Bilateral benefits of global health acts

Health care in the USA is expensive, using many resources and tests not available in much of the world. A usual query in caring for patients or deciding protocol is ‘why didn't you order/ do…?' We need to reconsider how useful all the evaluations are, how often they lead to more expenditure of resources, and how often they make a practical contribution to the patient's well being. Working as an American clinician in less developed countries forces one to question of the value of all tests, medications, advice or procedures to helping the patient ; the query always is ‘why did you order/do…, does it make a difference to the patient's outcome?' One cannot treat the patient by laboratory results and algorithms. The benefit to patients in the USA of a healthcare provider who considers the costs and benefits to the patient's well being rather than the rules of procedure and possibility of legal entanglement could be considerable. Most of the discussion and examples will be based on years of work in rural Haiti. Working in resource poor areas is an important possibility for Americans to think and act both globally and locally to the benefit of all.