Physicians writing on KevinMD about policy as it reaches the exam room: prior authorization and the state and federal rules now written for it, scope of practice laws state by state, the CDC opioid guideline and what forced tapers did to patients, and public health from vaccination to the pandemic. 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, Opioids: what physicians and pain patients say, in their own words, and Vaccines: what physicians say, in their own words.
The tenets of managing an ICU are relatively simple: Air goes in and out, blood goes round and round.
There’s this moment in the delivery room where everyone holds their breath. In that silence, we expect a tiny gasp or maybe a big cry. “Why isn’t he crying,” moms often ask. “Is there a problem? Is he breathing?” In that forever moment, the pediatrician in the room is wondering if they …
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To my friends in the black community: I hope your children breathe
My mother has a tattoo. Really. She does.
There is a small blue crucifix on the inner aspect of her right wrist. Let me pause here to point out a few things. First of all, my mother is not a “tattoo” person. Secondly, the inner aspect of the wrist is one of the most sensitive areas of the human body. Third, my mom doesn’t like needles. All that to say, if …
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We are not trying to be conservative or liberal. We are human.
Protect and serve. Do no harm. These are covenants our public servants promise to us. Police officers and clinicians are both entrusted with attending to our health and safety. Both are failing.
We must be able to trust clinicians and police with the intricate details of our living and dying. When they deliberately lapse in integrity, or are completely negligent of due diligence, they need to either be …
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Protect and serve. Do no harm. Both are failing.
As a resident in the 1970s, I used to receive the AMA weekly newsletter. A squib of a few paragraphs noted that the Alabama Medical Board had issued a reprimand to a surgeon for suturing the hand of a young African-American man, then removing the sutures when the fellow did not have $25 on him to cover the fee. The surgeon contested, indicating that a patient should have the expectation …
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Adapting medical safety standards to enhance police outcomes
When we hear or chant, “Black Lives Matter,” what all does this refer to? Is it the gruesome police brutality in the death of George Floyd? Or the murder of Ahmaud Arbery? Absolutely. But what else should it refer to? We know that Black lives aren’t equal in the face of COVID-19. As physicians, have we considered all the ways that Black lives may matter less in health care despite …
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It takes more than marching to make Black lives matter in health care
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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It’s time for a comprehensive universal health care system in America
“What do we owe to each other?”
If you watch television, you may recognize that as a quote from the show The Good Place; if you’re a philosophy buff, you may recognize the work of T. M. Scanlon on contractualism. Either way, it’s a good question. It comes up frequently, in one form or another, when we think about what it means to have a truly just society.
June is Pride month. …
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What do white LGBTQIA+ people owe to the black community?
When we think of the legacy of racism in the U.S., hospitals aren’t one of the first places we imagine – but they should be.
“It’s never going to change.” “Sometimes it’s too heavy to bear.” ‘”I’m so angry – I’m just tired of holding it all in.”
These statements reflect the pain of our patients of color. They may resonate with all of us in our country’s current climate, as the …
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Anti-blackness is a public health issue
When former U.S. President Richard Nixon officially declared his crusade against drugs, notoriously referred to as his so-called “War on Drugs,” on June 17, 1971, America’s police-prison-profit industrial complex could at best prognosticate and at worst balefully pray for the downstream disproportionate impact criminalization of narcotics would have on certain communities from then until now.
If there is one thing that has been made unassailably clear to us in the decades …
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The war on drugs: America’s secret racist war today
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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Anti-racism must be a priority for medical institutions
I am neither black nor white. I’m brown. I can choose to stay silent and indifferent, but the human and the American in me urges me to express my feelings and opinion about the current situation in the country resulting from a series of unfortunate events, particularly George Floyd’s blatant murder in broad daylight.
I immigrated to this great country about fifteen years ago. From a distance, …
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We need more black cops. We need more black physicians.
Many health care organizations – health plans and hospitals alike – continue to debate what it means to provide population health management (PHM). Most have landed on a definition that aligns closely with what PHM means to them, rather than operationalizing an overly broad definition that doesn’t resonate with the populations and communities they serve. This is smart. But what’s missing is the focus on a more important question: What …
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Why whole person care is needed for better population health management
Over the last few months, we have faced a relentless pandemic and seen humans rising to serve the most critically ill. However, we have also borne witness to the relentless evidence of health and health care disparities during a time in our country’s history in which the discourse around race, nationality, gender, sex, sexual orientation, class, and religion have reached a fever pitch of discord. We have become increasingly frustrated, …
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Racialized violence and health care’s call to action
There are two calamities killing Americans: COVID-19 and racism. One is novel, and the other is perennial.
It is not coincidental that black Americans have died of COVID-19 at almost three times the rate of white people. Both biological and socioeconomic factors contribute to this alarming statistic. However, as emergency physicians and public health practitioners who care for patients from diverse social and cultural backgrounds, we are keenly aware that biological …
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The 2 calamities killing Americans: COVID-19 and racism
While the COVID-19 pandemic has been straining our health care system, public support for health care workers has never been greater. Every evening for a few minutes, neighborhoods across the country erupt into enthusiastic cheering and instrumental noise as people show their support for us. My social media feed has erupted with posts, artwork, and hashtags praising us #healthcareheroes and #frontlinecovid19.
However, if you really want to support your “health care …
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Health care workers need policy changes, not just applause
Here we are again, mourning the death of another black person at the hands of the people that are supposed to protect and defend our rights. Another casualty in the 400+ year struggle that we have had in this country to be granted the same right to liberty, the same access to success and the same ability to live without fear, that we were promised. And while this may seem …
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We should be collectively tired as a society
You are outraged. You realize you are part of the problem. You abhor rampant, unchecked police brutality and centuries of systemic, institutionalized racism. It sickens you.
OK, awesome. Now what?
In recent days following the death of George Floyd and the massive uprisings of the American people from all across the country demanding decisive justice and sweeping reform, I couldn’t help but notice a resurgence of a curiously unsettling, but all-too-common phenomenon …
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You’re outraged by police brutality and racism. OK, now what?
As medical students with backgrounds in public health and global health care operations, we were shocked by the action on the part of the Trump administration to defund the World Health Organization (WHO). This decision undermines the global community’s progress in combating the COVID-19 pandemic and will ultimately cost the lives of thousands of individuals. To appropriately support the WHO, it is critical to understand its vital functions and limitations, …
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Just what is the WHO and why does it matter?
The COVID-19 narrative is strong and pervasive: we must sacrifice either jobs or lives. This debate has seemingly polarized our society on moral and ethical grounds.
For many healthcare professionals, the intrinsic value of life is self-evident. No price can ethically be placed on the value of health and human life.
Fortunately, from an economic point of view, the choice between the economy and health might be a false dilemma.
The intersection of …
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The economic argument for saving lives
