Something in the news triggered a synapse in my brain. Flashbacks (nonhallucinogenic) occurred. I remembered the great cultural revolution (also called a purge) that swept China under the last years Of Mao’s reign in the 1960s. I was in premed and med school during that time. I remember American students (presumably college) wearing China garb and holding the red book of the Sayings of Mao (I am not sure of the actual name). One thing that was championed was China’s Great Barefoot Doctors. This brought medical care to the underserved. There are significant parallels for what is going on here today. The Barefoot Doctors is the name of the participants who the Chinese trained to act as doctors for the masses. Most educated doctors followed the western model and concentrated in urban areas. Although the economy was reportedly classless, there were those some more classless than others. There were masses without doctors. The power was taken away from the physicians and given to the government. These leaders (and I do not recall the title) determined who and what was to be practiced. Farmers received 6 months of training and went to treat the hundreds of millions in the country. They were given a handbook to follow. They dared not veer from it. I remember the news reports of how successful this was. I later met Chinese doctors who had their own impressions, but the government determined this was a successful program that brought equitable health care to the country. I stumbled upon an English translation of the Barefoot Doctor’s manual while I was on active duty. If memory serves right, it was a good cookbook/first aid manual with was no variance permitted. Today, the US is trying to provide equitable care with all the doctor shortages projected. Programs are being pushed to train NPs and PAs to practice independently. There are guidelines that are to be closely followed based upon the science of “evidence based medicine” (replacing the art of medicine). A homogenous quality is the goal with quality standards being determined by the government. Reaching these standards will determine quality. “Everything old is new again.”
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