Veterans Day is a day to recognize and honor those who served in the Armed Forces. Retired Sergeant First Class Allen Barton spends each Veterans Day thinking about his time in service and remembering those he served with. Allen was enlisted in the U.S. Army on active duty and in the Army Reserve for 23… Read More »
Patient-provider racial/ethnic concordance (i.e., physician and patient identify as the same race/ethnicity) has emerged as one key suggestion for mitigating healthcare disparities. Past research has underlined its benefits, including improved infant mortality and more appropriate prescription regimens. However, the sum of the evidence remains unclear and many facets of the patient-provider relationship have yet to… Read More »
The need for youth activism and civic engagement in public health has never been greater. A mentor once said, “When public health is doing its thing, you will never hear a word about it.” But today, the profession doesn’t have that luxury. We must act if we want public health to remain a strong and… Read More »
As part of its partnership with the Patient-Centered Outcomes Research Institute (PCORI), Medical Care has published its first PCORI-sponsored article collection, which provides specific information about the costs that healthcare systems can expect to incur in promoting the uptake of specific evidence-based programs. In September’s special issue, five project teams that received Implementation Award funding from PCORI… Read More »
Ben King is joining our editorial team at The Medical Care Blog! Dr. King (he/him) is currently an Assistant Professor of Population Health at the new Tilman J Fertitta Family College of Medicine at the University of Houston. He has additional appointments in the Department of Behavioral and Social Sciences, with the UH-Humana Integrated Health… Read More »
What if there was a public health problem so big that even public health leaders were too enmeshed in its grip to be able to warn against its perils? I worry that we are in that very conundrum with regard to our relationship with technology. It has accelerated from being part of our world to… Read More »
To address calls for improving health equity, organizations could consider using CLAS Standards to advance diversity, equity, and inclusion (DEI). In recent years, health organization leaders have prioritized the need to address systemic inequities. A 2021 survey of health care organizations identified health equity as a top priority [pdf]. This focus has grown since the… Read More »
Patient experience surveys are a cornerstone of public reporting and pay-for-performance initiatives. Some healthcare providers, payers, and other stakeholders have expressed concerns about declining response rates and representativeness of these surveys [pdf], especially for underserved groups. Increasing response rates is an important goal. Several strategies have been proposed to increase response rates, including administering surveys… Read More »
It is more important than ever to expand access to a broad range of safe and effective contraceptives that includes long-acting reversible contraception (LARC) methods. We are living in a new era in the US. As of early November, 2022, abortions are banned from the point of conception in 12 states and severely restricted in… Read More »
The pursuit of health equity requires public health and medical professionals to become adept at policy in their health advocacy work. The American Public Health Association (APHA), in fact, defines policy work as one of its 10 essential public health services. APHA says professionals should be capable of “creating, championing and implementing policies, plans and laws”.… Read More »
Understanding internet access through a human rights framework has been a goal of human rights advocates for years. But COVID-19 has brought the idea of “broadband as a human right” to the forefront as a necessary and urgent human need. A recent study exploring the Social Determinants of Health and COVID-19 mortality, found that individuals without… Read More »
Last week, we detailed the findings of virtual convenings we held in North Carolina to improve care for children with complex health needs (CCHN). Here, we share our takeaways about the process of planning, holding and following-up on the convenings. We also outline the specific steps other leaders, innovators, and advocates can take to engage… Read More »
The COVID-19 pandemic has strained healthcare and public health. Many workers in these industries have felt growing frustration with leadership. They face a barrage of medical misinformation, ethical strains, and burnout. Now more than ever, authentic leadership is critical in supporting healthcare workers and advancing public health. This post will describe authentic leadership and examine… Read More »
The global Covid-19 pandemic came with financial, emotional, and physical health implications for just about everyone worldwide. Along with those burdens, a significant strain was placed on resources, people, and systems. Issues that were lingering just beneath the surface bubbled up, inequities became highlighted, and urgent outcries and demands for swift solutions became harder to… Read More »
White paper, grey literature, black box warning. The nature of our medical research, presentation, reporting, and publication has defined the values associated with colors. A white paper is defined as an “authoritative” report on a subject. Grey literature is described as being “non-conventional, fugitive, and sometimes ephemeral.” And a “black box” warning alerts physicians and… Read More »
Barriers to immigration into the United States are a common topic of political debates. Less frequently publicized are the numerous barriers to healthcare that undocumented immigrants (UIs) face even after their arrival. These obstacles can have profoundly negative effects: not just on the individual immigrants’ health, but on their local communities as a whole. Medical… Read More »
The World Health Organization (WHO) defines social determinants of health (SDOH) as the non-medical factors that influence health outcomes. They are the “conditions in which people are born, grow, work, live, and age.” Currently, SDOH is a hot topic as stakeholders try new ways to improve individual and population health, achieve health equity, and reduce… Read More »
COVID-19-related scams are spreading nearly as fast as COVID-19 and threatening the health and safety of our communities. Since January 2020, people across the country have filed over 426,000 COVID-19-related complaints to the Federal Trade Commission (FTC) about fraud, identify theft, and other consumer protection. They have reported losses totaling over $397 million. As trusted… Read More »
The pandemic has consistently exposed the underlying inequities and effects of systemic racism on American Indian (AI) and other marginalized communities. The health equity challenge of 2021 is around COVID-19 vaccine equity. Over the first months since the vaccine has become available, communities of color are not getting shots in the arm at the same… Read More »
Last week, we discussed three noteworthy trends from the past decade in treating the opioid crisis. The first was recognizing medication for opioid use disorder (MOUD) as the standard of care. The second was formalizing an addiction medicine specialty. And the third was expanding the availability of MOUD. This week, we’ll consider three additional trends in… Read More »
Historically, public health has served the nation through sanitation, immunization, and other disease-prevention activities (e.g., disease tracking and quarantine). For example, public health developed wastewater treatment programs to help fight typhoid fever during the industrial revolution. It also helped educate the public (and the food industry) on safely preparing and preserving foods. As a result,… Read More »
Our data says a lot about us – where we go, who we see, and what we do. And since our smartphones come with us everywhere, they are almost always collecting our data. To improve my understanding of how our data and devices can be used to fight the COVID-19 pandemic, I sat down with (over… Read More »
In our battle against COVID-19, one of our unique challenges is the use of face-coverings. Despite evidence that supports wearing face coverings, this has become a polarizing issue in a highly politically-divided climate. After shifting mask guidance in the early days of the pandemic, the WHO and the CDC issued formal guidelines on wearing face… Read More »
The COVID-19 pandemic has brought to light the gross underinvestment in public health, primary care, and the social determinants of health in the United States. Yet, this experience gives us a chance to rethink our health and social service systems, as these are often siloed. We see education, employment, healthcare, housing, and other social services… Read More »
With less than five weeks to go before welcoming a second child, the patient sat in my exam room in tears. By all accounts, this was a routine appointment at the end of a routine pregnancy. Except on this particular day, clutching family photos from their recent baby shower, the patient shared with me that… Read More »
We just wrapped up #SexEdForAll month in May, yet most people still believe sex education is just about sex. But it’s so much more than that! That’s why I created the Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators story map, in conjunction with the Robert Graham Center for Policy Studies in… Read More »
For decades, peer-reviewed journals have been a critical pathway for disseminating and advancing scientific knowledge. However, curbing the spread of misinformation requires evidence translation by experts into plain English. The rapidly evolving knowledge base on COVID-19 shines a spotlight on the issue. For example, a recent article in the New England Journal of Medicine offered… Read More »
Welcome to the final post in our series on patient portals – an attempt to imagine the future. Part 1 of this series summarized the latest data on who is using portals. Part 2 explained some of the barriers to use as well as what factors increase use. Evidence of Increased Patient Engagement and Other… Read More »
Do you recall the last time you did not have your morning cup of coffee or tea? Without it, you might be moody throughout the day and not get done what you intended. How about the last time you skipped lunch? Were you able to focus on your work with a rumbling stomach? Now imagine… Read More »
In Part 1 of this series, I summarized the latest data on who is accessing patient portals and for what purposes. In this post, I discuss the facilitators and barriers to patient portal use. General barriers to patient portal use Let’s start by discussing barriers to portal use. Patient portals have generally not been created to… Read More »
Providers’ portal usage rates have been high for some time. While many patients have access to a portal, routine use is less common. In this three-part series, we will explore several questions: Who is using portals? What are the factors that prevent or facilitate the optimal use of portals to engage patients in their care?… Read More »
As a sexual health educator at public high schools in Tennessee, teachers would consistently jump in as I approached the topic of contraception. Required by law, these teachers would “emphatically promote sexual risk avoidance through abstinence.” After this abrupt interruption, I would then proceed to talk about all forms of contraception, including abstinence. Students would… Read More »
I have been lucky enough in my career so far to visit communities around the United States to support public health efforts. While every community is different, one experience has remained the same: I am an outsider, and often a privileged one at that. Working across so many communities has given me a lot of… Read More »
Do you use social media? If so, how many social media platforms (e.g., Facebook, Twitter, Instagram, Pinterest, LinkedIn) are you a member of? With about 40% of the world’s population already on some form of online social media, even if you don’t use it, you’ve probably heard of it. Devoting several hours each day to… Read More »
If you have a question, how do you find the answer? Many of us do a quick Google search or search out the answer at a library. However, people with Autism Spectrum Disorder (ASD) and their families face many challenges and barriers when trying to locate information. A recent episode of the (highly recommended) podcast… Read More »
Patients are increasingly involved in shaping research in health care, especially since the advent of the federal Patient-Centered Outcomes Research Institute (PCORI). PCORI actively promotes the engagement of patients and other stakeholders (clinicians, caregivers, purchasers, etc.) in the research process. As we discussed in an earlier entry on this blog, research terminology alone can be a… Read More »
Engaging patients and families in their care has been a longstanding goal for quality improvement. Engaging patients and communities in research is an emerging field of work and collaboration, and a recent Medical Care article discusses some similarities and differences between engaging patients and communities. Why do we engage communities and patients in research? To create… Read More »
A relatively undiscussed and unconsidered form of discrimination continues to plague our health care institutions. It’s about time we talk about it. Insurance-based discrimination is the prejudicial treatment of a patient based on his/her insurance status. This type of discrimination mostly affects the 28.9 million Americans who have no health insurance coverage, although there is… Read More »
Are you happy with your healthcare provider? Most people are happy, even if they’re unhappy with the health care system as a whole. But if you’re unhappy with your doctor or your care, how likely are you to say so or search out a new healthcare provider? Visiting your doctor can be intimidating; so much so,… Read More »
In India, cardiovascular diseases (CVDs), specifically coronary heart disease and congestive heart failure, are leading causes of disability and death. The large projected population of patients with CVDs in the coming years poses one of the biggest threats to this fast developing nation’s future. The crushing magnitude of the problem is exacerbated in rural areas where… Read More »
“A graduate student was threatened with a lawsuit and retraction of a published paper unless she paid thousands of dollars and signed a retroactive license for having used a measure without paying the fee.” This example was one of the motivating factors for a recent Medical Care commentary by Dr. Ron Hays and colleagues. The commentary… Read More »
Ironically, many healthcare providers–doctors, nurses, physician and medical assistants–are not trained in “health” at all but in “medicine” instead. Often, as providers, our instinct is to first reach for a pill bottle or a procedure and forget about lifestyle changes that could be safer and more financially feasible for our patients. As the burden of… Read More »
In a graduate course this semester (at the Temple University College of Public Health) on Healthcare Quality and Safety, one of the assignments is to explore the internet to learn about how consumers/patients without specific healthcare knowledge might get information on quality of care. When students enter “consumer healthcare information” in Google, the first result… Read More »
Each year, millions of people around the world are victims of human trafficking. In the US, the National Human Trafficking Hotline, which maintains one of the most extensive data sets, received 13,897 calls in 2017, with 4,460 human trafficking cases reported. Of the 4,460 cases reported, 3,186 cases were of sex trafficking and 689 cases were… Read More »
Improving the overall patient care experience is an essential focus for organizations as healthcare delivery continues to evolve. The US Department of Health & Human Services Agency for Healthcare Research and Quality (AHRQ) notes patient experience as an integral component of healthcare quality, which includes “several aspects of healthcare delivery that patients value highly when… Read More »
October is here, so along with the fall foliage, prepare yourself for a deluge of pink ribbons, umbrellas, bumper stickers, and billboards: it’s Breast Cancer Awareness Month. Started as a well-intentioned campaign to raise awareness about breast cancer and fundraise for breast cancer research, some have said that the movement commodifies a deadly disease at… Read More »
As unconscious bias and discrimination comes to the forefront of national conversation, it is fitting to discuss bias in the healthcare system. Though we pledge to treat all patients fairly and to the best of our capacity, regardless of their background, increasing evidence suggests that healthcare providers, too, have bias and exhibit behaviors perceived by… Read More »
What’s the first thing you do when you get sick? For many people, a cursory search through various online resources is the initial step in gathering information toward obtaining a diagnosis. The internet places an infinite number of health-related resources at our fingertips, many of which are consumed through social media. Presently, 74% of US… Read More »
Violence against women and girls is an international concern that cuts across all sectors of society. The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary… Read More »
Adequacy of healthcare for transgender patients has recently come to light, particularly with the increased discussion of trans persons in the media. Trans individuals identify their gender differently from their assigned sex at birth. Trans healthcare is an emerging field of research, and this increased focus continues to uncover the lack of knowledge amongst providers… Read More »