A. Why Sick People Aren't Going
to the Hospital
Robinson: For most of this century
the hospital has been the center of the health care
delivery system in most communities. And that is
rapidly changing.
Narrator: : :
This is Science Today. Health economist James Robinson
of the University of California, Berkeley says that
more and more, sick people aren't going to the hospital.
Hospitals are expensive, and HMOs, which are becoming
the most common form of health insurance, are doing
their best to reduce costs.
Robinson: And the effect of that
is to reduce the role of the hospital, and now in
fact I think it's fair to say that the hospital
is no longer the center of the delivery system,
especially in California. The organizing center,
if you will, or center of coordination of the delivery
system is some combination of the medical groups
-- physician organizations -- and the health plans
themselves, such as HMOs. Neither of which are encumbered
with a lot of bricks and mortar -- big buildings,
expensive machinery and all of that.
Narrator: : And
while the change to physician organizations is most
evident in California, Robinson says that in health
care, as in most things, that state is setting the
trend. For Science Today, I'm Steve Tokar.
B. Diagnosing Skin Cancer: A 50-50
Chance
Narrator: : :
If you have skin cancer, your doctor might not find
it. This is Science Today. Managed care is forcing
primary care doctors to diagnose illnesses before
sending their patients on to specialists. Behavioral
scientist Barbara Gerbert of the University of California,
San Francisco did a study to see if primary care
doctors correctly diagnosed skin cancer.
Gerbert: In the study we did, we found that
primary care physicians were not ready yet to assume
this role as gatekeepers for skin cancer. The primary
care physicians missed skin cancers up to 50 percent
of the time. So you'd sort of have a 50-50 chance
if the primary care physician was the one to look
at your lesion.
Narrator: : Since skin cancer is
the most common cancer, that's a scary thought.
Fortunately, Gerbert found that three to four hours
of training can bring doctors up to par with dermatologists
in identifying it -- which is where they should
be.
Gerbert: Because although about 80 percent
of people each year visit a primary care physician,
not everyone goes to a dermatologist.
Narrator: : For Science Today,
I'm Steve Tokar.
C. How to Clean Up Drinking Water
Narrator: : This is Science Today.
In many areas of the country, drinking water comes
from groundwater. As ecologist Alex Horne of the
University of California, Berkeley points out, groundwater
has some pretty unsavory components.
Horne: In a lot of cases we have a mixture
of wastewater, which was once human waste, we have
agricultural runoff, which was either cattle waste
or fertilizer, and we have what we call nuisance
runoff -- the runoff from golf courses and from
irrigation in parks and landscaped areas -- sinking
into the ground, and then we have to do something
with it.
Narrator: : But in a series of
experiments near Los Angeles, Horne has discovered
that diverting the water through an artificial wetland
-- an area of shallow water with reeds and vegetation
-- cleans it up as well as or better than more high-tech
methods. And wetlands have other benefits.
Horne: I can do multiple uses, I can get
multiple benefits. I can get treatment of waste,
I can get a source of clean water, and I can grow
organisms that we would desire -- birds and plants
and so on. I can provide refuges for living organisms.
Narrator: : For Science Today,
I'm Steve Tokar.
D. Is It Worth Saving Oiled Animals?
Narrator: : Is it worth saving
oiled animals? This is Science Today. The most visible
victims of an oil spill are the birds and animals
that get coated with the stuff, usually fatally.
Marine scientist Steve Davenport of the University
of California, Santa Cruz says some biologists think
rescuing and cleaning them might not be in their
best interest. After the Exxon Valdez spill, only
about 200 otters were rescued and released.
Davenport: And of those, their fate really
is not well known.
Narrator: : Davenport says the
stress of human contact might be every bit as harmful
as the oil.
Davenport: And the chances of their survival
in the wild after release was really 50-50, maybe.
So there are some biologists that have expressed
the opinion after that experience that those animals
that were treated and released, of those, many perhaps
would have been better off to have never been exposed
to the stress of capture and treatment and so forth,
and there may have actually been a greater percentage
of success had they just had a hands-off policy.
Narrator: : For Science Today,
I'm Steve Tokar.
E. Intelligent Dust
Narrator: : Tiny machines smaller
than a human hair? It's not science fiction, it's
reality. This is Science Today. Engineer Chih-Ming
Ho of UCLA is working on the forefront of a new
technology -- the creation of tiny machines called
micro-machines.
Ho: One of the very exciting things about
this technology is that it's such a new technology,
and we start to talk about this and everyone can
come up with new ideas every five minutes.
Narrator: : One of the most intriguing
notions for the future is micro-sensors the size
of dust particles that can be scattered by the thousands
over a disaster site. As they move through the debris,
they can sense people who are still alive and alert
rescuers.
Ho: It's like dust. But a very intelligent
dust which can sense all sorts of things.
Narrator: : Intelligent dust can
also be embedded in paint. When the dust particles
sense heat from fire, they can automatically release
fire-extinguishing agents. It effect, it's a paint
that puts out fires. Ho predicts that intelligent
dust is only about five to ten years away from development.
For Science Today, I'm Steve Tokar.
