New Zealand Health Care Michelle Sommer

Auckland, New Zealand NZ Population 4.47 million people

Auckland City Hospital Public hospital where many medical students and registrars train New Zealand's largest public hospital and clinical research facility Part of Auckland District Health Board

Greenlane Clinical Centre Outpatient clinic site

Topic of Interest Health Care Compare and Contrast New Zealand vs. USA Underserved populations in New Zealand Differences in training physicians Wanted to compare a country with national care to the US

New Zealand Health Care National health care Funds provided mostly through District Health Boards Public health network is almost entirely free Most medications are subsidized and only cost $5NZ Even travelers are covered under the Accident Compensation Corporation http://www.health.govt.nz/new-zealand-health-system

Similarities Between Us Same hierarchy of consultant (attending), registrar (resident), house officer (intern), and medical student Western country styled culture Similar history of injustice against native peoples and downstream effects today

Underserved Population in NZ Native people called Maori Large cultural divide High prevalence of gout in the population, largely untreated Due to cultural biases of “doing it to themselves with diet and lifestyle” Maori Gout Action Group started in response

Training New Zealand United States Medical school for 4 years Two ways to enter House officer (intern) for 2 years Registrar (resident/fellow) for 5 years Consultant (attending) Undergraduate for 4 years Medical school for 4 years Residency for 3-7 years Fellowship for 1-3 years Attending

Profound Clinical Experience Scleroderma Vs. Pregnancy Young woman with scleroderma who was also trying to conceive Came into clinic with a digital ulcer on her left 3rd finger Agreed to be hospitalized, but did not want disease modifying drugs Teratogenic and would not be able to become pregnant

Profound Cultural Experience Geothermal Sulphur springs where Maori warriors would go to heal after battles Mount Ngauruhoe (Mound Doom) that is sacred to the Maori people

Cathedral Cove Owharoa Falls

Lake Taupo Hobbiton

References https://www.newzealandnow.govt.nz/living-in-nz/healthcare/paying-for- healthcare-services http://www.health.govt.nz/new-zealand-health-system The Experience and Impact of Living With Gout: A Study of Men With Chronic Gout Using a Qualitative Grounded Theory Approach.[Article] Interview with Dr. Suppiah