Go Doc Go: Doctors Doing Good | Medical | Hudson Valley | Hudson Valley; Chronogram
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Go Doc Go: Doctors Doing Good 

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A Win for Women's Health

Fast forward to October 2015, when Carpenter and Frengle-Burke returned to Ethiopia to check on the program, bring supplies, and meet with Ethiopia's Ministry of Health to discuss future projects. In the year that had passed, the Gondar hospital had screened over 1,000 women, treated over 400 with either cryo or LEEP, and performed 30–40 hysterectomies. (Normally, the cancer rate would have been 25–30 percent, says Carpenter, but many women had already been screened and referred by small local clinics.) The program was a success, but challenges still arose—such as the problem of keeping stocked with supplies, since shipping to Ethiopia is so difficult. (When Carpenter and Frengle-Burke arrived, supplies had run out and the program had a waiting list.) And transportation issues meant that follow-up with patients was basically nonexistent.

Whether at home or abroad, making a difference with medicine for underserved populations has its obstacles. In the US, the hurdles come mainly from bureaucracy, says Carpenter; in Ethiopia, it's infrastructure—basic, everyday things that we in the West take for granted, like electricity and cars. Both she and Frengle-Burke work with high-need populations at their day jobs at home: Carpenter has launched a house-call service for elderly and hospice patients on Medicaid, spending her days driving around Ulster County visiting housebound and disabled people, while Frengle-Burke works at the Greater Hudson Valley Family Health Center, a community health and urgent care clinic in Newburgh. "It's a lot easier to make changes [in Africa]," says Frengle-Burke. "They have so many needs there, and we can make much more of an impact doing what we do." Collaborating with doctors in Gondar, she was struck by their work ethic. "The physicians there don't have the same lifestyle or salaries as they do here, though they have the same hours," she says. "It's impressive to see them working so hard. They're not living large."

The differences in lifestyle appeared even more stark through the eyes of their children: On Go Doc Go's first trip to Gondar in 2014, Carpenter brought her 14-year-old son, Julian, and Frengle-Burke took her 12-year-old daughter, Amelia. The two kids had the chance to spend a day at a local school and even teach an English lesson; they also visited a few families' homes. "One of my favorite things was watching [Amelia] see how people could live with so few material belongings, yet also be incredibly happy. The [Ethiopian] children were running around and smiling," says Frengle-Burke. Of course, not everything was rosy: Amelia also visited a fistula repair clinic, where teen and preteen girls like herself were being treated for the complications of delivering babies before they were fully grown, leading to obstructions and injuries that left them incontinent, and often ostracized from their families and communities that had rejected them. "It was intense to have my daughter see that, but also pretty amazing for her to learn about relevant and substantial problems that kids don't often think about when they're 12 or 13." (After the trip, says their mothers, both Julian and Amelia have an intense desire to see the world—and the more exotic the destination, the better.)

Code Blue for American Medicine

For Carpenter, working in Africa underscores not just the advancements but also the shortcomings of our country's healthcare system—its bloated, wasteful spending; its tendency to overscreen and overtreat patients; and its insistence on keeping sick people alive through any means necessary, even when quality of life has gone out the window. "There is no way that our current system can handle our model of overtreatment," she says. "What I have a hard time with is not just the money being spent, but the agony that people go through in their later years here, in the false belief or hope that they need just one more treatment or one more medication. What are we doing to our elderly? We're pumping them up with more and more medications. It's frightening." In her palliative care house-call practice, called Nightingale Medical, Carpenter helps housebound patients edit down their list of unnecessary pharmaceuticals, keeping only those that will improve their daily life. She's seen about 150 patients in less than two years, logging hundreds of miles in her Volkswagen Jetta—and likely saving Medicaid thousands of dollars by reducing hospital visits and fall risks for her elderly and hospice patients. "I'm hoping to get a coalition of people together in Ulster and Dutchess County to get funding so I can expand [the program]," says Carpenter. "My goal is to reproduce it as a model that can be used in lots of different places."

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