Public Health & Policy

The middleman mentality is killing American medicine

Physician
October 18, 2022

Between producers and consumers, you’ll find a cadre of professionals who broker deals, facilitate transactions, and move goods and services along.

They’re called “middlemen,” and they thrive in virtually every industry — from real estate and retail to finance and travel services. If not for middlemen, houses and blouses wouldn’t sell. Banks and online booking sites wouldn’t exist. Middlemen are the reason a tomato grown in South America makes it aboard …

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Practicing great medicine got a lot simpler. It’s health care that’s getting in the way.

Policy
October 15, 2022

We pay more than any other nation for health care, yet we have suffered the single biggest decline in life expectancy since WWII. Something went wrong. At a time of record inflation and rising taxes, isn’t it time we stopped to ask where the money is going, what exactly we are paying for, and why?

Astonishingly, nearly half the federal budget goes to health care in one way or another. Either …

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Next of kin in the medical decision making process

Physician
October 14, 2022

Four years ago, as chairman of the hospital ethics committee, I was asked to convene an emergency meeting brought by a distraught family as medical decisions had to be made for their ill loved one. The hospital, HMO lawyers, the family, three adult children, and their mother were at the meeting.

The father had arrived at the hospital unconscious and was admitted to the intensive care unit, where medical care was …

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My motherland is burning, but patient care can’t wait

Physician
October 13, 2022

My relationship with my cultural identity has always been a complicated one. As many children of immigrants can relate, I often felt disconnected from my parents’ country of origin in an attempt to assimilate to American life.

I was born in Manhattan, New York, and have always defined myself as a New Yorker first and an Iranian-American second. From a young age, I have watched from the periphery as Iran has …

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America is a magnet for global STEM talent

Physician
October 11, 2022

This essay is inspired in part by my recent encounter with a scientist at NASA’s Jet Propulsion Laboratory (JPL). For starters, the National Aeronautics and Space Administration — or NASA for short — is an agency of the U.S. government responsible for America’s space program and aeronautics research. JPL, NASA’s research and development center located in Pasadena, California, produces spacecraft called rovers used in extra-planetary explorations.

It turns out that this …

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I went to Ukraine to help. Here’s what you can do.

Policy
October 10, 2022

I went to Poland and Ukraine in April and May of 2022, hoping to support the Ukrainian people in their defense of their country and democracy itself.

Vladimir Putin had put the world in a vise.

“Let me do what I want, or you will risk nuclear war,” was the implication. We’ve seen this before, I thought. Putin is Mussolini, Hitler and Stalin all rolled into one, and he needs to be …

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What does it mean to truly be an ally?

Policy
October 9, 2022

The University of Utah Physician Assistant Students Supporting Equity and Diversity (PASSED) group believes it’s important to discuss what it truly means to be an ally. This term has recently become more popular; however, it seems that “allyship” is being confused with “generalized/passive acknowledgment.” The definition of an ally is one who unites themselves with another to promote a common interest. Allyship calls for understanding the constant oppression that plagues …

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Exploring the critical gaps in Canada’s health workforce planning [PODCAST]

Podcast
October 8, 2022
YouTube video

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“We need to stop simply clapping our hands in support of health workers — and start planning to create better workforce conditions for them.  Let’s make improved health workforce science in Canada a key legacy in support …

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Public health requires collective courage [PODCAST]

Podcast
October 4, 2022
YouTube video

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“To create a healthier, more just, and more equitable world, we must confront the truth, and that requires an act of collective courage. Perhaps there needs to be a whole new consciousness that abandons ideas of reforms …

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Insurance companies deny medical care. And that’s wrong. [PODCAST]

Podcast
October 1, 2022
YouTube video

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

“Securing prior authorizations is a daily ordeal for most doctors’ offices. Doctors report that, on average, they must get insurance company approvals 41 times every week. Of the authorization requests that are denied, fully 73% ultimately get …

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Ending gun violence in America should be a no-brainer

Policy
September 29, 2022

Brain matter was spilling out the top of the patient’s head in the trauma bay. It doesn’t take a neurosurgeon to know that this is not normal. My pager screamed, “GSW to head – ED Room 1.” Gunshot wound to head – Emergency Department Room 1. As the neurosurgery resident physician on call that night, it was my job to evaluate this patient STAT. I wish I could say this …

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Is our health care system based on untruths?

Conditions
September 28, 2022

As Americans, we live in one of the most affluent countries in the world. Outwardly, many of our citizens seem to possess the necessities of life: shelter, food, job employment, and world-class health care. But what happens when we take a closer look? Do we see cracks in the foundation?

If we are honest, the answer is a resounding yes. When one looks at the area of health care, there is …

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We must work harder to provide COVID relief to other countries

Policy
September 27, 2022

Currently, U.S. officials are considering expanding eligibility for the monkeypox vaccine. Yet, elsewhere, people are still struggling to get access to the COVID-19 vaccine. In many low-income countries, less than half of the population is fully vaccinated against the novel coronavirus – sometimes far fewer.

In Haiti, for instance, only 1.4 percent of the population has been fully vaccinated, and only 2.2 percent …

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Don’t let vindictiveness creep into medicine like it has in politics

Policy
September 20, 2022

The callous and inhumane dislocation of migrants recently perpetrated by governors of the states of Florida and Texas reminded me of an equally disdainful and appalling tactic utilized by health care workers since the 1960s: “Greyhound therapy.”

Greyhound therapy refers to attempts by health care workers and administrators to remove undesirable patients from emergency rooms, hospitals, and other types of facilities by providing them one-way tickets on a Greyhound Lines …

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Patients come to you for treatment, not your politics

Physician
September 17, 2022

As he was being wheeled in for surgery, President Reagan joked, “I hope you are Republicans.” The surgeon, a liberal Democrat, replied, “Today, Mr. President, we are all Republicans.”

All very appropriate and from another era. As a usually intelligent and intellectual segment of society, it is not surprising that physicians should have opinions, including politics. As citizens, they are entitled to them too.

In fact, one would hope that physicians participate …

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The Inflation Reduction Act: Can it build back medicine better and reduce climate change?

Policy
September 12, 2022

The Inflation Reduction Act (IRA) of 2022 is an ambitious piece of legislation that was signed into law on August 16 of this year.  This was a revised, negotiated version of the Build Back Better Plan that failed to pass in December 2021.  Like many pieces of legislation, this is a complicated bill, 730 pages in length, with a very broad scope.  Although controversial, the costs of this bill will …

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Bulletproof backpacks: There’s more we can do

Policy
September 10, 2022

As a parent of elementary school children, every mass shooting, particularly ones killing school children like in Uvalde, jolts my doing-the-mom-thing-just-keep-busy-can’t-stop denial. On the last day of school before summer vacation, when the bus doors squeaked open, and my kids hopped off, I experienced a momentary sense of relief. They were safe for one more day, at least from school shootings. I hugged my kindergartener and patted the head (that’s …

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Medical education has woken up, and that’s a good thing

Education
September 5, 2022

A Black woman whose kidneys only function at 15 percent of normal wishes to be evaluated for a kidney transplant. Although this is very reasonable, before 2021, many physicians would have said, “I’m sorry, but your kidney function is not bad enough to be referred for a transplant.”

This is because the kidney function calculator used before 2021 overestimates kidney function for Black people, making her kidney function seem “too good” …

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