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Essay
Learning from Ervin’s Care: Ethics, Health Care Finance, and Human Connection
Background: The essay focuses on the care of a 70-year-old patient, Ervin, with complex medical conditions and intellectual disabilities. He was cared for in a Program of All-Inclusive Care for the Elderly (PACE) setting. The essay discusses the challenges of providing ethical medical and supportive care to individuals like Ervin, who often face complicated health and social issues.
Key Argument: Ervin’s story reveals significant challenges in the U.S. health care system, including gaps in social safety nets and ethical questions around caring for patients with reduced decision-making capacity. Many patients fall through the cracks due to the limitations of fee-for-service models and inadequate social services. Programs like PACE address some of these gaps through more personalized, team-based care. Ultimately, caring for this patient taught the author about the rewards of the human connections that primary care physicians establish with their patients.
Why It Matters:This essay highlights the need for health care systems to better support patients with complex medical and social needs. It underscores the importance of integrating medical care with social support to improve outcomes and build stronger connections between patients and their care teams.
Learning From Ervin’s Care: Ethics, Health Care Finance, and Human Connection
Amy C. Denham, MD, MPH
University of North Carolina at Chapel Hill School of Medicine,
Chapel Hill, North Carolina