Physicians writing on KevinMD about the rules they practice under: prior authorization and the algorithms now deciding it, gold card laws, scope of practice and who may practice without supervision, Medicare and Medicaid, the Affordable Care Act, drug pricing, rationing that is done and not named, and the policies that decide which patients get care. Four maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words, Race and medicine: what physicians say, in their own words, and Medical ethics: what physicians say, in their own words.
All across the United States, elementary and secondary school teachers are refusing to go back to school. Before you join the growing lynch mob that’s going after these teachers, you may want to consider why they’re staying home.
For starters, many school boards make their decisions based not on what is best for students, teachers, or the community they’re supposed to serve, but on the vested interests of the …
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Why teachers aren’t going back to school: a physician’s take
As a pediatric emergency physician in Chicago, I am no stranger to the effects of gun violence in our patient population and society. But what do we do when gun violence is turned on our own community as physicians?
Recently a beloved pediatrician in Austin, Texas, Dr. Lindley Dodson, was held hostage and killed in a murder-suicide carried out by another pediatrician with whom she had no relationship. This senseless tragedy has …
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Gun and health care workplace violence: Dr. Lindley Dodson’s tragic death
In the past year, the United States has faced compounding challenges as it struggled to control the COVID-19 pandemic and grappled with significant civil unrest. The American pandemic response has been primarily determined by the guidance—or lack thereof—of elected officials and enacted policies at the local, state, and federal levels. Now, with the development of vaccines to combat COVID-19, the interconnectedness of civic health and public health is increasingly clear. …
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Voting and vaccination are 2 sides of the same coin
There is a strong push for health care to move towards greater value-based care (VBC) arrangements. The prospect of VBC holds the opportunity to re-create partnerships designed to increase health care sustainability by strategically improving processes, care delivery, and patient outcomes to achieve higher quality output at a decreased cost. Furthermore, the held potential will not be optimized until providers, payers, patients, and communities are connected in this common goal …
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Why health care fails to deliver better value in patient care
In 2018, then-Senator Kamala Harris introduced the Maternal CARE (Care Access and Reducing Emergencies) Act and added the Black Maternal Health Momnibus Act of 2020. Collectively, both pieces of legislation would create a task force to study sobering disparities in medical care based on race, combat racial implicit biases in the medical field, and close gaps in access to quality medical care for pregnant African American mothers. The impetus was …
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Can the Maternal CARE Act fail moms?
When the federal government executed Corey Johnson at the United States Penitentiary in Terre Haute, Indiana, on the 14th of January, 2021, he was COVID-19 positive. He was executed while suffering from a highly contagious respiratory illness that is killing over 4,000 Americans each day. Despite his positive diagnosis for COVID-19 and his risk for infecting those around him with this respiratory illness, Corey Johnson’s execution was not postponed. Who …
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State sanctioned executions in the age of COVID-19
This week at work, I had a patient in the hospital who had been through a pretty challenging illness, and he was going to have to be discharged to a skilled nursing facility (SNF) to rehab for a few weeks. Sadly, SNFs in my area do not currently allow any visitors due to the pandemic. The patient is very close to his daughter, who lives out of state, and she …
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A real-life example of irrational health care spending
I am at a loss. While trying to explain the events to my children since January 6, I feel profound sadness and fear. Our country is built on freedom, yet the latest in a parade of crisis’ is being used by those in power to remove our freedoms at an alarming pace and divide our country further.
Less than one percent of the people who went to Washington, DC for a …
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The answer to hate speech or false speech is not censorship
Sometimes structural racism surfaces in a way that even those of us who would like to be “color-blind” cannot help but see.
In the spring of 2020, the video-recorded death of George Floyd (who was Black) at the hands of a law enforcement officer (who was white) brought millions of witnesses to the kind of hostility that is all-too-familiar to individuals of color. Individuals, many non-white, took to our nation’s capital …
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It is not enough to say we are anti-racist. We must address glaring disparities in treatment.
As a young and optimistic business school graduate, I recall when the consulting firm I worked for was retained to evaluate “USA Hospital and Medical Clinics” (pseudonym). “USA” had grown quickly and was struggling to manage the recent expansion.
We interviewed doctors, nurses, and medical assistants, and they told us about the problems they faced every day: They were pressured to get patients in and out quickly to keep average visit …
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This looks a lot different from the trenches: from consulting to the COVID ward
Disparities in rural health care have been well established with respect to socioeconomic status, race, and geography. COVID-19 brought these disparities to the surface within most rural communities in the United States, highlighting the limited access to health care specialists and subspecialists.
As an otolaryngologist, I have had the privilege and unique opportunity of serving two different communities: Chicago’s city dwellers and …
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Why states need to develop rural health outreach programs
In recent years, the divide between rural and urban areas of the United States has become more pronounced, with sharply divergent views on both social and economic policies. The results of this latest election show starkly that the divide persists, and indicate that the institutions that shape our nation are not successfully representing all portions of society.
One of those institutions appears to be medicine. A sign of this is how the public …
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Medicine is failing rural Americans
I recently read an opinion by a physician regarding the decision as to which COVID patient would receive care and which would not when hospitals became too full to care for every patient. He suggested that no one need be denied care if some structural changes were made in health care delivery. Given the expected post-Christmas/New Year tsunami of new cases; and limited supplies, equipment, and staff, it is doubtful …
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The ethics of rationing care during COVID
As communities of color continue to be disproportionately decimated by COVID-19 and the brutal impact of racism and other longstanding systemic inequalities, academic medicine finds itself at a critical inflection point in defining its role in addressing social injustices not only for its patients but also for its academic workforce. In the aftermath of George Floyd’s killing, many medical schools and teaching hospitals released statements condemning racial injustice and vowed …
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Translating social justice into meaningful change for underrepresented minorities in academic medicine
Though pushed to the back-burner by the never-ending orange election drama, the Supreme Court, with its significant conservative majority earned against the run of play, (to borrow a metaphor from sport) is one decision away from potential political irrelevance. Is there a way forward for the Supreme Court? Conservative hypocrisy and liberal outrage at the recent Republican machinations to pack the court with conservative jurists out of step with …
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A call schedule to fix the Supreme Court
Coming into Columbia University as a pre-med first-year student, I expected to be studying anatomy, biology, psychology, and many other subjects. I would have never thought that I would encounter gender and sexuality studies. Interestingly, this led to my discovery of a very pressing issue that not only affects the transgender community, but potentially many other people who rely on health insurance, like me. In recent years, health insurances have …
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How health insurance affects patients: That means the transgender community too
