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.

Practice Optimization Amidst COVID-19: A Note from Our Patient Partner

The impacts of the COVID-19 pandemic continue to be felt across the United States, and this includes the ways in which we interact with the healthcare system. As the mother of a daughter with complex medical needs and a diabetic patient myself—what many would refer to as “super-users” of the medical system—we had to quickly adjust and adapt to the ways we’d need to manage our health conditions throughout the pandemic, as COVID has not stopped our need for ongoing care management. So, when I was asked to serve as faculty for the Harvard Medical School Center for Primary Care

Mobile Clinics: A Powerful Resource for Addressing Health Disparities

The COVID-19 pandemic has laid bare the systemic limitations of the American health system when confronted with the unexpected emergence of major disease, and underserved communities are often those most affected. A possible solution to address these disparities: mobile clinics. Mobile clinics are vehicles customized with medical equipment and staffed with medical providers and other health ...

Integrating Addiction Treatment in Primary Care: Training Needs and Novel Approaches

Addiction is a chronic medical condition that carries significantly elevated risk of morbidity and mortality, as the sequelae of substance use disorders (SUD) can be severe and life-altering. While evidence-based treatments for SUD exist, many people face barriers to accessing care. For example, of the approximately 20 million people living with addiction in the United States in 2019, only 12.2% received ...

Relational Organizing Key to Addressing the Political Determinants of Health & Health Equity

As the world has watched with bated breath, the 2020 United States presidential election has unfolded into a paradigm shift marked by apprehension and anticipation. The American people—more civically engaged and politically informed than ever before—have mobilized in a historic show of democratic involvement. As American communities from all walks of life have been galvanized, a single factor has risen to ...

Here’s Why the US is Failing to Thrive

Americans die younger than people in other high-income countries. With a life expectancy of 78.5 years in 2018, Americans die 5.7 years younger than people in Japan, the global leader. They die 3.4 years younger than their northern neighbors in Canada. And they die 2.7 years younger than their

Promoting Health Equity through Voter Registration & Mobilization

It’s a warm September day. I neatly arrange my voter registration materials at a small table outside of the Somerville Urgent Care entrance. Sitting on a cool granite bench, I watch as a young girl and her mother approach. They are linked arm-in-arm, speaking Portuguese. “Hello! Are you registered to vote?!” They can’t see it, but I’m smiling behind my mask. The young girl’s face lights up, and, like many who visited my table before her, she begins to share her story. In just five days, she’ll turn 18. She’s finally old enough to vote ...

My Patient Anna, and Millions of Others Like Her, Are on the Ballot in November

Meet Anna. She’s a 47-year-old woman with diabetes and high blood pressure—that is, hypertension. When I first met Anna three years ago, she’d recently moved to Massachusetts and obtained health insurance for the first time in two decades. During her first clinic visit, Anna’s blood sugar was wildly uncontrolled—a clear indication of diabetes. She felt dizzy and fatigued, but this was her baseline. We spent over an hour, during a visit scheduled for 20 minutes, working with the pharmacist and health insurance company to find an insulin prescription for which she could ...

Child Care and Early Education is a Social Determinant of Health—For Children and Adults

More than six months into the COVID-19 pandemic, child care solutions for families remain scarce. A high-stakes problem typically confined to parents with children younger than five, lack of child care has now become a near-universal challenge, with remote K-12 learning upending care infrastructure for families with school-aged children as well. Consistent failure to provide public funding to the child care and early education sector—both traditionally and in this moment of crisis—is taking a heavy toll:

Don Berwick's Moral Determinants of Health

Donald M. Berwick, MD, MPP, is President Emeritus and Senior Fellow at the Institute for Healthcare Improvement (IHI), an organization that Dr. Berwick co-founded and led as President and CEO for 19 years. He is one of the nation’s leading authorities on healthcare quality and improvement. In July 2010, President Obama appointed Dr. Berwick to the position of Administrator of the Centers for Medicare and Medicaid Services (CMS), which he held until December 2011. A pediatrician by training, ...