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.

Mindfulness Can Improve Mental Health During & After the COVID-19 Crisis

Although there was no shortage of suffering before coronavirus, this global pandemic, compounded by tragic events involving the loss of Black lives, has brought rising levels of stress and uncertainty. Growing unemployment and physical separation from loved ones have led to increased substance ...

Reflections from a Health Policy Fellow

As many Family Medicine colleagues across the United States complete residency, I find myself looking back to those challenging yet invigorating years. Residency training certainly solidified my clinical skills, from diabetes to pregnancy labor management, but also heightened my interest in social issues. Training in Western North Carolina meant working in a non-Medicaid expansion state where Black babies were three times more likely to die within their first year of life than white babies and where those struggling with opioid addiction were often marginalized. Each day seemingly brought ...

Primary Care Transformation in a COVID-19 World

Access to comprehensive primary care has long been a challenge in the United States, and the economic and social impacts of the COVID-19 pandemic will have far reaching implications on our healthcare system. Sixty percent of Americans have at least one chronic condition, and many patients have complex needs that require additional coordination, time and resources than what traditional models of care ...

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 ...

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 ...

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

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 ...