Public Health & Policy

5 topics I don’t want to read about in 2022 (but I probably will anyway)

Physician
February 10, 2022

As 2021 passed into 2022, I was hoping new stories would emerge and dominate the medical landscape. So, I did a bit of crowdsourcing on social media and among colleagues. Here are five topics I’d like to read less about — if for no other reason than they’ve been discussed and vented ad nauseam with little likelihood of resolution unless words give way to meaningful action.

COVID-19

We’re rapidly approaching the three-year …

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Solving the low-acuity emergency department problem

Policy
February 9, 2022

Before I worked as a medical scribe, I didn’t realize how many mildly ill people visited the emergency department (ED). In my first few weeks, though, I learned that patients with minor complaints, such as sprains, cavities, rashes, and common cold symptoms, actually present to the ED quite often – often enough that the hospital where I worked had to dedicate an entire 12-bed wing to them. In most EDs, …

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How strong policies can improve guardianship

Policy
February 9, 2022

Millions of Americans each week watch as fictional television matriarch Rebecca Pearson, in the NBC-TV series, “This Is Us,” struggles with frustrations of early-onset Alzheimer’s disease and fear of an unknown health future. In the coming decades, millions more will experience this in real life.

Guardianship — or the care and legal control over another person’s life —may become one of the biggest issues of the next three …

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Why the health care industry must prioritize health equity

Policy
January 31, 2022

There are few silver linings related to the COVID-19 pandemic, but one that stands out is the growing recognition that health equity must be an essential guiding principle for health care organizations going forward.

The broader health care system suffered greatly due to the coronavirus outbreak that has infected tens of millions and killed hundreds of thousands nationwide, but vulnerable patient populations and marginalized communities were far more susceptible to long-term …

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Is EMTALA really protecting patients during COVID?

Policy
January 28, 2022

I am a physician at a critical access hospital. I manage both the ER and inpatient service and am the only physician in the hospital. This is the reality for many rural hospitals across the country. With no urgent care in town, and with primary care offices few and far between, these hospitals see everything.

We see patients with ailments from a minor finger laceration to those with septic shock from …

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The social imperative of health

Policy
January 25, 2022

As a nation, we have committed to a social imperative for education — an aspirational vision, based on its broad social benefit, for universal literacy and numeracy of our citizens — as manifested in our systems of mandatory K-12 education.

While this vision remains a work-in-progress — there are significant inequities and differences of opinion as to the process and content of education — the shared value of, and responsibility for, …

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The real value of high-value care

Policy
January 18, 2022

When newly admitted medical students enroll in their respective programs, they participate in the cherished White Coat Ceremony, in which they eagerly vow to stop at nothing to help patients—to go above and beyond to provide the highest quality care to any and every individual who needs it. Though this aspiration is not overtly naïve, it is, perhaps, exceedingly optimistic. As training progresses, many students come to realize that the …

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This physician is running for U.S. Senate. Here is his health plan outline.

Policy
January 17, 2022

Martin Luther King once said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Sadly, this remains true today. Instead of simply providing the care one needs, access to care varies based on wealth, status, and the type of insurance product a person has.

I have been working as an emergency physician, health services researcher, and leader in health care for over 30 years. …

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The physician and the podcast interview

Physician
January 17, 2022

As I plug in the microphone and check the link, I imagine them on the mountain, kicking frozen boots into the night ice as the wind explodes over the ridge and rifles through the down of their parkas. I imagine the anemic glow of Jeff’s headlamp against the expanse of the Himalayas and Erik bending into the incline as he follows the nylon rope; he can hear the sharp tinker …

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Legal challenge from Disability Rights Texas may have repercussions in schools across the country

Policy
January 16, 2022

Parents of disabled children together with Disability Rights Texas won a ruling in November that could have ramifications well beyond the state of Texas. In July, Texas Governor Abbot issued an executive order, GA-38, that prohibited schools from instituting a mask mandate. He insisted that whether a child should be compelled to wear a mask should be up to a child’s parents.

Judge Lee Yeakel declared that the Governor’s order Read more…

I am tired of the racism that remains embedded in our culture

Physician
January 15, 2022

A 2012 letter to Mr. Leonard Pitts, a Pulitzer Prize-winning journalist.

I am not sure why I feel so compelled to write you. You probably will not even see this email, but I still must do so. I am a 56-year-old Christian white male physician living in North Carolina. I am a graduate of the United States Military Academy at West Point and the University of Alabama School of …

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COVID-19 and the Tuskegee syphilis study

Meds
January 12, 2022

Despite health professionals’ efforts at conveying the effectiveness of immunization, many African Americans remain skeptical about the COVID-19 vaccine.

Getting to the root of this distrust is critical as the Delta and Omicron variants stoke up the number of positive COVID-19 cases across the United States. And the spread of the virus is not uniform. According to the National Vital Statistics System, Black Americans incur the highest COVID-19 …

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Crowdfunding to pay health bills [PODCAST]

Podcast
January 10, 2022
YouTube video

“Crowdfunding models of paying for health care maximize the probability that all members’ eligible bills will be paid in full each month. These models come without the burdens of skyrocketing premiums and deductibles. Unlike traditional models, members aren’t chained to yearly contracts and have more flexibility and autonomy with …

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Skin-in-the-game doesn’t have to be scary

Finance
January 6, 2022

When I entered the field of medicine, the goal was clear; to make patients “better.” Through my hospital-based training and practice as an internal medicine physician, I developed a strong interest in illness prevention — how can we keep patients from coming here in the first place? The answer became crystal clear. What wasn’t clear was how to focus on preventative care in the current structure of the U.S. health …

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It is time to make the unvaccinated pay their fair share

Policy
January 4, 2022

Massachusetts is again experiencing a COVID-19 surge and our hospitals are overwhelmed, mostly with unvaccinated patients.

As a practicing physician who takes care of many high-risk diabetic patients, I ask all my patients about their COVID-19 vaccination status. I explain to my unvaccinated patients that the benefits of vaccination far exceed the risk, both at the individual and societal levels.

Unfortunately, this conversation only convinces a minority of the unvaccinated to get …

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Virtual organizations in health care

Tech
January 1, 2022

In almost all organizations, an employee has a supervisor responsible for guiding the employee in doing their job. This requires good communication between the two.

Currently, in medicine, especially during stays in the hospital, there is a similar relationship between physicians: The attending physician recruits the necessary specialist physicians to provide care for the patient and supervises their care. The difference is that this relationship is just for the patient, and …

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CPT coding changes: 5 proven methods of how to do more with less

Policy
December 31, 2021

It’s well known that coding changes drive provider behavior, and billing behavior drives provider decisions.

For the last 30 years, little has changed in health insurance billing, which is why the standard of care within the payer system has remained, well, standard.

Then the pandemic hit, and suddenly everything was turned on its head. Patient demands increased sharply, office visits became impossible or prohibited across most of the country, and with telemedicine, …

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The U.S. doesn’t have enough faculty to train the next generation of nurses

Policy
December 29, 2021

Despite a national nursing shortage in the United States, over 80,000 qualified applications were not accepted at U.S. nursing schools in 2020, according to the American Association of Colleges of Nursing.

This was due primarily to a shortage of nursing professors and a limited number of clinical placements where nursing students get practical job training. Additional constraints include a …

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Emotional epidemiology of disease is as critical as clinical epidemiology

Physician
December 28, 2021

At this point in the COVID vaccination campaign, nearly all American adults who want the vaccine have gotten it, and are gratefully snapping up their boosters. Those who decline vaccination are largely impervious to public service announcements, community pressure, and case counts turbocharged by the Omicron variant.

Public health experts emphasize that primary care doctors and nurses are the key to this last mile of the vaccination effort. …

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