Structural racism is the biased societal approach to housing, education, employment, healthcare, and criminal justice. As scientists study racial health disparities in depth, a picture begins to emerge that there are bigger, stronger, and more insidious forces at play than economics alone. The psychological stress generated by unfair treatment may trigger a biological series of events that lead to worsened health outcomes in the long term.
A physician should be called a “physician.” A nurse practitioner should be identified as “nurse practitioner.” Please call a physician assistant, “physician assistant.” These are accurate titles, reflective of their specialized education, training, and expertise. They are all venerated professions which share a mutual goal of improving patient’s lives, yet the vocations are fundamentally different.
“Provider” was first utilized by The Third Reich, who embraced this moniker to degrade Jewish physicians as medical professionals. The historic root and use of the word “provider” deserves our attention and reflection because if we forget the tragic mistakes of history, we may be doomed to repeat them. While the more recent movement to disrespect the education and training of physicians was the brainchild of the federal government and corporatized medicine, this disdain for medical expertise has occurred before–to Jewish physicians living in Germany in 1937, before World War II.
The Regence auditor in charge of my case, Anke Menzer-Wallace, failed to turn up any irregularities in our documentation. But, still, Ms. Menzer-Wallace issued a stern admonition to my father and me, ordering us not to open our clinic on Saturdays to administer flu shots.
Dr. Mary Edward Walker was a female physician who embodied “antagonism.” She is the only female recipient of the Congressional Medal of Honor in U.S. history, cited for valor as a surgeon on the Civil War battlefield. She was also an abolitionist, prisoner of war, suffragist, writer and speaker. Two years before her death, the Army revoked her award yet she refused to comply. Her life story is inspiring.
Whether we recognize it or not, we’re in a housing affordability crisis. Over a third of households in the U.S., carry a shelter burden that is beyond the standard of affordability – that is, costs usurp more than 30% of monthly income. Locally, rents have increased by 50% over the last 5 years and more startling, the number of evictions has grown by 90% in the last 3 years.
To date, there have only been two female physicians elected to Congress. But in the coming midterm election there are six races with a chance at making history. It’s these battles which could make 2018 “The Year of the Female Physician.”
During the same period, the U.S. maternal mortality more than doubled, skyrocketing from 9.8 to 21.5 maternal deaths per 100,000 live births. That’s six times higher than most Scandinavian countries and three times higher than Canada and the United Kingdom. In the U.S., around 700-900 women die and another 65,000 experience life-threatening complications during or after childbirth. By any standard, the U.S. has the worst performance on this crucial measure of any country in the developed world.
As a pediatrician, watching enforcement of “zero tolerance” on children at our southern border has broken my heart. Every child needs safety and a sense of belonging. It defines who they are and shapes their perception of the world. For a young child, the loss of a parent is so devastating there can be no repair, only salvage of the wreckage.
Every child deserves the best possible start in life, and the statistics show that specialist neonatologists practicing at high-volume NICUs are in the best position to provide it. Just because smaller community hospitals that have invested in state-of-the-art equipment can, technically, deliver preemies, doesn’t mean they should.
