Archive

Perspectives in Primary Care features writing from practitioners, activists, and community members representing organizations, practices, and institutions across the United States and around the world.

COVID-19 and Homelessness in Boston: Thoughts from the Initial Surge

The COVID-19 pandemic has cast health inequities into stark relief, though this hasn’t surprised those of us already immersed in the care of homeless persons. Barbara McInnis, a beloved nurse at the Pine Street Inn in 1985 (for whom the Barbara McInnis House for medical respite was named ...

Beyond the Symptoms: How & Why Medical Providers Can Address Police Misconduct

Many of my teachers and fellow students feel that to be good healthcare providers, we must separate ourselves from our political opinions and the issues outside the walls of the hospital. That impulse can be helpful. We don’t want to mistreat our patients because they hold different opinions from us or see the world in a different way. At the same time, I think it limits the degree to which we can fully understand and address the problems our patients face. It is difficult to understand the injuries caused by violence or the illnesses caused by chronic stress ...

Running, Community, and Accountability to Get Back on My Feet

It’s 5:30 am, and while most of the world may still be sleeping, our community comes together, greeting each other with hugs and high fives. We come from all walks of life, running together to get in our morning miles. Our community shows up rain or shine, on the darkest of winter mornings and the brightest of summer days, knowing that by just showing up, we are helping each other put one foot in front of the other, pushing toward a brighter future.

The Changing Landscape of Medical Education Amidst the COVID-19 Pandemic

March 12 & 13, 2020. Just three months ago, yet it seems like eons. All my meetings were abruptly canceled so I could attend urgent education team meetings to discuss how to proceed with our medical school curriculum in the setting of the COVID-19 pandemic. Like many medical schools across the United States, we suspended in-person pre-clerkship lectures and small groups, clinical clerkships and electives and rapidly transitioned to online learning. Faculty, many of whom were digital immigrants (myself included), found themselves forced to use the very technology they had ...

Medicare-for-All in the COVID Era: A Path to Healing

As physicians in the intensive care unit (ICU) at Cambridge Health Alliance, a safety-net hospital in the Boston area, our patients regularly fall victim to the intersection of the social determinants of health and the failures of our dysfunctional healthcare financing system. We frequently treat patients whose health problems have been thrust upon them by structural forces: a Black man spiraling into ketoacidosis because he couldn’t pay for insulin at ...

The Common Cause for Healthcare and Education

Over the past few decades in the field of education, we have engaged in expensive, energetic and well-intentioned reform to our systems of schooling. These changes, including accountability, curriculum and instruction, have been aimed at achieving a very ambitious goal, summed up in the titles of our two most recent federal policy initiatives: “No Child Left Behind” and “Every Student Succeeds.” Sadly, the results of these reforms at the local, state and federal levels have been modest. There have been pockets of success in individual schools and ...

What Americans Can Do to Address Systemic Racism and Achieve Health Equity

I can’t breathe! This has become an all too familiar cry for many African Americans who everyday struggle to breathe in a society suffocated by systemic racism and entrenched inequities. They struggle to live in a society that has intentionally erected barrier after barrier intended to weaken their bodies and hasten their deaths. What we have is the perfect storm for a disaster—a serious health crisis, an inequitable method of health delivery, millions of uninsured and under-insured people, an uneven and politically charged approach to dealing with the pandemic, police brutality, and other ...

Defeating COVID-19 Locally: The Community Health Worker Ground Game

The Problem While COVID-19 is a novel virus, its devastating impact on public health has shone a spotlight on longstanding failures of our healthcare and social services systems. Thus far in the United States, the virus has claimed over 100,000 lives, dramatically reduced

Getting Home Safe: A Letter for My Brothers and Sisters

Dear Brother & Sister X, The feeling of grief, fear and frustration felt by our fellow Black and Brown siblings in America after the death of George Floyd, Ahmaud Arbery and Breona Taylor is impossible to dismiss, especially when it has been met with the president’s public combativeness towards protesters and promotion of state violence. History has shown us time and time again that the outcome of putting all of our hopes into large scale structural change leaves communities of color waiting for government institutions to act on our behalf; and while we wait, we ...

Striving for Patient Centeredness Amidst the COVID-19 Pandemic

I heard the commotion from my “captain’s chair,” the seat for the lead clinician at our respiratory clinic. The medical assistants, gloved and masked, hurriedly pushed the wheelchair past my door and into the “emergency” exam room, and I glimpsed a tiny hunched figure in the chair, all dressed in black, with her face grayish brown. “Oxygen saturation 84, we’re calling EMS,” the medical assistant called out, as a nurse walked swiftly into the room to apply oxygen. A clinician jogged over to the personal protective equipment (PPE) room to don her full armor before heading to the patient’s ...

Human Trafficking: A Review for Healthcare Providers

Human trafficking is a global pandemic and gross violation of human rights. Healthcare providers are often the first group of professionals to interact with victims of human trafficking with over 88% of victims ...

Coronavirus Pandemic Highlights the Need for Health Disparities Training as a Fundamental Part of Medical Education

If there is any silver lining to the COVID-19 pandemic, it’s that we now have the opportunity to address ongoing societal failures that have been thrown into stark relief by this crisis. Perhaps chief among them is our complacency toward deeply entrenched racial and socioeconomic health disparities, which have become even more deadly in the face of COVID-19. There is ample evidence in states across the country, including Michigan, Louisiana, and North Carolina, that disproportionately high rates of chronic diseases like hypertension, asthma, and diabetes among people of ...

The Role of Integrative Medicine Now: Tools in the Time of COVID

COVID-19 has affected people worldwide and sickened millions. It is no coincidence that people are looking for unconventional ways to stay or become healthy. As Family Medicine physicians who also practice integrative medicine, we are accustomed to being asked questions about wellness. Lately, the most common questions are: How can I deal with the stress of staying home/ possible illness/ concern for family and friends/ childcare? How do I improve my immune system and stay healthy? How can I get well faster if I do get COVID-19? ...