DECEMBER 2011


thing, where we can connect, where we can form a network. “This is a nexus event,” said


Didden. “I don’t know what’s going to happen. And that’s what’s exciting.” Didden says the outcomes


might be an organic develop- ment of the talents and in- terests already present in the community. “I’d like people to consider more formal connec- tions, so that in times of crisis, where we’re questioning what’s going on, we can reach out to each other. You know: ‘What’s the difference between consti- pation and appendicitis? And which side is my appendix on, anyway?’” A community network might


host forums to help answer questions on nutrition, well- ness, stress reduction, dealing with trauma—being a survivor of any type of trauma. “It can run the gamut.” The big idea is for commu-


nity members to share, to be resources for one another on anything from dealing with a family member who is hav- ing health issues to ideas on healthy parenting.


At the forum, Didden also


will present the possibility of his personal involvement in the Free Clinic, where he currently practices. He is developing an idea, Well Child, Well Family which would provide access to healthcare professionals in a way that is much more inter- active than the traditional fee- for-service model. This is espe- cially important for people who already have limited access to healthcare. “A lot of times peo- ple without access end up going to the emergency room for ba- sic care,” he said. Even people with insurance


end up going to primary care or urgent care. “They are told what they don’t have,” said Didden. “In the environment of defensive medicine, people get a lot of things ruled out, but they still end up not getting their questions answered.” By reimagining the practice


of medicine, and re-thinking public health as a community- building opportunity, Didden embraces the World Health Organization’s definition of health: “a complete state of physical, mental, and social


well-being, and not merely the absence of disease or infirmi- ty.”


Talking about community healthcare with Didden, it’s impossible not to ask two ques- tions: How did we get here, and if his ideas take off, how would things be different in ten years? He is reluctant to dwell too


much on what ails healthcare in the United States, but can’t help but say, “The healthcare indus- try in America is crumbling. It’s disintegrating. I wouldn’t ven- ture to guess what it will look like in ten years. “It’s the fact that corpo-


rate interests have permeated healthcare, and have attempted to adopt a business model for one of the most intimate rela- tionships that exists in human- ity,” said Didden. “The things that I talk about with patients, they don’t even talk about with their spouses sometimes, and they wouldn’t discuss with their children. The level of intimacy and questioning of the person is as intimate as it gets.” The corporate model might


work well enough for producing some consumer goods, but not for health. He says the system we have developed has empha- sized financial incentives and efficiency incentives to such a degree that modern medicine loses sight of the patient. When calculating physicians’ reimbursements, the admin- istration in a corporate model bases doctor pay on relative val- ue units, or, how much income a doctor produces for the prac- tice. “The more relative value units you produce—or generate in your quarter—the more you get paid,” said Didden. “So, the doctor-patient relationship has devolved into a relative value unit.” “But I’m an optimist,” Did- den says. “I really try to focus


on potential. Those experienc- es and challenges that people face when they’re accessing the traditional medical industry, while negative, are like com- post. We’re going to grow some- thing sustainable and meaning- ful from this. It will be limited in scope at first. But I think it has the potential to grow out of the ashes.” One of the first things to grow, hopes Didden, is health-


13


care by and of the communi- ty, in which people empower themselves and one another to lead healthier, more fulfilling lives. In the end, says Didden, that will help ensure that the miracle of modern medicine is more affordable and more available to those who truly need it—and that fewer and fewer of us ever do.


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