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.


Researching Organizational Structures of Primary Care

How does a clinician’s stress affect patient care? How can we alleviate the crisis of physician burnout? What was COVID-19’s impact on the field of primary care?

No Borders for Those Who Fight

"Não há fronteiras para os que exploram… não deve haver para os que lutam”—there are no borders for those who explore… there should not be for those who fight. This powerful statement was the rallying cry of representatives from dozens of waste picker organizations to the 2nd Latin American Congress. The gathering, held in 2005 in São Leopoldo, Brazil, unified a collection of marginalized peoples into a single voice calling for an end to ...

The Various Faces of Trauma

Trigger warning: Parts of this piece may be triggering. Please take the time and space to look after yourself and seek help. A few years ago, while I was packing for an upcoming move, I came across my old Pakistani passport. As I opened it, my 16-year-old self looked back at me, with the words “married” and “housewife.” I was a child bride. I am now in my 30s. I broke free from that child marriage a decade ago and built a wonderful new life of freedom for myself and my daughters. ...

Winds of Change: Communicating the Biden Administration’s Immigration Policies Can Help Combat the Pandemic

With rates of COVID-19 cases, hospitalizations, and deaths falling dramatically from peaks in January, the United States may be turning the corner on the pandemic. At the same time, the Biden administration has signaled a U-turn from the Trump era on immigration. From Day One, the new administration has expressed support for proposals to legalize millions of unauthorized immigrants, advanced executive actions to restore acceptance of asylum seekers at the U.S.-Mexico border, and embraced more welcoming ...

An Intersectional Approach to Understanding the Mental Health Challenges of America’s Essential Workers

In an effort to flatten the curve and promote containment of the novel coronavirus, many safety precautions have been enacted, including shelter-in-place ordinances. However, several members of the workforce, such as healthcare workers, bus drivers, sanitation workers, cashiers, and fast-food employees, collectively referred to as “essential workers,” have been deemed exempt from such policies. While there is general consensus around the importance of essential workers throughout the COVID-19 pandemic, there has been less attention towards the interplay of identity and ...

Diversifying the Healthcare Workforce is Key to Addressing Health Inequities

When we improve the health of the most marginalized, we improve the whole nation’s health. Brian Stevenson, Executive Director of the Equal Justice Initiative, noted in the American Public Health Association (APHA) 2020 Annual Meeting, “the health of our communities must not be judged on how well the powerful and privileged are doing, but by the health and well-being of the most vulnerable ...

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

The Inner Bully and the Burden of Charting: A Dose of Self-Compassion May Be the Best Medicine

If you are a physician, this may sound familiar: I can feel that old resentment bubbling up as I sit down to chart on a beautiful summer Saturday afternoon. Seventy-two hours and I have to get all the charts done or they will close themselves automatically, and my name is added to the departmental “late charts” email list. My daughter is waiting for me to take her to her mall. It’s always hanging over me, and I can’t stand the stress. The minute I login, I hear the familiar self-critical voice and internal task master who whips me to get the job ...

Emotional Intelligence in Medicine: A Two-Way Street

In the early evenings after work, I thoroughly enjoy taking brisk walks. Walks are a great opportunity to exercise of course, but I also cherish making time for myself to process the many thoughts that can occupy the mind of a busy wife, mother, pediatrician and medical director. My walks are typically the only time of the day when I can quietly meditate, ruminate, prioritize concerns or simply restore my soul. As I walk, I get to see families pushing strollers filled with young children, dogs walking their humans, and even the stray teenager riding a scooter or bike around the ...
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