The Association of American Medical Colleges (AAMC) predicts that at least 139,000 doctors will be needed by 2033, particularly in rural and low-income areas. In an attempt to address this need, states have been replacing physicians with non-physician health care providers and reducing physician oversight.
I’ve seen it firsthand.
One day in the ER, a patient came in fatigued and dehydrated. He had been to his …
How to tackle the physician shortage
At the same time that gun violence becomes the leading cause of death for children in the U.S., lawmakers and political pundits caution the public against turning gun violence into a political issue. Yet as Jelani Cobb writes in the New Yorker, the mass killing of children is always already a political issue.
Furthermore, as so many have articulated against the backdrop of decades of …
Politics is health care on a grand scale
“That is a very heteronormative lens.”
These words were uttered to me by a 23-year-old female patient as I explained i-PLEDGE and the steps she must complete to take oral isotretinoin.
The visit started as fairly routine. A young female presented with a complaint of acne. I quickly appraised the patient on entering. She was petite, with a blonde pixie cut. She wore clothes that …
A call to dismantle structural heteronormative care
Nineteen children were killed in a mass shooting in Texas. I have barely escaped the pandemonium of the pediatric emergency department to scarf down a bowl of pasta when I hear the announcement on the breakroom TV. My stomach drops. Again? How is it possible?
I step back into the ED and immediately am called over by an agitated mother whose infant came in with respiratory distress 30 minutes earlier. Any …
Senators are killing children by failing to enact gun control laws
On May 14, 2022, ten people were fatally shot with three injured at a Tops Supermarket in Buffalo, NY, constituting the second most deadly mass shooting this year at the time of writing. As the number of mass shootings and fatalities continues to climb each year with alarming frequency, researchers and policymakers have sought to examine the factors contributing to an increased incidence of deadly domestic terrorist …
The Buffalo mass shooting and food deserts
It is too early to hear the narratives from the families of the 19 children slain this week at Robb Elementary School in Uvalde, near San Antonio, Texas. But narratives from the 1993 Long Island Rail Road shooting, the 2012 Sandy Hook massacre in Newtown, Connecticut, and 16 other deadly gun violence events have just been published by Red Penguin books. From Bullet to Bullhorn is the …
A gun message for woke corporations
Many Americans will lose access to vital health care services in a few short months unless Congress passes bipartisan legislation already introduced in both the House and Senate.
Co-sponsored by Sens. Tom Carper (D-Del.) and Tim Scott (R-S.C.) and Reps. Earl Blumenauer (D-Ore) and Brad Wenstrup (R-Ohio), the Hospital Inpatient Services Modernization Act extends waivers allowing patients with acute illnesses to receive hospital-level care at home. The waivers are set to …
The public health emergency brought health care into the 21st century. Let’s keep moving forward.
I recently wrote a letter to the Davidson County, TN judge who will sentence RaDonda Vaught, a former Vanderbilt University Medical Center nurse convicted on two felony counts in the 2017 death of a patient. RaDonda faces up to 12 years in prison for her role in a complex chain of events that led to the death of Charlene Murphey. I shared my belief that incarcerating Ms. Vaught will not …
Why a nurse should not go to jail
A few years ago, my rural town expected the addition of a “J-1,” or foreign, physician. This addition was meant to alleviate the work of my father, who had been the only neurologist at our underserved hospital for the past few years. And yet, with this J-1’s arrival, my father and his office soon found themselves struggling with more work than ever before.
As many rural physicians can attest, this behavior …
The J-1 work exemption: a flawed solution to the physician shortage
The leaked Supreme Court draft opinion in Dobbs v. Jackson Women’s Health Organization has produced mixed emotions, including amongst health care providers. If the Supreme Court does indeed strike down the rights afforded women in Roe v. Wade almost 50 years ago, it is expected that many if not most states will ban abortions outright or significantly limit women’s access to abortions. If this occurs, as physicians, we should have …
Women’s mental health in an America without Roe
Recently, the New England Journal of Medicine published “Oral Health for All — Realizing the Promise of Science,” authored by some of the most respected officials in dentistry and medicine, including the U.S. Surgeon General. They declared the pressing need to address the “global public health threat” of inequitable dental care. With a surprisingly populist title, it was refreshing for a public health dentist to see a …
Oral health is justice for all
This spring, in my culminating semester of PA school, I took a course entitled “Health Care Delivery Systems.” After 30-something months, the end was in sight, and I was not particularly excited for another serious class while I was wrapping up rotations, studying for my boards, and writing my master’s paper.
However, as soon as I started working on the class assignments, I realized this class might deserve a higher rank …
A specific way to improve our health care delivery system
The reason I pursued PA school pertained to a loved one’s cancer diagnosis. During the trials and tribulations of the diagnosis and treatment, I learned a lot about our health care system. I witnessed the work of phenomenal PAs as they took care of my loved one, which inspired me to pursue my degree as a PA. During this time, I also promised myself that I would do my best …
The trials and tribulations of health care delivery
On May 2, 2022, news broke that Roe v. Wade would be overturned according to an initial draft majority opinion released by Politico. In the political economy that we find ourselves in, this news has had the immediate consequence of furthering divisions between Americans — those in favor of the ruling and those against. While much rhetoric about the morality of the underlying subject matter already …
Roe v. Wade: questions that need to be addressed in the near future
In a world of extremes where we are operating in black and white, living in the gray is where the real work happens of confronting truths of left and right, conservative and liberal, and opening up to varying perspectives that reflect diversity.
This is the space where I’ve witnessed the possibilities of navigating the divided worlds of pro-life activism and reproductive justice.
Vice President Kamala Harris recently acknowledged the …
Protecting Black women’s maternal health is urgent
“It feels different down here,” she said. I had just approached a young woman in our ED waiting room to apologize for the seven-hour wait to be seen. She looked at me with bloodshot, dark brown eyes and continued, “It feels like … the lower decks … Do you know what I mean?” I placed my hand on her shoulder, acknowledging her analogy with a shudder of complete understanding.
She was …
A voice from the lower decks of health care
All medical professionals are familiar with the jargon: quality metrics, P4P, low-cost/high-value care, PQRS, and meaningful use. We see these terms in multiple emails, staff and clinical meetings, and organization-wide initiatives. These measures and guidelines will significantly impact the type and quality of care we provide to our patients and how we are paid for it. This movement is not necessarily detrimental and could lead to improved health among …
When quality measures interfere with good care
There are no two ways about it: The health care system in the United States and Canada is failing. Few want to talk about a dirty little secret, but the facts are clear. Health care costs are rising at an unsustainable rate, and millions of Americans are uninsured or underinsured. The system is not accountable to the people it is supposed to serve.
Having experienced both the Canadian and United States …
The health care systems in the United States and Canada are failing
On December 27, 2017, as the result of a medication error, 75-year-old Charlene Murphey died tragically at Nashville’s Vanderbilt University Medical Center. The nurse who administered the medication, RaDonda Vaught, was criminally convicted for the mishap and the case ultimately caught the attention of the entire global health care community.
Unfortunately, medical errors are not an uncommon occurrence in health care. In fact, they are believed to be the third leading …
The criminalization of true medical errors is a step backwards for patient safety
Early in the COVID-19 pandemic, Lorna Breen, MD, a New York City emergency room doctor, committed suicide following weeks of incredible stress she endured at work. Nearly two years later, the Dr. Lorna Breen Health Care Provider Protection Act was signed into federal law, providing federal grants to support programs and training on reducing health care worker burnout.
While this legislation is an important step forward, it is not enough.
Two years …
Want to stem frontline worker burnout and walkout? Here are 3 ways.
Get free updates delivered free to your inbox.
