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.

Abortion During the COVID-19 Pandemic

The 1973 Roe v. Wade United States (US) Supreme Court case resulted in the historic decision that the US Constitution protects a person’s liberty to choose to have an abortion in private consultation with one’s clinician. Since that time patients and medical providers have had to continue to fight for access to abortion throughout this country. In the years since Roe v. Wade, over 1,000 abortion ...

Contraception During the COVID-19 Pandemic

We know that many barriers to accessing safe, equitable, and effective contraception exist at individual, institutional, and societal levels. These include things such as lack of insurance, inability to get a timely appointment, difficulty taking time off from work or childcare, and required (but not evidence-based) pelvic exams or other pre-requisites. Unfortunately, the COVID-19 pandemic is heightening many of these existing ...

Reflections on COVID-19, the Climate Crisis, Environmental Justice and Health Equity

We are living in an unprecedented time in which an unimaginable global pandemic has upended our way of life. Our current public health crisis is the kind of dramatic disruption that worries many climate advocates as our planet continues to warm. Climate change has and will continue to increase the frequency of natural disasters, the spread of infectious diseases and displacement for people around the world. The United Nations has made clear in their Intergovernmental Panel on Climate Change 2018

Pediatric Health Amidst the COVID-19 Pandemic

While knowledge of COVID-19 transmission and its clinical manifestations is rapidly expanding, many questions remain unanswered regarding the effects of this pandemic on children. Research suggests that most children develop mild illness with COVID, and the development of severe disease is generally limited to infants and patients with pre-existing medical conditions (e.g. cardiovascular disease, chronic lung disease, immunosuppression). ...

Protecting Those Who Protect Us

Health care workers, including residents, have stepped into the breach of the COVID-19 pandemic, and they have done so at great personal cost. We know that ICU physicians, emergency room physicians, nurses, and nursing home health aides have died in unprecedented numbers. At least one surgical resident is known to have died from COVID-19, and it is likely there are others as well. We also know that caring for patients with COVID-19 creates fear and anxiety among health care workers, leading to both burnout and disability, and a demand for hazard pay. And we know that approximately

Experiencing Rural Family Medicine During the COVID-19 Pandemic

I arrived in Valdez, Alaska in mid-February as a visiting third year medical student and was quickly immersed in full-scope Family Medicine. I was learning in a myriad of settings: seeing patients in clinic for routine primary care, evaluating a trauma in the emergency room, assisting with vaginal and cesarean deliveries, and rounding on inpatients in the 11-bed critical access hospital. Six Family Medicine physicians provide comprehensive care here in a town of 4,000 residents, more than 300 road miles from the next hospital, in a census area where the population density is 0.3 persons ...

“Some New Kind of Infection or Plague:"  The 1918 Flu Pandemic & COVID-19

A humbling sense of medical uncertainty. Tensions between public health concerns versus economic consequences for shuttered businesses. Public recognition of heroic healthcare workers, especially nurses. Concern over the standards used to gauge therapeutic efficacy. Even homemade masks. Such tensions and tropes of course color our contemporary experience of the COVID-19 pandemic, but they likewise appeared throughout the 1918 influenza pandemic ...

Immigrant Health, COVID-19, and the Duty to Care

Three months ago, the novel coronavirus arrived in the Boston area. It struck first in wealthy communities of international business travelers and exchange students, then spread quickly to the low-income and immigrant neighborhoods of their housekeepers and personal care attendants. Fear in communities of privilege led to early characterizations of COVID-19 as a disease that doesn’t discriminate. But the disease’s case rate in Chelsea, MA (majority Latinx, poor and working-class) is now

In Times of Crisis, Family Medicine Rises to the Challenge

We are all looking forward to the day when COVID-19 no longer dominates the news cycle, nor our lives. The ongoing conversations about treatment, improving preparedness, and how we move forward are vital and must continue. However, I would like to make a quick aside to these discussions and share why I am grateful for my Family Medicine training. A crisis is not a common time for gratitude, and I admit that I have felt plenty of despair during this pandemic. All the same a recurring thought keeps coming to me that provides me with some comfort: “I was trained really, really well.” My ...