Mercedes drove two hours to the nearest healthcare clinic to get her first physical exam in ten years. I met Mercedes while shadowing a primary care physician, Dr. L. In the clinic, Mercedes divulged to me how nervous she had been driving in – she knew what the meeting held in store. Her fears were confirmed: just five minutes into her exam, Dr. L advised her, “Mercedes, you have to lose weight.”
This unrest reached a high point in September, when nurse Dawn Wooten filed a formal complaint against Dr. Mahendra Amin, a Georgia physician working at an Immigration and Customs Enforcement (ICE) detention center, who she claims performed mass hysterectomies on detained immigrant women without consent. While the country reacted in shock, the reality is that coerced sterilization against communities of color is not new. The United States has a shameful history of exploiting Black and brown women’s bodies as part of a larger objective for population control rooted in white supremacy — and the medical field is partly to blame.
There is a cost crisis in medicine: the healthcare industry accounts for about 18 percent of the GDP in the United States, and predictive models see this increasing in the coming years. This is a problem for the country as a whole as an estimated 41 percent of working Americans have some level of medical debt.
Now, I am a fourth-year medical student standing at the foot of a tall ladder. The hierarchy of medicine requires that I follow some unwritten rules in order to climb. Throughout my training, I have gotten the sense that one of those rules is: avoid trouble, good or bad. Of course, now, doctors are beginning to find their voices through movements like White Coats for Black Lives. But as a young trainee, I sometimes feel the sentiment directed at James in 2018: shut up and doctor.
I am worried that these stories of heroism are harming the very people they celebrate. By creating an ideal “health care worker” as an endlessly altruistic individual, it stigmatizes the medical workers who refuse to take on these risks — even though there are many legitimate reasons not to.
President Trump signed an executive order this past June that directs the Health and Human Services Department to develop a rule requiring hospitals to disclose online the prices that insurers and patients pay for common items and services. The rule also requires hospitals to reveal the amounts they are willing to accept in cash for an item or service. However, hospitals not complying only face a civil penalty of $300 a day, giving them latitude to effectively ignore the executive order.
Yes, unfortunately, I have become one of the 60,000 and rising daily cases in the nation. Yet, I am one of the lucky ones.
Despite this, most medical students will obtain little formal leadership training. We seek to improve our leadership abilities as burgeoning physicians. We developed this podcast to challenge ourselves to explore ideas in leadership development and how they apply to medical training.
For a variety of reasons, the substance use population is particularly vulnerable to the impacts of the COVID-19 pandemic. Based on data from previous financial crises, the emotional toll will increase rates of new substance use, escalate current use, and trigger relapse even among those with long-term abstinence. There may be a significant lag before these changes are detected and treated because health care resources are being funneled toward the pandemic.
As medical students, we marvel at the endless combinations of letters often embroidered on white coats representing physicians’ degrees and association affiliations: MD, MBBS, DO, PhD, MSc, MBA, MPH, MPP, MS, MTR, JD, MSHP and so on. This “alphabet soup” represents the important diversity that exists in our profession.
Hahnemann’s doors stay closed and our patients are waiting. While Philadelphia has stopped negotiations, we, as students with futures in health care, cannot accept this. We demand that Freedman provide free use of Hahnemann for the duration of the pandemic.
The nightmare of the COVID-19 pandemic offers a view of what climate change will impose on our future health system and communities if uncontrolled. As future doctors, on the 50th Anniversary of Earth Day we raise our voices in unison to draw attention to the urgency of the climate crisis.