Public Health & Policy

The expanding role of specialists in value-based care

Policy
June 13, 2021

Value-based care has become a buzzword over the past decade with early experiments in Massachusetts, followed by creating Medicare accountable care organizations (ACOs) as part of the Affordable Care Act. As commercial insurers jumped onto this bandwagon, most providers became familiar with the concepts of gainsharing, upside and downside risk, and bundled payments.

Much of the activity in this space has focused on primary care, particularly for ACOs and ACO lookalikes. …

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Bridging the political divide [PODCAST]

Podcast
May 26, 2021
YouTube video

“Where do we go from here? Conventional wisdom suggests that we can only transform ourselves. This is why I propose that we attempt to recognize the Trump that lies within each of us and to heal him. We are plagued not just by the pandemic but by the human condition—and no …

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A secret for my $40,000 health care bills

Policy
April 29, 2021

On Twitter @jpegjoshua recently posted about a staggering health care bill for going to the hospital for a life-threatening condition and then receiving an outrageous statement, which reminded me of a similar story that I had.

I also received a bill for nearly $40,000 but luckily managed to have it cleared through an unmentioned secret. For me, it all started the second …

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Health care as an uncommon good

Policy
April 29, 2021

American medicine is facing an identity crisis. The COVID-19 pandemic brought renewed attention to socioeconomic health disparities and turned up the heat on the question of whether health care is a right or a privilege. The financial strain on hospitals resulting from the temporary postponement of scheduled surgeries exposed a vulnerability caused by an inherently flawed payment system.

The answer to the right versus privilege question has much more significant implications …

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Daunte Wright’s death: intersectionality, racism, and ableism

Physician
April 20, 2021

Most of the world knows by now that on the afternoon of April 11th, a 20-year-old Black man named Daunte Wright was killed by a police officer in an inner-ring suburb of the city I call home: Minneapolis.

Most of the world is watching Minneapolis as Derek Chauvin, the former police officer who knelt on George Floyd’s neck, is tried on charges of manslaughter and homicide. Several hours before I typed …

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Physician morale and the doctor’s voice [PODCAST]

Podcast
April 19, 2021
YouTube video

“It is dangerously unfortunate that the use of masks has been politicized in many parts of our nation. The Dakotas (or North and South COVID as they were recently called on Saturday Night Live) are far from exempt from this phenomenon. Likely, if Governor Burgum’s decision was less influenced by fear …

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I was a teenage rifle owner, then an ER doctor

Physician
April 14, 2021

Many who know me might be shocked by this: I shot my first pistol when I was 8 or 9, taught by my father, a physician, aiming at targets in our basement. At summer camp, I loved riflery the way some kids loved art. Staring through the sight, down the barrel, I proved an excellent shot, gathering ever more advanced medals from the National Rifle Association. As a reward, for …

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Physicians of color need student loan forgiveness

Physician
April 1, 2021

I urge the president to use executive action to cancel student debt. As president, he can take immediate action on student debt which would be a lifeline for students, parents, and their families.

The COVID-19 pandemic is a health crisis like we have never seen before. Adding the heavy burden of student debt is a recipe for disaster for millions of families. Student debt cancellation would provide much-needed relief during the …

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A physician’s response to anti-Asian racism

Physician
March 31, 2021

“Wait, are you Chinese? I don’t want to get COVID.”

First of all, I am Vietnamese, and second, not all Asians look alike. And third, what? Those were the thoughts going through my head while working at the San Carlos Respiratory Clinic in April 2020. Initially shivering from the cold weather underneath my scrubs and PPE, I could now feel my body hot with anger as I listened to a patient’s …

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The rise and fall of Hahnemann University Hospital

Physician
March 28, 2021

In March, thousands of medical students received their residency match results. For most specialties, match rates for graduating U.S. MD seniors have typically remained above 90 percent. This almost certain job security is what allows most medical students to consider taking on astronomical amounts of student debt.

The individualist message is clear throughout medical school: Focus on yourself, your achievements, and hope for the best.

Absent from these …

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Inside the $1.9 trillion coronavirus stimulus bill is a political time bomb for Republicans

Policy
March 4, 2021

Contained inside the Democrats’ $1.9 trillion coronavirus stimulus bill is a political time bomb for Republicans.

Included in the bill’s long list of stimulus spending is a provision that delivers on President Biden’s promise to strengthen the Affordable Care Act or Obamacare.

Obamacare’s big failure has been what it did not do to help––and actually hurt––middle-class buyers of individual health insurance. Since the health law’s inception, consumers, who are eligible for little …

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Why environmental justice is integral to the future of medicine

Policy
March 3, 2021

This past year has been one of overwhelming extremes: global pandemic, a national reckoning on racism, devastating wildfires and storms, and political disarray. To some it was perhaps just a difficult year. But to those who can identify the common thread of injustice, it is clear that this was the product of decades of systemic inequities. It is also clear that if these inequities are not addressed, what we have …

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An open letter to the medical community at large regarding the termination of Dr. Princess Dennar

Physician
February 22, 2021

Deeply entrenched racism, rooted in the foundation of white supremacy, has had a stronghold in medicine for hundreds of years. Its legacy of harm against Black, Indigenous, and people of color (BIPOC) communities, particularly its atrocities against Black Americans, is undeniable. Yet significant change eludes us. For decades, these communities have borne the disproportionate burden of public health short-comings from police brutality, gun violence, infant and maternal mortality, and …

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The pandemic exposes critical gaps in Canada’s health workforce planning

Policy
February 20, 2021

Health workers in Canada experience endemic levels of burnout directly related to understaffing and work overload. Leaves of absence from work for mental health and stress-related issues are 1.5 times higher among health workers than the rest of the population. Increasingly, health workers are significantly reducing their hours worked to cope or leaving their jobs altogether.

That was before the pandemic. With COVID-19, we are witnessing levels of stress, overload, and burnout …

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Why teachers aren’t going back to school: a physician’s take

Policy
February 13, 2021

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 health care fails to deliver better value in patient care

Policy
February 8, 2021

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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Stop the us vs. them mentality in medicine

Physician
February 8, 2021

As a foreign medical graduate and a multiple-time career changer — from being a doctor to a hospital process improvement and leadership coach to a business professor to a transformational career coach for female physicians — I have closely examined the U.S. health care industry from various lenses.

The one thing that stands out for me is the us vs. them attitude. Us being physicians and them being administrators.

I have seen …

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There’s a doctor in the house, and maybe also a physician: a view from osteopathic medicine

Physician
January 21, 2021

The Wall Street Journal’s decision to publish an attack on Dr. Jill Biden’s right to be called “doctor” has appropriately unleashed a firestorm. According to Joseph Epstein, the editorial’s author, Biden should drop the title because she isn’t what people often think of when they hear the word “doctor,” namely a physician. For Epstein, ‘Dr. Jill Biden’ sounds and feels fraudulent, not to …

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