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.

A Model for Managing Outpatient COVID-19

On March 18, 2020, Cambridge Health Alliance (CHA) opened its COVID-19 outpatient clinic (now referred to as the acute care clinic), with the goal to triage and provide care for patients with respiratory symptoms, ultimately reducing strain on our local emergency departments. CHA is an academic community healthcare system based in the Boston area and serves ...

Here’s Why Mental Healthcare Is So Unaffordable & How COVID-19 Might Help Change This

If you ask a patient to describe their experience finding a therapist or psychiatrist in the community, don’t be surprised if ‘expensive,’ ‘difficult,’ and ‘discouraging’ are some of the first words that come to mind. The decades-long separation of mental healthcare from physical health has left patients and clinicians alike with serious challenges navigating options for care. And the cost has been much more than just inconvenience—our poorly integrated system is responsible for

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 ...

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:

Precision Medicine & the Pivotal Role of Primary Care to Shape the Future of Healthcare

"My dear, here we must run as fast as we can, just to stay in place. And if you wish to go anywhere, you must run twice as fast as that." - Lewis Carroll, Alice in Wonderland This is the only quote which I clearly recall from my early childhood, and it took me several years to fully understand its meaning. It is truly universally applicable, and physicians are not exempt—I believe most of us are undeniably permanently running at least twice as fast, attempting to contribute to the (r)evolution of medicine, and also not lag behind. ...

Racial and Ethnic Disparities in COVID-19 Mortality Among Children and Teens

Due to early misconceptions that COVID-19 didn’t lead to severe disease or death in children, US state surveillance dashboards were not set up to track the course of the pandemic among age-specific groups. Over time, state reporting for children has gradually improved, and The COVKID Project has been synthesizing and sharing data for children and teens since late April 2020. Although 49 of 50 states now report COVID-19 case counts by age (with New York being the exception), only 2 ...
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