It is an unfortunate fact that medicine sometimes fails to achieve what it ought to be able to achieve. In this issue, we are reminded of some of the obstacles to success and consider strategies that may help us to overcome them.
Homelessness is one such obstacle.
Even when effective treatments and preventive measures are available, homeless people are frequently unable to take advantage of them. Age, race, income, education, place of birth, self-rated seriousness of illness and indicators of health care utilization were not associated with failure to fill prescriptions. They suggest that extending drug benefit coverage to residents of all shelters would potentially improve health outcomes in this vulnerable population. It is a story about sanatoria, collapse therapy, surgery, BCG vaccination, mass radiography, tuberculin surveys and anti-tuberculosis drugs, but most of all it is a story about suffering people, who still require our continued efforts to find better methods of treatment and prevention. Despite overwhelming public awareness of the problem, physical abuse is another area where medicine and society seem to have failed us.