The Festive Period, Health Systems and Are Parachutes Really Effective?Dr Kunal Patel 17 Dec 2018
In some parts of the world, it has become darker and colder, in others, brighter and blistering hot. Either way, much, but not all the world will be settling into what is commonly referred to as the festive period.
From a healthcare perspective, this can bring on many things including an increased strain on health systems which we previously referred to as ‘a winter of Narnia’ when discussing the role of collaboration and the strengthening of health systems globally. However, it can also create an environment unique to health professionals in that we end up working in an atmosphere that is unique to this time of year. Overindulgence, a thankful drop in inappropriate admissions, children inhaling parts of their new toys, breakups after too much mulled wine to slipping on ice are some examples of what will be seen. However, behind all this, there is commonly a rise in serious flu cases, abandonment of the elderly, a rise in loneliness and more, including, let’s not forget that diseases such as cancer, just don’t stop for Christmas.
A recent perspective from a medical student in the US, focuses on how more community experience can help going forward, creating better doctors. This could very well be true as we look at it more in the future, however, what is clear, is that more health workers are needed in the community, full stop. This is particularly the case during times of year when stress on health systems, can be at it’s highest, such as winter. These workers can cross over with the term ‘rural’ or country physicians and in areas where winter can have a huge impact in terms of access, these types of individuals or teams are essential. So much so, we are now seeing the emergence of rural /community medicine as its own specialty in regions such as New Zealand, making it clear that we must focus the community and geographies where health access is needed the most, particularly in the colder months.
Talking of colder months, one thing that is always great about this time of year are the festive research publications. Not that this is my bedside reading, far from it, however, you do get the occasional paper that makes you laugh. None more so, than the recent work by Robert Yeh and colleagues at Harvard who decided to conduct a randomized controlled trial on whether parachutes prevent death or major traumatic injury when jumping from an aircraft! Have a read and the findings a brilliant. Parachute use did not significantly reduce death or major injury (0% for parachute v 0% for control; P>0.9). This was maybe because the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps.
So, in conclusion, even when the winter months can be tough and we need better, stronger health systems, we still find it difficult to conduct an RCT on parachute effectiveness and its impact on death!
Have a great festive period!