Ask Dr. Hallberg: Despite year of cholera, obesity, there's plenty to be hopeful about

It's been an interesting year for health stories. A huge health care reform bill passed Congress, but the debate after the fact seemed to raise more rancor than the discussion leading in. An earthquake killed hundreds of thousands in Haiti, followed by a deadly outbreak of cholera. In the meantime, America's epidemic of obesity has spread to other nations across the globe.

But even with all those challenges and uncertainties, MPR's regular medical analyst Jon Hallberg said there is still reason to be hopeful when it comes to health and wellness this Thanksgiving.

Hallberg is a physician in family medicine at the University of Minnesota and medical director of the Mill City Clinic in Minneapolis. He spoke with MPR's Steven John on Tuesday.

Steven John: So how does a person who deals with illness and bad news, find reasons to be hopeful?

Jon Hallberg: I really have been giving this a lot of thought, and I had to step back and think just really big picture because it's so easy in a day-to-day practice to get overwhelmed by that, by the bad news, by trying to take care of everyone's needs. You're constantly giving, and it gets tough.

So I really sat back and thought, and I came up with three broad areas I think that I'm very hopeful and thankful for, the directions that health care seems to be going in.

John: So give us an example.

Hallberg: I think one of the things that strikes me right off the bat is I am really struck by the idealism displayed by so many of the medical students, especially at the University of Minnesota Medical School, where I'm on faculty. In this time of uncertainty, young people are going into medical school knowing full well how much they're going to be carrying in terms of debt, knowing that there's so much up in the air in terms of health care reform. There's so much rancor in the air, and here they are going into medicine knowing all that.

And I'm also impressed that last year we had an uptick in people going into family medicine in a time when it's seeming less desirable for lots of reasons. There it is, sort of bucking the trend. We're seeing more people going into primary care. So I'm very hopeful in that sense and thankful because these are the physicians who will be caring for us in the years to come.

John: What else are you thankful for this Thanksgiving week?

Hallberg: Well since I knew I would be talking about this, I've been thinking a lot over the last week about this. And it struck me that there are so many silos and walls that are constructed that ... prevent physicians and other health care providers from really collaborating, working together.

And yet despite that, I was amazed this last week how much compassion was displayed by my fellow colleagues across different systems, whether it's North Memorial or an Allina system or at the University or (wherever) it might be, reaching out, calling, paging, emailing, bumping into people, doing favors for one another.

I think that physicians forget this and patients often forget this, too, the amount of time and energy to takes to really do good care. And there's no compensation for that, for my reaching out to somebody or somebody reaching out to me, that's nothing you can bill. That's done because it's the right thing to do.

This week in particular, I had a friend who looked at some pathology slides for me, and he just did it because it was the right thing to do. And I received a phone call from a doctor at North Memorial who was really persistent in getting a hold of me, and I was hard to get a hold of, but he kept trying because he knew that by speaking with me, we'd provide ultimately better care for a patient. And that's very cool, and that's not something you get in a letter or that you get through the mail. That's really kind of above and beyond, and a lot of that goes on every single day, and I'm very thankful for that.

John: Let's talk about the Haiti situation for a moment, with the cholera outbreak because of the sewage in the water and the people just don't have the infrastructure that we have here.

Hallberg: Well that's what really got me thinking about all of this was just the horrifying news and the pictures coming out of Haiti, and just realizing what happens when you don't have something as basic as sanitation that works. We take that for granted every single day. You pour a glass of water. You drink out of the tap. You wash your hands. You flush the toilet. You don't think about where it goes or where it's come from or is it safe. We just, we know that it is, at least broadly. Sure, there are things in the water, and we're worried about trace amounts of this and that, but the fact is, though, that we're not dying in the thousands or tens of thousands or millions because of that.

And then I start thinking more broadly beyond that. What are some things in medicine that I'm just thankful for that I haven't been thinking about lately?

John: What about immunizations?

Hallberg: Absolutely. There's another thing, too. Yes, there's controversy. People may be concerned about it, but the bottom line is that there's probably, next to clean drinking water, nothing other than immunizations that has done more to prevent unnecessary death, particularly in children. I mean look around the world. What are children dying of? It's typically immunization preventable diseases, and we just don't think about that.

And I think one of the reasons we have so much concern here about immunizations is because we're generally healthy, and kids make it through childhood. And so when there's possibly something going on with it, we have the ability to think and ponder and question that, whereas most of the world, that's not a luxury that they have.

John: As for the controversial health care reform law that passed, and putting politics aside (as to) whether it was the right thing to do or if it was debated correctly in Congress, it does raise some uncertainties for physicians. Are you hopeful that you'll be able to deal with things going forward and still keep your positive attitude?

Hallberg: Absolutely. I mean I have no choice. I have to be positive and upbeat and think that it's going to work and help people, although I think we all know that it's not making things much easier. In fact, we're already starting to get calls from people asking for prescriptions for over-the-counter meds because they now need their physicians to write prescriptions so they can get it through their health care spending accounts. That's going to be dozens of medications for some people. That is already adding to our burden.

So I'm trying to remain upbeat and not let that get me down and imagine what it's going to be like every January 1, but it's going to have some major challenges for us.

(Interview edited and transcribed by MPR reporter Madeleine Baran)

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