In order for the country to make meaningful progress in tackling the opioid epidemic, we need a cultural shift in the way patients and providers think about pain.
Pharmaceutical companies and physicians are being demonized for their manufacturing and dispensing of opioid analgesics. Money-hungry executives from Big Pharma caused the crisis by brainwashing doctors to prescribe these medications left and right. Greedy doctors want patients dependent upon them for years, ensuring a steady stream of paying patients in their waiting room. Drugs drive the market. Drugs lead to big profits for everyone involved. The more drugs, the better.
For most of our childhoods growing up in the Midwest, the Iowa we called home was a swing state proud of its investments in education, was welcoming to refugees from around the world, and was the third US state to legalize marriage equality.
Physician burnout has emerged as an increasingly concerning phenomenon in medicine. As high as 51% of physicians in a Medscape survey report symptoms of burnout. Doctors face higher demands with less time and support. Academic medical centers, which historically have been insulated from outside forces, are now seeing larger patient censuses, leaving less time for physicians to work through each patient’s case carefully.
Just like many Americans, Teresa is a busy mother-of-two with a lot on her plate. When her four-year-old daughter fell ill with the flu, she was grateful that the Child Health Insurance Coverage (CHIP) their family relies on was recently reauthorized in January after four months of funding limbo.
On July 26, President Donald Trump released another polemic tweet informing the public that “the United States Government will not accept or allow Transgender individuals to serve in any capacity in the US military,” citing the “tremendous medical costs” that transgender individuals pose to the health system.
The House-approved American Health Care Act of 2017 (AHCA) and the proposed Senate Better Care Reconciliation Act (BCRA) would approve cuts to Medicaid that hurt Iowans.
Good afternoon, ma’am. Wow, what a contagious smile you have. I hear that you are here because of a stuffy nose? They said that you tried Claritin and that did not help. You feel congested, and it’s hard to blow anything out? And no fevers, no cough, no difficulty breathing or any wheezing?
Several months ago, I was asked by an attending about my future plans. “So I can pimp you,” he said. I told him that I am pursuing further training in addiction medicine. “Isn’t that just for psychiatrists?”
Ana sits on the exam table in front of me explaining how, in three short weeks, her mother will evict her from her childhood home. She is eight months pregnant and is studying night courses to become a paralegal. As her prenatal provider and primary care physician, I have been sending referrals to numerous community agencies in hopes of securing housing at the local YWCA.
Health and wellness are more than a simple product of access and initiative, as such a simplified formula is only enjoyed by a very small minority. The equation becomes more complicated as new factors enter, such as unemployment or housing insecurity. Despite their importance as determinants of health, such elements are seldom addressed in the medical interaction between patient and physician, and are thus discarded in the interest of a perceived efficiency.
As I contemplate the future of our country, the future of medicine and the future of reproductive health and justice, I am truly frightened of what is to come. Since our president appears to base his desires on what makes him popular, I fear that he will gut Planned Parenthood, turn over Roe v Wade, and make it even more difficult for women to afford and access care, all in the name of ego.
Physicians must begin to view domestic violence as we do influenza or vehicle safety. We must prevent it at all costs. And if it is not prevented, we must aggressively treat it. This will require extensive collaboration with colleagues, public health services and law enforcement. Though the challenge is enormous, physicians ought to address this societal disease and be at the forefront of care.