Yet, 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. I’ve talked to doctors in China who have watched their friends and colleagues die during the SARS epidemic, who have watched the government break its promises to support their families after their death, and who, as a result, are no longer willing to volunteer on the frontlines. I’ve watched videos of nurses in the U.S. crying after they were forced to quit their jobs because hospitals are not providing them with the personal protective equipment (PPE) necessary to keep them safe. Many of them said that they were afraid of getting infected and spreading the disease to their high-risk family members. Who can say these are not real concerns? Who can call these physicians and nurses selfish and irresponsible?
It is not uncommon for transgender and gender-nonbinary individuals (TGNB) to be misgendered by healthcare providers or in the healthcare setting. This negatively affects their health and their relationship with their providers. Leaders in the field of transgender and non-binary healthcare recommend asking about a person’s pronouns and integrating pronoun introductions into the clinical setting.
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. Trump’s executive order is formalized by the Center for Medicare and Medicaid Services’ (CMS) Hospital Price Transparency Final Rule, which applies to every hospital in the United States and is set to be effective on the 1st of January next year.
So, what is planetary health? It refers to a burgeoning field focused on understanding the health impacts of human-caused disruptions of Earth’s natural systems, including climate change and environmental pollution. This also encompasses the immediate and downstream health threats from such disruptions, which have impacts on communities at the local level — Philadelphia is no exception.
As many urban academic medical centers have become the world’s leaders in research and patient care, their bordering neighborhoods have suffered through decades of disinvestment and economic blight. Medical students often receive their first years of training in hospitals that serve these disadvantaged populations. While the current focus on social determinants of health represents a rising cornerstone of medical education, what else do medical students need to know about inner city poverty?
Yes, unfortunately, I have become one of the sixty thousand and rising daily cases in the nation.
Yet I am one of the lucky ones.
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.
Mrs. H’s story is just one of millions of Americans who have become victims of structural violence and suffered from the social determinants of health. With a clearer understanding of the complex factors that contribute to patients’ health outcomes, I now aim to reunite the erroneously separated domains of medicine and social sciences.
Medicine is a discipline that claims to be based on empirical and scientific truth about human nature. Instead, its knowledge and practice are often steeped in biases like racism. For example, medicine was used in the nineteenth century to justify slavery due to the “biologically inherent superiority” of White races.
In Nicaragua, where I was born and raised, we routinely stayed at home for dengue outbreaks, violence and hurricanes. I had experienced at least three lockdowns as a child, and now as an adult, I was experiencing another. Although the Nicaraguan lockdowns I experienced happened in the 1990s, the COVID-19 lockdown was still familiar.
As a White male, there are certain things that I will never understand. I was raised in an upper-middle-class family in a safe neighborhood — one with adequate resources, education and funding. I have never had to live in fear in my community, worry about my safety on my street, or been threatened or condemned because of how I look. My reality is inexplicably shaped by the privilege and opportunities that I have been given. I realize that to me, racism appears nonexistent because I have not seen it.
Is medical education doing enough to address future physicians’ abilities to understand the perspectives of their patients? As a medical student, my growing disillusionment begins with medical school and the lack of opportunities afforded to us during our education to discuss matters such as racial inequality.