The Joy of Practicing Medicine Outside the U.S.

Written by David Sprayberry MD

I recently spent 3 weeks serving at a mission hospital in Kenya. It was a highly challenging time, with a much greater severity of illness and greater limitation of resources than we have here, but it was the most rewarding thing I have ever done as a physician. The work I did was needed, difficult, and stressful, but I did not have to fight an insurance company once and I did not have to constantly worry about my documentation meeting the minutiae of coding regulations that, if not followed precisely, might lead to accusations of billing fraud. I was able to focus on taking care of patients who needed help without significant intrusions by insurance companies. I was able to document what was important to the care of the patient, not what the insurance company or government wants to see on paper. It was demanding and refreshing at the same time.

In Kenya, I was able to perform procedures and take care of rather complex patients because I was the most qualified person available. In the U.S., I am forced to refer patients to subspecialists for problems I can handle, because I would have great liability if a patient had a poor outcome and I had not referred them out. In Kenya, I took care of premies who required intensive care, I intubated and ventilated babies, and I set up and changed ventilators. I managed kids with severe hypoglycemia, severe malnutrition, severe dehydration, meningitis, sepsis, tuberculosis, malaria, and congestive heart failure, most of whom I would not have had an opportunity to care for here in the U.S. because a subspecialist would have had to be involved.

Despite the limited resources we had to work with and despite the heartbreaking events that occur when practicing medicine in the Third World, I must say that my experience in Kenya is why I went into medicine. It is comforting to know that I can go practice there if our government and our insurance companies ever make practice here unbearable. In fact, I could practice there now.

Dr. Sprayberry is a practicing pediatrician and believes there is more to medicine than shuffling patients in and out the door. To read more about Dr. Sprayberry’s medical trips to Kenya, visit his blog, Pediatrics Gone to the Dawgs.