Social Media for Doctors

This is a meant to be a bit of a “starter kit” for doctors looking to explore social media for the purposes of continuing medical education or advocacy. It’s certainly not a conclusive list, but it includes some of my favorites. I’ll continue to add to this over time.

Twitter

Free Open-Access Medical Education (#FOAMed)
Physician-Advocates
Other

Podcasts

I use Overcast for listening to podcasts, but most phones will have a native app you can use.

Anti-Racism Reading Group #6: Race and Gun Policy

In an effort to hold myself accountable to better anti-racism theory and practice, I’ve started hosting an anti-racism reading group in the Seattle area. In this series, I’d like to share both these readings and some of the discussion. You can read summaries of previous discussions here.

The topic of this month’s anti-racism reading group was inspired in part by the Parkland shooting and the resulting public demonstrations for better public policy to prevent future gun violence.

Given that one of the main purposes of this reading group is to improve our capacity to understand the impacts of racism, this seemed to be a good opportunity to explore how racism impacts the gun control debate in our country. The following readings were sent out in advance:

  1.  “The simple, surprising factor that explains America’s gun problem” by Jason McDaniel and Sean McElwee
  2. “Racism, Gun Ownership and Gun Control: Biased Attitudes in US Whites May Influence Policy Decisions” by O’Brien, et al.
  3. “Racial Resentment and Whites’ Gun Policy Preferences in Contemporary America” by Filindra and Kaplan
  4. “The Secret History of Guns” by Adam Winkler
  5. “A researcher explains how racial resentment drives opposition to gun control” by German Lopez

While people went through these readings, I asked them to consider the following questions:

  1. What are the ways in which race and racism influence how people perceive gun ownership and gun control?
  2. How has the politics of gun regulation varied with the politics of race in American history?
  3. Philando Castile was a gun owner who had a concealed carry permit. He was explaining to Officer Jeronimo Yanez that he had a legal weapon on his person when Yanez shot him to death. How does he fit into this story of race and gun ownership?

Continue reading “Anti-Racism Reading Group #6: Race and Gun Policy”

Anti-Racism Reading Group #5: Seeing White

In an effort to hold myself accountable to better anti-racism theory and practice, I’ve started hosting an anti-racism reading group in the Seattle area. In this series, I’d like to share both these readings and some of the discussion. You can read summaries of previous discussions by following these links: one, twothree, four.

For the fifth anti-racism reading group, we listened to Seeing White, an excellent podcast hosted by John Biewen at the Center for Documentary Studies at Duke University. In it, Biewen and regular guest Dr. Chenjerai Kumanyika explore the history and consequences of White racial identity in a way that is both extremely accessible and intellectually rigorous.

This was a particularly ambitious project because the podcast series is fourteen episodes long, meaning there were many hours of material to discuss. For the purposes of our discussion group, we focused on the first three episodes which cover the history of Whiteness and the last two episodes on anti-racist action. However, I encouraged the group (as I encourage you) to listen to the full series, because every episode is worth your time.

Given the expanse of the source material and the conversation, I don’t have a thorough summary of the discussion, but rather three items of conversation that I found particularly interesting. Continue reading “Anti-Racism Reading Group #5: Seeing White”

Anti-Racism Reading Group #4: White Fragility

In an effort to hold myself accountable to better anti-racism theory and practice, I’ve started hosting an anti-racism reading group for health care practitioners in the Seattle area. In this series, I’d like to share both these readings and some of the discussion. You can read part one here, part two here, and part three here.

For the third reading of the anti-racism reading group we focused on White Fragility. Our reading was the article White Fragility from the International Journal of Critical Pedagogy which you can download here. Supplementary materials were Dr. DiAngelo’s White Fragility and Rules of Engagement and this comedic White Fragility Workplace Training Video.

What is White Fragility? In Dr. DiAngelo’s words:

White Fragility is a state in which even a minimum amount of racial stress be- comes intolerable, triggering a range of defensive moves. These moves include the outward display of emotions such as anger, fear, and guilt, and behaviors such as argumentation, silence, and leaving the stress-inducing situation. These behaviors, in turn, function to reinstate white racial equilibrium.

Continue reading “Anti-Racism Reading Group #4: White Fragility”

Do No Harm: A Doctor’s Case For Single Payer

In 2013, Drs. Ubel, Abernethy, and Zafar published “Full Disclosure — Out-of-Pocket Costs as Side Effects” in the New England Journal of Medicine. In this essay, the authors grapple with the ethical responsibilities of physicians when it comes to the enormous cost of modern medicine. If a surgery or a course of chemotherapy is likely to bankrupt a patient, what is our duty to warn them, to ensure that they have considered both benefits and harms? A larger question, however, was left unasked: “How do we as physicians ethically operate within a medical system that forces people on a regular basis to choose between health and financial stability”

To grasp the extent of the issue, consider that even after the passage and defense of the Affordable Care Act, 27 million American remain uninsured. An additional 41 million Americans are underinsured which is to say that their out-of-pocket expenses (such as deductibles and copays) are enough to cause financial duress, despite having health insurance. And as health insurance deductibles increases faster than wages, the proportion of Americans who are underinsured continues to grow.

The consequences of this are grave. Three out of ten American adults report forgoing needed medical care due to cost concerns. One in four were unable to pay for basic necessities like food, heat, or rent because of medical bills. One third spent down all of their savings.

When health economists have looked to explain why it is that health care is so enormously expensive in America, time and time again they have found (in the words of the late, great Uwe Reinhardt) that “it’s the prices, stupid.”

That is to say that hospitals, doctors, pharmaceutical companies, and medical device manufacturers charge Americans prices far in excess of what people are charged in other high-income countries. Joseph Dieleman and his colleagues at Harvard reassessed this question for the Journal of the American Medical Association just last year and came to the same conclusion (though with a less blunt title).

One key distinction between America and its peer nations is that other nations have centralized institutions to determine fair pricing for medical goods and services. In Germany, this is the Institute for Quality and Efficiency in Health Care (IQWiG). In the U.K., it is the National Institute for Health and Clinical Excellence (NICE). In France, it is the National Union of Health Insurance Funds (UNCAM). Each of these countries takes advantage of a strong price negotiating position through centralization.

The other crucial distinction between America and its peer nations is that these other nations recognize that some minimum level of health is a necessary precondition to social, civic, and economic participation and as such is worth the investment of public funds. In other words, by treating health care as a human right, they protect their citizens’ capacity to exercise their other rights in good health. This framework justifies  distributing the costs of health care equitably, and in turn preventing financial penalty from compounding the injury of illness.

These two features of an improved health care system – 1) centralized purchasing and 2) equitable funding – are achievable in the United States with a transition to a Single Payer system. In such a system, a single publicly funded entity (e.g. Medicare) would pay for all medical goods and services on behalf of Americans. Medical care will still be delivered by private doctors and hospitals, and medical goods will still be produced by private companies. The only difference for most people is that the money that you had been paying to a private insurance company will instead be going to a public insurance entity (e.g. Medicare).

Many proposals for different Single Payer systems are currently being considered by both national and state legislative bodies in the United States. Perhaps the most famous at this time is Bernie Sanders’ Medicare For All Act (S. 1804 with 16 co-sponsors) and its accompanying house legislation (H.R. 676 with 120 co-sponsors) introduced by Representative John Conyers. Senator Chris Murphy has been working on his own Single Payer strategy which is qualitatively similar to Representative Pete Stark’s AmeriCare Single Payer plan. There are also numerous state-level Single Payer plans including The Washington Health Security Trust (HB 1026SB 5701), The Healthy California Act (SB 562), and the New York Health Act (A. 4738 and S. 4840).

These legislative pushes take place in the context of the rising popularity of Single Payer, which has now achieved majority support in public opinion polling. As the popularity of Single Payer legislation grows, Democrats positioning themselves for 2020 presidential bids like Kamala Harris, Cory Booker, and Kirsten Gillibrand have already declared their support, recognizing that Single Payer is a necessary part of a popular Democratic platform.

This momentum should not inspire complacency, however. There is a great deal of organizing, consensus building, and legislative refinement needed in the months ahead. For my part, I plan on working with Health Care For All Washington on their push for state-level single payer and Democratic Socialists of America on their push for federal-level Medicare For All. Others are doing great work through Physicians for a National Health Program and National Nurses United.

If this has piqued your interest, I encourage you to continue read up on Single Payer and find the right level of involvement for yourself. Whether that’s calling your elected officials, talking with your friends and co-workers, writing an op-ed for your local newspaper, or knocking on doors, it’s all important work.

More articles on Single Payer:

Securing Housing For All

As a family doctor in Seattle, I take care of numerous patients experiencing homelessness. The toll this takes on their bodies is impossible to ignore. Sleep deprivation, chronic stress, physical and sexual assault, temperature extremes, and malnutrition all weather the body rapidly. As a physician sworn to preserve and prolong life, it is profoundly disturbing to come up against such profane and preventable degradation on a daily basis.

For this reason, I joined the Housing For All Coalition last night as they put forth a call to action to a packed hall at the Seattle Labor Temple. Speakers from the Transit Rider’s Union, Socialist Alternative Seattle, Nickelsville, SHARE/WHEEL, and DESC each spoke to the urgency of ending Seattle’s housing crisis. While each speaker brought a unique perspective, including the perspective of the formerly and currently homeless, they all emphasized the importance of increasing access to both affordable permanent housing and safe temporary shelter.  Continue reading “Securing Housing For All”

Anti-Racism Reading Group #3: Perinatal Mortality

In an effort to hold myself accountable to better anti-racism theory and practice, I’ve started hosting an anti-racism reading group for health care practitioners in the Seattle area. In this series, I’d like to share both these readings and some of the discussion. You can read part one here and part two here.

For the third meeting of the anti-racism reading group, we focused on increased rates of perinatal death (i.e. death around the time of birth) for black women with this excellent piece of reporting by NPR and Propublica. NPR’s Code Switch team produced an excellent podcast on this same story which you can listen to here or read the write-up here.

This is an especially timely reading given Erica Garner’s recent death at age 27 from a heart attack just three months after giving birth. Erica was the daughter of Eric Garner who was murdered by the New York City Police. Since his death, she had risen up to be a prominent and effective activist against police violence.   Continue reading “Anti-Racism Reading Group #3: Perinatal Mortality”