I am responding to an article and editorial in the Feb. 23 Oberlin Review , regarding the College's Student Health Service. I want too establish from the outset that I do not work closely with Judith Appleton.
First, I was surprised that students intelligent enough to be at OC would consider the results of a non-random sample worthy of print. If the Student Senate or the Review wanted an accurate survey of student opinion, then a random sample of Student Health users should have been obtained. Qualifying remarks by Beinstein-Miller about inaccuracies of the Student Senate's methodology were buried deep within the piece, leaving the majority of readers who scan headlines or leading paragraphs with a negative impression not backed-up by the evidence presented.
The examples the Review used to support its points of view regarding Dr. Appleton were particularly misleading. For instance, the Review mentions a student whose mononucleosis was misdiagnosed as a cold. Mono's typical symptoms are fever, sore throat, swollen glands and fatigue which are also symptoms of other viral infections (including colds). Chronicity of the illness is often the first clue that distinguishes mono from other viruses, suggesting the need for lab work. The Monospot (a diagnostic test for detecting mononucleosis) does not detect the illness until the person has had it for at least a week or more. Monospot testing every patient with flu and cold symptoms would not be cost effective and would be of dubious value. The Review cites "Another student's medication made him sick." Medications always present trade-offs because of side effects. Inserts that accompany any prescription or over-the-counter drug list an impressive number of potential problems. No one can predict an allergic reaction if the patient is taking a medication for the first time. A risk/benefit ratio accompanies all medication.
The Review suggests that having to wait 2-3 days for an appointment reflects inferior health care, implying that only immediate access to a health-care provider is acceptable. This is unrealistic. If appointments are not booked to some degree, costs rise because medical offices have a substantial number of "no shows," people not courteous enough to cancel appointments. These result in frustrating delays for the patients needing appointments. Economics rather than the doctor are the problem in this situation. If a condition is transient enough to have subsided by the time of the appointment, then it was not a compelling medical problem to begin with. If immediate medical care is needed then urgent/emergency room care should be sought. If uncertainty as to the seriousness of a problem exists then obtain telephone advice from the office as well as information about what to do in the mean time.
Comments like "giving out medicine like candy" and "trying to kill me by not giving an antibiotic" are contradictory, and probably indicate that the physician is doing something in between these extremes. People also are frequently unaware that antibiotics are inappropriate for viral conditions.
In conclusion, if the goal was to fairly assess student health, as Beinstein-Miller suggests, conduct a sizable random survey of users to obtain an unbiased sample. If your goal was to smear Student Health Service in an attention-grabbing piece with half-baked evidence, then congratulate yourselves for a job well done.
Copyright © 1996, The Oberlin Review.
Volume 124, Number 17; March 8, 1996
Contact Review webmaster with suggestions or comments at ocreview@www.oberlin.edu.
Contact Review editorial staff at oreview@oberlin.edu.