Despite the financial woes of the United States Postal Service (USPS), the government agency is responsible for promoting a less talked about public benefit.
Consider that of the more than 500,000 workers USPS employs, slightly more than 300,000 of those employees qualify as "mail carriers", i.e. the people you see out for delivery on streets, sidewalks and assorted roadways.* Carriers are the real troopers --the men and women charged with braving the elements to ensure timely delivery of the public's mail.
As part of their work environment, USPS mail carriers (similar to their private-sector FedEx and UPS brethren) should be physically capable of performing simple yet demanding tasks like climbing stairs, lifting and carrying packages, and traversing short to medium-scale distances with the occasional sprint from hostile pets.
Boiled down to a granular level, USPS mail carriers, at least in most urban and some suburban areas, on a weekly basis demonstrate a positively healthy behavior --walking. Anytime you see a carrier park his/her vehicle to get out and walk their route is what is referred to as the "park and loop".*
While estimates for a carrier's average mileage covered by walking don't exist, we might reasonably assume that even 15 minutes of walking (while carrying a load) has a direct impact on that worker's health. Public health experts acknowledge that even short bouts of walking spread throughout a person's day produces long-term benefits.*
At the same time, mail carriers are constantly out of doors. Recent research suggests that even the scent of flora like pine trees can have a demonstrable effect on one's mental health while reducing levels of stress.* By being both physically active and outdoors, these workers exhibit healthy and replicable behaviors all within the public's eye. Perhaps in this respect more than any other, USPS mail carriers serve as model citizens.
Sunday, March 10, 2013
Sunday, February 3, 2013
Prescribe-first-treat-later
Reading the featured article in today's Times, one thing in particular stood out to me -- the "prescribe-first" mindset and it's deleterious effects on unsuspecting patients and their families. Richard Fee was a young man who was obviously both physically and psychologically addicted to a manufactured substance --a "medicine", if you please. Richard's family seemed aware of their son's spiraling addiction, yet the doctors, clinical experts, and specialists who "treated" him seemed less conscious of this important fact.
Most troubling was the doctors' continued reliance on prescriptions to treat maladies that likely arose from another prescribed medication. For example, even when Richard's doctors were advised of his past abuse of drugs (like Adderall) used to calm his ADHD, on more than one occasion they proceeded to prescribe additional medications (often anti-depressants) to quote-unquote treat the negative side-effects of that prior drug. This mentality of "prescribe-first-treat-later" is alarming in the sense these doctors abdicated their Hippocratic responsibility to "first, do no harm."
One cannot help but think of the influence drug manufacturers and their associated actors had on Richard Fee's life. A more likely culprit for Richard's death was not the myriad doctors who prescribed his medications but the drug companies who created, manufactured, and packaged-for-sale the pills that ended up in his body. Are doctors to blame when they are on a weekly basis in contact with representatives from pharmaceutical companies? Or does this speak to an even larger issue --the way in which medical services are delivered in this country?
It seems unlikely that Richard's doctors were malicious in any way. Granted, some were obviously imprudent in their actions. Yet the real theme here seems to be the overwhelming influence of moneyed interests. As evidenced by Mr. Fee's case, several actors stood to gain financially -- drug manufacturers, insurance companies, retail outlets like CVS, and a motley crue of medical specialists. Fifteen-minute "med checks" sound awfully transactional. In the span of fifteen minutes, a sick patient becomes a customer in a check-out line. Most unfortunately, Richard Fee and his family learned this the hard way.
Most troubling was the doctors' continued reliance on prescriptions to treat maladies that likely arose from another prescribed medication. For example, even when Richard's doctors were advised of his past abuse of drugs (like Adderall) used to calm his ADHD, on more than one occasion they proceeded to prescribe additional medications (often anti-depressants) to quote-unquote treat the negative side-effects of that prior drug. This mentality of "prescribe-first-treat-later" is alarming in the sense these doctors abdicated their Hippocratic responsibility to "first, do no harm."
One cannot help but think of the influence drug manufacturers and their associated actors had on Richard Fee's life. A more likely culprit for Richard's death was not the myriad doctors who prescribed his medications but the drug companies who created, manufactured, and packaged-for-sale the pills that ended up in his body. Are doctors to blame when they are on a weekly basis in contact with representatives from pharmaceutical companies? Or does this speak to an even larger issue --the way in which medical services are delivered in this country?
It seems unlikely that Richard's doctors were malicious in any way. Granted, some were obviously imprudent in their actions. Yet the real theme here seems to be the overwhelming influence of moneyed interests. As evidenced by Mr. Fee's case, several actors stood to gain financially -- drug manufacturers, insurance companies, retail outlets like CVS, and a motley crue of medical specialists. Fifteen-minute "med checks" sound awfully transactional. In the span of fifteen minutes, a sick patient becomes a customer in a check-out line. Most unfortunately, Richard Fee and his family learned this the hard way.
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