangantakar jama'a da tsarin kiwon lafiya galibi ta hanyar likitansu na farko. Shin jama'a za su mayar da martani daban-daban idan suna sane da cewa wanda suka fi amincewa da shi don taimaka musu wajen tafiyar da tsarin kiwon lafiya yana kallon wani ba su ba?
A wannan lokaci, wata halaltacciyar tambaya da za a iya yi: me zai sa wani ya saurari abin da zan faɗa? Amsata ita ce, ina cikin ƙungiyar da ta ƙunshi kila kashi 1% na likitocin ƙasar nan waɗanda suka sami horo, ilimi, da gogewa a duk fannoni guda huɗu; kuma na yi haka sama da shekaru 50. Ku yarda da ni lokacin da na ce ban tashi kan wannan hanyar sana'a ba. Maimakon haka, ɓarkewar rayuwata ta sana'a ce ta kai ni ga wannan matsayi; wasu daga ciki suna da zafi da wahala. Bugu da ƙari, yin ritaya yana ba da ƙarin fa'ida a cikin cewa ba ni da hannu cikin aiki inda hankalina ya fifita horo ɗaya akan kowane ɗayan. Na fahimci cewa hakan ya ba ni hangen nesa da wasu kalilan a cikin sana'ata ke da su.
Musamman, Ina da shekaru 7 (1973-80) na horar da likitanci (SunY Downstate Medical School da Kings County Hospital IM Residency). Yayin nan, na ga kusan komai, tun daga rawan St. Vitus zuwa sanyin uremic. Abin lura, abu ɗaya da ban taɓa gani ba, ko ji, ko karantawa game da shi shine nau'in ciwon sukari na 2 a cikin duk wanda ke ƙasa da shekaru 30-35, wani abu da ke yaduwa a cikin matasa a yau. Wannan saboda shawarwarin Ma'aikatar Aikin Gona ta Amurka don maye gurbin carbohydrates don mai a cikin abincin Amurka bai faru ba sai ƙarshen 1970s. Sakamakon da ba a yi niyya ba na wannan canjin shine cewa abincin Amurka ya karu, a matsakaita, da adadin kuzari 500 / rana, don haka yana haifar da annoba ta tagwaye na kiba da ƙananan shekaru Nau'in ciwon sukari na 2.
Na tuna da tsinkaya a cikin 2005 a wani zaman da ke rufe 'Healthy People 2010' a taron shekara-shekara na Ƙungiyar Kiwon Lafiyar Jama'a ta Amirka cewa a cikin shekaru 5-10 masu zuwa, tsawon rayuwa a Amurka zai fara raguwa saboda yawan mutuwar da ba a kai ba daga kiba da kuma matasa masu shekaru Type 2 ciwon sukari. A gaskiya ma, 2015-2017 ya ga raguwar shekaru 3 na farko a cikin tsawon rayuwa tun bayan cutar ta mura ta 1918-20. Duk da yake an dangana wannan da farko ga mutuwar yanke ƙauna, na yi imanin kiba da ƙananan shekaru masu ciwon sukari na 2 sun kasance aƙalla mahimmanci. Ina ba da waɗannan cikakkun bayanai, domin, kamar yadda zan nuna, ya dace da yanayin tsarin kiwon lafiya na yanzu.
Komawa zuwa horo na likita; yayin da Anthony Fauci ya yi alfahari game da ganin cutar kanjamau a farkon 1981, wanda ke da wuri, na ga shari'ata ta farko na abin da muka gane daga baya shine HIV/AIDS a watan Satumba na 1977. Lokacin da NYC ta sami fashewar manyan Legionnaires a 1978, na kasance babban mazaunin asibitin Kings County pulmonary ward inda aka shigar da kararraki biyu. Na yi gabatar da shari'ar a Grand Round, wanda ƙwararrun masu kamuwa da cuta daga ko'ina cikin ƙasar suka halarta, gami da jama'a daga CDC, waɗanda kuma ke da hannu yayin da majinyata ke kwance a asibiti. Wannan babban matsayi ne ga CDC. Yaya nisan da maɗaukaki suka fāɗi! Na kuma sami horo da yawa game da kula da masu fama da tarin fuka, wanda har yanzu ya zama ruwan dare a Brooklyn. Gabaɗaya, na sami kusan horo a kan cututtukan cututtuka kamar wanda ya yi hulɗar cututtukan cututtuka.
Makarantar likitancina da horar da zamana ta biyo bayan kusan shekaru 40 na ƙwarewar kiwon lafiya, gami da shekaru 19 na kula da marasa lafiya kai tsaye a cikin ƙauyen wuri a matsayin Kwamitin Certified Internist; Shekaru 17 na bincike na asibiti a cikin wuraren amfani da abubuwa, HIV, da HCV a wata hukumar kiwon lafiya mai zaman kanta ba don riba ba, inda na kasance jagora ko marubucin kusan takaddun dozin biyu da aka buga a cikin mujallolin likitancin da aka bita. Na kuma yi sama da shekaru 35 na shiga harkar kiwon lafiyar jama’a, musamman a matsayina na memba na shekaru 10 na Kwamitin Ba da Shawarwari na Kulawa na Cibiyar Kula da Lafiya ta NYS. Ayyukan tsarin kiwon lafiya na da ayyukan gudanarwa sun kasance da farko a fannonin Inganta Ingantawa da Biyayya, inda nake da alhakin haɓakawa, aiwatarwa, da jagoranci na waɗannan shirye-shirye a cibiyoyin da nake da alaƙa ko aiki.
Lokacin da na yi ritaya shekaru 6 da suka gabata, na zama memba na Hukumar Binciken Institutional Review (IRB) a hukumar da na yi bincike a asibiti. Na kasance Shugaban IRB tsawon shekaru 4 da suka gabata, don haka ko da na yi ritaya, har yanzu ina cikin fage. Dangane da abubuwan da suka gabata, na gaskanta cewa na cancanci, daga yanayin kiwon lafiya, kamar yadda kowa zai yi ta “hayaniyar” don samun gaskiyar da bayanai masu mahimmanci.
Tafiya na na Covid ya fara ne a ranar Juma'a 13th na Maris 2020, ranar da aka ba da sanarwar dakatar da makonni 2 don 'lalata tsarin'. Na sauko da abin da nake zargin peri-myocarditis ne, kuma na ɗauka yana daga kamuwa da cutar Covid. An rufe ofisoshin likitoci, kuma an sami rahotanni (wanda ya zama na ƙarya) na mutuwar mutane da yawa a asibitocin da ke kusa da ni a Queens, NYC, don haka a zahiri na yanke shawarar fitar da shi. Alamun nawa sun kasance na raguwa da ƙarfi a cikin tsawon kwanaki bakwai, kuma sun tafi da rana ta takwas. A rana ta 10, na dawo yin hawan keke na mil 20 sau biyu a mako ba tare da wata matsala ba. Muhimmancin hakan zai bayyana daga baya.
A lokacin, na karɓi dabarar 'Flatten the curve', tunda ban taɓa gani ba tukuna (saboda ƙungiyar cece-kuce sun riga sun fara aiki) takaddun da John Ioannidis ko Jay Bhattacharya ya yi yana nuni da cewa adadin mace-macen da aka buga ya wuce gona da iri, har ma a cikin tsofaffi. Duk da haka, da na ga cewa za a tsawaita tsawon makonni 2, kuma kalmar kullewa ta fara aiki, sai na fara jin kamshin bera.
Idan an kulle mutane a cikin gidajensu, da alama babu makawa a gare ni cewa wani zai shigar da kwayar cutar a cikin gida, yana mai da ita abincin Petri. Tare da ilimina da gogewa na kula da kamuwa da cuta, na yi mamakin cewa babu wanda (sai dai Dr. Ben Carson) ya taɓa ambaton girman 'inoculum' a matsayin ƙayyadaddun yadda za ku yi rashin lafiya. Na kuma san cewa tuntuɓar cutar ta iska aikin wawa ne. Abin da kuke samu ke nan lokacin da likitoci irin su Fauci da Deborah Birx, waɗanda suka yi amfani da mafi yawan ayyukansu wajen magance cutar kanjamau, waɗanda ake ɗauka ta hanyar jima'i ko ta hanyar amfani da ƙwayoyi ta cikin jijiya, an sa su kula da magance cutar ta iska.
Na kuma san cewa abin rufe fuska ba shi da amfani. Na tuna da ji a lokacin cewa dakatar da kwayar cutar ta hanyar sanya abin rufe fuska yana da amfani kamar dakatar da sauro ta hanyar sanya shingen hanyar haɗin gwiwa a kewayen farfajiyar ku! Wannan kwatankwacin ya jure gwajin lokaci sosai. Na kuma sane da haɗarin CO2 narcosis daga sanye da abin rufe fuska tam. Wannan ilimin ya samo asali ne daga kwanakin horo na lokacin da amfani da Librium ko Valium don magance hare-haren firgici da kyar ke kan allon radar. Abin da muka yi shi ne sa majiyyaci ya numfasa cikin jakar takarda mai launin ruwan kasa har sai CO2 narkos ya kwantar musu da hankali. Yayi aiki sosai, a zahiri! Har yanzu ina tunawa da wata mace mai yawan firgita da za ta bayyana a cikin ma'aikatar gaggawa kawai lokacin da kayan aikinta na takarda launin ruwan kasa ya ƙare.
Lokacin da a ƙarshe na sami damar ganin likitana na farko a cikin Yuli 2020, an tabbatar da ganewar asali na peri-myocarditis (Ina da jujjuyawar T-wave akan EKG wanda daga baya ya warware). Mafi mahimmanci a gare ni, ina fatan cewa na yi maganin rigakafi ga kwayar cutar ta Covid. ban yi ba! Wannan yana da damuwa tunda, daga perch na, yana da matukar wahala a sami kyakkyawar kulawa kan ko hydroxychloroquine da azithromycin da zinc ko ivermectin suna da tasiri. Duk da yake na yi zargin cewa suna da tasiri (Na riga na san daga shekarun aikina cewa an yi karin gishiri da / ko rashin gaskiya); yunƙurin tauhidi ya kasance kamar yadda na yi shakka. Na lura duk da haka, cewa binciken da ke nuna cewa waɗannan magungunan ba su da tasiri ba a kan ƙungiyar da ake amfani da su ba; wato mutanen da suka sami alamun alamun kasa da kwanaki 3-4.
A lokacin faɗuwar 2020 ne na fara ganin tabbatacciyar takarda akan rage cutar mura ta Donald Henderson, MD, MPH da aka buga a 2006:
Jagoran da ke cikin wannan takarda ya yi tsayayya da martanin Covid da nake gani. Idan aka yi la’akari da irin kwarewar da Henderson ya samu a matsayin shugaban kungiyar da ta kawar da cutar sankarau a duniya, kuma a lokacin mutuwarsa a shekarar 2016, ya jagoranci kungiyoyin da ke daf da kawar da cutar shan inna da kyanda, shaidarsa ba ta da tushe.
Bugu da kari, Sweden ta ba da rukunin kulawa ta zahiri, ta yadda babu kulle-kulle, babu rufe makarantu, babu dokar rufe fuska, kuma babu buƙatun nisantar da jama'a. Duk da wannan, ƙasar ba ta da mace-mace a cikin yara 'yan ƙasa da shekaru 18. Yawan mace-macen su gaba ɗaya bai fi ƙasashen da aka kulle su ba, kuma rikice-rikicen zamantakewa da tattalin arziki sun yi ƙasa da takwarorinsu.
Dangane da bayanan da na yi bayaninsu a sama, na yanke shawarar cewa lokacin da aka saki Covid jab, zan ɗauka, amma sai bayan aƙalla wasu miliyan 10 wasu sun ɗauke shi ba tare da ɗimbin abubuwan da suka faru ba, tunda har yanzu na yi imani cewa ga waɗanda shekarunsu suka kai 65 ko sama da haka, yana da daraja. Daga bayanin da ya gabata, zaku iya ganin cewa a wannan lokacin, har yanzu ban san tsawon lokacin da hukumomin kiwon lafiyar jama'a suka bi don ɓoye adadin munanan abubuwan da suka faru daga jab ba. Tabbas, kafin shan jab, na yi shirin sake gwada ƙwayoyin rigakafi da farko don ganin ko na sami rigakafi na halitta.
Wannan ya kawo mu ga bayanin Babban Umarnin Likita: 'Na farko kada ku cutar da shi.' Lokacin da FDA ta amince da sabon magunguna don amfani da haƙuri, ko da a ƙarƙashin tsarin yarda da aka saba, ba za ku taɓa son kasancewa cikin rukunin farko na likitoci don rubuta wannan sabon samfurin ba, sai dai a cikin yanayi mai wuya. Me yasa wannan? Domin yawan majinyatan da suka shiga cikin binciken don kammala gwaji na Mataki na 3 ba su da yawa sosai. Sabili da haka, lokacin da aka saki samfurin, adadin marasa lafiya da aka sanya a kan sabon magunguna yawanci sau da yawa yawan mahalarta bincike. A sakamakon haka, mummunan halayen, ciki har da mutuwa, daga sabon samfurin da ba a gani ba yayin binciken zai iya fitowa. Kusan sau ɗaya a shekara, FDA za ta cire daga kasuwa wani magani da ta amince da shi a baya saboda munanan abubuwan da aka gani bayan amfani da tartsatsi… kuma wannan ya kasance yanayin aƙalla shekaru 40 da suka gabata.
A cikin shekaruna na aikin kulawa na farko, ana yawan bincikar likitoci akan lokacin da zasu fara rubuta sabon samfurin magunguna. Kashi kaɗan za su rubuta shi da zarar an samu; kashi kaɗan za su rubuta shi bayan wasu abokan aikinsu sun yi amfani da shi; kusan 70-80% zai rubuta shi ne kawai bayan an yi amfani da shi sosai; kuma kusan kashi 10-15% ba za su rubuta samfurin ba har sai an yi la’akari da shi a matsayin “ma’aunin zinariya”. Lokacin da nake aiki, kusan koyaushe ina cikin rukuni #3. Halin da ba kasafai ba lokacin da kuke son zama na farko a layi shine lokacin da majiyyaci ya kasance akan kowane tsarin jiyya da ake samu kuma har yanzu yana yin mara kyau. Misali zai kasance marasa lafiya da ke fama da rashin lafiya, waɗanda, a mafi kyau, har yanzu suna fama da ciwon kullun duk da cewa sun kasance a kan kowane tsarin da aka yarda.
Ganin cewa Covid jab, a ƙarƙashin Izinin Amfani da Gaggawa, an sake shi yayin da yake samfurin bincike na Mataki na 3, yakamata a sami ƙarin sa ido kan tallace-tallace fiye da yadda aka saba. ina da rubuta game da waɗannan gazawar sa ido a baya don Brownstone:
Komai ya canza min a cikin Disamba 2020 lokacin da na yi kwangilar cutar Covid a karo na biyu. Ba tare da yin cikakken bayani ba, na sami ƙarancin isashshen numfashi sakamakon guguwar cytokine da ta haifar da Covid-11 ta hanyar ciwon huhu na kwayan cuta. Na yi kwana 20 a asibiti. Idan ba don ƙarin ajiyar huhu daga shekarun hawan keke ba, tabbas da na mutu. Ba zato ba tsammani, an ba ni Remdesivir, amma a lokacin, na san cewa kawai mutanen da ke amfana da wannan maganin su ne Fauci da Bill Gates. Na dauki wucewa Makonni shida bayan sallama, na dawo yin hawan kekena mai tsawon mil XNUMX.
A wannan lokacin, ya kamata in yi magana da waɗanda suka yi imanin cewa ba a cikin ƙwayar cuta ba ce ta haifar da zamba. Dangane da yanayin rashin lafiya na guda biyu, na ƙi wannan ra'ayi gaba ɗaya. Mutuwar kwayar cutar ce aka wuce gona da iri, ba kasancewarta ba!
A farkon 2021, shawarar ita ce ko da kuna da ƙwayoyin rigakafi ga Covid, ya kamata ku karɓi jabs na mRNA guda biyu watanni uku bayan gwajin rashin lafiyar cutar bayan cutar. A gare ni, wannan zai kasance a ƙarshen Afrilu ko farkon Mayu na 2021. Shirina shi ne in gwada ƙwayoyin rigakafi a ƙarshen Afrilu, kuma in ƙi jab idan na yi maganin rigakafi, duk da shawarar da shugaban magungunan huhu a asibitin da nake jinya. Dalilin da aka bayar na jab ba shi da ma'ana a gare ni, kuma ya saba wa shekaru 2,500 na ilimi game da rigakafi.
A cikin watanni 3 masu zuwa, an buga kyakkyawan bincike a fili yana nuna cewa rigakafi na halitta yana da aƙalla tasiri kamar jab. Lokacin da na gwada inganci don maganin rigakafi, babu yadda za a yi a yi min jabed. Kasancewar ƙarin shaidun da ke bayyana cewa wasu mutane na iya kamuwa da mummunar toshewar jijiyoyi daga jab, da kuma la'akari da tarihin iyalina na mutuwar farko daga cututtukan jijiya, shawarar da ba a yi ba zai iya ceton raina. Af, CDC ba ta yarda da ƙimar rigakafin halitta a bainar jama'a ba har zuwa ƙarshen Janairu na 2022, kuma har ma a ƙarshen ranar, sun binne shi a cikin jadawali ba tare da ambaton ba a cikin labarin da ke tare da jadawali.
Babban abin da ya faru na gaba, daga hangen nesa, shine lokacin da FDA ta yi la'akari da jab ga yara masu shekaru 12-17. A wannan makon da Kwamitin Ba da Shawarwari na FDA ke yin bitar su, wani bincike daga Isra’ila ya nuna cewa a cikin yara kasa da 100,000 da aka ba da jab, akwai lokuta 1,200 na myocarditis. Ga allurar rigakafin da ake zato, wannan babban adadi ne mai girman gaske na munanan abubuwan da suka faru. Kasancewar babu yaron da aka kwantar da shi a asibiti ba abin mamaki bane.
Na ga wannan binciken a cikin kwana daya da fitowar shi. Wannan binciken, tare da gaskiyar cewa a cikin ƙasashen da ke da kyawawan bayanai game da mace-mace daga Covid a cikin yara, adadin waɗanda suka mutu bai kai ba, ya sa na yi imani cewa babu wata hanyar da za a amince da jabs ga wannan ƙungiyar. Yaro nayi kuskure! A lokacin, na yi tunanin cewa wannan ya zama rashin da'a na kimiyya wanda ya ketare layin zuwa aikata laifuka. Idan wani abu, al'amuran da suka biyo baya sun ɗora abubuwan ban mamaki da yawa ga wannan ƙima. Da yawa don bin kimiyya! Wasu ƙasashen Turai ba su amince da jab ga waɗanda ba su kai shekara 18 ba, kuma har yanzu ba su yarda ba.
Don ƙara zagi ga rauni, na ga tambayoyi biyu da Randi Weingarten yayi game da makonni 6-8. A cikin kwanaki 7-10 bayan kowace hira, CDC ta fitar da jagororin kula da ilimin yara da kiwon lafiya waɗanda na tabbata sun fito kai tsaye daga waɗannan tambayoyin. Tabbas, musayar imel tsakanin Weingarten da Rochelle Walensky, sannan Daraktan CDC, an sake su suna nuna babu shakka cewa Weingarten yana ba CDC umarnin tafiya. Ganin cewa Weingarten mugu ne, mara kyau, ba shi da horo na likita, kuma ba ta da haihuwa ya sa ta zama mutum na ƙarshe da za ku so ku sami ikon sanin yadda ya kamata yaranku su sami ilimi da kuma lafiyar da ya kamata su samu. Yana kama da samun Hansel da Gretel akan ci gaba da madauki, sai dai cewa mugayen mayya koyaushe suna yin nasara!
Sai na ci karo da wadannan binciken, wanda na yi tunanin an yi shi da kyau:
Ya nuna cewa a tsakanin majinyatan Medicare da ke karɓar tsarin farko na harbi biyu a farkon 2021, an sami fa'ida cikin tsawon watanni 6. A kan wannan binciken, har yanzu na ci gaba da cewa jab yana da amfani ga wannan ƙungiyar. Duk da haka, ban kubuta daga lurata ba cewa a cikin shekaru biyu masu zuwa, karatu a wasu ƙungiyoyin da aka tsawaita na tsawon watanni 6 ko fiye ba su zo ba. Abin da ya fi ban mamaki shi ne cewa babu wani kari da ya wuce watanni 6 a cikin ƙungiyar daga binciken da aka ambata a sama. Ganin rashin kyawun kusan dukkanin karatun da ke fitowa daga hukumomin lafiyar jama'a (binciken da aka danganta a sama ya kasance ban mamaki sosai), na gamsu cewa lokacin da suka yi ƙoƙarin tsawaita binciken fiye da watanni 6, sakamakon ya yi rauni sosai har ma ba za su iya yin ƙoƙarin sarrafa bayanan ba, kamar yadda suka yi a lokuta da yawa (kuma kusan koyaushe ana kama su).
Na bayanin kula, daga Satumba 2021 har zuwa ƙarshen 2023, Na shiga kai tsaye akan rukunin yanar gizon MedPage, wanda aka iyakance ga ƙwararrun kiwon lafiya. A lokacin da nake kan MedPage, na fita daga kasancewa mai ficewa, wanda aka zarge shi da duk abubuwan da aka saba yi na Covid zuwa kasancewa ɗaya daga cikin shugabannin abin da ya zama mafi rinjaye na 75%. An ɗauki kimanin shekara guda kafin canjin ya faru. Ku yi imani da ni, an yi daidai adadin kuka da cizon haƙora ta Covidian goons. A duk lokacin da zan kalubalanci kungiyar don samar da binciken da ya yi daidai da binciken da aka danganta a sama, babu wani abu sai crickets, duk da haka sun ci gaba da tallafawa ba da jab ga duk wanda ke da bugun jini. A ƙarshen 2023, Daular ta sake dawowa tare da ƙungiyar goon ta sake samun iko. A lokacin, na cire rajista. Daga baya na gano cewa MedPage babban rukunin yanar gizo ne wanda ke sarrafa Pharma. Idan gaskiya ne, na yi mamakin yadda na iya ba da gudummawa muddin na yi.
Idan aka yi la'akari da rikice-rikice na Covid, ba zai zama rashin hankali ba a yi zargin cewa wasu abubuwan da ake zaton 'masu daidaita' na kiwon lafiya, musamman game da magunguna, an yi watsi da su. Kwanan nan, na sami abin da na yi imani yana da kyakkyawar hulɗa tare da masu ba da gudummawar Brownstone, waɗanda galibi ba ƙwararrun kiwon lafiya ba ne. Zan siffanta ɗayan waɗannan tattaunawa a matsayin ƙarin matsalolin Covid jab ga harbin mura. Muhimmin batu daga waccan tattaunawar ita ce ingancin bayanan da ke tallafawa amfanin harbin mura ya bayyana ya fi muni fiye da na Covid jab, wanda zai yi kama da ba za a iya tunani ba, amma tabbas cikakken kwatanci ne.
Yayin da na yarda cewa tallafina na kusan ba tare da wani sharadi ba ya girgiza, har yanzu zan ci gaba da shan ta kowace shekara, kamar yadda na yi a cikin lokutan mura 42 da suka wuce, kuma har yanzu zan ba da shawarar ta ga mutanen da suka haura shekaru 44, da yara ‘yan ƙasa da shekara 65. Me ya sa zan yi haka? Domin sanina ya gaya mani cewa bayan shekaru 18 na amfani, maganin mura ya tabbatar da cewa yana da aminci sosai (ya bambanta da Covid jab), kuma hukunci na asibiti shine cewa kyawawan bayanai zasu nuna cewa yana rage cututtuka da mace-mace daga mura, koda kuwa wannan raguwar ta yi kadan. A wasu kalmomi, na yi imani cewa hadarin / fa'ida rabo yana da kyau ... amma zai yi kyau a sami kyakkyawan bayanai don tallafawa ko karyata wannan hukunci.
Tattaunawa ta biyu shine game da amfani da statins don hyperlipidemia. Yayin da bayanan da ke goyan bayan amfani da shi azaman rigakafin na biyu ga wanda ya sami abin da ya faru na zuciya ya zama mai ƙarfi, amfani da waɗannan magunguna don rigakafin farko ya bayyana yana kan ƙasa mai girgiza. Wannan batu ne, da aka ba da yiwuwar tasiri mai mahimmanci daga amfani da statins na dogon lokaci. Wani muhimmin batu shi ne cewa matakin hawan lipid wanda ke ba da izinin maganin rigakafin farko ya ragu cikin shekaru. Hankali na shine babban Pharma ne ya tura wannan a cikin ƙoƙarin samun kowa a cikin ƙasar don shan magani, maimakon kowace ƙima ga marasa lafiya.
Har yanzu, hukuncin asibiti shine mabuɗin, musamman a fannin zaɓin majinyacin da ya dace. Har ila yau, zan yi amfani da kaina a matsayin misali. Ina da tarihin iyali na farkon mutuwar zuciya a gefen namiji wanda zai shake doki! Saboda haka, lokacin da aka gano ina da matsakaicin hyperlipidemia kimanin shekaru 25 da suka wuce, tare da matsananciyar hawan jini zuwa matsananciyar hawan jini, an bi da ni duka biyu. Yanzu na wuce duk dangi na kusa da maza, kuma ba tare da cututtukan zuciya ba. Ba ni da shakka cewa yin amfani da waɗannan magunguna ya kasance muhimmiyar mahimmanci a wannan sakamakon.
A wannan gaba, bari in canza kayan aiki zuwa tsarin kiwon lafiya gabaɗaya. A cikin makon da ya gabata, na karanta mai zuwa Labari wanda aka buga akan tattaunawar Brownstone:
Takardar ta kwatanta tasirin da ake tsammani na lalacewa na canji daga tsarin Flexnerian na horar da likitoci, wanda shine abin da na karɓa, zuwa abin da za a iya kwatanta shi a matsayin bambancin, daidaito, da haɗawa (DEI). An nuna cewa Abraham Flexner, wanda ya fitar da rahotonsa na seminal a 1910, ba likita ba ne. Duk da haka, shi ma'aikacin asibiti ne, kuma mahaifinsa da dukan 'yan uwansa likitoci ne, don haka aƙalla, akwai wadataccen ƙwarewar kiwon lafiya da za a iya zana a cikin tattara abin da aka sani da rahoton Flexner. Daga nan an nuna cewa Flexner ya sami mummunar tasiri daga sha'awar kamfanoni, maimakon sha'awar ingantattun horarwar likitoci da ƙwarewa.
Yarda da waɗannan suka a matsayin suna da aƙalla wasu inganci, don sanya duk wannan a cikin mahallin da ya dace, yana buƙatar cewa dole ne a bincika abubuwan da suka faru ta hanyar amfani da lokacin da ya dace. Duk da yake na yarda da waɗanda suka yi imani cewa ingancin tsarin kiwon lafiyar Amurka yana raguwa aƙalla shekaru 20 da suka gabata, ba saboda gazawar samfurin Flexnerian ba. Tsarin Flexnerian ya yi sarauta mafi girma daga 1910s har zuwa farkon 1990s. A wannan lokacin, cibiyar girman ci gaban kiwon lafiya a duk duniya ta ƙaura daga Turai zuwa Amurka.
Wannan canjin ya haɓaka bayan WWII lokacin da Turai ta karɓi ƙirar 'maganin zamantakewa', kuma ta shiga cikin sauri a cikin lokacin daga ƙarshen 1970s zuwa farkon 1990s. Duk da wannan nasarar da aka samu, an fara wargaza tsarin Flexnerian da gaske a tsakiyar shekarun 1990, duk da cewa an fara yunƙurin ƙara yawan shiga makarantun likitanci na mata da marasa rinjaye a farkon shekarun 1970, lokacin da na fara karatun likitanci na, kuma na sami wani matakin nasara. A bayyane yake, masu iko ba su gamsu da ƙoƙarin bambancin ba.
Ka'idar ta game da dalilin da ya sa ci gaba da haɓakawa daga ƙarshen 1970s zuwa farkon 1990s ya faru shine lokacin da aikin injiniya a matsayin aiki ya mutu a cikin duka shekaru goma na 1970s (eh, hakan ya faru), ɗimbin ɗaliban da suka riga sun fara aikin injiniya sun tafi pre-med. A haƙiƙa, mafi girman yawan kaso mafi girma a cikin masu neman makarantar likitanci ya faru a cikin waɗannan shekaru goma. Sakamakon samun daliban injiniya sun shiga sana'ar likitanci da yawa, an sami fashewar ci gaban fasaha da magunguna wanda ya taimaka wa manyan ɓangarorin manya. Misalan sun haɗa da daidaitawa don amfani da likita ko sabon ci gaban sonography, CT scans, MRI, angioplasty, m endoscopy, laparoscopy, beta-blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), da dai sauransu, da dai sauransu, da dai sauransu.
Duk waɗannan da ƙari sun faru a cikin ɗan gajeren lokaci na shekaru 15. Na sami damar samun horo a lokacin, da kuma iya kawo wa marasa lafiya nawa ci gaban. Wadannan ci gaban sun tsawaita tsawon da ingancin rayuwar manya marasa lafiya ta hanyoyin da ba a taba ganin irin su ba, kuma, a ganina, ba su faru ba tun daga lokacin.
Don yin gaskiya, ba kawai kutsawa na shirye-shiryen DEI ba ne a tsakiyar 1990s waɗanda ke da mummunan tasiri akan tsarin kiwon lafiya. Sauran ci gaban shine canjin likitoci daga ayyukan masu zaman kansu (mafi yawa a cikin manyan kungiyoyi na musamman guda ɗaya ko na musamman) zuwa ma'aikatan manyan tsarin kiwon lafiya na yanki, kamfanonin inshora, ko wasu manyan cibiyoyi. Masu ba da gudummawar Brownstone sun rubuta jahannama daga gaskiyar cewa wannan canjin ya tsananta lalacewar da Covid ya haifar, saboda an lalata ikon ikon likita, algorithms na kwamfuta, dangane da abin da muka sani yanzu na iya zama bayanan sirri (sharar cikin, datti) ya maye gurbin hukuncin asibiti, kuma tsoro ya yi mulki.
Shin abin mamaki ne cewa muna inda muke? Na ambata a baya cewa tsawon rayuwa ya ragu har tsawon shekaru uku a jere tun daga 2015. Gaskiyar ita ce, tun daga 2017, yanayin rayuwa gaba ɗaya ya ci gaba da komawa ƙasa. Duk da yake rayuwa tabbas abu ne mai mahimmanci a cikin wannan raguwa, zai fi kyau mu fara duba ko tsarin lafiyar mu yana ƙara wannan bala'i. Babban cikas, a ganina, shine mutanen da suka fi dacewa a cikin tsarin kiwon lafiya don yin canje-canjen da suka dace sun kasance marasa ƙarfi. Mai yuwuwa mafi muni, sabon tsarin horar da likitoci na iya ba da wannan ƙungiya mai mahimmanci tare da fasahar fasaha da ake buƙata don fahimtar abin da za a yi don juya wannan jirgin.
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Steven Kritz, MD likita ne mai ritaya, wanda ya kasance a fagen kiwon lafiya tsawon shekaru 50. Ya sauke karatu daga SUNY Downstate Medical School kuma ya kammala zama na IM a Asibitin Kings County. Wannan ya biyo bayan kusan shekaru 40 na ƙwarewar kiwon lafiya, ciki har da shekaru 19 na kulawa da haƙuri kai tsaye a cikin ƙauyen ƙauye a matsayin Kwamitin Certified Internist; Shekaru 17 na bincike na asibiti a wata hukumar kiwon lafiya mai zaman kanta-ba don riba ba; kuma sama da shekaru 35 na shiga cikin lafiyar jama'a, da tsarin kiwon lafiya da ayyukan gudanarwa. Ya yi ritaya shekaru 5 da suka gabata, kuma ya zama memba a Hukumar Binciken Institutional Review (IRB) a hukumar da ya yi bincike a asibiti, inda ya kasance shugaban IRB tsawon shekaru 3 da suka gabata.
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