Progress Notes features doctors and medical students across the country on the frontlines of our health care system. Our views and experiences are diverse, but we share common goals and values. We speak up to move toward a future where everyone can have access to affordable, high-quality health care. Please share our posts, and follow us on Facebook and Twitter!
When it comes to addressing gun violence, doctors and medical students have proven ourselves to be one of the most effective messengers.
Together, we have made national and international news to raise awareness for the 20-year ban on gun violence research at the Centers for Disease Control and Prevention (CDC). We’ve led over 100 of the Nation’s leading medical and public health groups -- including the American Medical Association-- to support ending the effective ban on gun violence research. Our voices are having a tremendous impact.
In order to keep up this important work we must chip in more than our time. We need to raise funds to keep fighting to reduce gun violence and make our communities safer. Without your generous donation, Doctors for America won't be around to fight these important battles.
As doctors, we know the long-lasting devastation that comes with gun violence, with 91 Americans who die each day and the 108 who are injured. It is so important for us to keep speaking up. There has never been a better time to maximize your donation. Please consider giving today.
Nina Agrawal, MD and David Berman, DO
Co-Leaders of the DFA Gun Violence Prevention Campaign
It’s that time of year again.
Today, we’re kicking off our Spring Membership Drive.
Over the next week and a half you will hear from us about our victories together, the work ahead and what is required to continue to fund this movement with the same independent approach to advocacy that has allowed Doctors for America to mobilize thousands of physicians and medical students to improve the health and lives of our patients for the last seven years.
In that time, you have helped us prove the power of the collective physician voice in making change for our patients in matters of public health. From the confirmation of our past President and co-founder Surgeon General Vivek Murthy, to our success in helping to pass the Affordable Care Act, to standing up for Flint, and raising awareness for the nearly 20-year effective ban on CDC gun research.
Doctors for America depends on individuals like you for the majority of our funding. The future of our work together will only be limited only by the scope of our commitment. And, that includes the financial commitment of our membership in seeing the tremendous work of this organization continue in the years ahead.
Please consider joining myself and your colleagues in supporting Doctors for America today.
Mona Mangat, MD
Doctors for America, Chair
As physicians and medical students, we know all too well that the price of prescription drugs affects the health of our patients. High prices for prescription drugs prevent many of our patients from accessing the treatments that they need, forcing many to choose between medications and rent as out of pocket costs grow.
However, what is most frustrating is this: any time a common-sense proposal to address drug prices is put forward, powerful interests mobilize to quickly quash it.
This is happening now with a new proposal. The Centers for Medicare & Medicaid Services is proposing a set of 6 pilot projects aimed at testing possible reforms to how prescription drugs are reimbursed and the “value” of a drug is measured under Medicare Part B. These reforms are sensible approaches that deserve to be piloted and compared, as it is only through their testing that we can make an educated choice about which reforms will be most effective for our healthcare system – especially our patients.
However, political interests are rallying against them, and a battle is brewing.
Your voices – and those of your patients - need to be heard! CMS is seeking public comment on the proposed reforms, and YOU can submit a comment to support them and counteract those with financial interests in fighting these reforms. The deadline for submitting comments is May 9th.
Below is sample language to get you started. Feel free to modify with your own perspective and stories about how drug prices have affected your patients. If you are willing, please also EMAIL your comment to Justin Lowenthal (justin.lowenthal@
As always, if you have any questions or ideas, or if you have further thoughts in agreement OR disagreement on this issue, please email one of us and make your voice heard!
Always fighting to make care affordable for our patients,
Justin Lowenthal, MD/PhD student
Bruce Rector, MD
Mark Rood, MD
Dennis Deruelle, MD
Co-leaders of the DFA Drug Pricing/Value Campaign
“As a PHYSICIAN/MEDICAL STUDENT advocating on behalf of the patients I see every day, , I support the proposal by the CMS to test a sensible set of models aimed at changing how CMS pays for medications under Medicare Part B. High drug prices affect all types of patients: those needing chemotherapy, drugs for cardiovascular disease, treatments for autoimmune diseases, even antibiotics for life-threatening
No matter whether a primary care physician in family practice or subspecialist oncologist, each of us sees the effects of this problem daily. We know that drug prices are too high to be sustainable for our healthcare system and are alarmed by frequent, often exorbitant price increases. As a (INSERT DESCRIPTION – PRIMARY CARE PHYSICIAN, ONCOLOGIST, DOCTOR-IN-TRAINING
I think the approach that CMS is taking – to test a set of alternative payment models and other proposed reforms to better reward the value of a prescription drug – is a laudable and common-sense approach. It is only through this testing of pilot reforms that we will be able to choose the best option for our health care system and our patients moving forward.
I urge CMS to resist pressure from political interests on Capitol Hill and to move forward with this proposed set of reforms. In doing so, you will have my full support, and that of Doctors for America.”
We have some huge news.
Doctors for America members spoke up by the thousands to make a national issue of the effective ban preventing the Centers for Disease Control and Prevention from conducting gun violence research. And, today, the Nation's leading voices have signaled they have heard your calls.
Over 100 medical and public health groups, including the American Medical Association andAmerican Public Health Association, representing more than 1 million health professionals across the country have joined with members of the scientific community and research universities to urge Congress to end the ban on gun violence research and to fund this critical work at the CDC.
These calls echo the requests from 17 Senators and 53 members of Congress who recently urged for dedicated funds for the CDC to conduct research into the causes and prevention of gun violence.
Doctors and medical students know federal research has tackled some of our Nation’s most pressing public health challenges. We believe gun violence must be next.
Help spread the word by sharing this major development today!
We won’t stop fighting to #EndTheBan. Thanks for standing with us.
This is part of a new blog series sharing goings on in the Nation’s Capitol with doctors, medical students, and interested parties around the country.
Today, Doctors for America was invited to the White House to attend a forum on climate change and its current and future impacts on health. It coincided with their release of a new report, "Impacts of Climate Change on Human Health in the United States: A Scientific Assessment."
The event was an eye-opener even for me, an environmentalist since the fifth grade when I first learned about the impacts we were having on the planet and our responsibility to be better stewards of it for future generations.
What I learned today was climate change is not only about polar bears and national parks, it’s about people getting sick and dying . . . not in thirty years, but today. And particularly the most vulnerable people that Doctors for America has been working to help every day.
The event was opened by Robert Simon and John Holdren from the White House Office of Science and Technology Policy and Gina McCarthy, EPA administrator -- framing the launch of this groundbreaking report that for the first time draws very specific connections between climate change and many many health impacts.
The first panel was expert scientists largely from the National Oceanic and Atmospheric Administration. They highlighted a few of the important findings from their scientific modeling:
Extreme weather events will increase and disproportionately impact the most vulnerable. As they said this, I recalled the NICU babies at NYU being transferred out of a powerless hospital during Superstorm Sandy. I remembered standing outside the fenced off Charity Hospital in New Orleans in 2010 years after it was shut down by Katrina. I thought about patients being unable to get their medications, go to dialysis, or have enough food to prevent a diabetic patient from getting hypoglycemic.
More floods mean more food-borne illnesses. They also mean more mold, which means worse asthma especially for those who can’t afford to remove the mold.
Heat will kill more people than will be saved by warmer winters. Fewer people will freeze, but many more people will die from heat in the summer. I started picturing my frailest poorest patients home alone getting hotter and hotter, more and more dehydrated, and finally succumbing. It's hard to imagine in our climate controlled hospitals, but this is reality for people who cannot afford to have air conditioners in their homes..
Vector-borne diseases. Lyme disease will move northward and start earlier in the year. We will see more varied tropical disease showing up in the U.S.
Shell-fish and vibrio. More shellfish will be exposed to vibrio, so more people will get sick.
Mental health. Anything that impacts your health and the health of people you care about will impact your mental health. Extreme weather events exacerbate PTSD, depression, anxiety. 44 million people a year have mental illness.
Human impact on the planet is making survival of the fittest hardest for the very old and very young, the sick, the poor. Our most vulnerable patients. The ones we try hardest to protect.
It turns out that climate change makes social determinants of health even worse for everyone but especially those who have the least..
Now what can we do about this all? How do we both address the root causes of climate change and help our patients and communities be more resilient in the face of a changing planet?
For a high level view on this question, we heard from Senator Ed Markey of Massachusetts. He was pretty pleased with the all-star Massachusetts team working on this - EPA Administrator Gina McCarthy,Surgeon General Vivek Murthy, Director of the White House Office of Science and Technology Policy John Holdren, and Secretary of State John Kerry.
He emphasized that today's report shows that climate change impact on health is much worse than we thought. A sick planet will impact the health of people.
Senator Markey is now working on legislation to fund programs to train medical and public health professionals, fund research, and come up with a comprehensive plan. We have to come up with a treatment plan for the planet, he said. We need clean energy, low-energy vehicles, and shared solutions and political will with the rest of the planet. The political climate is contentious, but we have to look back on this time and know that we tried.
The next panel was moderated by Linda Birnbaum of the National Institute of Environment Health Science and included non-government leaders from the American Lung Association, the Center for Public Service Communications, the George Washington University Milken Institute School of Public Health, and the Maryland Department of Health and Mental Hygiene.
Here are some key notes on what we can do with the new report and what is already happening:
Use data to help parents understand impacts of air pollution: A panelist shared a story of a mom of three kids with severe asthma. She was at her wits end, until her doctor told her to move away from the polluted air. They picked up their lives and moved to another state. Today, the kids are thriving, playing soccer, even playing the saxophone at Carnegie Hall. Not every family has resources to do that, but knowledge helped this family.
What can health care providers do? Health care providers need to be educated. They can educate others and urge policymakers to reduce climate change and fund research so we know how best to address the health impacts. The panelists also gave a shout out to many hospitals that are working hard to reduce their footprint through the Healthy Hospitals Initiative.
What should health professional and public health schools do? Educate students on the facts and how to apply it, conduct research on how to prepare communities and model policy options, work with communities around them.
What should departments of public health do? Everything in public health is impacted by environment. Engage with the true front lines in communities with the information in this report, like working with forecasters to help with reduce heat problems in public workers.
How to reach communities like indigenous communities and other minorities? Need to make the information relatable to minorities and underserved communities. Nurture and mentor leaders from within the community. Need to incorporate the needs, voices, cultures, and languages of urban and rural minorities.
Teaching climate literacy in middle and high school. This must be done to help people be better prepared for civic participation on what's happening and spark interest in STEM fields.
How do we balance mitigating and adapting to climate change? What’s the bottom line?
It's critical for people to know effects are happening right now.
It's not only polar bears - it's clean air to breathe, not being flooded, avoiding disease.
It's clear we have to mitigate worsening climate change and adapt to what’s already happened.
After the panel, the closing speaker was Doctors for America's former president and co-founder, our nation’s 19th Surgeon General Vivek Murthy! He shared stories of caring for patients with respiratory illnesses -- and that so many of our patients say that being unable to breathe is the scariest thing to experience. We have an opportunity to prevent that from happening. He also shared inspiring words about the urgency of acting now, about our American values of being responsible for one another, and of our capacity to face this challenge and overcome it.
Doctors for America has not yet as a movement spoken up about climate change because it felt less directly relevant to a physician’s experience than a patient having no health insurance. But today’s event and this new report have definitely opened my eyes to the urgency of doctors getting educated and speaking up about the impact of climate right now on the health and lives of our patients.
Today is National Doctors Day -- a moment in the hustle bustle of life to say thank you for being a doctor or doctor-in-training. For those friends-of-doctors who receive our emails, I hope you'll indulge a moment of self-reflection on this day.
The Doctors for America Drug Price & Value Campaign team leaders Dennis Deruelle, Justin Lowenthal, Bruce Rector, and Mark Rood are actively working to inform, encourage, and empower physicians to join discussions on healthcare value and pharmaceutical prices. We are at a critical moment in discussions about reforming our system of pricing drugs, as is evident by heavy media coverage and the surfeit of politicians proposing initiatives to address high drug costs. The US has long had a problem with the rising costs of drugs and the unaffordability of prescriptions to our patients as well as the healthcare system as a whole. We plan to lead the push for solutions in order to foster a health care system that leads in innovation while also delivering medicines that are both affordable and effective. There are many innovative proposals on the table and moving forward will require the perspectives of all stakeholders. We must ensure that the perspective of physicians are included at the table so that we can advocate on behalf of our patients and for the good of the health care system that serves them.
Our team leaders have been actively participating in national and local meetings on drug prices to learn more about possible solutions, to provide the DFA provider perspective on initiatives, and to focus the debate on our patients needs. Among these high levels meetings are the HHS Pharmaceutical Forum (Bruce), Academy Health National Health Policy Conference (Mark), Center for American Progress Stakeholder Roundtable on Drug Costs (Bruce), John Hopkins Symposium on Prescription Drug Pricing: New Solutions (Justin), and alternative payment reform discussions (Dennis). As part of these, we want to get our membership involved! We will be holding educational events, providing resources, delivering breaking news updates about recent price increases, cataloging legislative initiatives relevant to local DFA chapters, and developing tools for our members to use in their communities when discussing drug prices and their value for our patients and health care system. We also plan to survey the DFA membership to learn more about their particular views, including stories of how drug prices have affected patients they care for and particular policy issues about which they are most passionate. Please contact one of us to get additional information and to become involved! We welcome any and all input, as there is much that we can be doing. Check back here on the blog for additional information on our campaign.
Bruce Rector is the New York State Director.
Dr. Manisha Sharma and I represented Doctors for America at a “Stop the Sham” rally on the steps of the US Supreme Court March 2, joining thousands of other supporters of women’s access to safe and legal abortion care, on a very cold and windy day.
The 8 Justices were hearing oral arguments in one of the most significant abortion case in decades, Whole Woman’s Health v. Hellerstedt. Abortion providers in Texas, led by Whole Woman’s Health, have challenged Texas HB2, a law that forces abortion clinics to meet the standards of hospital-style surgery centers and requires providers to obtain admitting privileges at a nearby hospital. These TRAP (Targeted Regulation of Abortion Providers) laws are shams, designed to shut clinics down while pretending to make clinics safe. Much riskier procedures, such as colonoscopies, are never the targets of these types of laws. Already, with the law partially in place, about half of the more than 40 abortion clinics in Texas have closed. If the law comes into full effect, the Texas, a state with a population of 27 million, could be left with just nine or 10 clinics.
A small group of anti-abortion protesters was present, but the huge crowd supporting women vastly outnumbered them. We heard from numerous speakers, including Dr. Bhavik Kumar (a friend of Manisha and Texas abortion provider), Representative Jan Schakowsky, and Dr. Willie Parker (an abortion doctor in Mississippi). Stephanie Toti, the lawyer from the Center for Reproductive Rights, spoke to the crowd after she argued the case in front of the Supreme Court.
Dr. Katherine Scheirman is a retired internist and US Air Force Colonel who resides in New York.
On Saturday, March 12th, The Health Department’s Center for Health Equity was joined by the Icahn School of Medicine at Mount Sinai (ISMMS), the Institute for Family Health, Doctors for America-NY, White Coats for Black Lives, CUNY School of Public Health and several other organizations to co-host a day-long, action-oriented forum, “Dismantling Racism in the NYC Health System –The Time is Now.” The event marked a historic day for the health community in New York City.
Racial and ethnic disparities in healthcare exist and because they are associated with worse outcomes in many cases, are unacceptable. Having grown up in a community that was either neglected or targeted, I was often skeptical about all the talking we learned to do as medical professionals. After seeing injustice and oppression, I knew that we needed more doers and fewer talkers. I went into my third year of medical school with my eyes open. I witnessed and then became part of many patient stories. It didn't take long to realize that institutional racism, structural violence and segregated care are alive and kicking, and that our own unconscious and conscious biases must be acknowledged and combated. We cannot perpetuate the seemingly endless cycle of oppression and, if we are to be the voice of those who are so often ignored or unheard, we must find our own voice. Obviously, in the world we are hoping to live in, we will learn to listen to those being ignored and not just become their voice.
I have been involved in a number of social justice initiatives in East Harlem, West Harlem, and the Indo-Caribbean community in Queens, NY, and have been privileged to work with fellow student leaders, community organizers, academic medicine leadership, social workers, teachers, local government officials, public health advocates, faith-based leaders and so many more inspiring individuals in various realms. I was fortunate to join the Doctors for America NY state leadership team in my third year of medical school. In this leadership position, I wanted to work with others to spearhead the formation of a citywide coalition that would have a unified voice on institutional racism. Doctors for America has been instrumental in raising awareness and action on social justice issues, including institutional racism. At the Doctors for America National Leadership Conference in November 2015, key leaders including Dr. Aletha Maybank, Deray McKesson and Jamar Brown spoke candidly on racism in health, and a true dialogue was started in the health community.
I was very familiar with the many dedicated people who were working tirelessly to undo racism in NYC – from student activists at Mount Sinai and other NY schools to faculty members at academic medical centers to community leaders advocating on a daily basis for basic human rights for all. I felt that too many people were doing extraordinary, emotionally and physically exhausting, herculean work in isolated silos. So, with lots of idealism and hope, our Doctors for America-NY team attempted to bring various stakeholders together.
On November 18th, 2015, representatives from a number of NYC institutions and organizations were able to sit together and make a commitment to dismantle institutional racism within the NYC health system. Over the past several months, we have met frequently to continue conversations and strategize for our upcoming work together. It is clear that individuals are ready to remove themselves from silos and unite their voices and hearts to combat racism. The citywide forum that we planned together was just the starting point of what promises to be sustainable, meaningful and collaborative work. We are so grateful that this work is supported by the NYC Department of Health under the leadership of both Dr. Aletha Maybank and our Commissioner of Health, Dr. Mary T. Bassett.
It has taken over 500 years to construct racism as a dominant, prevailing narrative - one that leads to inequities in health that are unfair and avoidable. It will take all of us to undo racism. This shared vision is larger than any one person, institution or organization.
We have created working groups in an effort to capitalize on the expertise of those in our coalition working in these areas, have smaller teams with actionable goals and commit to tackling a number of important issues at the same time. Creating a sustainable coalition of doers with a shared goal and united voice is our top priority. The forum was successful in setting the stage and bringing light to key areas within the realm of racism. The working groups are: Education & Curriculum Development, Health Policy & Legislation, Research, Access to Care, Representation in the Health Field, Intersectionality, Narrative Healing and Community Engagement & Advocacy.
Members of the coalition include: Center for Multicultural & Community Affairs, Icahn School of Medicine at Mount Sinai, Medical Education Department, Icahn School of Medicine at Mount Sinai, Committee of Interns and Residents / SEIU Healthcare, Department of Family & Social Medicine, Montefiore-Einstein, Doctors Council, Doctors for America-NY, Institute for Family Health, Latino Medical Students Organization, National Medical Association, Empire State Medical Association, Manhattan Central Medical Society, National Physicians Alliance-NY, New York City Department of Health’s Center for Health Equity, Physicians for a National Health Program – NY Metro Chapter, Student National Medical Association, White Coats for Black Lives, the Doctors Council, The National Medical Association, People’s Institute of Survival and Beyond-NY, SEIU, and Commission on the Public's Health System (CPHS). You can view the NYC DOHMH press release here.
If you are interested in getting involved or holding a similar forum in your area, please contact email@example.com.
Read on for an overview of the content of the forum:
Raising Awareness and Getting on the Same Page
Associate Commissioner of the NYC Department of Health and Director of the Center for Health Equity, Dr. Aletha Maybank, and Chair of SEIU Healthcare, Dr. Toni Lewis, chaired the program. Kamini Doobay, fourth year medical student at ISMMS and DFA-NY co-leader, shared the story behind the formation of the coalition and gave an overview of its goals and objectives. Dr. Ayman A.E. El-Mohandes, internationally renowned public health leader and Dean of the CUNY School of Public Health, welcomed participants to the CUNY Graduate Center and urged participants to fully engage and experience the energy and passion in the room: “Something is about to happen.”
NYC Health Commissioner Mary T. Bassett delivered the first keynote presentation on “Race, Racism and Public Health.” She delved deep into NYC’s racialized pattern of health, referencing studies she published in 1986 and beyond. Commissioner Bassett dismissed claims that lifestyle choices allow for widely disparate outcomes.
"I don’t think anyone decides, 'I want to live in a neighborhood with really bad housing, or poor air quality,'” she said. “Nobody says, 'I really prefer a neighborhood where there is only fast food available.' ... These are not personal choices. These are a lack of choice.”
In addition to substantiating her claims with past and current data, Dr. Bassett told provocative, emotionally stirring stories from her childhood and her days working in the Black Panther Party’s free medical clinic in Boston. Her presentation was compelling, informative and awe-inspiring.
Dr. Neil Calman, Chair of Mount Sinai’s Department of Family Medicine and Community Health and CEO of Instiute for Family Health, then delivered a talk on medical apartheid in NYC hospitals.
"We don't have signs that say 'colored' anymore, but we've found more subtle ways to create racism in our health care system,” he stated. He showed data that revealed that the US population whitens with age due to the premature death of people of color.
Dr. Calman also reported that enormous profits are being made by some of the institutions in NYC with the lowest numbers of uninsured patients and those on Medicaid. He proposed a “tax” on those profits to help to subsidize the care for the uninsured and those on Medicaid whose care is being provided largely by the public hospital system. A long time advocate for eliminating racial and ethnic disparities in the health care and health outcomes, he is known for his truth-telling and this forum was no exception. He was bold, transparent and moving.
Next up was an abbreviated form of the People’s Institute for Survival and Beyond’s Undoing Racism Workshop (URW). With an interactive workshop, Diana Dunn, Milta Vega-Cardona, Candida Brooks-Harrison and Christiana Best, challenged participants to analyze structures of power and privilege that hinder equity within the health system. They provided history that allowed us to understand how racism was consciously and systematically erected, and how it can be dismantled if people understand what it is, how it functions and why it is perpetuated.
After the URW, emotions and energy were high. Participants formed smaller groups and reflected on what they were thinking and feeling after the morning’s sessions. Together, they explored their emotions and continued to create a safe space to engage and strategize.
Translating Awareness into Action
How do we use our knowledge to create action? That was the theme of the afternoon.
Dr. Camara P. Jones, President of the American Public Health Association and Senior Fellow at the Satcher Health Leadership Institute and the Cardiovascular Research Institute, Morehouse School of Medicine, delivered the second keynote presentation on, “Achieving Health Equity: Tools for a National Campaign against Racism.” Her talk rejuvenated the spirits of everyone in the room and served as a call to action.
Dr. Jones’ lifelong passion has been naming and addressing the impacts of racism on the health of our nation, and she has developed allegories that enable us to understand the many layers and nuances of institutionalized, personally-mediated and internalized racism. She shared her allegory, “A Gardener's Tale,” in the jam-packed room filled with participants who were in awe of her passion, brilliance and vision.
The strategy and action panel was next up. In addition to collectively raising awareness of how racism affects health, the forum was the official kickoff of the coalition’s working groups. Leaders in the fields of each of the working group areas were invited to speak on work they have done and what they envision as actionable goals for the working groups. The following speakers were dynamic, engaging, and informative:
Education and Curriculum Development: Sharon Washington , Ed.D., MPH
Health Policy and Legislation: Assembly Member Richard Gottfried
Access to Care: Neil Calman, MD
Community Engagement: Anthony Feliciano
Research: B. Cameron Webb, MD, JD
Intersectionality: Elizabeth Lorde-Rollins, MD, MSc
Narrative Healing: Alan Pean & Adjoa Duker, MD, MPH
Representation in the Health Field: Adam Aponte, MD
Kamini Doobay then delivered concluding remarks. She urged participants to commit to undoing racism in the health system together. “There is so much energy, passion and fire in this room. This shared goal is larger than any one of us, and now is the time for us to join together and have a unified voice – for the sake of our patients, communities, society and generations to come.” She ended with proposed next steps.
We thank our champion sponsors, the Department of Medical Education at Icahn School of Medicine at Mt. Sinai, NYC DOHMH’s Center for Health Equity, and the CUNY Graduate School of Public Health, and all of the other sponsoring organizations.
Kamini Doobay is a medical student co-leader of DFA-NY, who facilitated the formation of the coalition and is the liaison between member organizations.