Policy

Why are so many community hospitals transferring children to larger facilities?

Policy
September 13, 2020

A recent edition of Pediatrics has some disturbing research: “Trends in Capability of Hospitals to Provide Definitive Acute Care for Children: 2008 to 2016.” What the paper really does is document what many of us who work in referral hospitals have noted for some time: More and more community hospitals are transferring children who appear in their emergency departments to other, larger facilities instead of admitting them to …

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Why doctors should be trained to speak out and lead the movement for social justice

Policy
September 7, 2020

Dr. Anthony Fauci, National Institute of Health Director of Allergy and Infectious Disease and White House Coronavirus Task Force member, recently underwent surgery to remove a vocal cord polyp. This is not surprising given that a major risk factor for developing vocal cord polyps is overuse of the voice, something Fauci has likely experienced during the COVID19 pandemic as he has been called upon to speak …

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Direct primary care: Great for some doctors, but challenging for patients

Policy
September 3, 2020

The COVID-19 pandemic and the consequent drop in patient visits have led some observers to conclude that primary care physicians would be better off financially if they were capitated than if they were paid fee for service. If they received a fixed amount of money per health plan member per month, they’d have a guaranteed income stream regardless of how many patients came to their offices.

However, a growing number …

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What happens if you are both too rich and too poor for health insurance?

Policy
August 15, 2020

After being kept up all night responding to pages, I was still half-asleep walking into Mr. Jenkins’ room for what I thought would be a routine early morning admission for new-onset seizures. From scanning through the electronic medical record, I was not expecting to encounter the unfortunate and complex array of social factors underlying his condition.

Mr. Jenkins was in his late 20s and had three children to take care of. …

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Declaring racism as a public health crisis from the lens of two Latinx student doctors

Policy
July 15, 2020

“I often heard as a child that Mexicans were lazy and dirty. As a Mexican-American, I did not wear shorts for years despite the heat because I thought my knees looked dirty. Now I fully embrace my identity. However, as a medical student, I still feel the pressure to disprove these stereotypes.”
– Camila Hurtado

“Growing up in the barrio, my white classmates would tease and bully the brown Latino kids constantly. …

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Uninsured medical students are at risk

Policy
July 14, 2020

During clinical training, medical students worry about caring for patients, learning how to do procedures, memorizing drug interactions, and documenting their work in the electronic medical record —they shouldn’t be worried about paying medical bills at the same time. Shortages of personal protective equipment and the subsequent dangers of working in health care permeate the news and threaten our ability to overcome the COVID pandemic. However, there is another often-neglected …

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The uncertainty of an international medical graduate during the COVID-19 pandemic

Policy
July 13, 2020

A quarter of the physician workforce in the United States consists of international medical graduates (IMGs). This year 4,222 non-U.S. citizens matched in first-year residency positions. I am an IMG from Guatemala, where I completed medical school. In March of 2014, I matched to an internal medicine residency in the United States. The road has been both satisfying and challenging, with all kinds of uncertainties. I have always been attracted to …

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Immigrant physicians: Acknowledge our privilege and move to action

Policy
July 12, 2020

Born in the United States of America to Nigerian parents, I was raised in Nigeria and returned to the U.S. after medical school for residency training. I have practiced medicine in Chicago, IL for 25 years, and like many others, have had to deal with microaggressions and racism within and outside the workplace. However, this article is not aheabout outlining my personal experiences. This is a call to action to …

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3 reasons why doctors don’t unionize

Policy
July 10, 2020

In a market economy, business leaders take every opportunity to shrink the cost line of labor on the balance sheet to boost profits and shareholder/investor value. It’s the metric on which they are evaluated, and left unopposed; they will do it more and more.

The core strategy for shrinking labor costs (along with automation and offshoring) is to drive increased “efficiencies” by demanding more and more work from the same number …

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Minorities and medical research: Who is still excluded?

Policy
July 6, 2020

In the United States, there is clear evidence that minority populations continue to be underrepresented in clinical research related to new therapies for common and serious long-term medical conditions such as type 2 diabetes (T2D). This is despite these same populations facing a continuing and disproportionate burden of T2D, which shows no signs of abating.

Black people have one of the highest rates of T2D (13.2 percent), a rate almost twice …

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Primary care is dying: Why that should scare every large employer

Policy
July 6, 2020

Primary care is on life support. COVID-19’s toll on American health care extends beyond the hospitals and medical workers besieged by infection. An equally insidious but less-visible crisis is engulfing primary care, the long-neglected foundation of our health care system. Given the role of America’s largest corporations in providing health care benefits, the C-suite should be on high alert.

As growing numbers of patients postpone appointments over concerns about …

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Who should be the first responders to mental health crises?

Policy
July 2, 2020

First and foremost, a mental health crisis is a medical emergency well within the sector of public health. Therefore, the question of who should respond to mental health emergencies is one in which physicians and all medical providers should have a say. Medical providers should not only be aware of the systems in place to respond to mental health crisis but must advocate for patient safety as a measurable outcome …

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What the police and psychiatrists have in common

Policy
June 23, 2020

“Give ‘em out like candy,” advised a senior resident while handing me a stack of small flyers. The text outlined a list of services provided by a nearby community resource center for help with things like housing, food, education, employment, and legal issues. I never thought this quarter page of paper would prove so critical throughout my time working as a psychiatry resident in our county clinic.

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The cancel culture and the erasure of less just times and imperfect people

Policy
June 22, 2020

Two years ago, my wife and I spent our 20th wedding anniversary in Charleston, SC, a city steeped in national history, both good and bad. Nothing could be more iconic of good history than Fort Sumter, and nothing more iconic of bad history than the Old Slave Market on Chalmers Street. We learned a great deal about how our country grappled with its shortcomings. The Great American Experiment, through blood …

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Proactive care is the linchpin for saving America’s health care system

Policy
June 21, 2020

Even before the pandemic, the U.S. health care system needed a significant overhaul. For too long, we have operated in a reactive mode, prioritizing treating illness over ensuring health and wellness. In the post-COVID-19 era, stakes are even higher. Our health care system faces an unprecedented demand surge from millions who put their own care on hold over the past several months. How we approach this impending surge will determine …

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South Asian physicians must be part of the solution against racism

Policy
June 15, 2020

Over the last few days, physicians and nurses across the country have taken a knee, galvanized by the recent death of George Floyd, as well as the disproportionate effect of the coronavirus pandemic on African-American families. The White Coats for Black Lives movement firmly identifies racism as a public health issue and calls on everyone in the health care system to take action.

As physicians, we can see what …

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It’s time for a comprehensive universal health care system in America

Policy
June 11, 2020

When it comes to health care, this election cycle has been different than previous ones. Either it is Medicare for all or public option in the ACA, democratic candidates have shown support for some version of universal health care. As the health care costs, including prescription drug prices, keep rising, many Americans have started to advocate for universal health care coverage. At the same time, others still believe in the …

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Anti-racism must be a priority for medical institutions

Policy
June 7, 2020

I want to start with a moment of silence to remember so many who have been stolen from their families and communities as a direct result of rampant white supremacy, anti-blackness, and police violence: George Floyd, Ahmaud Arbery, Tony McDade, Breonna Taylor, and too many others.

George Floyd was murdered on May 25. Protests began the following day in Minneapolis and have catalyzed a swift wave of righteous anger and rebellion …

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