Marketplace aired this wonderful story this evening, about a Vietnam vet and unemployed engineer who was killing himself by smoking, he admitted, but made sure the EMTs could always find him to take him to the hospital because he didn't want to die alone.
He was a regular in the ER -- a high-cost patient who cycles in and out of hospitals -- until he became part of a program at the University of Pennsylvania Hospital that focuses on helping people who live in five zip codes from which 85 percent of the readmissions occur.
All this man needed was someone who cared about him to turn his life around. This hospital program enabled that to happen.
This goes to what Vincent Felitti believes -- and, to an extent, what the American Academy of Pediatrics and the American Academy of Neurology have recently recommended. If physicians ask what's happening in a person's life -- i.e., probe specifically about abuse, neglect, homelessness, loneliness, etc. -- and have programs or relationships with organizations that can assist, for some, perhaps many, of these people, they'll obtain appropriate care and their visits to physicians and ERs will decrease.
btw, Shreya Kangovi, the internist who set up the program, did a commentary about this issue in JAMA last October.
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