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: He Didn’t Have to Die

He’s young. Just 49 years old. A long life ahead of him. He was hospitalized a week ago and doing okay initially on the medical floor. After his saturations were consistently in the 80s on the highest level of supplemental oxygen, he needed to be intubated. We asked him if he wanted to call his family before intubation, just like we do with all our COVID patients… because we know it might be the last time. He declined, said he’s not in touch with his family and has no friends to call. He was adamant that he didn’t want his estranged parents or brother contacted for updates while ...

Investment & Innovation in Primary Care: An Update and Call to Action

We’ve all seen the headlines—primary care practices are in trouble: “America’s looming primary care crisis,” “Fewer than 10% of primary care practices have stabilized operations amid COVID-19 pandemic,” and “

LGBTQ Youth Face Unique Challenges Amidst COVID-19

The physical toll of the COVID-19 pandemic is tangible, though its impact on mental health is just starting to be understood—and this includes the mental health impact on LGBTQ youth. At baseline, LGBTQ youth are more than four times as likely to attempt suicide compared ...

COVID-19 & the Political Determinants of Health

From the earliest days of the COVID-19 pandemic, it was clear that America’s deep-rooted inequities would play a central, and likely devastating, role in the magnitude and distribution of the burden of disease. In early March, former New York City Health Commissioner Dr. Mary T. Bassett and I outlined these inequities and called for a human rights-based response focused on ...

My Moral Responsibility as a Physician: Addressing the Political Determinants of Health

A while back I was invited to attend a panel discussion on primary care at an area medical school. For 45 minutes the other two primary care doctors and I shared a lighthearted conversation about why we love primary care, interspersing various plugs for why the students should consider the field for themselves. After several stories about the satisfaction we derive from our jobs and the joys in the relationships we form with our patients, a student raised their hand to ask a question about how the current political climate was affecting our practice. “I’ll take this ...

Food Insecurity… Emerging Again from the Shadows of COVID-19

On first glance, COVID-19 appeared to be the “great equalizer,” particularly with reports of celebrities and world leaders infected and succumbing to the unruly virus. It seemed that income, race, ethnicity, and location were no longer protective factors. On second glance, though, we find COVID-19 is actually the “great magnifier.” It has shed light on the

The Impacts of Racism on the Health of our Nation

Dr. Martin Luther King, Jr. once said, “Our lives begin to end the day we become silent about things that matter.” The American Academy of Family Physicians (AAFP) has a legacy of being outspoken on issues that matter to our patients and the communities in which our members serve. We advocate loudly for our most marginalized patients, including those who are transgender, those with limited English proficiency, those with disabilities and, of course, people of color. It is in that spirit we issued a

Overdose & Harm Reduction in the Time of COVID-19

Long before the COVID-19 pandemic, the United States faced an epidemic of drug overdose, topping half a million deaths over the last decade. COVID-19—both the virus itself and some of the strategies and policies implemented in response to ...

COVID-19 and the Social Determinants of Health

The COVID-19 crisis continues to expose deep vulnerabilities in the U.S. healthcare system—from the dearth of personal protective equipment to the lack of surge capacity to fragile hospital financials. And yet many of the most concerning issues laid bare are ones that originate outside the system. Some have called this coronavirus the “great equalizer,” as all of us—in every corner of the country—are at risk. But although pathogens might not discriminate, our society certainly does. And with each passing day, patterns in COVID-19 morbidity and mortality are revealing the ...