Contributing Writer
Mount Sinai School of Medicine
My name is John Power, a 2012 graduate of Johns Hopkins University in Baltimore, Maryland and a member of the Class of 2018 at Mount Sinai School of Medicine. Before medical school, I spent one year working with a community health program in rural Haiti and one year working on health policy issues with an HIV advocacy group. Let's be good doctors together.
Much has been said about the growing crisis of mass incarceration in our country, especially how it disproportionately affects people of color. And it’s true, the United States currently houses 2.2 million people behind bars, a greater percentage of the population than that of any other nation in the world. Sixty percent of those incarcerated today are people of color.
In the recent White Coat Die-In demonstrations orchestrated by medical students across the nation, aspiring physicians displayed solidarity with the message that racial injustice is a public health concern that merits the attention and efforts of health care professionals. It is clear from the mobilization and investment of our medical community that there is a desire to engage in clearer articulation and understanding of the health disparities landscape.
“What can you do here that we can’t do at home?” This question angered my resident. How dare a patient admitted to the hospital ask for justification of their plan? The progress note had already been written and orders entered; assent to the plan was assumed and having to walk the patient through the options would extend rounds considerably. What an inconvenience.
After introducing myself as a first-year medical student working the attending physician, I went through the medical history with the patient in order to ascertain his chief complaint and history of present illness.
A common complaint among emergency room physicians surrounds the solicitation of pain medications. Nearly half a million ER visits in 2009 were due to the misuse or abuse of prescription painkillers. Several years ago I worked closely with a family physician in Binghamton who warned a [bout patients who feigned illness to acquire narcotics (…)
As health care reform begins to take hold in America, we are beginning to see some significant departures from our “ways of old.” The new forms of payment that are taking hold seem so foreign to us because they are in direct opposition to our past system. Our previous method, primarily fee-for-service, was one where there was an incredible amount of wiggle room for what payments should be. Individual hospitals or practitioners would negotiate with an insurance company as to what their reimbursement should be for a given service or procedure. This has led to enormous disparities in what individual hospitals may receive for the same procedure and the same outcome.
After a nearly 40-year moratorium, a controlled study of the therapeutic use of LSD in humans has been published in The Journal of Neural and Mental Disease after the pioneering work of Swiss psychiatrist Peter Gasser. Sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS) and approved by the BAG (the Swiss Drug Enforcement Agency), the study has completed treatment of all subjects after having enrolled its first patient in April of 2008. Many hallucinogens, such as psilocybin and MDMA, are being investigated today for their clinical benefits as a result of a gradual effort to reexamine the pharmacologic and psychiatric interests in hallucinogens.
According to CIA director Michael Hayden, the role of medical officers during interrogations has always been “to ensure the safety and the well-being of the detainee.” The Senate Select Committee on Intelligence refuted this testimony as “incongruent with CIA records.” What a gross understatement that would prove to be.
“Americans don’t lose weight.” This was the favorite tagline of a gastroenterologist I shadowed as a second-year medical student. In the few hours I spent with him, he seemed to have a defeatist attitude towards the potential that patients have in caring for themselves. Unfortunately, I do not believe this physician is alone in his thoughts. The allopathic medical education culture lends itself to treat people with medications and surgeries.
This afternoon, medical students across the country, from Providence to San Francisco, will lay down on sidewalks and atrium floors in their white coats to express solidarity with ongoing victims of racial violence. As aspiring health care professionals, we don our white coats for these “die-ins” to express our commitment to the idea that racial injustice can and should be framed as a public health issue demanding our attention and efforts.
To begin our examination of doctors’ salaries, let us first look at the real cost of becoming one. According to Medical School Admission Requirements (MSAR), the data warehouse for medical school application services, less than 60 percent of all applicants to MD programs are accepted.
You can’t ask your co-worker for narcotics the same way you can ask for extra Advil stashed in their purse or backpack. There are good reasons for this. Drugs like Advil or Tylenol carry no association with danger and can be easily bought at any local drugstore. While they are perfectly good for minimal pain relief from headaches or muscle soreness, they are underequipped for addressing major sources of pain. In comparison, opioid narcotics are serious painkillers.
Writer-in-Training and in-Training Staff Member
Warren Alpert Medical School of Brown University
The white coat is a scary, scary thing, and I'm still trying to figure out if I should have one. If you like screaming about ethnic rage, dance, or the woes of medical education, we should probably do some of those fun activities that friends do.
I have few answers, many questions. Dialogue is huge. Feel free to email with questions and comments!
