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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!


Blogs from DC: Climate Change and Health at the White House

By Dr. Alice Chen
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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.
      IMG_5112[1].JPG 

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.

Read the report at health2016.globalchange.gov, share it with your friends, and let us know your ideas for what we can do by emailing DFAHQ@drsforamerica.org.

 

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A special thank you on National Doctors Day

By Dr. Alice Chen
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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.
 
I am reminded today of a weekend way back in February 2009 when Doctors for America sent out our first petition -- supporting health care investments in the stimulus package. In that early effort, we collected signatures by email and entered them one by one into a spreadsheet. We heard from hundreds of doctors and medical students. Emails poured in from states and cities I had never been to, but the sentiment was the same -- across the country, doctors and medical students wanted better for our patients and for the practice of medicine, and they wanted it so much they were publicly standing up for it. I particularly remember hearing from a 90-year-old retired rheumatologist who wrote, "I have waited my whole life for health reform to happen. I can't travel anymore, but I want to be a part of this movement."
 
What I love about working with all of you at Doctors for America is the extraordinary diversity of people who share a common generosity of spirit and compassion toward the suffering of our patients and complete strangers.  Some of you are retired after a long career of touching thousands of lives. Some of you are in medical school just learning how to care for people. Some of you see patients in a rural private practice or a large academic hospital. Some of you are world-expert subspecialty surgeons and others are family practice doctors who see it all. In clinics, hospitals, medical school classrooms, public health departments, government agencies, research labs and institutions, the public and private sector, you are making difference in the health and lives of people around you. 
 
Each of you in your own way has made sacrifices to be a physician or physician-to-be. You have spent birthdays and holidays at a patient's side.  You have sat at home after a long day still worried about that one patient. You have clinched that diagnosis with all the art and science of medicine you could muster. You have stood up for your patients when a baffling medical bureaucracy has threatened to hurt them. You have shared sorrows and joys with patients and their families.  
 
Above and beyond that, at some point you chose to be a part of the Doctors for America movement. You chose to join hands with colleagues across the country to take that extra step -- to sign a petition, respond to a survey attend a call with a policy expert, ride along with a bus tour, show up in a white coat at a rally, write to your members of Congress or your local paper, meet fellow Doctors for America members at a national conference, educate the people around you. Your individual efforts big and small have added up to a movement that is transforming the profession of medicine and the health of the nation.
 
Today, we say thank you for all you do as physicians, advocates, citizens. In the midst of news cycles filled with political strife and divisiveness, it is this movement that gives me hope. Colleagues in all 50 states who believe that everyone -- no matter who you are, where you're from, or the color of your skin -- deserves to have the greatest health possible so they can live their lives and follow their dreams.
 
From the bottom of my heart, thank you. May you have a beautiful day today and take a moment to thank yourself and your colleagues in your service to humanity.  

 

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Update from the Drug Pricing Working Group

By Bruce Rector
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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.

 

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Rally to Protect Abortion Access

By Dr. Katherine Scheirman
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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.

 

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Dismantling Racism in the Health System: The Time is Now, an Action-Oriented Forum

By Kamini Doobay
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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 info@drsforamerica.org.

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.

 

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Update on Medicaid expansion in LA

By Heidi Sinclair, MD, MPH
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In 2008 Governor Jindal had proposed his own “Louisiana Health First” Medicaid expansion program.  Four years later however, he had reversed course and, along with most other “Red State” Governors, was standing opposed to Medicaid expansion in Louisiana,

While the Affordable Care Act has provided many benefits beyond extending coverage to the poor through Medicaid expansion, most of the patients and families that I see and work with, live at or below the Federal Poverty Level, and therefore have been unable to obtain coverage through the ACA marketplace or exchanges.  Meanwhile, unlike some states that already extend Medicaid benefits to adults up to 133% of Federal Poverty Level, the working poor in Louisiana are generally not eligible for Medicaid at all, leaving hundreds of thousands uninsured.

The Legislative session in Louisiana is short - only from March or April until first week of June. I attended my first legislative Health and Welfare Committee Hearing in Spring of 2013.  Like most Americans, I didn’t know that these legislative committee hearings are open to the public!  Citizens are invited to fill out cards pro or con on bills being presented to be voted on during each hearing.  These cards are counted and comments included are often read into the record.  There are usually members of the public or government officials scheduled in advance to speak on the issue before the committee, but anyone present can also, on their submitted card, request to speak. I was not prepared or planning to speak that first day but I was asked to, and did. I have since been invited to present in favor of Medicaid Expansion, among other things, at other House and Senate Committee Hearings.

I joined the Campaign for Healthcare for Everyone Louisiana on meeting the Campaign Organizer, Alma Stewart, at that first legislative hearing.  There are over forty local or state-wide organizations that are endorsed members of this campaign and over one hundred organizations and five hundred individual signed on to HCEL’s initial 2013 public letter to Governor Jindal asking him to support of Medicaid Expansion. In addition to letter’s to editors and op-eds penned by members of HCEL and others, there has been editorial support for Medicaid Expansion from all of the major local newspapers. HCEL set up separate committees to focus on legislative matters, media, education and grass-roots organizing which I think has been effective in providing a “multi-pronged” approach.  As it became clear Medicaid expansion was not going to happen in 2013, HCEL developed a longer-range, eighteen month plan, with focus on making Medicaid expansion and important issue for the Gubernatorial election of 2015.  Meanwhile, HCEL continued to partner and network with other groups working in support of Medicaid expansion, meeting with legislators, promoting letter writing campaigns, organizing or participating in press conferences or interviews on radio or TV, organizing or participating in rallies and “Dying for Coverage” candlelight vigils at the capital, visiting churches, health fairs and enrollment events, etc.  In the Fall of 2014, in coordination with the American Public Health Association’s annual meeting in New Orleans, HCEL organized a Day of Action in support of Medicaid expansion and both Alma Stewart and I were invited to present at the conference as well.

Each legislative session, more and more regular people from all over the state were coming to Senate and House committee hearings to show their support for Medicaid Expansion.  The last hearing I attended required two additional over-flow rooms to accommodate everyone!

In 2015, in coordination with Dillard University, New Orleans, HCEL organized a televised Gubernatorial Candidate Forum on Healthcare in Louisiana.  Despite the legislature’s continued refusal to advance any bills in support of Medicaid expansion in Louisiana, all three Gubernatorial candidates had expressed at least willingness to consider some version.  Representative John Bel Edwards was the only candidate, however, to make Medicaid Expansion a corner-stone of his campaign. I believe Governor Edwards’ strong support for Medicaid expansion played an important role in his election and the Governor was true to his word, signing in support of Medicaid Expansion his first day in office!

Beyond HCEL, I have also been networking with Tulane students and residents who are part of Tulane University School of Medicine’s Advocacy Track as well as other physician-advocate friends and, following the lead of Tulane resident, Sarah Candler, have been involved in efforts to revive the Louisiana Chapter of the American College of Physician’s Health and Public Policy committee.

Most recently, as State Director for Doctors for America in Louisiana, I was invited to participate in Louisiana Public Broadcasting’s Public Square program on Medicaid Expansion in Louisiana and was able to bring other DFA members to participate in the discussion as well.  Meanwhile. HCEL, in collaboration with Louisiana Public Health Institute and the Department of Health and Hospitals - Office of Public Health, has also organized a state-wide Health Summit which will be held in Baton Rouge this Tuesday, March 29th.

There is still a lot of work left to do!  Louisiana is struggling with an unprecedented budget crisis and some legislators have already filed bills to block or limit expansion, despite the obvious overall fiscal benefits to the state. Dr. Rebekah Gee, the new secretary of the Department of Health and Hospitals, is optimistic however, citing support even from many conservative legislators previously opposed.  Another important point to keep in mind, is that access to health insurance does not always translate into access to care.  While Rebekah Gee and others cite “new models” of care in development and while community clinics and even private hospitals are adding new primary care positions specifically for those newly insured under Medicaid expansion, a key to attracting and retaining providers will be ensuring adequate and reliable reimbursement.  Medicaid Pay Parity, which would put Medicaid reimbursement on par with Medicare reimbursement rates, has been discussed by DHH and was part of the recommendations of Governor Edwards’ newly created Healthcare Advisory Panel.

As a member of Doctors for America, I pledge to continue collaborating with dedicated community partners and fellow healthcare advocates in working towards a more equitable, healthier future for the people of Louisiana.

DFA Louisiana Dr.'s representing at filming of LPB Louisiana Public Square Jule Asserq, Heidi Sinclair and Sarah Candler (not pictured Dr. Christy Valentine)

Dr. Heidi Sinclair is the Louisiana State Director.


 

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The next big abortion case

By Dr. Katherine Scheirman
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Next week, the U.S. Supreme Court will hear an important case regarding abortion access with far reaching implications.

The Whole Woman’s Health v. Hellerstedt case challenges a restrictive Texas law, HB2, which was designed to prevent women from accessing their constitutional right to an abortion. This law puts the health and rights of millions of women at risk.

By requiring admitting privileges in a nearby hospital and imposing prohibitively expensive and unnecessary architectural modifications, ​clinics in Texas are closing. This places a huge burden on women, including military women and families, and severely restricts their access to this important Constitutional right. 

As doctors and medical students, we know playing politics with women's health isn't just wrong, it's dangerous. That’s why Doctors for America has signed onto an amicus brief urging the Court to strike down these medically unnecessary restrictions. But, we need your help to make the physician voice heard during the oral arguments.

Raise your voice and join us in telling the Court to strike down these requirements which harm, not help, women’s health.

Here’s what you can do:

1. Rally on the steps of the Supreme Court on March 2:

March 2, 2016, 8 AM – 12 PM at the U.S. Supreme Court, Washington, D.C.
RSVP HERE
(Please note: the form does provide an option to select a bus. While we are not organizing the buses, we are aware of the option for those traveling from NY, NJ, PA, OH, VA or NC).

2. Use this tool kit to take action in your community and online.

3. Join the conversation online at #StopTheSham:

Click here to add a Twibbon to your profile picture

Click here to join the Thunderclap.

 

Dr. Katherine Scheirman resides in New York and is a retired internist and US Air Force Colonel.



 

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Flint needs you

By Dr. Alice Chen
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The Flint water crisis is a health and human rights issue. We need you to make your voice heard to help the victims of this preventable tragedy.

Nutritious food, clean air and water, safe shelter and communities. These are the most basic things our patients need to be able to be healthy and pursue their dreams. Yet, elected officials hid the dangerous levels of lead in the water until a pediatrician sounded the alarm on unusually high lead levels in children.

It's time we follow this doctor's lead and signal the alarm with leaders in Congress.

Send a letter to Congress to make sure Flint gets clean water and access to health care.

Lead poisoning is well known to cause lifelong medical and psychiatric problems for children, sapping the potential of both individual lives and entire communities. Reductions in lead poisoning rates - often against opposition from very powerful interests - is one of the biggest public health triumphs of the past century. The fact that lead poisoning has been allowed to return with a vengeance in one of the nation's poorest communities is an unconscionable tragedy that must be addressed with the greatest urgency.

Call on Congress to make clean water a priority: Provide funds to replace the lead pipes in Flint so people can drink water without being afraid it will make them sick.  And make sure people in Flint get the health care they need.

We know that even as we write, more low-income communities beyond Flint are finding that their water is not as safe as they thought. That’s why it’s so important for doctors and medical students to stand up and speak up now.

 

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Doctors for America: Exciting Work in 2015, Big Plans for 2016


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2015 has been a big year for Doctors for America and the health of the nation. This week, we launch our end-of-year fundraising drive so we can keep going strong into 2016.  We have so much to celebrate. Here are a few highlights from the year:

King v. Burwell: Doctors for America was at the forefront of the monumental King v. Burwell Supreme Court case. We made headlines and made sure the case was understood as a matter of people’s health and lives – not politics.  The Court’s decision in favor of the ACA kept 6.4 million people from losing their ability to pay for health insurance.  

Medicaid Expansion: We kept the heat on state legislators and governors to expand Medicaid in a dozen states including Utah, Texas, Florida, Maine, and North Carolina.

Supporting Key Health Issues: Through the year, Doctors for America supported efforts to renew the Children’s Health Insurance Program, prevent the defunding of Planned Parenthood, address rising drug prices, and protect the nation’s investments in prevention and low-income nutrition programs.

Celebrating our Surgeon General: We celebrated in person or on Periscope the change of command ceremony for our nation’s 19th Surgeon General, our former president and co-founder Dr. Vivek Murthy.

National Leadership Conference: We had our most highly rated National Leadership Conference ever with engaging speakers on social determinants of health, food insecurity, remaining barriers to access, racial disparities, advocacy, and physician wellness.

CDC Gun Research Ban: We made national and international news when we demanded that that Congress end the ban on CDC and NIH gun violence research – just hours before another mass shooting in San Bernardino. Our #EndTheBan hashtag made over 3.2 million Twitter impressions in just 24 hours. We brought together 68 of the nation’s leading medical and public health organizations. And, both President Obama and House Minority Leader Nancy Pelosi spoke up on the issue.

In 2016, we have exciting opportunities to keep moving forward on improving the health of the nation.

As we continue to push on expanding Medicaid, we are hearing rumblings that a couple of states are getting ready to move. We will be right there to build momentum and make the case that expansion is good for people and good for states. We are also building a new campaign on Making the Most of Medicaid, which we will roll out in the early part of the year.

We are also opening a new focus on food insecurity, which affects one in seven of our patients - even though most of us don't know it. Hunger is a health issue that impacts the ability of our patients to be healthy and to keep their chronic conditions in check. Keep your eyes out for our new Food as Medicine initiative, and let us know if you have particular expertise in this area.

We will also work to build on our momentum to remove the CDC and NIH gun research restrictions.  Plus, we have opportunities to bring physician voices to the challenges of rising drug prices, national and international policies on curbing and treating substance abuse including opioids, Supreme Court cases challenging access to abortions and contraception, payment reform efforts, and the myriad other issues that affect the lives of our patients. Of course, with the change of administration on the horizon, we will also be watching carefully to make sure the concerns of doctors and our patients are at the forefront.

Through it all, we will build new avenues to recruit, train, and support physicians and medical students to be the best advocates they can be for their patients and for a healthier America. 

Thank you to all our members and supporters for making Doctors for America possible.  

One final note, we rely on individual donations for the majority of our budget. As we close one year and open a new one, we hope that everyone can contribute whatever we can to ensure that Doctors for America can keep fighting for the health of the nation.  

Please show your support for Doctors for America with a tax-deductible donation today.

 

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Happy Thanksgiving!

By Dr. Alice Chen
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On this Thanksgiving Day, we want to share a heartfelt thank you for being a part of the Doctors for America movement. 

Thank you for coming together by the thousands from all 50 states to fight for equitable, affordable health care for all. Together, we are creating an America where everyone has the opportunity to lead a healthy and fulfilling life.

We create change because you choose action over cynicism - reading an email to get informed, signing a petition, sharing a patient story, writing an op-ed, joining a webinar, putting up a flier, running a campaign.

It is because of your efforts that the uninsurance rate in America is below 10% for the first time ever. Over 17 million more people are insured than when we first began this movement. With your continued efforts, We will get more people signed up for coverage before the end of open enrollment on January 31. We will expand Medicaid in every state and keep working until every person is covered. We will improve affordability, availability, and quality of care. And we will shine a light on social determinants like hunger and gun violence that affect our patients every day.

Did you know that Doctors for America members do all this on top of caring for over 1 million patients a month? Thank you to primary care doctors, psychiatrists, surgeons, neurologists, hospitalists, ob-gyns, anesthesiologists, cardiologists, and doctors of every specialty. To rural and urban doctors for your commitment to underserved communities. To private practice owners and tertiary care academics for improving care in every setting.

A special note of appreciation to those who are on call this weekend - caring for patients, answering their worried questions, bringing warmth and light to the sick during the holidays.

Thank you to physician administrators, researchers, innovators, and policymakers who bring a much needed clinical voice to policies and programs. To those who have committed their lives to public service and the uniformed services. To deans and medical educators for training the next generation of physicians. To retirees who have paved the way for the rest of us. To medical students whose energy and enthusiasm carry all of us forward.

Thank you to those who have donated funds to sustain our movement. Your support has been essential, and we are grateful for you.

Some of you are not doctors or medical students, but you stand with Doctors for America as our supporters and colleagues. Thank you for working alongside us to build a more just and equitable future for the health of the nation.

And thank you to Doctors for America's board members, state directors, advisors, and national campaign leaders who volunteer their time to lead our movement and to our small but mighty staff who support all of us.

On behalf of the whole Doctors for America family, may you and yours have a very happy, safe, and wonderful Thanksgiving.

Warm Wishes,

Alice Chen, MD
Executive Director

 

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