US vs. Argentinan Healthcare: a Firsthand Look
By Jen Obrigewitch, Biology, 2016
For my spring 2015 co-op at Northeastern, I accepted a position as a doctor’s assistant in a public hospital outside of Buenos Aires, Argentina. Immediately after agreeing to the internship, I was given a slew of instructions detailing that I was not to perform any procedures above my capabilities that could potentially harm patients. I was also warned that if I were to do anything that was considered unethical in the United States while I was abroad, the American Medical Association would not allow me to matriculate in any medical school at all.
Arriving at the hospital on my first day, I couldn’t help but notice differences from what I was used to while shadowing in the United States. The doctors from the oncology department meet in a café across the street from the hospital to discuss patient cases once a week; American doctors would not discuss that amount of medical information in public. In the outpatient clinic rooms, multiple patients share the same space during their appointments. The coverings on the examination beds are not changed between every patient. Doctors do not wash their hands as often as I would have expected. Patients are not asked for permission to let students observe their examinations. All of these differences shocked me during my first week, and I began to wonder where the lines were drawn in Argentine law, so I started to do some research.
According to the data privacy and personal information laws of Argentina, doctors who are treating or have treated a certain patient are able to use that patient’s health information in ways that would aid in bettering the patient’s mental or physical well being. Giving personal information to sources that do not promise security of information is prohibited unless it is necessary in treating a patient. Also, using medical information is allowed in surveys and research as long as the patient is unidentifiable by the published information.
These three conditions are stated in the Personal Data Protection Act, but it seems that the interpretation of when it is in the patient’s interest to share his or her information is left up to the doctors. In the U.S., personal information laws are laid out much more strictly in the Health Insurance Portability and Accountability Act, with explicit guidelines for violation enforcements, public safety disclosures, and how information is to be given to spouses of both heterosexual and homosexual marriages.
The differences in hygiene regulations are also established in the laws of each country. The CDC supplies plenty of research debating the best methods for sanitizing medical rooms and equipment, and requires frequent hand washing in order to keep the potential germs from one patient as far from other patients as possible. Argentine sanitation and sterilization protocols are much more relaxed, not requiring such separation between patients or infected areas.
These differences affect the recovery of their respective patients. 11.3 percent of patients develop hospital-acquired infections in Argentina, whereas only 4.5 percent of patients acquire infections in U.S. hospitals. Because of the amount of sterilization occurring in hospitals, both countries have begun struggling with “superbugs” that have evolved into strains of bacteria that cannot be killed by the current methods of sanitation, making them stronger and more dangerous than their weaker, less sterilized counterparts might have been.
Every year in hospitals across all 50 U.S. states, 2 million patients are affected by hospital-acquired antimicrobial-resistant infections, and of this, 23,000 patients die. In Argentina, the percentage of deaths by these infections is twenty times higher. This data shows that Argentine hospitals have a higher rate of deadly hospital-acquired infections, though less of these infections come from the powerful “superbugs” since the sanitization protocols are also lower. And if these infections are not from “superbugs,” then they should be more easily treatable. Yet, the death rate is much higher.
Looking at the myriad of statistics on the subject, it seems clear that U.S. medical protocols are much more standardized, stringent, and better able to protect both the patients and doctors. So why hasn’t Argentina adopted their laws? They have borrowed a few ideas, but they cannot afford to take on every protocol at once. Even working in one of the more well-financed hospitals in the country, I have seen that although doctors wish they could have only one patient to a room and use as many pairs of gloves and bed sheets as they’d like, those supplies simply do not exist.
In a developing country like Argentina, the medicine is also still developing. Patients take more time to heal or even die from wounds and diseases that they could have easily survived with the better, more available technology and medical supplies in the U.S. In this comparison between the medical practices and protocols of doctors in the United States and Argentina, the United States is proven to be more efficient, effective, and capable in every area of medicine. The next step in the scientific method dictates that we need to question why this remains so, and determine how to change the current state of affairs. Because patients in developing countries around the world deserve the medicine that would already be theirs had they happened to be born in the U.S. instead. Geography should not be anyone’s cause of death.