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FM","link":"/"}},"news_11935261":{"type":"posts","id":"news_11935261","meta":{"index":"posts_1591205157","site":"news","id":"11935261","score":null,"sort":[1671056343000]},"guestAuthors":[],"slug":"alarming-decline-new-doctors-shun-infectious-diseases-specialty-leaving-nearly-half-of-training-programs-unfilled","title":"'Alarming Decline': New Doctors Shun Infectious Diseases Specialty, Leaving Nearly Half of Training Programs Unfilled","publishDate":1671056343,"format":"standard","headTitle":"NPR | KQED News","labelTerm":{"term":253,"site":"news"},"content":"\u003cp>Thousands of doctors ready to continue their training celebrated \u003ca href=\"https://www.nrmp.org/wp-content/uploads/2022/11/Medicine-and-Peds-Specialties-MRS-Report.pdf\">Match Day (PDF)\u003c/a> for specialty fellowships on Nov. 30, but one group lamented its results: infectious diseases physicians. Despite its central role in the COVID pandemic, the infectious diseases specialty saw 44% of its training programs go unfilled.\u003c/p>\n\u003cp>\"I'm bummed out,\" says \u003ca href=\"https://vaccines.emory.edu/faculty/primary-faculty/delrio-carlos.html\">Dr. Carlos Del Rio\u003c/a>, a professor at the Emory School of Medicine and president of the \u003ca href=\"https://www.idsociety.org/news--publications-new/articles/2022/idsa-statement-on-id-fellowship-match-rates/\">Infectious Diseases Society of America\u003c/a>. \"I love my field, I love what I do. And it's upsetting to know that my field may not be as attractive to trainees as I would like it to be.\"\u003c/p>\n\u003cp>At the University of Washington, which has one of the nation's \u003ca href=\"https://www.usnews.com/education/best-global-universities/united-states/infectious-diseases\">top-ranked programs\u003c/a>, administrators were scrambling to find suitable candidates for two fellowship spots that were still open after the match process. \"It feels unsettling,\" says Dr. Paul Pottinger, director of UW's infectious diseases fellowship training program, \"Typically, we match our full eight slots on the first go.\"[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Daniel Bourque, Boston Medical Center\"]'COVID has had a tremendous impact on human life, and it continues to have an impact. I do believe that can and should inspire people to pursue careers in infectious diseases.'[/pullquote]At Boston Medical Center, affiliated with Boston University, none of their three fellowship positions got filled in this year's Match — a \"challenging\" and unprecedented situation for \u003ca href=\"https://www.bumc.bu.edu/medicine/profile/daniel-bourque/\">Dr. Daniel Bourque\u003c/a>, who runs their fellowship program: \"There was a decrease in the number of applicants this year, and that decrease appears to be a trend.\"\u003c/p>\n\u003cp>Becoming an infectious diseases specialist takes years of training. Generally, after four years of medical school, followed by several years in a medical residency, an aspiring ID physician applies to a fellowship program of at least two years. The field hit a \u003ca href=\"https://www.idsociety.org/globalassets/ektron-import/idsa/careers_and_training/program_director_resources/match/infectious-disease-match-and-trends-report\">low point\u003c/a> in recruiting for fellowships in 2016. In the past five years, it was somewhat stable, with around 65%–70% of training programs getting filled.\u003c/p>\n\u003cp>But 2020 was the exception, when a flood of applicants yielded a record match rate — a phenomenon dubbed the \"Fauci effect.\" As infectious diseases dominated the news, \"a lot of us saw it as a [sign of] reinvigorated interest in ID\" due to the pandemic, says \u003ca href=\"https://providers.emoryhealthcare.org/provider/Boghuma+Kabisen+Titanji/2216539\">Dr. Boghuma Titanji\u003c/a>, an infectious diseases physician at Emory University. But the slide since then — capped off by \u003ca href=\"https://www.idsociety.org/news--publications-new/articles/2022/idsa-statement-on-id-fellowship-match-rates/\">this year's \"alarming decline\"\u003c/a> — shows that the pandemic boost may have been a blip in the specialty's long-term struggles.\u003c/p>\n\u003cp>Despite guiding colleagues and the public through the COVID pandemic and the recent mpox outbreak; despite their lifesaving work in keeping hard-to-treat infections from spreading in hospitals; despite \u003ca href=\"https://academic.oup.com/ofid/article/6/4/ofz092/5364554\">high job satisfaction\u003c/a> and a profession that many described to NPR as \"never boring\": new doctors are not choosing to specialize in infectious diseases.\u003c/p>\n\u003cp>It's a decline that has the field's top experts searching for explanations.\u003c/p>\n\u003ch2>Training more to get paid less\u003c/h2>\n\u003cp>The most obvious reason is that the pay is low compared with other specialties, says Titanji at Emory University, \u003ca href=\"https://twitter.com/Boghuma/status/1598106987442900992\">whose Tweet\u003c/a> kicked off a robust discussion about the Match Day results. \"We're talking about a six-figure pay difference,\" she says, citing a \u003ca href=\"https://www.medscape.com/slideshow/2022-compensation-overview-6015043?faf=1#3\">2022 Medscape report\u003c/a> that infectious diseases specialists earn an average of $260k a year, which is more than $100,000 less than the average salary for all specialists.\u003c/p>\n\u003cp>In some cases, doctors who specialize in infectious diseases end up making less than they would have \u003cem>before\u003c/em> the extra two to three years of training — for instance, as a hospitalist, which is an internal medicine doctor that sees patients in the hospital. One can \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/29578550/\">become a hospitalist\u003c/a> — making between $200,000–$300,000 a year — after completing medical school and residency training, with no additional specialty fellowships required. \"I get paid less to work more hours than I did as a hospitalist,\" \u003ca href=\"https://twitter.com/hannahnammd\">Dr. Hannah Nam\u003c/a>, an infectious diseases physician at UC Irvine, tweeted. \"My student debt isn't going anywhere. Don't regret my choice but don't fault anyone for not choosing it either.\"[aside label=\"Related Stories\" postID=\"news_11934066,news_11933882,news_11935249\"]The pay disparities are rooted in the way the U.S. medical system is structured, Titanji and others say. \"A lot of the medical compensation system is based on doing procedures or interventions that are highly reimbursed,\" Titanji says.\u003c/p>\n\u003cp>Infectious diseases doctors, on the other hand, examine and interview patients and consult with colleagues — \"we think for a living,\" Pottinger, at the University of Washington, says, \"And because we don't have a surgery to do, I think that's where this legacy of reduced pay has come from.\"\u003c/p>\n\u003cp>Even if the pay is less than other specialties, \"it's \u003ca href=\"https://www.kff.org/other/state-indicator/median-annual-income/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Median%20Annual%20Household%20Income%22,%22sort%22:%22asc%22%7D\">still very good\u003c/a>,\" Pottinger says. \"There's plenty of money in it, both in academic [settings] and in private practice, and our pay is rising over time.\"\u003c/p>\n\u003cp>Still, the prospect of getting extra training to take a pay cut deters many from choosing the field. \"Medical education in the U.S. is incredibly expensive,\" says Del Rio from Emory. \"If you graduate with a lot of debt, you're not going to go to a specialty that doesn't pay as much as others.\"\u003c/p>\n\u003ch2>Long hours and public criticism\u003c/h2>\n\u003cp>The relatively low pay is \u003ca href=\"https://academic.oup.com/cid/article/63/2/155/1745334?login=false\">not the only issue\u003c/a>, experts say. The field has long been understaffed, leading to long hours — a problem supercharged by the strain of the pandemic. \"Every infectious diseases doctor can tell you that the first year of the pandemic felt like being on call 24/7 because everyone was calling you — and relying on the knowledge that you had — to be able to respond to this,\" Titanji says.\u003c/p>\n\u003cp>The current class of doctors largely started their post-graduate residencies in the summer of 2020. All of their training happened during the COVID pandemic, Bourque from Boston Medical Center notes. The long hours and poor work-life balance they observed in ID doctors — and \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2790791\">physicians leaving\u003c/a> the field in droves due to burnout — may have cut the appeal. \"Long hours and low pay are a dreadful combination,\" del Rio says.\u003c/p>\n\u003cp>The COVID spotlight also made prominent ID doctors targets for bitter vitriol from people who disagreed with them. \"Many of us, myself included, have been attacked in the media and other places,\" for sharing thoughts on COVID, del Rio says. Dr. Anthony Fauci, a top COVID adviser to President Donald Trump and President Biden, was a lightning rod for criticism — and even death threats. \"People [considering the field] realize there's a personal risk. When the chief infectious diseases doctor for the nation has to have bodyguards, that doesn't necessarily make you think 'Oh, this is a great profession,'\" del Rio says.\u003c/p>\n\u003ch2>Loan forgiveness could help\u003c/h2>\n\u003cp>Infectious diseases had a recruiting problem before the pandemic, too: 2016 was an especially disappointing year, recalls Marcelin at University of Nebraska, who was going through her specialty training at the time. That year, \u003ca href=\"https://www.nrmp.org/wp-content/uploads/2021/07/Results-and-Data-SMS-2016_Final.pdf\">57% of programs (PDF)\u003c/a> went unfilled. \"A lot of the conversations that happened then, are happening again now,\" Marcelin says.[pullquote align=\"right\" size=\"medium\" citation=\"Dr. Carlos Del Rio, president, Infectious Diseases Society of America\"]'I love my field, I love what I do. And it's upsetting to know that my field may not be as attractive to trainees as I would like it to be.'[/pullquote]It spawned some soul-searching for the field, with \u003ca href=\"https://academic.oup.com/cid/article/63/2/155/1745334?login=false\">researchers trying to figure out\u003c/a> how to attract more doctors. On the money front, medical associations like the \u003ca href=\"https://www.idsociety.org/news--publications-new/articles/2022/id-loan-repayment-advances-in-senate-prevent-pandemics-act/\">IDSA have lobbied\u003c/a> Congress for student loan repayment programs, to reduce the medical school debt for doctors who choose the field. They're also advocating for \u003ca href=\"https://www.idsociety.org/policy--advocacy/access-and-reimbursement/\">higher reimbursement rates\u003c/a> for the work ID doctors do. If the pay gap for infectious diseases decreases, \"that may make it more worthwhile for trainees to consider it as a career path,\" Titanji says.\u003c/p>\n\u003cp>They've also stepped up their efforts to bring new candidates into the infectious diseases field, with grants and \u003ca href=\"https://idweek.org/attendees/residents/\">mentorship programs\u003c/a>. Still, over the past five years, \"despite our recruitment and mentorship efforts, we have made minimal progress in reversing this trend,\" IDSA leaders \u003ca href=\"https://www.idsociety.org/globalassets/healthy-futures-tf-security-rfi-idsa-response_dm-jph.pdf\">wrote to Congress (PDF)\u003c/a> earlier this year. In 2020, \u003ca href=\"https://www.acpjournals.org/doi/full/10.7326/M20-2684\">a research paper\u003c/a> co-authored by Dr. Rochelle Walensky, then chief of the infectious diseases division at Massachusetts General Hospital and now the CDC's director, found that 80% of U.S. counties had no infectious diseases doctors — including most counties that were hit hard by COVID in the first year.\u003c/p>\n\u003cp>\"What I'm learning is that it's a long road ahead,\" says Marcelin at University of Nebraska.\u003c/p>\n\u003cp>And the stakes are high, leaving the nation unprepared against outbreaks and health emergencies. \"If we don't have enough infectious diseases physicians moving forward, it's going to impact our ability to deal with everything from recognizing and diagnosing a disease, to informing the public, to creating guidance and administering proper treatments,\" Marcelin says. Then there are the less visible impacts — disease outbreaks in hospitals that could have been prevented in consultation with ID physicians; deaths from infections with treatment-resistant bacteria and viruses that could have been stopped by ID physicians.\u003c/p>\n\u003cp>That the COVID pandemic hasn't yet inspired more doctors to go into infectious diseases might not be the end of it, says Bourque, looking back at the galvanizing effect the HIV/AIDS crisis had on the field. \"There was a point in time where it felt like [infectious diseases] may be a dying subspecialty, and then HIV/AIDS demonstrated the importance of the infectious diseases specialist and really spawned a generation of doctors,\" including Bourque, to choose it as a career. He says COVID's effects are still unfolding: \"COVID has had a tremendous impact on human life, and it continues to have an impact. I do believe that can and should inspire people to pursue careers in infectious diseases.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Experts cite low pay and understaffing that leads to long hours — and even public criticism and political vitriol — as some of the reasons why so many new doctors are veering away from the field of infectious diseases.","status":"publish","parent":0,"modified":1671056343,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":1699},"headData":{"title":"'Alarming Decline': New Doctors Shun Infectious Diseases Specialty, Leaving Nearly Half of Training Programs Unfilled | KQED","description":"Experts cite low pay and understaffing that leads to long hours — and even public criticism and political vitriol — as some of the reasons why so many new doctors are veering away from the field of infectious diseases.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"'Alarming Decline': New Doctors Shun Infectious Diseases Specialty, Leaving Nearly Half of Training Programs Unfilled","datePublished":"2022-12-14T22:19:03.000Z","dateModified":"2022-12-14T22:19:03.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"nprByline":"\u003ca href=\"https://www.npr.org/people/729920828/pien-huang\">Pien Huang\u003c/a>","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","path":"/news/11935261/alarming-decline-new-doctors-shun-infectious-diseases-specialty-leaving-nearly-half-of-training-programs-unfilled","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Thousands of doctors ready to continue their training celebrated \u003ca href=\"https://www.nrmp.org/wp-content/uploads/2022/11/Medicine-and-Peds-Specialties-MRS-Report.pdf\">Match Day (PDF)\u003c/a> for specialty fellowships on Nov. 30, but one group lamented its results: infectious diseases physicians. Despite its central role in the COVID pandemic, the infectious diseases specialty saw 44% of its training programs go unfilled.\u003c/p>\n\u003cp>\"I'm bummed out,\" says \u003ca href=\"https://vaccines.emory.edu/faculty/primary-faculty/delrio-carlos.html\">Dr. Carlos Del Rio\u003c/a>, a professor at the Emory School of Medicine and president of the \u003ca href=\"https://www.idsociety.org/news--publications-new/articles/2022/idsa-statement-on-id-fellowship-match-rates/\">Infectious Diseases Society of America\u003c/a>. \"I love my field, I love what I do. And it's upsetting to know that my field may not be as attractive to trainees as I would like it to be.\"\u003c/p>\n\u003cp>At the University of Washington, which has one of the nation's \u003ca href=\"https://www.usnews.com/education/best-global-universities/united-states/infectious-diseases\">top-ranked programs\u003c/a>, administrators were scrambling to find suitable candidates for two fellowship spots that were still open after the match process. \"It feels unsettling,\" says Dr. Paul Pottinger, director of UW's infectious diseases fellowship training program, \"Typically, we match our full eight slots on the first go.\"\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'COVID has had a tremendous impact on human life, and it continues to have an impact. I do believe that can and should inspire people to pursue careers in infectious diseases.'","name":"pullquote","attributes":{"named":{"align":"right","size":"medium","citation":"Dr. Daniel Bourque, Boston Medical Center","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>At Boston Medical Center, affiliated with Boston University, none of their three fellowship positions got filled in this year's Match — a \"challenging\" and unprecedented situation for \u003ca href=\"https://www.bumc.bu.edu/medicine/profile/daniel-bourque/\">Dr. Daniel Bourque\u003c/a>, who runs their fellowship program: \"There was a decrease in the number of applicants this year, and that decrease appears to be a trend.\"\u003c/p>\n\u003cp>Becoming an infectious diseases specialist takes years of training. Generally, after four years of medical school, followed by several years in a medical residency, an aspiring ID physician applies to a fellowship program of at least two years. The field hit a \u003ca href=\"https://www.idsociety.org/globalassets/ektron-import/idsa/careers_and_training/program_director_resources/match/infectious-disease-match-and-trends-report\">low point\u003c/a> in recruiting for fellowships in 2016. In the past five years, it was somewhat stable, with around 65%–70% of training programs getting filled.\u003c/p>\n\u003cp>But 2020 was the exception, when a flood of applicants yielded a record match rate — a phenomenon dubbed the \"Fauci effect.\" As infectious diseases dominated the news, \"a lot of us saw it as a [sign of] reinvigorated interest in ID\" due to the pandemic, says \u003ca href=\"https://providers.emoryhealthcare.org/provider/Boghuma+Kabisen+Titanji/2216539\">Dr. Boghuma Titanji\u003c/a>, an infectious diseases physician at Emory University. But the slide since then — capped off by \u003ca href=\"https://www.idsociety.org/news--publications-new/articles/2022/idsa-statement-on-id-fellowship-match-rates/\">this year's \"alarming decline\"\u003c/a> — shows that the pandemic boost may have been a blip in the specialty's long-term struggles.\u003c/p>\n\u003cp>Despite guiding colleagues and the public through the COVID pandemic and the recent mpox outbreak; despite their lifesaving work in keeping hard-to-treat infections from spreading in hospitals; despite \u003ca href=\"https://academic.oup.com/ofid/article/6/4/ofz092/5364554\">high job satisfaction\u003c/a> and a profession that many described to NPR as \"never boring\": new doctors are not choosing to specialize in infectious diseases.\u003c/p>\n\u003cp>It's a decline that has the field's top experts searching for explanations.\u003c/p>\n\u003ch2>Training more to get paid less\u003c/h2>\n\u003cp>The most obvious reason is that the pay is low compared with other specialties, says Titanji at Emory University, \u003ca href=\"https://twitter.com/Boghuma/status/1598106987442900992\">whose Tweet\u003c/a> kicked off a robust discussion about the Match Day results. \"We're talking about a six-figure pay difference,\" she says, citing a \u003ca href=\"https://www.medscape.com/slideshow/2022-compensation-overview-6015043?faf=1#3\">2022 Medscape report\u003c/a> that infectious diseases specialists earn an average of $260k a year, which is more than $100,000 less than the average salary for all specialists.\u003c/p>\n\u003cp>In some cases, doctors who specialize in infectious diseases end up making less than they would have \u003cem>before\u003c/em> the extra two to three years of training — for instance, as a hospitalist, which is an internal medicine doctor that sees patients in the hospital. One can \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/29578550/\">become a hospitalist\u003c/a> — making between $200,000–$300,000 a year — after completing medical school and residency training, with no additional specialty fellowships required. \"I get paid less to work more hours than I did as a hospitalist,\" \u003ca href=\"https://twitter.com/hannahnammd\">Dr. Hannah Nam\u003c/a>, an infectious diseases physician at UC Irvine, tweeted. \"My student debt isn't going anywhere. Don't regret my choice but don't fault anyone for not choosing it either.\"\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"Related Stories ","postid":"news_11934066,news_11933882,news_11935249"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>The pay disparities are rooted in the way the U.S. medical system is structured, Titanji and others say. \"A lot of the medical compensation system is based on doing procedures or interventions that are highly reimbursed,\" Titanji says.\u003c/p>\n\u003cp>Infectious diseases doctors, on the other hand, examine and interview patients and consult with colleagues — \"we think for a living,\" Pottinger, at the University of Washington, says, \"And because we don't have a surgery to do, I think that's where this legacy of reduced pay has come from.\"\u003c/p>\n\u003cp>Even if the pay is less than other specialties, \"it's \u003ca href=\"https://www.kff.org/other/state-indicator/median-annual-income/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Median%20Annual%20Household%20Income%22,%22sort%22:%22asc%22%7D\">still very good\u003c/a>,\" Pottinger says. \"There's plenty of money in it, both in academic [settings] and in private practice, and our pay is rising over time.\"\u003c/p>\n\u003cp>Still, the prospect of getting extra training to take a pay cut deters many from choosing the field. \"Medical education in the U.S. is incredibly expensive,\" says Del Rio from Emory. \"If you graduate with a lot of debt, you're not going to go to a specialty that doesn't pay as much as others.\"\u003c/p>\n\u003ch2>Long hours and public criticism\u003c/h2>\n\u003cp>The relatively low pay is \u003ca href=\"https://academic.oup.com/cid/article/63/2/155/1745334?login=false\">not the only issue\u003c/a>, experts say. The field has long been understaffed, leading to long hours — a problem supercharged by the strain of the pandemic. \"Every infectious diseases doctor can tell you that the first year of the pandemic felt like being on call 24/7 because everyone was calling you — and relying on the knowledge that you had — to be able to respond to this,\" Titanji says.\u003c/p>\n\u003cp>The current class of doctors largely started their post-graduate residencies in the summer of 2020. All of their training happened during the COVID pandemic, Bourque from Boston Medical Center notes. The long hours and poor work-life balance they observed in ID doctors — and \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2790791\">physicians leaving\u003c/a> the field in droves due to burnout — may have cut the appeal. \"Long hours and low pay are a dreadful combination,\" del Rio says.\u003c/p>\n\u003cp>The COVID spotlight also made prominent ID doctors targets for bitter vitriol from people who disagreed with them. \"Many of us, myself included, have been attacked in the media and other places,\" for sharing thoughts on COVID, del Rio says. Dr. Anthony Fauci, a top COVID adviser to President Donald Trump and President Biden, was a lightning rod for criticism — and even death threats. \"People [considering the field] realize there's a personal risk. When the chief infectious diseases doctor for the nation has to have bodyguards, that doesn't necessarily make you think 'Oh, this is a great profession,'\" del Rio says.\u003c/p>\n\u003ch2>Loan forgiveness could help\u003c/h2>\n\u003cp>Infectious diseases had a recruiting problem before the pandemic, too: 2016 was an especially disappointing year, recalls Marcelin at University of Nebraska, who was going through her specialty training at the time. That year, \u003ca href=\"https://www.nrmp.org/wp-content/uploads/2021/07/Results-and-Data-SMS-2016_Final.pdf\">57% of programs (PDF)\u003c/a> went unfilled. \"A lot of the conversations that happened then, are happening again now,\" Marcelin says.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'I love my field, I love what I do. And it's upsetting to know that my field may not be as attractive to trainees as I would like it to be.'","name":"pullquote","attributes":{"named":{"align":"right","size":"medium","citation":"Dr. Carlos Del Rio, president, Infectious Diseases Society of America","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>It spawned some soul-searching for the field, with \u003ca href=\"https://academic.oup.com/cid/article/63/2/155/1745334?login=false\">researchers trying to figure out\u003c/a> how to attract more doctors. On the money front, medical associations like the \u003ca href=\"https://www.idsociety.org/news--publications-new/articles/2022/id-loan-repayment-advances-in-senate-prevent-pandemics-act/\">IDSA have lobbied\u003c/a> Congress for student loan repayment programs, to reduce the medical school debt for doctors who choose the field. They're also advocating for \u003ca href=\"https://www.idsociety.org/policy--advocacy/access-and-reimbursement/\">higher reimbursement rates\u003c/a> for the work ID doctors do. If the pay gap for infectious diseases decreases, \"that may make it more worthwhile for trainees to consider it as a career path,\" Titanji says.\u003c/p>\n\u003cp>They've also stepped up their efforts to bring new candidates into the infectious diseases field, with grants and \u003ca href=\"https://idweek.org/attendees/residents/\">mentorship programs\u003c/a>. Still, over the past five years, \"despite our recruitment and mentorship efforts, we have made minimal progress in reversing this trend,\" IDSA leaders \u003ca href=\"https://www.idsociety.org/globalassets/healthy-futures-tf-security-rfi-idsa-response_dm-jph.pdf\">wrote to Congress (PDF)\u003c/a> earlier this year. In 2020, \u003ca href=\"https://www.acpjournals.org/doi/full/10.7326/M20-2684\">a research paper\u003c/a> co-authored by Dr. Rochelle Walensky, then chief of the infectious diseases division at Massachusetts General Hospital and now the CDC's director, found that 80% of U.S. counties had no infectious diseases doctors — including most counties that were hit hard by COVID in the first year.\u003c/p>\n\u003cp>\"What I'm learning is that it's a long road ahead,\" says Marcelin at University of Nebraska.\u003c/p>\n\u003cp>And the stakes are high, leaving the nation unprepared against outbreaks and health emergencies. \"If we don't have enough infectious diseases physicians moving forward, it's going to impact our ability to deal with everything from recognizing and diagnosing a disease, to informing the public, to creating guidance and administering proper treatments,\" Marcelin says. Then there are the less visible impacts — disease outbreaks in hospitals that could have been prevented in consultation with ID physicians; deaths from infections with treatment-resistant bacteria and viruses that could have been stopped by ID physicians.\u003c/p>\n\u003cp>That the COVID pandemic hasn't yet inspired more doctors to go into infectious diseases might not be the end of it, says Bourque, looking back at the galvanizing effect the HIV/AIDS crisis had on the field. \"There was a point in time where it felt like [infectious diseases] may be a dying subspecialty, and then HIV/AIDS demonstrated the importance of the infectious diseases specialist and really spawned a generation of doctors,\" including Bourque, to choose it as a career. He says COVID's effects are still unfolding: \"COVID has had a tremendous impact on human life, and it continues to have an impact. I do believe that can and should inspire people to pursue careers in infectious diseases.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11935261/alarming-decline-new-doctors-shun-infectious-diseases-specialty-leaving-nearly-half-of-training-programs-unfilled","authors":["byline_news_11935261"],"categories":["news_457","news_8","news_356"],"tags":["news_27989","news_17606","news_32164"],"affiliates":["news_253"],"featImg":"news_11935274","label":"news_253"},"news_11929860":{"type":"posts","id":"news_11929860","meta":{"index":"posts_1591205157","site":"news","id":"11929860","score":null,"sort":[1666657847000]},"guestAuthors":[],"slug":"multiple-strikes-in-bay-area-health-care-reflect-a-workforce-decimated-by-labor-shortage","title":"Multiple Bay Area Health Care Strikes Reflect a Workforce Under Increasing Strain","publishDate":1666657847,"format":"standard","headTitle":"KQED News","labelTerm":{"site":"news"},"content":"\u003cp>Nearly 2,000 registered nurses at Alta Bates Summit Medical Center campuses in Oakland and Berkeley began a five-day strike Monday in response to high turnover rates, staff shortages and workplace safety issues.\u003c/p>\n\u003cp>The nurses, represented by the California Nurses Association and National Nurses United, called on Sutter Health to implement workplace violence prevention plans, increase staffing and provide more robust safety resources, including better access to medical-grade safety equipment.\u003c/p>\n\u003cp>\"I am seeing nurses leave the medical center for other nursing positions on a regular basis. We have nurses working overtime, and even double shifts, day after day to keep the hospital running,\" said Mike Hill, a nurse in Sutter's intensive care unit.\u003c/p>\n\u003cp>Hill said that while workplace violence in hospitals — mostly of patients toward staff — has always been a concern, there was an uptick in incidents during the pandemic, when many patients didn’t have the family support they needed.\u003c/p>\n\u003cp>\"Sometimes it’s intentional. Other times, it’s from anger, fear or a medical condition that causes them to lash out at staff. Either way, it’s dangerous for us as professionals,\" said Hill. \"It's not just physical violence. Sometimes it's verbal threats.\"\u003c/p>\n\u003cp>When workplace violence occurs, hospitals announce \"code gray\" on the intercom system to alert security, Hill said. But like the nursing team, the security department at Alta Bates is understaffed, and in some cases it takes too long for guards to arrive at the scene, Hill said, forcing other nurses to step in to help their colleagues. Hill said more security guards are needed both inside the hospital and in the parking garage, to prevent vehicle break-ins, thefts and attacks on staff.\u003c/p>\n\u003cp>Those concerns about violence, he added, are compounded by the hospital failing to take the necessary measures to effectively protect nurses from COVID exposure and other diseases.\u003c/p>\n\u003cp>Last year, the California Division of Occupational Safety and Health (Cal/OSHA) fined Sutter Health for violations tied to COVID-related workplace safety issues after an investigation was launched in response to the July 2021 \u003ca href=\"https://www.nationalnursesunited.org/press/calosha-finds-alta-bates-summit-medical-center-guilty-eight-serious-violations\">death of an Alta Bates nurse\u003c/a>, who contracted the disease.\u003c/p>\n\u003cp>“Sutter must create working conditions to enhance patient care while also providing a safe work environment that retains nurses,\" said Hill.\u003c/p>\n\u003cp>Ann Gaebler, a registered nurse of over 40 years, said she has never seen Sutter \"act this disrespectfully\" toward nurses, and it's causing experienced health care providers to leave.\u003c/p>\n\u003cp>\"Without proper mentorship, we see young nurses suffering the moral injury and the moral distress of having to care for patients without the support they need, and so they leave,\" Gaebler said in a statement. \"This is not how you grow the next generation of nurses or how to take care of a community. We need Sutter to step up to address our concerns about retention, so we can continue to provide excellent care to our patients.\"[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Joanne Spetz, director, Philip R. Lee Institute for Health Policy Studies, UCSF\"]'I think the pandemic revealed and exacerbated a lot of problems that existed already, and some of those problems were brewing around stress and burnout and workloads, as we're hearing from physicians and nurses and other health care professionals.’[/pullquote]\u003c/p>\n\u003cp>In response to the walkout, Sutter management faulted local leaders in the nurses unions, accusing them of putting \"politics above the patients and the nurses they represent\" despite Sutter being willing to bargain, a spokesperson said in a statement on Monday.\u003c/p>\n\u003cp>“Our attention remains on providing safe, high-quality care to the patients and communities we’re honored to serve, and we are confident in our ability to manage this disruption,\" the statement said. \"We are hopeful the union shares our desire to reach an agreement and enable our nurses to turn their focus back to the patients the union has asked them to walk away from.”\u003c/p>\n\u003cfigure id=\"attachment_11930036\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut.jpg\">\u003cimg class=\"size-medium wp-image-11930036\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-800x533.jpg\" alt=\"People holding yellow and red signs and wearing red nurse outfits walk across the street.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Nurses begin a five-day strike at Alta Bates Summit Medical Center in Oakland on Oct. 24, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sutter Health's proposed contract includes a pay increase of more than 20% over four years and a commitment to pursuing initiatives aimed at promoting diversity and advancing equity among its employees, along with continued health coverage for nurses and their families.\u003c/p>\n\u003cp>The Sutter nurses strike is just the latest in a slew of labor actions in recent months among health care workers throughout the Bay Area, mirroring a larger nationwide trend.\u003c/p>\n\u003cp>The walkout comes less than a week after some 2,000 Kaiser Permanente mental health care employees approved \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/new-4-year-agreement-ratified\">a four-year contract\u003c/a>, ending an unprecedented, grueling 10-week strike over staffing shortages, wages and patient care, and just days after the Valley Physicians Group, a union representing about 450 doctors employed by Santa Clara County, announced its intention to hit the picket line on November 1 over similar issues.[aside postID=\"news_11929713,news_11924980\" label=\"Related Posts\"]Even though \u003ca href=\"https://www.bls.gov/opub/ted/2020/union-membership-rate-8-point-6-percent-in-manufacturing-23-point-4-percent-in-utilities-in-2019.htm#:~:text=Bureau%20of%20Labor%20Statistics,-The%20Economics%20Daily&text=In%202019%2C%20the%20union%20membership,hunting%3B%20and%20finance%20and%20insurance.\">less than 7% of health care workers nationwide were unionized\u003c/a> as of 2020, the health care sector \u003ca href=\"https://www.npr.org/sections/health-shots/2021/01/11/955128562/for-health-care-workers-the-pandemic-is-fueling-renewed-interest-in-unions\">also has seen renewed interest in unionization since the pandemic\u003c/a>.\u003c/p>\n\u003cp>“I think the pandemic revealed and exacerbated a lot of problems that existed already, and some of those problems were brewing around stress and burnout and workloads, as we're hearing from physicians and nurses and other health care professionals,” Dr. Joanne Spetz, director of the Philip R. Lee Institute for Health Policy Studies at UCSF, told KQED.\u003c/p>\n\u003cp>The pandemic, she added, also laid bare the extent of labor shortages across a wide range of essential jobs within health care settings, including custodial staff, nursing assistants, food-service workers and delivery people.\u003c/p>\n\u003cp>“When those jobs are all in short supply, that puts even more pressure on physicians, nurses and others,” Spetz said.\u003c/p>\n\u003cp>And many health care workers are finding that their most common demands — for reduced workloads, more support services, more time for administrative tasks and, in a growing number of instances, tougher security measures — are often not sufficiently met by employers, who often cite nationwide labor shortages and rising costs of doing business.\u003c/p>\n\u003cp>Unionization is more popular than it’s ever been, even across political lines, with \u003ca href=\"https://news.gallup.com/poll/398303/approval-labor-unions-highest-point-1965.aspx\">a recent Gallup poll showing that 71% of Americans approve of labor unions\u003c/a>, the highest approval rating since 1965.\u003c/p>\n\u003cp>But questions remain over how financially well positioned hospitals are to hire and train more people and meet their employees’ increasingly vocal — and organized — demands.\u003c/p>\n\u003cp>“Health care is competing against a lot of other industries and sectors that also are having difficulty recruiting,” Spetz said.\u003c/p>\n\u003cp>“A skilled trade or retail or a restaurant can change their prices pretty quickly, but for health care, they are in these often multiyear insurance contracts and they cannot immediately drum up more revenue in order to pay those higher wages,” said Spetz. “They're likely to be going back to the insurance industry in the next few years as their contracts come up for renegotiation and ask for more money. And then the insurance companies eventually are going to need to figure out how to pass that on in the price of higher premiums.”\u003c/p>\n\u003cp>And, Spetz added, the pressure of keeping costs down at a time of rampant inflation in a labor-intensive field like health care is exacerbated by the rising costs of supplies and equipment.\u003c/p>\n\u003cp>“Because it takes a while to have the ability to raise revenue … that just puts more financial pressure,” Spetz said, adding that as the pandemic relief money fades, hospitals will be facing financial shortfalls and worrying about “how the money's going to play out for them.”\u003c/p>\n\u003cp>“A lot of it comes down to building a workplace where health care workers really feel valued, are able to use all their skills, are respected as professionals, regardless of what level they work within the organization … and have the autonomy to use their knowledge and skills to the highest ability,” Spetz said. “You need to be adequately staffed in general. And so that's going to be the big challenge for employers, is how to create that healthy, supportive work culture. And you have to do that while you’re dealing with labor shortages and plugging all the holes that need to be plugged.”\u003c/p>\n\u003cp>\u003cem>Additional reporting was contributed by Bay City News and KQED's Laura Klivans.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Thousands of nurses at Alta Bates Summit Medical Center went on strike Monday, marking the latest in a slew of recent actions among health care workers throughout the region.","status":"publish","parent":0,"modified":1666827960,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1424},"headData":{"title":"Multiple Bay Area Health Care Strikes Reflect a Workforce Under Increasing Strain | KQED","description":"Thousands of nurses at Alta Bates Summit Medical Center went on strike Monday, marking the latest in a slew of recent actions among health care workers throughout the region.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Multiple Bay Area Health Care Strikes Reflect a Workforce Under Increasing Strain","datePublished":"2022-10-25T00:30:47.000Z","dateModified":"2022-10-26T23:46:00.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11929860 https://ww2.kqed.org/news/?p=11929860","disqusUrl":"https://ww2.kqed.org/news/2022/10/24/multiple-strikes-in-bay-area-health-care-reflect-a-workforce-decimated-by-labor-shortage/","disqusTitle":"Multiple Bay Area Health Care Strikes Reflect a Workforce Under Increasing Strain","audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-4[…]/e3861ac6-5a6e-44bf-896d-af36000bd3d2/audio.mp3?download=true","excludeFromSiteSearch":"Include","path":"/news/11929860/multiple-strikes-in-bay-area-health-care-reflect-a-workforce-decimated-by-labor-shortage","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Nearly 2,000 registered nurses at Alta Bates Summit Medical Center campuses in Oakland and Berkeley began a five-day strike Monday in response to high turnover rates, staff shortages and workplace safety issues.\u003c/p>\n\u003cp>The nurses, represented by the California Nurses Association and National Nurses United, called on Sutter Health to implement workplace violence prevention plans, increase staffing and provide more robust safety resources, including better access to medical-grade safety equipment.\u003c/p>\n\u003cp>\"I am seeing nurses leave the medical center for other nursing positions on a regular basis. We have nurses working overtime, and even double shifts, day after day to keep the hospital running,\" said Mike Hill, a nurse in Sutter's intensive care unit.\u003c/p>\n\u003cp>Hill said that while workplace violence in hospitals — mostly of patients toward staff — has always been a concern, there was an uptick in incidents during the pandemic, when many patients didn’t have the family support they needed.\u003c/p>\n\u003cp>\"Sometimes it’s intentional. Other times, it’s from anger, fear or a medical condition that causes them to lash out at staff. Either way, it’s dangerous for us as professionals,\" said Hill. \"It's not just physical violence. Sometimes it's verbal threats.\"\u003c/p>\n\u003cp>When workplace violence occurs, hospitals announce \"code gray\" on the intercom system to alert security, Hill said. But like the nursing team, the security department at Alta Bates is understaffed, and in some cases it takes too long for guards to arrive at the scene, Hill said, forcing other nurses to step in to help their colleagues. Hill said more security guards are needed both inside the hospital and in the parking garage, to prevent vehicle break-ins, thefts and attacks on staff.\u003c/p>\n\u003cp>Those concerns about violence, he added, are compounded by the hospital failing to take the necessary measures to effectively protect nurses from COVID exposure and other diseases.\u003c/p>\n\u003cp>Last year, the California Division of Occupational Safety and Health (Cal/OSHA) fined Sutter Health for violations tied to COVID-related workplace safety issues after an investigation was launched in response to the July 2021 \u003ca href=\"https://www.nationalnursesunited.org/press/calosha-finds-alta-bates-summit-medical-center-guilty-eight-serious-violations\">death of an Alta Bates nurse\u003c/a>, who contracted the disease.\u003c/p>\n\u003cp>“Sutter must create working conditions to enhance patient care while also providing a safe work environment that retains nurses,\" said Hill.\u003c/p>\n\u003cp>Ann Gaebler, a registered nurse of over 40 years, said she has never seen Sutter \"act this disrespectfully\" toward nurses, and it's causing experienced health care providers to leave.\u003c/p>\n\u003cp>\"Without proper mentorship, we see young nurses suffering the moral injury and the moral distress of having to care for patients without the support they need, and so they leave,\" Gaebler said in a statement. \"This is not how you grow the next generation of nurses or how to take care of a community. We need Sutter to step up to address our concerns about retention, so we can continue to provide excellent care to our patients.\"\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'I think the pandemic revealed and exacerbated a lot of problems that existed already, and some of those problems were brewing around stress and burnout and workloads, as we're hearing from physicians and nurses and other health care professionals.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Dr. Joanne Spetz, director, Philip R. Lee Institute for Health Policy Studies, UCSF","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In response to the walkout, Sutter management faulted local leaders in the nurses unions, accusing them of putting \"politics above the patients and the nurses they represent\" despite Sutter being willing to bargain, a spokesperson said in a statement on Monday.\u003c/p>\n\u003cp>“Our attention remains on providing safe, high-quality care to the patients and communities we’re honored to serve, and we are confident in our ability to manage this disruption,\" the statement said. \"We are hopeful the union shares our desire to reach an agreement and enable our nurses to turn their focus back to the patients the union has asked them to walk away from.”\u003c/p>\n\u003cfigure id=\"attachment_11930036\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut.jpg\">\u003cimg class=\"size-medium wp-image-11930036\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-800x533.jpg\" alt=\"People holding yellow and red signs and wearing red nurse outfits walk across the street.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut-1536x1024.jpg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/10/RS59635_001_KQED_SutterRNStrikeOakland_10242022-qut.jpg 1920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Nurses begin a five-day strike at Alta Bates Summit Medical Center in Oakland on Oct. 24, 2022. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sutter Health's proposed contract includes a pay increase of more than 20% over four years and a commitment to pursuing initiatives aimed at promoting diversity and advancing equity among its employees, along with continued health coverage for nurses and their families.\u003c/p>\n\u003cp>The Sutter nurses strike is just the latest in a slew of labor actions in recent months among health care workers throughout the Bay Area, mirroring a larger nationwide trend.\u003c/p>\n\u003cp>The walkout comes less than a week after some 2,000 Kaiser Permanente mental health care employees approved \u003ca href=\"https://about.kaiserpermanente.org/who-we-are/labor-relations/new-4-year-agreement-ratified\">a four-year contract\u003c/a>, ending an unprecedented, grueling 10-week strike over staffing shortages, wages and patient care, and just days after the Valley Physicians Group, a union representing about 450 doctors employed by Santa Clara County, announced its intention to hit the picket line on November 1 over similar issues.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11929713,news_11924980","label":"Related Posts "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Even though \u003ca href=\"https://www.bls.gov/opub/ted/2020/union-membership-rate-8-point-6-percent-in-manufacturing-23-point-4-percent-in-utilities-in-2019.htm#:~:text=Bureau%20of%20Labor%20Statistics,-The%20Economics%20Daily&text=In%202019%2C%20the%20union%20membership,hunting%3B%20and%20finance%20and%20insurance.\">less than 7% of health care workers nationwide were unionized\u003c/a> as of 2020, the health care sector \u003ca href=\"https://www.npr.org/sections/health-shots/2021/01/11/955128562/for-health-care-workers-the-pandemic-is-fueling-renewed-interest-in-unions\">also has seen renewed interest in unionization since the pandemic\u003c/a>.\u003c/p>\n\u003cp>“I think the pandemic revealed and exacerbated a lot of problems that existed already, and some of those problems were brewing around stress and burnout and workloads, as we're hearing from physicians and nurses and other health care professionals,” Dr. Joanne Spetz, director of the Philip R. Lee Institute for Health Policy Studies at UCSF, told KQED.\u003c/p>\n\u003cp>The pandemic, she added, also laid bare the extent of labor shortages across a wide range of essential jobs within health care settings, including custodial staff, nursing assistants, food-service workers and delivery people.\u003c/p>\n\u003cp>“When those jobs are all in short supply, that puts even more pressure on physicians, nurses and others,” Spetz said.\u003c/p>\n\u003cp>And many health care workers are finding that their most common demands — for reduced workloads, more support services, more time for administrative tasks and, in a growing number of instances, tougher security measures — are often not sufficiently met by employers, who often cite nationwide labor shortages and rising costs of doing business.\u003c/p>\n\u003cp>Unionization is more popular than it’s ever been, even across political lines, with \u003ca href=\"https://news.gallup.com/poll/398303/approval-labor-unions-highest-point-1965.aspx\">a recent Gallup poll showing that 71% of Americans approve of labor unions\u003c/a>, the highest approval rating since 1965.\u003c/p>\n\u003cp>But questions remain over how financially well positioned hospitals are to hire and train more people and meet their employees’ increasingly vocal — and organized — demands.\u003c/p>\n\u003cp>“Health care is competing against a lot of other industries and sectors that also are having difficulty recruiting,” Spetz said.\u003c/p>\n\u003cp>“A skilled trade or retail or a restaurant can change their prices pretty quickly, but for health care, they are in these often multiyear insurance contracts and they cannot immediately drum up more revenue in order to pay those higher wages,” said Spetz. “They're likely to be going back to the insurance industry in the next few years as their contracts come up for renegotiation and ask for more money. And then the insurance companies eventually are going to need to figure out how to pass that on in the price of higher premiums.”\u003c/p>\n\u003cp>And, Spetz added, the pressure of keeping costs down at a time of rampant inflation in a labor-intensive field like health care is exacerbated by the rising costs of supplies and equipment.\u003c/p>\n\u003cp>“Because it takes a while to have the ability to raise revenue … that just puts more financial pressure,” Spetz said, adding that as the pandemic relief money fades, hospitals will be facing financial shortfalls and worrying about “how the money's going to play out for them.”\u003c/p>\n\u003cp>“A lot of it comes down to building a workplace where health care workers really feel valued, are able to use all their skills, are respected as professionals, regardless of what level they work within the organization … and have the autonomy to use their knowledge and skills to the highest ability,” Spetz said. “You need to be adequately staffed in general. And so that's going to be the big challenge for employers, is how to create that healthy, supportive work culture. And you have to do that while you’re dealing with labor shortages and plugging all the holes that need to be plugged.”\u003c/p>\n\u003cp>\u003cem>Additional reporting was contributed by Bay City News and KQED's Laura Klivans.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11929860/multiple-strikes-in-bay-area-health-care-reflect-a-workforce-decimated-by-labor-shortage","authors":["11812","257","11784"],"categories":["news_1758","news_457","news_8","news_13"],"tags":["news_17606","news_683","news_21790","news_2109","news_793","news_21789"],"featImg":"news_11930035","label":"news"},"news_11902591":{"type":"posts","id":"news_11902591","meta":{"index":"posts_1591205157","site":"news","id":"11902591","score":null,"sort":[1643202119000]},"guestAuthors":[],"slug":"why-do-so-many-doctors-oppose-single-payer-health-care","title":"Why Do So Many Doctors Oppose Single-Payer Health Care?","publishDate":1643202119,"format":"audio","headTitle":"The California Report | KQED News","labelTerm":{"term":72,"site":"news"},"content":"\u003cp>Legislation that \u003ca href=\"https://www.kqed.org/news/11901347/will-california-create-nations-first-universal-health-care-system\">would help create a single-payer health care system in California\u003c/a>, the first of its kind in the nation, faces a crucial test in the next week. The bill — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1400\" target=\"_blank\" rel=\"noopener noreferrer\">AB 1400\u003c/a> — must pass the full Assembly by Jan. 31, or it’s dead.\u003c/p>\n\u003cp>The California Nurses Association, the state’s nurses union, is leading the effort to pass AB 1400. But the state's largest association of doctors, the California Medical Association, opposes the bill.\u003c/p>\n\u003cp>“It will disrupt people's health care at the worst possible time,” said Ned Wigglesworth, a spokesperson for Protect California Health Care, a coalition formed to oppose AB 1400. The coalition includes the California Medical Association as a member.\u003c/p>\n\u003cp>“It will force all 40 million Californians into a new untested state government program and will prohibit them from being able to choose private coverage even if they want it,” he said.\u003c/p>\n\u003cp>In nearly all previous attempts to create a single-payer health system in the United States, the fiercest objections have come from doctors, said \u003ca href=\"https://medicareforallbook.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Micah Johnson, co-author of the book \"Medicare for All: A Citizen’s Guide\"\u003c/a> and a practicing internal medicine physician in Boston.\u003c/p>\n\u003cp>Doctor opposition to single-payer may seem counterintuitive — but Johnson said doctors cannot help but view health reform through the lens of what's best for them as well as what's best for their patients. To the extent they're most concerned with changes to their own pay and autonomy, Johnson called doctors \"double agents in the health reform debate for the last century.\"\u003c/p>\n\u003cp>Johnson spoke with KQED's April Dembosky about the history of physician opposition to single-payer.\u003c/p>\n\u003cp>\u003cem>The following interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>April Dembosky: In your book, you call doctors the \"perennial opponents of health reform.\" What events led you to draw that conclusion? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Dr. Micah Johnson\u003c/strong>: Doctors have had a century-long history in the health reform debate, usually as the opponents. That started back in the 1910s during the progressive era of reforms. This is after Germany, in 1883, had passed health insurance. In 1911, Great Britain had passed health insurance. It seemed clear that the U.S. would be following suit. And initially, it looked like doctors and the American Medical Association were going to be supporters of the bill. But as the discussions unfolded, doctors turned.\u003c/p>\n\u003cp>\u003cstrong>What were their concerns?\u003c/strong>\u003c/p>\n\u003cp>The top one is really their own pay. And the second one is their autonomy in the practice of medicine. Going back to the 1910s and also in the 1940s, there's this fear that if there is a universal public insurance plan, doctors are going to get paid less.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Dr. Micah Johnson, physician and author\"]'I think doctors have been double agents in the health reform debate for the last century ... We wear the hat of medical experts, people who know a lot about what's best for patients, and we also wear a hat that's just our own personal financial interest.'[/pullquote]The most striking example is Harry Truman's health care proposal in the 1940s. This is the first and really only time a sitting U.S. president gave a full-throated endorsement of a single-payer-style, truly universal national health insurance plan.\u003c/p>\n\u003cp>The American Medical Association were the top opponents of the plan. They hired a PR firm called Campaigns Inc. that rose to fame in California, helping to defeat a statewide universal health insurance plan. The American Medical Association put an incredible amount of money behind this at the time: $3.5 million. In today's dollars, that's about $40 million. It was the largest lobbying campaign the nation had ever seen — and it worked.\u003c/p>\n\u003cp>So at the beginning, the public was in support of this national health insurance plan. But then support dwindled over the years — and the vast majority of people had heard of the AMA's opposition to the plan.\u003c/p>\n\u003cp>\u003cstrong>When I talk to doctors who are opposed to the single-payer proposals right now, they say their top concerns are their patients. \u003c/strong>\u003c/p>\n\u003cp>I think doctors have been double agents in the health reform debate for the last century.\u003c/p>\n\u003cp>We wear two hats in these conversations. We wear the hat of medical experts, people who know a lot about what's best for patients, and we also wear a hat that's just our own personal financial interest. I think these things can often get confused and, you know, can be leveraged against each other.\u003c/p>\n\u003cp>\u003cstrong>In the early '60s, there was an early attempt to create a Medicare program for seniors, and back then, doctors hired \u003ca href=\"https://www.youtube.com/watch?v=AYrlDlrLDSQ\" target=\"_blank\" rel=\"noopener noreferrer\">actor Ronald Reagan to speak out\u003c/a> against the idea. He said, “One of the traditional methods of imposing state-ism or socialism on a people, has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project.”\u003c/strong>\u003c/p>\n\u003cp>Definitely a remarkable moment in the history of health reform, and even though Medicare passed, Ronald Reagan was also elected in a landslide in 1980 and ended up presiding over the Medicare program. So we have all these ironies in health reform.\u003c/p>\n\u003cp>[aside postID=news_11901347 hero='https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS5067_NurseChecksBloodPressure-1020x680.jpg']\u003cstrong>How has doctors' thinking evolved from the early 20th century to the Medicare days, to now? \u003c/strong>\u003c/p>\n\u003cp>I think we're really seeing an evolution.\u003c/p>\n\u003cp>First, in seeing doctors support the Affordable Care Act in 2008, 2009. And then over the last 10 years, we've seen a lot of very interesting developments.\u003c/p>\n\u003cp>For one, a majority of doctors in most polls now support single-payer health care. Secondly, we've seen at the American Medical Association that there's some internal debate about what the stance is going to be. In recent years, at one of the AMA's big meetings, it was actually the medical student chapter that brought up a resolution to try to remove the AMA's opposition to single-payer health care — and it very narrowly failed.\u003c/p>\n\u003cp>It got 47% support. So the AMA still opposes single-payer, but we can see signs that things are changing.\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"Doctor opposition to single-payer in California may seem counterintuitive — but it's nothing new. Dr. Micah Johnson, author of 'Medicare for All: A Citizen's Guide,' says doctors are 'double agents' in the health care debate, and are most concerned with changes to their pay and autonomy.","status":"publish","parent":0,"modified":1643217048,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1055},"headData":{"title":"Why Do So Many Doctors Oppose Single-Payer Health Care? | KQED","description":"Doctor opposition to single-payer in California may seem counterintuitive — but it's nothing new. Dr. Micah Johnson, author of 'Medicare for All: A Citizen's Guide,' says doctors are 'double agents' in the health care debate, and are most concerned with changes to their pay and autonomy.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Why Do So Many Doctors Oppose Single-Payer Health Care?","datePublished":"2022-01-26T13:01:59.000Z","dateModified":"2022-01-26T17:10:48.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11902591 https://ww2.kqed.org/news/?p=11902591","disqusUrl":"https://ww2.kqed.org/news/2022/01/26/why-do-so-many-doctors-oppose-single-payer-health-care/","disqusTitle":"Why Do So Many Doctors Oppose Single-Payer Health Care?","audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-41c5-bcaf-aaef00f5a073/00d2d454-591e-4c96-a803-ae28011298b7/audio.mp3","excludeFromSiteSearch":"Include","path":"/news/11902591/why-do-so-many-doctors-oppose-single-payer-health-care","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Legislation that \u003ca href=\"https://www.kqed.org/news/11901347/will-california-create-nations-first-universal-health-care-system\">would help create a single-payer health care system in California\u003c/a>, the first of its kind in the nation, faces a crucial test in the next week. The bill — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220AB1400\" target=\"_blank\" rel=\"noopener noreferrer\">AB 1400\u003c/a> — must pass the full Assembly by Jan. 31, or it’s dead.\u003c/p>\n\u003cp>The California Nurses Association, the state’s nurses union, is leading the effort to pass AB 1400. But the state's largest association of doctors, the California Medical Association, opposes the bill.\u003c/p>\n\u003cp>“It will disrupt people's health care at the worst possible time,” said Ned Wigglesworth, a spokesperson for Protect California Health Care, a coalition formed to oppose AB 1400. The coalition includes the California Medical Association as a member.\u003c/p>\n\u003cp>“It will force all 40 million Californians into a new untested state government program and will prohibit them from being able to choose private coverage even if they want it,” he said.\u003c/p>\n\u003cp>In nearly all previous attempts to create a single-payer health system in the United States, the fiercest objections have come from doctors, said \u003ca href=\"https://medicareforallbook.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Micah Johnson, co-author of the book \"Medicare for All: A Citizen’s Guide\"\u003c/a> and a practicing internal medicine physician in Boston.\u003c/p>\n\u003cp>Doctor opposition to single-payer may seem counterintuitive — but Johnson said doctors cannot help but view health reform through the lens of what's best for them as well as what's best for their patients. To the extent they're most concerned with changes to their own pay and autonomy, Johnson called doctors \"double agents in the health reform debate for the last century.\"\u003c/p>\n\u003cp>Johnson spoke with KQED's April Dembosky about the history of physician opposition to single-payer.\u003c/p>\n\u003cp>\u003cem>The following interview has been edited for length and clarity.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>April Dembosky: In your book, you call doctors the \"perennial opponents of health reform.\" What events led you to draw that conclusion? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Dr. Micah Johnson\u003c/strong>: Doctors have had a century-long history in the health reform debate, usually as the opponents. That started back in the 1910s during the progressive era of reforms. This is after Germany, in 1883, had passed health insurance. In 1911, Great Britain had passed health insurance. It seemed clear that the U.S. would be following suit. And initially, it looked like doctors and the American Medical Association were going to be supporters of the bill. But as the discussions unfolded, doctors turned.\u003c/p>\n\u003cp>\u003cstrong>What were their concerns?\u003c/strong>\u003c/p>\n\u003cp>The top one is really their own pay. And the second one is their autonomy in the practice of medicine. Going back to the 1910s and also in the 1940s, there's this fear that if there is a universal public insurance plan, doctors are going to get paid less.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'I think doctors have been double agents in the health reform debate for the last century ... We wear the hat of medical experts, people who know a lot about what's best for patients, and we also wear a hat that's just our own personal financial interest.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Dr. Micah Johnson, physician and author","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>The most striking example is Harry Truman's health care proposal in the 1940s. This is the first and really only time a sitting U.S. president gave a full-throated endorsement of a single-payer-style, truly universal national health insurance plan.\u003c/p>\n\u003cp>The American Medical Association were the top opponents of the plan. They hired a PR firm called Campaigns Inc. that rose to fame in California, helping to defeat a statewide universal health insurance plan. The American Medical Association put an incredible amount of money behind this at the time: $3.5 million. In today's dollars, that's about $40 million. It was the largest lobbying campaign the nation had ever seen — and it worked.\u003c/p>\n\u003cp>So at the beginning, the public was in support of this national health insurance plan. But then support dwindled over the years — and the vast majority of people had heard of the AMA's opposition to the plan.\u003c/p>\n\u003cp>\u003cstrong>When I talk to doctors who are opposed to the single-payer proposals right now, they say their top concerns are their patients. \u003c/strong>\u003c/p>\n\u003cp>I think doctors have been double agents in the health reform debate for the last century.\u003c/p>\n\u003cp>We wear two hats in these conversations. We wear the hat of medical experts, people who know a lot about what's best for patients, and we also wear a hat that's just our own personal financial interest. I think these things can often get confused and, you know, can be leveraged against each other.\u003c/p>\n\u003cp>\u003cstrong>In the early '60s, there was an early attempt to create a Medicare program for seniors, and back then, doctors hired \u003ca href=\"https://www.youtube.com/watch?v=AYrlDlrLDSQ\" target=\"_blank\" rel=\"noopener noreferrer\">actor Ronald Reagan to speak out\u003c/a> against the idea. He said, “One of the traditional methods of imposing state-ism or socialism on a people, has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project.”\u003c/strong>\u003c/p>\n\u003cp>Definitely a remarkable moment in the history of health reform, and even though Medicare passed, Ronald Reagan was also elected in a landslide in 1980 and ended up presiding over the Medicare program. So we have all these ironies in health reform.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11901347","hero":"https://ww2.kqed.org/app/uploads/sites/10/2022/01/RS5067_NurseChecksBloodPressure-1020x680.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cstrong>How has doctors' thinking evolved from the early 20th century to the Medicare days, to now? \u003c/strong>\u003c/p>\n\u003cp>I think we're really seeing an evolution.\u003c/p>\n\u003cp>First, in seeing doctors support the Affordable Care Act in 2008, 2009. And then over the last 10 years, we've seen a lot of very interesting developments.\u003c/p>\n\u003cp>For one, a majority of doctors in most polls now support single-payer health care. Secondly, we've seen at the American Medical Association that there's some internal debate about what the stance is going to be. In recent years, at one of the AMA's big meetings, it was actually the medical student chapter that brought up a resolution to try to remove the AMA's opposition to single-payer health care — and it very narrowly failed.\u003c/p>\n\u003cp>It got 47% support. So the AMA still opposes single-payer, but we can see signs that things are changing.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11902591/why-do-so-many-doctors-oppose-single-payer-health-care","authors":["3205"],"programs":["news_72"],"categories":["news_457","news_8"],"tags":["news_18538","news_17606","news_27626","news_22597","news_29900"],"featImg":"news_11902679","label":"news_72"},"news_11871986":{"type":"posts","id":"news_11871986","meta":{"index":"posts_1591205157","site":"news","id":"11871986","score":null,"sort":[1620071791000]},"guestAuthors":[],"slug":"a-moral-obligation-south-asian-diaspora-assist-covid-in-india-with-money-and-time","title":"‘A Moral Obligation’: South Asian Diaspora Assists COVID Efforts in India With Money and Time","publishDate":1620071791,"format":"standard","headTitle":"KQED News","labelTerm":{"site":"news"},"content":"\u003cp>As the South Asian diaspora continues to witness the \u003ca href=\"https://apnews.com/article/india-science-coronavirus-business-health-c2a72c4d2ab29aa163e785ca98181023\" target=\"_blank\" rel=\"noopener noreferrer\">horrific scenes\u003c/a> of mass funeral pyres and overrun hospitals in India, many in the Bay Area and across the country are finding ways to contribute to ongoing relief efforts rooted in community-based organizations in India.\u003c/p>\n\u003cp>They're pioneering creative ways of providing help and assistance, like cross-continental video chats for doctor's visits. As the country's official death toll nears 220,000, \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2021/04/30/992451165/india-is-counting-thousands-of-daily-covid-deaths-how-many-is-it-missing\">with many saying that is an undercount\u003c/a>, the need to help is only mounting.\u003c/p>\n\u003cp>“It is totally surreal,\" said Harish Ramadas, president of the San Francisco Bay Area chapter of \u003ca href=\"https://aidindia.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Association for India’s Development\u003c/a>, on the contrast between the ease of getting a vaccine in the Bay Area and the pain and suffering in many parts of India.\u003c/p>\n\u003cp>Ramadas said he and many fellow AID volunteers cope with the disconnect between their lives in the rapidly reopening Bay Area and horrors in India by volunteering and fundraising as much as possible, and using their privileged position to advocate on behalf of others.[pullquote size=\"medium\" align=\"right\" citation=\"Zain Alam, co-creator of Doctors in Diaspora\"]'We have the access to technology, we have WhatsApp, we have phones, we have the internet, we can be creative and make a difference.'[/pullquote]\u003c/p>\n\u003cp>AID is a mainly volunteer-run organization that has supported traditional development efforts in India for nearly 30 years. Ramadas said their focus is on grassroots partnerships, working in areas of social and environmental justice, health care, education and labor rights. \u003c/p>\n\u003cp>“We learn from them and the solutions that we help implement are all community-driven as opposed to a sort of top-down, paternalistic colonial approach,” Ramadas said. AID works directly with communities.\u003c/p>\n\u003cp>Shrinaath Chidambaram, who lives in Los Altos, is on the board of directors for AID. For him, it's about more than the current news media cycle. \u003c/p>\n\u003cp>“I think first thing is for people to just go beyond the headlines and recognize that this is a multidimensional problem,\" he said. \"Hospital scenes and the crematorium scenes are heartbreaking, but there is a much bigger crisis yet to come,” Chidambaram said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>AID is taking a multipronged approach — looking at four main aspects: oxygen shortages, supporting medical help desks, helping people stay home and promoting vaccine awareness. For \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2020/03/31/822642382/coronavirus-lockdown-sends-migrant-workers-on-a-long-and-risky-trip-home\" target=\"_blank\" rel=\"noopener noreferrer\">daily wage earners, and migrant laborers\u003c/a>, earning enough money and buying supplies in advance can be a challenge and nearly impossible in some cases. \u003c/p>\n\u003cp>“If not controlled in some form, it's going to really lead to a disaster of epic proportions,” Chidambaram said of COVID-19 in India. The impact is already being \u003ca href=\"https://apnews.com/article/india-europe-business-global-trade-coronavirus-e95f0515b68ed20ea1f0a53bdea3ffae\" target=\"_blank\" rel=\"noopener noreferrer\">felt in neighboring Bangladesh\u003c/a>, as the federal government bans vaccine exports.\u003c/p>\n\u003cp>While AID has existed for many years and is a reliable grassroots organization serving many parts of India, others in the Bay Area are focusing donations and assistance to specific marginalized communities, like the transgender community, or \u003ca href=\"https://www.npr.org/sections/parallels/2014/04/18/304548675/a-journey-of-pain-and-beauty-on-becoming-transgender-in-india\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cem>hijra\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>“While we recognize that everybody is in panic and running around, our community is being left behind,” Anjali Rimi told KQED. \u003c/p>\n\u003cp>“They are starving,” Rimi said of the trans community in India. “Other communities still have access to the internet to be able to order delivery or be able to go out.” \u003c/p>\n\u003cp>Rimi is encouraging people to give to a specific GoFundMe, \u003ca href=\"https://www.gofundme.com/f/save-indian-trans-lives-covid-relief\" target=\"_blank\" rel=\"noopener noreferrer\">Save Indian Trans Lives: COVID Relief\u003c/a>, organized by \u003ca href=\"https://parivarbayarea.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Parivar Bay Area\u003c/a>. \u003c/p>\n\u003cp>“We have now over 6,000 trans folks that have reached out for help,” Rimi said.\u003c/p>\n\u003cp>In addition to Bay Area efforts, newer initiatives have popped up across the country in the last week to meet the immediate needs of those in search of doctors and medical attention.\u003c/p>\n\u003cp>Zain Alam, along with members of the South Asian diaspora mostly based in New York, started \u003ca href=\"http://doctorsindiaspora.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Doctors in Diaspora\u003c/a> just last week to connect volunteer doctors virtually to people in India facing a medical professional shortages.\u003c/p>\n\u003cp>“We were really, just really, really struck by what we were hearing from our families and India about the total lack of a response on the part of the state there,” Alam said. They are urging doctors from the Indian diaspora to sign up, as well as doctors in less impacted locations in India. Based on availability, doctors are then matched with those needing assistance in India for remote consultations. Others interested in supporting the project are also welcome, and Alam said they’ve just had the first round of calls this weekend. But they will soon be using an app designed for the pandemic, which will allow doctors and patients to speak without the need to reveal personal contact information.\u003c/p>\n\u003cp>Alam said the initial calls between doctors and patients underlined how critical this work is. Though they estimated each call would be closer to 10 minutes, Alam said most were closer to 20 minutes. “There's just not enough medical professionals in India right now to speak to people — they don't have time to talk to anyone,” he said.\u003c/p>\n\u003cp>Alam and others involved in the project hope to take advantage of the wealth, knowledge and resources of the diaspora. \"We have a very specific ability to speak to the needs in India right now,\" he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While he acknowledged that often the American way to give aid is \"throwing money at a problem,\" he said, “this is a way that we can give that is a little bit more pointed than just giving money.\" [aside tag=\"india, covid\" label=\"More Related Stories\"]\u003c/p>\n\u003cp>In this case, the ease in which many in India and abroad are able to access technology makes the project possible. “We have the access to technology, we have WhatsApp, we have phones, we have the Internet, we can be creative and make a difference,” Alam said.\u003c/p>\n\u003cp>Back in the Bay Area, members of AID are also suggesting those in the U.S. lobby members of Congress to get the federal government \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2021/01/05/953653373/some-experts-say-temporary-halt-on-drug-patents-is-needed-to-stop-pandemic-world\">to release vaccine patents\u003c/a>.\u003c/p>\n\u003cp>“This is a situation where we really have a moral obligation to just put in everything we've got to help the people of India and other parts of the world that are in similarly difficult situations,” Ramadas said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"'This is a situation where we really have a moral obligation to just put in everything we've got to help the people of India — and other parts of the world that are in similarly difficult situations,' said Harish Ramadas, president of the San Francisco chapter of Association for India’s Development.","status":"publish","parent":0,"modified":1620075279,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1067},"headData":{"title":"‘A Moral Obligation’: South Asian Diaspora Assists COVID Efforts in India With Money and Time | KQED","description":"'This is a situation where we really have a moral obligation to just put in everything we've got to help the people of India — and other parts of the world that are in similarly difficult situations,' said Harish Ramadas, president of the San Francisco chapter of Association for India’s Development.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"‘A Moral Obligation’: South Asian Diaspora Assists COVID Efforts in India With Money and Time","datePublished":"2021-05-03T19:56:31.000Z","dateModified":"2021-05-03T20:54:39.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11871986 https://ww2.kqed.org/news/?p=11871986","disqusUrl":"https://ww2.kqed.org/news/2021/05/03/a-moral-obligation-south-asian-diaspora-assist-covid-in-india-with-money-and-time/","disqusTitle":"‘A Moral Obligation’: South Asian Diaspora Assists COVID Efforts in India With Money and Time","path":"/news/11871986/a-moral-obligation-south-asian-diaspora-assist-covid-in-india-with-money-and-time","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>As the South Asian diaspora continues to witness the \u003ca href=\"https://apnews.com/article/india-science-coronavirus-business-health-c2a72c4d2ab29aa163e785ca98181023\" target=\"_blank\" rel=\"noopener noreferrer\">horrific scenes\u003c/a> of mass funeral pyres and overrun hospitals in India, many in the Bay Area and across the country are finding ways to contribute to ongoing relief efforts rooted in community-based organizations in India.\u003c/p>\n\u003cp>They're pioneering creative ways of providing help and assistance, like cross-continental video chats for doctor's visits. As the country's official death toll nears 220,000, \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2021/04/30/992451165/india-is-counting-thousands-of-daily-covid-deaths-how-many-is-it-missing\">with many saying that is an undercount\u003c/a>, the need to help is only mounting.\u003c/p>\n\u003cp>“It is totally surreal,\" said Harish Ramadas, president of the San Francisco Bay Area chapter of \u003ca href=\"https://aidindia.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Association for India’s Development\u003c/a>, on the contrast between the ease of getting a vaccine in the Bay Area and the pain and suffering in many parts of India.\u003c/p>\n\u003cp>Ramadas said he and many fellow AID volunteers cope with the disconnect between their lives in the rapidly reopening Bay Area and horrors in India by volunteering and fundraising as much as possible, and using their privileged position to advocate on behalf of others.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'We have the access to technology, we have WhatsApp, we have phones, we have the internet, we can be creative and make a difference.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Zain Alam, co-creator of Doctors in Diaspora","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>AID is a mainly volunteer-run organization that has supported traditional development efforts in India for nearly 30 years. Ramadas said their focus is on grassroots partnerships, working in areas of social and environmental justice, health care, education and labor rights. \u003c/p>\n\u003cp>“We learn from them and the solutions that we help implement are all community-driven as opposed to a sort of top-down, paternalistic colonial approach,” Ramadas said. AID works directly with communities.\u003c/p>\n\u003cp>Shrinaath Chidambaram, who lives in Los Altos, is on the board of directors for AID. For him, it's about more than the current news media cycle. \u003c/p>\n\u003cp>“I think first thing is for people to just go beyond the headlines and recognize that this is a multidimensional problem,\" he said. \"Hospital scenes and the crematorium scenes are heartbreaking, but there is a much bigger crisis yet to come,” Chidambaram said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>AID is taking a multipronged approach — looking at four main aspects: oxygen shortages, supporting medical help desks, helping people stay home and promoting vaccine awareness. For \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2020/03/31/822642382/coronavirus-lockdown-sends-migrant-workers-on-a-long-and-risky-trip-home\" target=\"_blank\" rel=\"noopener noreferrer\">daily wage earners, and migrant laborers\u003c/a>, earning enough money and buying supplies in advance can be a challenge and nearly impossible in some cases. \u003c/p>\n\u003cp>“If not controlled in some form, it's going to really lead to a disaster of epic proportions,” Chidambaram said of COVID-19 in India. The impact is already being \u003ca href=\"https://apnews.com/article/india-europe-business-global-trade-coronavirus-e95f0515b68ed20ea1f0a53bdea3ffae\" target=\"_blank\" rel=\"noopener noreferrer\">felt in neighboring Bangladesh\u003c/a>, as the federal government bans vaccine exports.\u003c/p>\n\u003cp>While AID has existed for many years and is a reliable grassroots organization serving many parts of India, others in the Bay Area are focusing donations and assistance to specific marginalized communities, like the transgender community, or \u003ca href=\"https://www.npr.org/sections/parallels/2014/04/18/304548675/a-journey-of-pain-and-beauty-on-becoming-transgender-in-india\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cem>hijra\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>“While we recognize that everybody is in panic and running around, our community is being left behind,” Anjali Rimi told KQED. \u003c/p>\n\u003cp>“They are starving,” Rimi said of the trans community in India. “Other communities still have access to the internet to be able to order delivery or be able to go out.” \u003c/p>\n\u003cp>Rimi is encouraging people to give to a specific GoFundMe, \u003ca href=\"https://www.gofundme.com/f/save-indian-trans-lives-covid-relief\" target=\"_blank\" rel=\"noopener noreferrer\">Save Indian Trans Lives: COVID Relief\u003c/a>, organized by \u003ca href=\"https://parivarbayarea.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Parivar Bay Area\u003c/a>. \u003c/p>\n\u003cp>“We have now over 6,000 trans folks that have reached out for help,” Rimi said.\u003c/p>\n\u003cp>In addition to Bay Area efforts, newer initiatives have popped up across the country in the last week to meet the immediate needs of those in search of doctors and medical attention.\u003c/p>\n\u003cp>Zain Alam, along with members of the South Asian diaspora mostly based in New York, started \u003ca href=\"http://doctorsindiaspora.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Doctors in Diaspora\u003c/a> just last week to connect volunteer doctors virtually to people in India facing a medical professional shortages.\u003c/p>\n\u003cp>“We were really, just really, really struck by what we were hearing from our families and India about the total lack of a response on the part of the state there,” Alam said. They are urging doctors from the Indian diaspora to sign up, as well as doctors in less impacted locations in India. Based on availability, doctors are then matched with those needing assistance in India for remote consultations. Others interested in supporting the project are also welcome, and Alam said they’ve just had the first round of calls this weekend. But they will soon be using an app designed for the pandemic, which will allow doctors and patients to speak without the need to reveal personal contact information.\u003c/p>\n\u003cp>Alam said the initial calls between doctors and patients underlined how critical this work is. Though they estimated each call would be closer to 10 minutes, Alam said most were closer to 20 minutes. “There's just not enough medical professionals in India right now to speak to people — they don't have time to talk to anyone,” he said.\u003c/p>\n\u003cp>Alam and others involved in the project hope to take advantage of the wealth, knowledge and resources of the diaspora. \"We have a very specific ability to speak to the needs in India right now,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While he acknowledged that often the American way to give aid is \"throwing money at a problem,\" he said, “this is a way that we can give that is a little bit more pointed than just giving money.\" \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"tag":"india, covid","label":"More Related Stories "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In this case, the ease in which many in India and abroad are able to access technology makes the project possible. “We have the access to technology, we have WhatsApp, we have phones, we have the Internet, we can be creative and make a difference,” Alam said.\u003c/p>\n\u003cp>Back in the Bay Area, members of AID are also suggesting those in the U.S. lobby members of Congress to get the federal government \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2021/01/05/953653373/some-experts-say-temporary-halt-on-drug-patents-is-needed-to-stop-pandemic-world\">to release vaccine patents\u003c/a>.\u003c/p>\n\u003cp>“This is a situation where we really have a moral obligation to just put in everything we've got to help the people of India and other parts of the world that are in similarly difficult situations,” Ramadas said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11871986/a-moral-obligation-south-asian-diaspora-assist-covid-in-india-with-money-and-time","authors":["11626"],"categories":["news_457","news_28250","news_8"],"tags":["news_29418","news_27350","news_27504","news_26027","news_29419","news_17606","news_29420","news_18436","news_28528"],"featImg":"news_11871988","label":"news"},"news_11825898":{"type":"posts","id":"news_11825898","meta":{"index":"posts_1591205157","site":"news","id":"11825898","score":null,"sort":[1593007241000]},"guestAuthors":[],"slug":"i-feel-so-overwhelmed-covid-19-and-police-violence-takes-a-toll-on-black-health-care-workers","title":"'I Feel So Overwhelmed': COVID-19 and Police Violence Takes a Toll on Black Health Care Workers","publishDate":1593007241,"format":"audio","headTitle":"KQED News","labelTerm":{"site":"news"},"content":"\u003cp>Dr. Tiffany Chioma Anaebere doesn’t remember where she was when she heard about George Floyd’s death.\u003c/p>\n\u003cp>She could’ve been at her home in Emeryville, where she lives with her fiance. Or in the car, during one of her many commutes between Stockton and Modesto, where she works in two different hospitals as an emergency medicine physician on the frontlines of the coronavirus pandemic.\u003c/p>\n\u003cp>All she knows is that, at first, she avoided watching the video.\u003c/p>\n\u003cp>“I refused to. Like, I cannot see anything right now. And I'm normally the person that's like, ‘Girl, did you see this video?’” she said. “I was like ‘No, no, no, no, no, I’m not watching anything.’”\u003c/p>\n\u003cp>But eventually, days after the story of Floyd’s death had permeated the national consciousness and tens of thousands took to the streets to demand justice, Chioma Anaebere finally sat down and watched it.\u003c/p>\n\u003cp>“I remember watching it and just being like, ‘OK, well, I am now debilitatingly depressed,’” she said. “I was already teetering on the edge. And… it was over after that.\"\u003c/p>\n\u003cfigure id=\"attachment_11825940\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11825940\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Tiffany Chioma Anaebere removes the medical gear that she uses as an emergency room doctor. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘Depression, Anxiety, Insomnia, Distress’\u003c/h3>\n\u003cp>Across the United States, and the world, health care workers are experiencing high levels of anxiety and stress due to the overwhelming workload of the COVID-19 pandemic. \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229\">A March study\u003c/a> of over 1,200 health care workers in China found that a large proportion experienced symptoms of “depression, anxiety, insomnia and distress.”\u003c/p>\n\u003cp>And those feelings of stress and anxiety can be compounded for Black health care workers, who make up more than 11% of these types of workers in the United States.\u003c/p>\n\u003cp>Along with reports showing that the coronavirus \u003ca href=\"https://www.npr.org/sections/health-shots/2020/05/30/865413079/what-do-coronavirus-racial-disparities-look-like-state-by-state\">disproportionately impacts\u003c/a> Black, Latino and Indigenous people, workers also leave their long, grueling shifts only to experience racism in many aspects of their daily life — including coming home to news reports and videos of violence. [pullquote size='medium' align='right' citation='Dr. Tiffany Chioma Anaebere, after seeing the video of George Floyd being killed']''OK, well, I am now debilitatingly depressed.' I was already teetering on the edge. And… it was over after that.'[/pullquote]\u003c/p>\n\u003cp>Dr. Georgia Davies is an emergency medicine physician currently wrapping up her residency at Rutgers Medical School. Davies said she felt the same depression and sadness as her colleagues in the medical field due to COVID-19. But it wasn’t until news about the deaths of George Floyd, Breonna Taylor and numerous others came out that she started noticing the effects on her mental health.\u003c/p>\n\u003cp>“I’m the type of person that, when I’m tired, I can go to sleep immediately. And for the first time ever in my life, like, last week and the week before, I’ve not really been able to,” Davies said.\u003c/p>\n\u003cp>“You have fathers, your brothers, your uncles, you have nephews, … you have significant others that look like someone like George Floyd. And just, getting scared for them and scared for yourself,” she added.\u003c/p>\n\u003cp>“The racism, the police brutality, the [pandemic], the poverty, the inequities and injustices—all of those things are creating this hurricane of violence that's out there in the community,” said Deborah Burger, president of the California Nurses Association.\u003c/p>\n\u003cp>Burger said health care workers need “some kind of outlet” to help deal with both their stressful work environment and the stressors they’re experiencing every day.\u003c/p>\n\u003ch3>A Crisis Line for Health Care Workers\u003c/h3>\n\u003cp>It was in that spirit that Alameda County mental health workers and advocates began developing a crisis line for health care workers. The line \u003ca href=\"https://sites.google.com/crisissupport.org/ssac19/home\">launched in May\u003c/a> and is designed to encompass workers from all sectors of the health care — including janitorial and maintenance staff.\u003c/p>\n\u003cp>Alice LoCicero, president-elect of the Alameda County Psychological Association, helped craft the program.\u003c/p>\n\u003cp>“Some of the least well-served and most stressed people in the health care settings are not only the health care workers themselves … but all the other workers,” LoCicero said. “Sanitation crews and maintenance people and food service employees and others who are really often unseen, but are having the same kinds of stresses.” [pullquote size='medium' align='right' citation='Binh Au, Crisis Line Program Director']'Everyday they’re holding a trauma and they’re holding these experiences and grief. And COVID-19 has exacerbated that trauma, has exacerbated that grief'[/pullquote]\u003c/p>\n\u003cp>The line currently has 100 volunteers and 20 paid staff. Workers at the crisis line say callers are expressing feelings of compassion-fatigue and burnout.\u003c/p>\n\u003cp>“When you’re in the helping profession, one way of self care is to have a distance between yourself and the person you’re helping,” said Binh Au, the crisis line program director at Crisis Support Services of Alameda County.\u003c/p>\n\u003cp>But, Au said, during a pandemic it’s difficult to get that distance because workers are experiencing the same conditions as the people they’re serving. And that includes experiencing racism firsthand as well as the secondary trauma of seeing Black people killed by police officers.\u003c/p>\n\u003cp>“Everyday they’re holding a trauma and they’re holding these experiences and grief. And COVID-19 has exacerbated that trauma, has exacerbated that grief,” Au explained.\u003c/p>\n\u003cfigure id=\"attachment_11825941\" class=\"wp-caption aligncenter\" style=\"max-width: 1912px\">\u003cimg class=\"size-full wp-image-11825941\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43682_010_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg\" alt=\"\" width=\"1912\" height=\"1403\">\u003cfigcaption class=\"wp-caption-text\">“We're not getting any reprieve,” Dr. Tiffany Chioma Anaebere said. “We're not getting any sort of respite from the pandemic. And you’re putting this on our communities as well. Like... have some empathy, have some mercy.” \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Coping with Additive Stress\u003c/h3>\n\u003cp>After watching the video of George Floyd, Chioma Anaebere said she stayed in bed, in the dark, for days. At one point, she considered calling out sick from work.\u003c/p>\n\u003cp>“I feel so overwhelmed and almost as if I can't pay attention,” she said. “And I don't want to, you know, put patients at risk cause I literally cannot focus. But then having to [say] like, ‘OK, I need to block this out.’”\u003c/p>\n\u003cfigure id=\"attachment_11825943\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11825943 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1.jpeg\" alt=\"Dr. Jessica Edwards of Texas said she's been spending even more time with her patients, talking through their feelings in this moment.\" width=\"1920\" height=\"2560\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1.jpeg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-800x1067.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-1020x1360.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-160x213.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-1152x1536.jpeg 1152w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-1536x2048.jpeg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-1122x1496.jpeg 1122w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-840x1120.jpeg 840w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-687x916.jpeg 687w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-414x552.jpeg 414w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-354x472.jpeg 354w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Edwards of Texas said she's been spending even more time with her patients, talking through their feelings in this moment. \u003ccite>(Courtesy of Dr. Jessica Edwards)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But the video sat in the back of her mind. In order to help process what she’d seen, Chioma Anaebere started writing.\u003c/p>\n\u003cp>She drafted an article on the lessons police can learn from health care practitioners, which was recently published in \u003ca href=\"https://www.scientificamerican.com/article/policing-can-take-a-lesson-from-health-care/\">Scientific American\u003c/a>. Finishing it, she said, was the first time she felt “a huge sigh of relief” because it allowed her to work her thoughts and feelings out on the page.\u003c/p>\n\u003cp>Dr. Jessica Edwards, a family physician in Texas, also said writing has helped her process her feelings. She’s written several \u003ca href=\"https://www.straightfactsnochaserpodcast.com/blog\">blog posts\u003c/a> and dedicated an episode of \u003ca href=\"https://www.straightfactsnochaserpodcast.com/podcastepisodes\">her podcast\u003c/a> to social determinants of health and how they impact Black Americans.\u003c/p>\n\u003cp>“For me, those things have been really important for my mental health,” Edwards said.\u003c/p>\n\u003cp>Edwards has also been spending even more time with her patients, talking through their feelings in this moment.\u003c/p>\n\u003cp>But between a pandemic that disproportionately impacts communities of color and ongoing police violence, it’s a lot of weight to carry.\u003c/p>\n\u003cp>“We're not getting any reprieve,” Chioma Anaebere said. “We're not getting any sort of respite from the pandemic. And you’re putting this on our communities as well. Like... have some empathy, have some mercy.”\u003c/p>\n\u003cp>And while protesting in a pandemic may be dangerous, Chioma Anaebere says that, for many, this issue is more important than their own personal health. [ad fullwidth]\u003c/p>\n\u003ch3>Other Ways to Cope\u003c/h3>\n\u003cp>Here are some other techniques health care workers recommended for taking care of one’s mental health during this challenging time:\u003c/p>\n\u003cp>\u003cstrong>Dr. Tiffany Chioma Anaebere, Emeryville:\u003c/strong> “Talking to friends and family helps a lot as well. And hearing people feel the same way that you do, and know that you're not isolated in your own experience.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Georgia Davies, New Jersey:\u003c/strong> “I'm really big on my mental health and physical fitness, and I feel like physical being physically fit kind of helps with your mental health.\u003c/p>\n\u003cp>“One thing I had to do in the last two weeks is, I don't turn on the TV anymore to really watch the news at all, because I think I was also making me very anxious. … [I]t's always something new. It's always something different. So I think shutting that off is, kind of, helping me cope as well.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Jessica Edwards, Texas:\u003c/strong> “...Being able to, you know, donate to an action PAC … volunteering with my local democratic society as a physician, volunteering and, you know, going door to door, knocking on doors … it's not always a fun experience, but that's the way that I can sort of get my emotions out now.”\u003c/p>\n\u003cp>\u003cstrong>President-Elect of the Alameda County Psychological Association Alice LoCicero:\u003c/strong> “The big four are: sleep, nutrition, exercise and social connection.”\u003c/p>\n\u003cp>\u003cstrong>Crisis Support Services of Alameda County Director Binh Au:\u003c/strong> “The message that we want to send our workers is that: please reach out for help. Treat yourself with the kindness and care that you would treat your patients, your colleagues, your clients. And think about self care as a necessary part of your job.”\u003c/p>\n\u003ch3>More Resources\u003c/h3>\n\u003cul>\n\u003cli>\u003ca href=\"https://sites.google.com/crisissupport.org/ssac19/home\">Staying Strong Against COVID-19\u003c/a>: The Alameda County Crisis Line for Health Care Workers, 510-420-3222\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/arts/13881725/where-to-find-affordable-culturally-competent-therapy-in-bay-area-and-beyond\">Where to Find Affordable, Culturally Competent Therapy in Bay Area and Beyond\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11808968/coronavirus-is-impacting-the-bay-areas-mental-health-where-can-you-find-help#resources\">Coronavirus Is Impacting the Bay Area's Mental Health. Where Can You Find Help?\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>California state officials also compiled a list of mental health resources \u003ca href=\"https://covid19.ca.gov/resources-for-emotional-support-and-well-being/#top\">here\u003c/a>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Across the United States, and the world, health care workers are experiencing high levels of anxiety and stress due to the overwhelming workload of the COVID-19 pandemic. And those feelings of stress and anxiety can be compounded for Black health care workers. ","status":"publish","parent":0,"modified":1592977211,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":40,"wordCount":1692},"headData":{"title":"'I Feel So Overwhelmed': COVID-19 and Police Violence Takes a Toll on Black Health Care Workers | KQED","description":"Across the United States, and the world, health care workers are experiencing high levels of anxiety and stress due to the overwhelming workload of the COVID-19 pandemic. And those feelings of stress and anxiety can be compounded for Black health care workers. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"'I Feel So Overwhelmed': COVID-19 and Police Violence Takes a Toll on Black Health Care Workers","datePublished":"2020-06-24T14:00:41.000Z","dateModified":"2020-06-24T05:40:11.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11825898 https://ww2.kqed.org/news/?p=11825898","disqusUrl":"https://ww2.kqed.org/news/2020/06/24/i-feel-so-overwhelmed-covid-19-and-police-violence-takes-a-toll-on-black-health-care-workers/","disqusTitle":"'I Feel So Overwhelmed': COVID-19 and Police Violence Takes a Toll on Black Health Care Workers","audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-41c5-bcaf-aaef00f5a073/42722567-4b40-452a-86aa-abe30106e296/audio.mp3","path":"/news/11825898/i-feel-so-overwhelmed-covid-19-and-police-violence-takes-a-toll-on-black-health-care-workers","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Tiffany Chioma Anaebere doesn’t remember where she was when she heard about George Floyd’s death.\u003c/p>\n\u003cp>She could’ve been at her home in Emeryville, where she lives with her fiance. Or in the car, during one of her many commutes between Stockton and Modesto, where she works in two different hospitals as an emergency medicine physician on the frontlines of the coronavirus pandemic.\u003c/p>\n\u003cp>All she knows is that, at first, she avoided watching the video.\u003c/p>\n\u003cp>“I refused to. Like, I cannot see anything right now. And I'm normally the person that's like, ‘Girl, did you see this video?’” she said. “I was like ‘No, no, no, no, no, I’m not watching anything.’”\u003c/p>\n\u003cp>But eventually, days after the story of Floyd’s death had permeated the national consciousness and tens of thousands took to the streets to demand justice, Chioma Anaebere finally sat down and watched it.\u003c/p>\n\u003cp>“I remember watching it and just being like, ‘OK, well, I am now debilitatingly depressed,’” she said. “I was already teetering on the edge. And… it was over after that.\"\u003c/p>\n\u003cfigure id=\"attachment_11825940\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-11825940\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43685_013_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Tiffany Chioma Anaebere removes the medical gear that she uses as an emergency room doctor. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>‘Depression, Anxiety, Insomnia, Distress’\u003c/h3>\n\u003cp>Across the United States, and the world, health care workers are experiencing high levels of anxiety and stress due to the overwhelming workload of the COVID-19 pandemic. \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229\">A March study\u003c/a> of over 1,200 health care workers in China found that a large proportion experienced symptoms of “depression, anxiety, insomnia and distress.”\u003c/p>\n\u003cp>And those feelings of stress and anxiety can be compounded for Black health care workers, who make up more than 11% of these types of workers in the United States.\u003c/p>\n\u003cp>Along with reports showing that the coronavirus \u003ca href=\"https://www.npr.org/sections/health-shots/2020/05/30/865413079/what-do-coronavirus-racial-disparities-look-like-state-by-state\">disproportionately impacts\u003c/a> Black, Latino and Indigenous people, workers also leave their long, grueling shifts only to experience racism in many aspects of their daily life — including coming home to news reports and videos of violence. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"''OK, well, I am now debilitatingly depressed.' I was already teetering on the edge. And… it was over after that.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Dr. Tiffany Chioma Anaebere, after seeing the video of George Floyd being killed","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Georgia Davies is an emergency medicine physician currently wrapping up her residency at Rutgers Medical School. Davies said she felt the same depression and sadness as her colleagues in the medical field due to COVID-19. But it wasn’t until news about the deaths of George Floyd, Breonna Taylor and numerous others came out that she started noticing the effects on her mental health.\u003c/p>\n\u003cp>“I’m the type of person that, when I’m tired, I can go to sleep immediately. And for the first time ever in my life, like, last week and the week before, I’ve not really been able to,” Davies said.\u003c/p>\n\u003cp>“You have fathers, your brothers, your uncles, you have nephews, … you have significant others that look like someone like George Floyd. And just, getting scared for them and scared for yourself,” she added.\u003c/p>\n\u003cp>“The racism, the police brutality, the [pandemic], the poverty, the inequities and injustices—all of those things are creating this hurricane of violence that's out there in the community,” said Deborah Burger, president of the California Nurses Association.\u003c/p>\n\u003cp>Burger said health care workers need “some kind of outlet” to help deal with both their stressful work environment and the stressors they’re experiencing every day.\u003c/p>\n\u003ch3>A Crisis Line for Health Care Workers\u003c/h3>\n\u003cp>It was in that spirit that Alameda County mental health workers and advocates began developing a crisis line for health care workers. The line \u003ca href=\"https://sites.google.com/crisissupport.org/ssac19/home\">launched in May\u003c/a> and is designed to encompass workers from all sectors of the health care — including janitorial and maintenance staff.\u003c/p>\n\u003cp>Alice LoCicero, president-elect of the Alameda County Psychological Association, helped craft the program.\u003c/p>\n\u003cp>“Some of the least well-served and most stressed people in the health care settings are not only the health care workers themselves … but all the other workers,” LoCicero said. “Sanitation crews and maintenance people and food service employees and others who are really often unseen, but are having the same kinds of stresses.” \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'Everyday they’re holding a trauma and they’re holding these experiences and grief. And COVID-19 has exacerbated that trauma, has exacerbated that grief'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Binh Au, Crisis Line Program Director","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The line currently has 100 volunteers and 20 paid staff. Workers at the crisis line say callers are expressing feelings of compassion-fatigue and burnout.\u003c/p>\n\u003cp>“When you’re in the helping profession, one way of self care is to have a distance between yourself and the person you’re helping,” said Binh Au, the crisis line program director at Crisis Support Services of Alameda County.\u003c/p>\n\u003cp>But, Au said, during a pandemic it’s difficult to get that distance because workers are experiencing the same conditions as the people they’re serving. And that includes experiencing racism firsthand as well as the secondary trauma of seeing Black people killed by police officers.\u003c/p>\n\u003cp>“Everyday they’re holding a trauma and they’re holding these experiences and grief. And COVID-19 has exacerbated that trauma, has exacerbated that grief,” Au explained.\u003c/p>\n\u003cfigure id=\"attachment_11825941\" class=\"wp-caption aligncenter\" style=\"max-width: 1912px\">\u003cimg class=\"size-full wp-image-11825941\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/RS43682_010_KQED_Emeryville_TiffanyChiomaAnaebere_06172020-qut.jpg\" alt=\"\" width=\"1912\" height=\"1403\">\u003cfigcaption class=\"wp-caption-text\">“We're not getting any reprieve,” Dr. Tiffany Chioma Anaebere said. “We're not getting any sort of respite from the pandemic. And you’re putting this on our communities as well. Like... have some empathy, have some mercy.” \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Coping with Additive Stress\u003c/h3>\n\u003cp>After watching the video of George Floyd, Chioma Anaebere said she stayed in bed, in the dark, for days. At one point, she considered calling out sick from work.\u003c/p>\n\u003cp>“I feel so overwhelmed and almost as if I can't pay attention,” she said. “And I don't want to, you know, put patients at risk cause I literally cannot focus. But then having to [say] like, ‘OK, I need to block this out.’”\u003c/p>\n\u003cfigure id=\"attachment_11825943\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"wp-image-11825943 size-full\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1.jpeg\" alt=\"Dr. Jessica Edwards of Texas said she's been spending even more time with her patients, talking through their feelings in this moment.\" width=\"1920\" height=\"2560\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1.jpeg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-800x1067.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-1020x1360.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-160x213.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-1152x1536.jpeg 1152w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-1536x2048.jpeg 1536w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-1122x1496.jpeg 1122w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-840x1120.jpeg 840w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-687x916.jpeg 687w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-414x552.jpeg 414w, https://ww2.kqed.org/app/uploads/sites/10/2020/06/123_1-354x472.jpeg 354w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Jessica Edwards of Texas said she's been spending even more time with her patients, talking through their feelings in this moment. \u003ccite>(Courtesy of Dr. Jessica Edwards)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But the video sat in the back of her mind. In order to help process what she’d seen, Chioma Anaebere started writing.\u003c/p>\n\u003cp>She drafted an article on the lessons police can learn from health care practitioners, which was recently published in \u003ca href=\"https://www.scientificamerican.com/article/policing-can-take-a-lesson-from-health-care/\">Scientific American\u003c/a>. Finishing it, she said, was the first time she felt “a huge sigh of relief” because it allowed her to work her thoughts and feelings out on the page.\u003c/p>\n\u003cp>Dr. Jessica Edwards, a family physician in Texas, also said writing has helped her process her feelings. She’s written several \u003ca href=\"https://www.straightfactsnochaserpodcast.com/blog\">blog posts\u003c/a> and dedicated an episode of \u003ca href=\"https://www.straightfactsnochaserpodcast.com/podcastepisodes\">her podcast\u003c/a> to social determinants of health and how they impact Black Americans.\u003c/p>\n\u003cp>“For me, those things have been really important for my mental health,” Edwards said.\u003c/p>\n\u003cp>Edwards has also been spending even more time with her patients, talking through their feelings in this moment.\u003c/p>\n\u003cp>But between a pandemic that disproportionately impacts communities of color and ongoing police violence, it’s a lot of weight to carry.\u003c/p>\n\u003cp>“We're not getting any reprieve,” Chioma Anaebere said. “We're not getting any sort of respite from the pandemic. And you’re putting this on our communities as well. Like... have some empathy, have some mercy.”\u003c/p>\n\u003cp>And while protesting in a pandemic may be dangerous, Chioma Anaebere says that, for many, this issue is more important than their own personal health. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>Other Ways to Cope\u003c/h3>\n\u003cp>Here are some other techniques health care workers recommended for taking care of one’s mental health during this challenging time:\u003c/p>\n\u003cp>\u003cstrong>Dr. Tiffany Chioma Anaebere, Emeryville:\u003c/strong> “Talking to friends and family helps a lot as well. And hearing people feel the same way that you do, and know that you're not isolated in your own experience.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Georgia Davies, New Jersey:\u003c/strong> “I'm really big on my mental health and physical fitness, and I feel like physical being physically fit kind of helps with your mental health.\u003c/p>\n\u003cp>“One thing I had to do in the last two weeks is, I don't turn on the TV anymore to really watch the news at all, because I think I was also making me very anxious. … [I]t's always something new. It's always something different. So I think shutting that off is, kind of, helping me cope as well.”\u003c/p>\n\u003cp>\u003cstrong>Dr. Jessica Edwards, Texas:\u003c/strong> “...Being able to, you know, donate to an action PAC … volunteering with my local democratic society as a physician, volunteering and, you know, going door to door, knocking on doors … it's not always a fun experience, but that's the way that I can sort of get my emotions out now.”\u003c/p>\n\u003cp>\u003cstrong>President-Elect of the Alameda County Psychological Association Alice LoCicero:\u003c/strong> “The big four are: sleep, nutrition, exercise and social connection.”\u003c/p>\n\u003cp>\u003cstrong>Crisis Support Services of Alameda County Director Binh Au:\u003c/strong> “The message that we want to send our workers is that: please reach out for help. Treat yourself with the kindness and care that you would treat your patients, your colleagues, your clients. And think about self care as a necessary part of your job.”\u003c/p>\n\u003ch3>More Resources\u003c/h3>\n\u003cul>\n\u003cli>\u003ca href=\"https://sites.google.com/crisissupport.org/ssac19/home\">Staying Strong Against COVID-19\u003c/a>: The Alameda County Crisis Line for Health Care Workers, 510-420-3222\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/arts/13881725/where-to-find-affordable-culturally-competent-therapy-in-bay-area-and-beyond\">Where to Find Affordable, Culturally Competent Therapy in Bay Area and Beyond\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/news/11808968/coronavirus-is-impacting-the-bay-areas-mental-health-where-can-you-find-help#resources\">Coronavirus Is Impacting the Bay Area's Mental Health. Where Can You Find Help?\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>California state officials also compiled a list of mental health resources \u003ca href=\"https://covid19.ca.gov/resources-for-emotional-support-and-well-being/#top\">here\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11825898/i-feel-so-overwhelmed-covid-19-and-police-violence-takes-a-toll-on-black-health-care-workers","authors":["11526"],"categories":["news_457","news_8"],"tags":["news_27350","news_27504","news_17606","news_27626","news_2109","news_27086"],"featImg":"news_11825939","label":"news"},"news_11814408":{"type":"posts","id":"news_11814408","meta":{"index":"posts_1591205157","site":"news","id":"11814408","score":null,"sort":[1587935345000]},"guestAuthors":[],"slug":"private-clinics-at-risk-of-closing-or-raising-patient-costs","title":"Private Clinics at Risk of Closing – Or Raising Patient Costs","publishDate":1587935345,"format":"standard","headTitle":"CALmatters | KQED News","labelTerm":{},"content":"\u003cp>In a matter of weeks, Dr. William Goral, a private practice ear, nose and throat specialist in San Bernardino County, will be out of business.\u003c/p>\n\u003cp>His small, solo clinic, which has served patients throughout the Inland Empire for 30 years, postponed about 80% of patient visits due to coronavirus restrictions. That’s not enough revenue to pay rent, utilities or staff.\u003c/p>\n\u003cp>“We are going into the red even having laid off two-thirds of my employees,” Goral said.\u003c/p>\n\u003cp>At private practices and small clinics across the state, independent physicians are worried their businesses won’t survive the current crisis, forcing them to either close their doors or sell their practices, which could lead to higher patient costs. In either case, experts worry that will leave the health care system vastly diminished at a time when the state is facing \u003ca href=\"https://www.chcf.org/blog/ever-rising-health-costs-worsen-californias-coronavirus-threat/\">skyrocketing costs\u003c/a> and a \u003ca href=\"https://calmatters.org/projects/californias-worsening-physician-shortage-doctors/\">shortage of doctors\u003c/a>.\u003c/p>\n\u003cp>About one in three Californians get care from private practice physicians and specialists, according to the California Medical Association, which represents roughly 50,000 doctors across the state. In a \u003ca href=\"https://www.cmadocs.org/Portals/CMA/files/public/CMA%20COVID-19%20Financial%20Hardship%20Survey%20Summary.pdf?ver=2020-04-22-145742-467\">recent survey\u003c/a>, nearly 76% of members reported being extremely worried or very worried about finances.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Empty clinics triggered a cash crunch for doctors after Gov. Gavin Newsom issued a shelter-in-place order last month. That’s because the statewide lockdown forced a majority of medical procedures, from hip replacements to annual checkups, to be canceled or delayed unless they are deemed an emergency.\u003c/p>\n\u003ch3>A catastrophe for private practices\u003c/h3>\n\u003cp>On Wednesday, the governor \u003ca href=\"https://www.gov.ca.gov/2020/04/22/governor-newsom-announces-plan-to-resume-delayed-health-care-that-was-deferred-as-hospitals-prepared-for-covid-19-surge/\">announced\u003c/a> plans to resume some delayed medical care such as heart valve replacements, angioplasty and and tumor removals, but he warned the state remains far from reopening.\u003c/p>\n\u003cp>And though the federal government is providing aid, most say it’s not nearly enough.\u003c/p>\n\u003cp>“The whole situation is catastrophic for the entire profession in terms of economics,” said Dr. Thomas LaGrelius, a family medicine doctor in Torrance, California, and president of the American College of Private Physicians.\u003c/p>\n\u003cp>LaGrelius currently is only able to conduct about three in-person patient consults per day and has tried to switch as many appointments as possible to online video conferences. Unlike other doctors who received emergency grants this week from the U.S. Department of Health and Human Services, LaGrelius’ clinic has yet to get any relief from the federal Coronavirus Aid, Relief and Economic Security Act, or CARES Act.\u003c/p>\n\u003cp>HHS, which is doling out $100 billion to doctors based on the amount of patients they serve who are on Medicare, gave him a test deposit of $0 and told him a grant would come later.[pullquote size=\"medium\" align=\"right\" citation=\"Debbie Rood, private clinic business manager\"]'If you lose all of your primary care doctors and your (obstetricians) because you can’t make a living, where are patients going to go?'[/pullquote]And while grants are certainly welcome, they’re a “drop in the bucket,” said Debbie Rood, business manager for her husband’s obstetrics and gynecology practice in Manteca. Rood’s husband, Dr. George Scott, said they received about $2,000 since most women over the age of 65 don’t see a gynecologist regularly.\u003c/p>\n\u003cp>His private practice’s finances are complicated by the fact that insurance companies won’t reimburse him until after patients give birth, leaving him and his staff performing unpaid labor for months. At the same time, their rent tripled, forcing them to downsize to a smaller clinic.\u003c/p>\n\u003ch3>Taking out a second mortgage\u003c/h3>\n\u003cp>Scott and Rood are determined to keep the business running but they may need to take a second mortgage on their home. They are also concerned about the long-term implications the economic crisis will have on access to care.\u003c/p>\n\u003cp>“If you lose all of your primary care doctors and your (obstetricians) because you can’t make a living,” Rood said, “where are patients going to go?”\u003c/p>\n\u003cp>It’s a question with a complicated answer, said James Robinson, professor of health economics at UC Berkeley. The economic fallout of the pandemic will lead to the closure of many private practices, but the implications are less clear.\u003c/p>\n\u003ch3>Consolidating practices\u003c/h3>\n\u003cp>Increasingly, in the past decade, independent doctors and private community hospitals have been swallowed by sprawling health care delivery systems through mergers and buyouts. Nearly 60% of Californians received care from an integrated health care system in 2018, which organizes doctors, hospitals, and sometimes insurance companies into one coordinated system, according to Let’s Get Healthy California, a state task force that monitors key health indicators including access to care.\u003c/p>\n\u003cp>Because small businesses like independent physicians typically don’t have the financial reserves to ride out severe economic downturns, the current pandemic will hasten the consolidation of health care, Robinson said.\u003c/p>\n\u003cp>“I think that it’s going to drive them into the arms of health plan places like Kaiser,” Robinson said.\u003c/p>\n\u003cp>The loss of private practices isn’t necessarily a bad thing, experts say. Consolidated health care can lead to better communication between doctors, more efficient use of testing and scans, and more cost-effective treatment, he added.\u003c/p>\n\u003cp>The problem is many of California’s rural counties, which often face provider shortages to begin with, still rely on private physicians and community health clinics. Forty of the state’s 58 counties had below-average access to consolidated health care in 2018, with as little as \u003ca href=\"https://letsgethealthy.ca.gov/goals/lowering-the-cost-of-care/receiving-care-in-an-integrated-system/\">10% of the population in Del Norte County\u003c/a> enrolled in a managed health care plan.\u003c/p>\n\u003ch3>Mergers raise costs on patients\u003c/h3>\n\u003cp>A large body of evidence shows that hospital mergers and physician buyouts have increased insurance prices throughout the state.[aside label='Related Coverage' tag='health']In areas with high hospital consolidation and high proportions of hospital-owned physician practices, health insurance premiums cost up to 12% more than in areas with average levels of consolidation, according to research published in Health Affairs, a peer-reviewed health policy journal.\u003c/p>\n\u003cp>“There was an uptick in merger activity right after 2008,” said Daniel Arnold, co-author of the paper and research director at the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare at UC Berkeley. “I think you will see something similar here.”\u003c/p>\n\u003cp>Rood said she’s scared to death of what will happen to patients should her husband, Scott, become ill from coronavirus or should their private practice be forced out of business. Already, with only five obstetricians and gynecologists in their area and one planning to leave in June, Scott said there aren’t enough OB-GYNs to take emergency calls at the local hospital.\u003c/p>\n\u003cp>Like many other doctors and business owners, Rood and Scott applied to the Small Business Administration’s Paycheck Protection Program, a $350 billion emergency fund created by Congress to avert business closures and layoffs during the COVID-19 pandemic.\u003c/p>\n\u003ch3>Last hope hangs on second relief package\u003c/h3>\n\u003cp>Their bank, however, took 11 days to send the application to the first-come, first-serve relief program. The day after they submitted, the Small Business Administration announced it had run out of money.\u003c/p>\n\u003cp>Now, with Congress approving a second \u003ca href=\"https://www.washingtonpost.com/us-policy/2020/04/23/congress-coronavirus-small-business/\">$484-billion relief package\u003c/a> with $75 billion set aside for physicians and hospitals, independent physicians like Scott and Goral are hoping to save their life’s work.\u003c/p>\n\u003cp>Goral, the ear, nose and throat specialist, was unsuccessful in obtaining help in the first round of federal funding, but he hopes the second round of funding will buy time until patients return. Still, his position is precarious. Each passing day pushes his business further into debt and he fears he’ll close before ever seeing any money.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“If we have to shut our doors and we don’t have a practice anymore, then the opportunity has been missed,” Goral said.\u003c/p>\n\n","blocks":[],"excerpt":"Faced with empty clinics and a cash crunch, independent physicians are worried about closing their doors or selling their private practices — a prospect that could lead to higher patient costs.","status":"publish","parent":0,"modified":1588008204,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1324},"headData":{"title":"Private Clinics at Risk of Closing – Or Raising Patient Costs | KQED","description":"Faced with empty clinics and a cash crunch, independent physicians are worried about closing their doors or selling their private practices — a prospect that could lead to higher patient costs.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Private Clinics at Risk of Closing – Or Raising Patient Costs","datePublished":"2020-04-26T21:09:05.000Z","dateModified":"2020-04-27T17:23:24.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11814408 https://ww2.kqed.org/news/?p=11814408","disqusUrl":"https://ww2.kqed.org/news/2020/04/26/private-clinics-at-risk-of-closing-or-raising-patient-costs/","disqusTitle":"Private Clinics at Risk of Closing – Or Raising Patient Costs","source":"CALMATTERS","sourceUrl":"https://calmatters.org/","nprByline":"\u003ca href=\"https://calmatters.org/author/kristen-hwang/\">Kristen Hwang\u003c/a>","path":"/news/11814408/private-clinics-at-risk-of-closing-or-raising-patient-costs","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a matter of weeks, Dr. William Goral, a private practice ear, nose and throat specialist in San Bernardino County, will be out of business.\u003c/p>\n\u003cp>His small, solo clinic, which has served patients throughout the Inland Empire for 30 years, postponed about 80% of patient visits due to coronavirus restrictions. That’s not enough revenue to pay rent, utilities or staff.\u003c/p>\n\u003cp>“We are going into the red even having laid off two-thirds of my employees,” Goral said.\u003c/p>\n\u003cp>At private practices and small clinics across the state, independent physicians are worried their businesses won’t survive the current crisis, forcing them to either close their doors or sell their practices, which could lead to higher patient costs. In either case, experts worry that will leave the health care system vastly diminished at a time when the state is facing \u003ca href=\"https://www.chcf.org/blog/ever-rising-health-costs-worsen-californias-coronavirus-threat/\">skyrocketing costs\u003c/a> and a \u003ca href=\"https://calmatters.org/projects/californias-worsening-physician-shortage-doctors/\">shortage of doctors\u003c/a>.\u003c/p>\n\u003cp>About one in three Californians get care from private practice physicians and specialists, according to the California Medical Association, which represents roughly 50,000 doctors across the state. In a \u003ca href=\"https://www.cmadocs.org/Portals/CMA/files/public/CMA%20COVID-19%20Financial%20Hardship%20Survey%20Summary.pdf?ver=2020-04-22-145742-467\">recent survey\u003c/a>, nearly 76% of members reported being extremely worried or very worried about finances.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Empty clinics triggered a cash crunch for doctors after Gov. Gavin Newsom issued a shelter-in-place order last month. That’s because the statewide lockdown forced a majority of medical procedures, from hip replacements to annual checkups, to be canceled or delayed unless they are deemed an emergency.\u003c/p>\n\u003ch3>A catastrophe for private practices\u003c/h3>\n\u003cp>On Wednesday, the governor \u003ca href=\"https://www.gov.ca.gov/2020/04/22/governor-newsom-announces-plan-to-resume-delayed-health-care-that-was-deferred-as-hospitals-prepared-for-covid-19-surge/\">announced\u003c/a> plans to resume some delayed medical care such as heart valve replacements, angioplasty and and tumor removals, but he warned the state remains far from reopening.\u003c/p>\n\u003cp>And though the federal government is providing aid, most say it’s not nearly enough.\u003c/p>\n\u003cp>“The whole situation is catastrophic for the entire profession in terms of economics,” said Dr. Thomas LaGrelius, a family medicine doctor in Torrance, California, and president of the American College of Private Physicians.\u003c/p>\n\u003cp>LaGrelius currently is only able to conduct about three in-person patient consults per day and has tried to switch as many appointments as possible to online video conferences. Unlike other doctors who received emergency grants this week from the U.S. Department of Health and Human Services, LaGrelius’ clinic has yet to get any relief from the federal Coronavirus Aid, Relief and Economic Security Act, or CARES Act.\u003c/p>\n\u003cp>HHS, which is doling out $100 billion to doctors based on the amount of patients they serve who are on Medicare, gave him a test deposit of $0 and told him a grant would come later.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'If you lose all of your primary care doctors and your (obstetricians) because you can’t make a living, where are patients going to go?'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Debbie Rood, private clinic business manager","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>And while grants are certainly welcome, they’re a “drop in the bucket,” said Debbie Rood, business manager for her husband’s obstetrics and gynecology practice in Manteca. Rood’s husband, Dr. George Scott, said they received about $2,000 since most women over the age of 65 don’t see a gynecologist regularly.\u003c/p>\n\u003cp>His private practice’s finances are complicated by the fact that insurance companies won’t reimburse him until after patients give birth, leaving him and his staff performing unpaid labor for months. At the same time, their rent tripled, forcing them to downsize to a smaller clinic.\u003c/p>\n\u003ch3>Taking out a second mortgage\u003c/h3>\n\u003cp>Scott and Rood are determined to keep the business running but they may need to take a second mortgage on their home. They are also concerned about the long-term implications the economic crisis will have on access to care.\u003c/p>\n\u003cp>“If you lose all of your primary care doctors and your (obstetricians) because you can’t make a living,” Rood said, “where are patients going to go?”\u003c/p>\n\u003cp>It’s a question with a complicated answer, said James Robinson, professor of health economics at UC Berkeley. The economic fallout of the pandemic will lead to the closure of many private practices, but the implications are less clear.\u003c/p>\n\u003ch3>Consolidating practices\u003c/h3>\n\u003cp>Increasingly, in the past decade, independent doctors and private community hospitals have been swallowed by sprawling health care delivery systems through mergers and buyouts. Nearly 60% of Californians received care from an integrated health care system in 2018, which organizes doctors, hospitals, and sometimes insurance companies into one coordinated system, according to Let’s Get Healthy California, a state task force that monitors key health indicators including access to care.\u003c/p>\n\u003cp>Because small businesses like independent physicians typically don’t have the financial reserves to ride out severe economic downturns, the current pandemic will hasten the consolidation of health care, Robinson said.\u003c/p>\n\u003cp>“I think that it’s going to drive them into the arms of health plan places like Kaiser,” Robinson said.\u003c/p>\n\u003cp>The loss of private practices isn’t necessarily a bad thing, experts say. Consolidated health care can lead to better communication between doctors, more efficient use of testing and scans, and more cost-effective treatment, he added.\u003c/p>\n\u003cp>The problem is many of California’s rural counties, which often face provider shortages to begin with, still rely on private physicians and community health clinics. Forty of the state’s 58 counties had below-average access to consolidated health care in 2018, with as little as \u003ca href=\"https://letsgethealthy.ca.gov/goals/lowering-the-cost-of-care/receiving-care-in-an-integrated-system/\">10% of the population in Del Norte County\u003c/a> enrolled in a managed health care plan.\u003c/p>\n\u003ch3>Mergers raise costs on patients\u003c/h3>\n\u003cp>A large body of evidence shows that hospital mergers and physician buyouts have increased insurance prices throughout the state.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"Related Coverage ","tag":"health"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>In areas with high hospital consolidation and high proportions of hospital-owned physician practices, health insurance premiums cost up to 12% more than in areas with average levels of consolidation, according to research published in Health Affairs, a peer-reviewed health policy journal.\u003c/p>\n\u003cp>“There was an uptick in merger activity right after 2008,” said Daniel Arnold, co-author of the paper and research director at the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare at UC Berkeley. “I think you will see something similar here.”\u003c/p>\n\u003cp>Rood said she’s scared to death of what will happen to patients should her husband, Scott, become ill from coronavirus or should their private practice be forced out of business. Already, with only five obstetricians and gynecologists in their area and one planning to leave in June, Scott said there aren’t enough OB-GYNs to take emergency calls at the local hospital.\u003c/p>\n\u003cp>Like many other doctors and business owners, Rood and Scott applied to the Small Business Administration’s Paycheck Protection Program, a $350 billion emergency fund created by Congress to avert business closures and layoffs during the COVID-19 pandemic.\u003c/p>\n\u003ch3>Last hope hangs on second relief package\u003c/h3>\n\u003cp>Their bank, however, took 11 days to send the application to the first-come, first-serve relief program. The day after they submitted, the Small Business Administration announced it had run out of money.\u003c/p>\n\u003cp>Now, with Congress approving a second \u003ca href=\"https://www.washingtonpost.com/us-policy/2020/04/23/congress-coronavirus-small-business/\">$484-billion relief package\u003c/a> with $75 billion set aside for physicians and hospitals, independent physicians like Scott and Goral are hoping to save their life’s work.\u003c/p>\n\u003cp>Goral, the ear, nose and throat specialist, was unsuccessful in obtaining help in the first round of federal funding, but he hopes the second round of funding will buy time until patients return. Still, his position is precarious. Each passing day pushes his business further into debt and he fears he’ll close before ever seeing any money.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“If we have to shut our doors and we don’t have a practice anymore, then the opportunity has been missed,” Goral said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11814408/private-clinics-at-risk-of-closing-or-raising-patient-costs","authors":["byline_news_11814408"],"categories":["news_8"],"tags":["news_27350","news_17606","news_27626","news_18543","news_4392","news_27086"],"affiliates":["news_18481"],"featImg":"news_11814422","label":"source_news_11814408"},"news_11812402":{"type":"posts","id":"news_11812402","meta":{"index":"posts_1591205157","site":"news","id":"11812402","score":null,"sort":[1586959553000]},"guestAuthors":[],"slug":"doctors-offices-are-small-businesses-too-and-theyre-struggling-to-stay-afloat-during-the-pandemic","title":"Doctors Offices Are Small Businesses Too. And They're Struggling to Stay Afloat During the Pandemic","publishDate":1586959553,"format":"standard","headTitle":"The California Report | KQED News","labelTerm":{},"content":"\u003cp>At a time when doctors are more in demand than ever because of COVID-19, they are also being laid off and struggling to keep their practices open.\u003c/p>\n\u003cp>Since hospitals began canceling non-essential surgeries in mid-March to preserve medical resources, and patients have been too afraid to see their doctor for routine care, physicians are watching their revenues plummet.\u003c/p>\n\u003cp>“We had such a decrease in patient volume, we had to furlough about 75% of our staff,” said Dr. Sean Liston, an ophthalmologist and partner at Chico Eye Center. “So we're still paying their health insurance, but we're not paying them for hours they're not working.”\u003c/p>\n\u003cp>About half the medical care in California is delivered by solo and small practice physicians, according to the California Medical Association. In a recent survey of its members, 50% of doctors said they’ve had to lay off fellow physicians, nurses and office staff because of the downturn, and 11% closed down temporarily.\u003c/p>\n\u003cp>Liston specializes in corneal transplants, but he hasn’t done one in weeks. He shut down his surgery center, furloughing 90% of the surgery staff, and the medical office where he does eye exams is only open in the mornings now. The four doctors who own the business suspended their own salaries for March and are considering the same for April.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We didn’t pay ourselves because we needed to make certain that we have enough cash reserves to be able to weather this,” Liston said.\u003c/p>\n\u003cp>They have had to weather a lot. They shut down their office in Paradise after the \u003ca href=\"https://www.kqed.org/news/tag/camp-fire\">2018 Camp Fire\u003c/a> burned through town, then watched dozens of doctors leave Chico when there was already a shortage.\u003c/p>\n\u003cp>“We had almost the same number of patients and significantly less physicians. So it was even worse,” said Liston, who recently served as the president of the local Butte-Glenn Medical Society.\u003c/p>\n\u003cp>He’s worried that another wave of doctors might close shop if the coronavirus shutdown lasts much longer. That could leave patients scrambling to find a primary care doctor, a pediatrician or a psychiatrist.\u003c/p>\n\u003cp>The California Medical Association is lobbying the governor to direct health insurance companies to give doctors “retention grants.” Patients are paying their premiums, but insurers aren’t paying claims, the association said, so why not share some of that money around to keep the physician network stable.\u003c/p>\n\u003cp>[aside label=\"More Coronavirus Coverage\" tag=\"coronavirus\"]\u003c/p>\n\u003cp>“Three months down the road, we're going to have high demand for physician services, surgical and primary care, and we've got to be able to meet that,” said Dustin Corcoran, CEO of the California Medical Association. “Physician practices operate on very, very thin margins. They don't have the reserves that payers have to weather the storm.”\u003c/p>\n\u003cp>Blue Shield of California is distributing $200 million to doctors in advance payments and loans, but they will have to be paid back. The federal government is depositing $30 billion in the bank accounts of ailing physician practices, but these grants are based on how many Medicare patients they typically see. So while the grants provided a welcome relief to some doctors, for others they only covered a fraction of their losses.\u003c/p>\n\u003cp>“If only one payer steps up, that’s not going to be enough to sustain physician practices,” Corcoran said. “That requires a state effort and private payers to do their part.”\u003c/p>\n\u003cp>Dr. George Scott, an OB-GYN in Manteca, sees very few patients over 65, so he got virtually nothing from the Medicare payment, according to his wife, Debbie Rood, who manages all the finances for the practice.\u003c/p>\n\u003cp>Their patient load has dropped by half, she said, as women skip their annual exams. Pre-natal visits are all over video now, which takes more time but pays less because there’s no physical contact. On top of everything, their landlord tripled the rent. Rood has been begging her husband and their three employees to conserve medical equipment and even electricity.\u003c/p>\n\u003cp>“For three weeks I have been telling them, ‘We are not going to have any money. ‘We're not going to have any money',” she said.\u003c/p>\n\u003cp>Insurance companies are sensitive to doctors’ struggles, but not to the point of handing out grants.\u003c/p>\n\u003cp>“It's a pretty simple solution to a very complex problem — and we think too simple,” said Charles Bacchi, CEO of the California Association of Health Plans, a trade group for health insurance companies.\u003c/p>\n\u003cp>Insurers have their own financial obligations and government regulations they must abide by, Bacchi said, and they would rather decide on a case-by-case basis who to help and how. Advance payments or loans might make more sense than grants, because, eventually, patients will come back for their cancer screenings and cornea transplants.\u003c/p>\n\u003cp>“You can't pay dollars now to keep this doctor's office open and then pay again when someone comes in in four months to have their health care services,” Bacchi said.\u003c/p>\n\u003cp>But doctors like George Scott have to pay rent and salaries now and in four months, as well as the months in between. Scott and his wife really don’t want to lay off any of their staff.\u003c/p>\n\u003cp>“If we have to take out a second mortgage on our house, then we'll have to take it out, and we just won't be able to retire,” Scott said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Scott is 66. If he has to, he said, he’ll just keep delivering babies until he’s 80.\u003c/p>\n\n","blocks":[],"excerpt":"When doctors don't do surgeries, they don't get paid. Canceled operations and appointments have three-quarters of California physicians worried about their finances. ","status":"publish","parent":0,"modified":1586983318,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":957},"headData":{"title":"Doctors Offices Are Small Businesses Too. And They're Struggling to Stay Afloat During the Pandemic | KQED","description":"When doctors don't do surgeries, they don't get paid. Canceled operations and appointments have three-quarters of California physicians worried about their finances. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Doctors Offices Are Small Businesses Too. And They're Struggling to Stay Afloat During the Pandemic","datePublished":"2020-04-15T14:05:53.000Z","dateModified":"2020-04-15T20:41:58.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11812402 https://ww2.kqed.org/news/?p=11812402","disqusUrl":"https://ww2.kqed.org/news/2020/04/15/doctors-offices-are-small-businesses-too-and-theyre-struggling-to-stay-afloat-during-the-pandemic/","disqusTitle":"Doctors Offices Are Small Businesses Too. And They're Struggling to Stay Afloat During the Pandemic","source":"Coronavirus","sourceUrl":"https://www.kqed.org/coronavirus","audioUrl":"https://traffic.omny.fm/d/clips/0af137ef-751e-4b19-a055-aaef00d2d578/ffca7e9f-6831-41c5-bcaf-aaef00f5a073/dd1e9583-0df9-47ed-8be8-ab9e0124b3d7/audio.mp3","path":"/news/11812402/doctors-offices-are-small-businesses-too-and-theyre-struggling-to-stay-afloat-during-the-pandemic","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>At a time when doctors are more in demand than ever because of COVID-19, they are also being laid off and struggling to keep their practices open.\u003c/p>\n\u003cp>Since hospitals began canceling non-essential surgeries in mid-March to preserve medical resources, and patients have been too afraid to see their doctor for routine care, physicians are watching their revenues plummet.\u003c/p>\n\u003cp>“We had such a decrease in patient volume, we had to furlough about 75% of our staff,” said Dr. Sean Liston, an ophthalmologist and partner at Chico Eye Center. “So we're still paying their health insurance, but we're not paying them for hours they're not working.”\u003c/p>\n\u003cp>About half the medical care in California is delivered by solo and small practice physicians, according to the California Medical Association. In a recent survey of its members, 50% of doctors said they’ve had to lay off fellow physicians, nurses and office staff because of the downturn, and 11% closed down temporarily.\u003c/p>\n\u003cp>Liston specializes in corneal transplants, but he hasn’t done one in weeks. He shut down his surgery center, furloughing 90% of the surgery staff, and the medical office where he does eye exams is only open in the mornings now. The four doctors who own the business suspended their own salaries for March and are considering the same for April.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We didn’t pay ourselves because we needed to make certain that we have enough cash reserves to be able to weather this,” Liston said.\u003c/p>\n\u003cp>They have had to weather a lot. They shut down their office in Paradise after the \u003ca href=\"https://www.kqed.org/news/tag/camp-fire\">2018 Camp Fire\u003c/a> burned through town, then watched dozens of doctors leave Chico when there was already a shortage.\u003c/p>\n\u003cp>“We had almost the same number of patients and significantly less physicians. So it was even worse,” said Liston, who recently served as the president of the local Butte-Glenn Medical Society.\u003c/p>\n\u003cp>He’s worried that another wave of doctors might close shop if the coronavirus shutdown lasts much longer. That could leave patients scrambling to find a primary care doctor, a pediatrician or a psychiatrist.\u003c/p>\n\u003cp>The California Medical Association is lobbying the governor to direct health insurance companies to give doctors “retention grants.” Patients are paying their premiums, but insurers aren’t paying claims, the association said, so why not share some of that money around to keep the physician network stable.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More Coronavirus Coverage ","tag":"coronavirus"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Three months down the road, we're going to have high demand for physician services, surgical and primary care, and we've got to be able to meet that,” said Dustin Corcoran, CEO of the California Medical Association. “Physician practices operate on very, very thin margins. They don't have the reserves that payers have to weather the storm.”\u003c/p>\n\u003cp>Blue Shield of California is distributing $200 million to doctors in advance payments and loans, but they will have to be paid back. The federal government is depositing $30 billion in the bank accounts of ailing physician practices, but these grants are based on how many Medicare patients they typically see. So while the grants provided a welcome relief to some doctors, for others they only covered a fraction of their losses.\u003c/p>\n\u003cp>“If only one payer steps up, that’s not going to be enough to sustain physician practices,” Corcoran said. “That requires a state effort and private payers to do their part.”\u003c/p>\n\u003cp>Dr. George Scott, an OB-GYN in Manteca, sees very few patients over 65, so he got virtually nothing from the Medicare payment, according to his wife, Debbie Rood, who manages all the finances for the practice.\u003c/p>\n\u003cp>Their patient load has dropped by half, she said, as women skip their annual exams. Pre-natal visits are all over video now, which takes more time but pays less because there’s no physical contact. On top of everything, their landlord tripled the rent. Rood has been begging her husband and their three employees to conserve medical equipment and even electricity.\u003c/p>\n\u003cp>“For three weeks I have been telling them, ‘We are not going to have any money. ‘We're not going to have any money',” she said.\u003c/p>\n\u003cp>Insurance companies are sensitive to doctors’ struggles, but not to the point of handing out grants.\u003c/p>\n\u003cp>“It's a pretty simple solution to a very complex problem — and we think too simple,” said Charles Bacchi, CEO of the California Association of Health Plans, a trade group for health insurance companies.\u003c/p>\n\u003cp>Insurers have their own financial obligations and government regulations they must abide by, Bacchi said, and they would rather decide on a case-by-case basis who to help and how. Advance payments or loans might make more sense than grants, because, eventually, patients will come back for their cancer screenings and cornea transplants.\u003c/p>\n\u003cp>“You can't pay dollars now to keep this doctor's office open and then pay again when someone comes in in four months to have their health care services,” Bacchi said.\u003c/p>\n\u003cp>But doctors like George Scott have to pay rent and salaries now and in four months, as well as the months in between. Scott and his wife really don’t want to lay off any of their staff.\u003c/p>\n\u003cp>“If we have to take out a second mortgage on our house, then we'll have to take it out, and we just won't be able to retire,” Scott said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Scott is 66. If he has to, he said, he’ll just keep delivering babies until he’s 80.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11812402/doctors-offices-are-small-businesses-too-and-theyre-struggling-to-stay-afloat-during-the-pandemic","authors":["3205"],"programs":["news_72"],"categories":["news_1758","news_457","news_8"],"tags":["news_18538","news_24968","news_27350","news_27504","news_17606"],"featImg":"news_11812483","label":"source_news_11812402"},"news_11788977":{"type":"posts","id":"news_11788977","meta":{"index":"posts_1591205157","site":"news","id":"11788977","score":null,"sort":[1575046807000]},"guestAuthors":[],"slug":"med-school-free-rides-and-loan-repayments-california-tries-to-boost-its-dwindling-doctor-supply","title":"Med School Free Rides and Loan Repayments — California Tries to Boost Its Dwindling Doctor Supply","publishDate":1575046807,"format":"standard","headTitle":"The California Report | KQED News","labelTerm":{},"content":"\u003cp>Primary care doctors are a hot commodity across California.\u003c/p>\n\u003cp>Students are being lured by full-ride scholarships to medical schools. New grads are specifically recruited for training residencies. And full-fledged doctors are being offered loan repayment programs to serve low-income residents or work in underserved areas.\u003c/p>\n\u003cp>These efforts are intended to ease or stave off the physician shortage expected to peak within the next decade in California. By 2030, the state will be short some 4,000 physicians, according to a study from the HealthForce Center at UC San Francisco.\u003c/p>\n\u003cp>The shortage is already acute in rural and inner city areas, especially in the Inland Empire of Southern California where the number of physicians needs to double just to reach the recommended amount to serve the fast-growing population.\u003c/p>\n\u003cp>“The Inland Empire region has one of the lowest ratios of physicians, including primary care physicians, and that creates a number of challenges,” said Dr. Geoffrey Leung, ambulatory medical director for the Riverside University Health System. “ When we have delays in care, that can result in sort of chronic illnesses or acute illnesses that become worse.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>With high student loans, medical school grads have been turning to better-paying specialties instead of primary care, such as family practice, pediatrics or obstetrics, leaving some areas in dire need.\u003c/p>\n\u003cp>“In California in particular, what’s unique is that the total number of physicians isn’t as big of a problem as where they are located,” said Mark Henderson, professor of internal medicine and associate dean of admissions at the UC Davis School of Medicine. “It’s really a maldistribution problem.”\u003c/p>\n\u003cp>Health insurers, medical professionals and community leaders are working on solutions. This summer, the state offered 250-plus doctors loan repayment plans in exchange for ensuring 30% of their caseloads were Medi-Cal patients.\u003c/p>\n\u003cp>Meanwhile, insurer LA Care is spending millions on recruiting new doctors and, in South Los Angeles, the Martin Luther King Jr. Community Hospital is working to create a new residency program. In the Inland Empire, leaders are working to create a “middle school to medical school” pipeline.\u003c/p>\n\u003cp>Because doctors tend to practice near where they trained, where they are from or where they have a family connection, resources are being poured into the expansion or creation of training programs that are situated where the need is.\u003c/p>\n\u003cfigure id=\"attachment_11789007\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11789007\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-3-800x594.jpg\" alt=\"\" width=\"800\" height=\"594\">\u003cfigcaption class=\"wp-caption-text\">Dr. Moazzum Bajwa completed his residency with Riverside County’s University Health System and stayed on as a full-fledged physician and faculty member of the residency. \u003ccite>(Elizabeth Aguilera/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Most Impacted Region In The State: The Inland Empire\u003c/h3>\n\u003cp>Inland Empire officials have been working on this for quite some time. A statewide report from The Future Health Workforce Commission released this year found the number of physicians is 35 per 100,000 people, compared to the recommended 70 doctors, making it the most impacted region in the state.\u003c/p>\n\u003cp>Because of that need the state approved a new University of California medical school that opened in 2013 at UC Riverside specifically to train doctors to serve the local area. It offers scholarships to students who promise to return after residency to practice in the area and reaches out to kids interested in health careers.\u003c/p>\n\u003cp>The county and medical school have partnered to expand long-standing residency programs by inviting more students to train in the area. And both institutions recruit with an eye toward geographic nativity, meaning if an applicant is from or has a connection to the area they get priority.\u003c/p>\n\u003cp>For cancer survivor Cesilia Jimenez these efforts by the county are paying off.\u003c/p>\n\u003cp>Recently Jimenez received the results of her latest scans at the Moreno Valley Community Health Center from Dr. Moazzum Bajwa.\u003c/p>\n\u003cp>She had been putting it off.\u003c/p>\n\u003cp>“I’ve been so nervous to hear those results, I knew I wanted to hear them from you,” she told Bajwa after he assured her that everything on the scans looked good.\u003c/p>\n\u003cp>It was Bajwa, who was a resident at the time, who diagnosed a cancerous tumor in her neck and got her treatment for it after she had sought answers for years as to why she was losing her ability to walk.\u003c/p>\n\u003cfigure id=\"attachment_11789006\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11789006\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-2-800x567.jpg\" alt=\"\" width=\"800\" height=\"567\">\u003cfigcaption class=\"wp-caption-text\">Dr. Moazzum Bajwa and patient Cesilia Jimenez hug after her recent appointment. Jimenez said he’s a godsend and that without him she might still be trying to figure out what was wrong. \u003ccite>(Elizabeth Aguilera/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, he is an attending physician and teaching residents through Riverside University Health System and the UCR medical school. Bajwa is considered a success story in Riverside County’s efforts to grow, recruit and retain primary care doctors in the region.\u003c/p>\n\u003cp>So far the county is seeing success, Leung said. About four out of 10 residents stay in the Inland Empire after their training and eight to nine stay in Southern California. While those numbers are not that different from other programs across the state, opening the medical school and expanding training slots have kept doctors in the area.\u003cbr>\nDr. Takesha Cooper is on the admissions committee at the medical school, where priority is given to applicants who have a permanent or active mailing address in the area or went to college or attended high school in the Inland Empire.\u003c/p>\n\u003cp>“We do a holistic review and don’t just look at test scores,” she said. “We call it mission fits.”\u003c/p>\n\u003cp>Cooper defines it as applicants with connections to the area and who believe in the school’s mission to help the medically underserved region and train a diverse workforce of physicians. “We have to focus and attract and try to keep people who are growing up in this area, who have ties and are more likely to stay,” she said.\u003c/p>\n\u003cp>So far, the medical school is seeing early success. Of its 128 graduates, about 31% are training as residents in the Inland Empire.\u003c/p>\n\u003ch3>“I Needed To Serve This Population\"\u003c/h3>\n\u003cp>Cooper is the kind of local student the school hopes to capture.\u003c/p>\n\u003cp>She grew up in Moreno Valley long before the medical school opened. She went away for college, completed medical school at the University of Southern California and moved to the Bay Area for her residency and a fellowship in child and adolescent psychiatry.\u003c/p>\n\u003cp>And, as statistics bear out, she set up her practice in Palo Alto, near Stanford where she finished her training.\u003cbr>\n“I did that for five years but I started to feel like I’m not really needed here,” she said. “My heart told me I needed to serve this population.”\u003c/p>\n\u003cp>So she came back to Riverside to practice and then she joined the faculty at UCR and has since helped start a residency in general adult psychiatry and a fellowship in child psychiatry as a way to train and keep much-needed mental health professionals in the area.\u003c/p>\n\u003cp>“If our residents had to go to UCLA or UC San Diego or Irvine, chances are they would have stayed in that area and practiced,” she said. “It’s what I did.”\u003c/p>\n\u003cp>It’s the same strategy the county uses in recruiting medical school graduates like Bajwa to its residency programs, said Dr. Adolfo Aguilera, associate director of the University Health System residency program, who also stayed on after he trained in Riverside more than two decades ago.\u003c/p>\n\u003cp>“When somebody has a connection to the area, you know, they are invested in what they’re going to be doing,” he said. “If they’re here to stay, they’re going to want to make sure that they are providing the best care that they can, that they are essentially trying to build the program so that we’re able to outreach to our community and serve their needs”\u003c/p>\n\u003cp>Bajwa is from the East Coast but the program’s goals matched his when he interviewed and Riverside was his first choice. He also had another reason for coming and staying: His wife is from Riverside and she’s also a physician.\u003c/p>\n\u003cp>“The connection with my wife is what brought me out here first,” he said. “But it was the community and identity of building something bigger than myself that I fell in love with.”\u003c/p>\n\u003cp>That’s what Leung, Aguilera and others in Riverside hope will happen with many of the students and residents they recruit. And they are not alone.\u003c/p>\n\u003cfigure id=\"attachment_11789008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11789008\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-4-800x566.jpg\" alt=\"\" width=\"800\" height=\"566\">\u003cfigcaption class=\"wp-caption-text\">Dr. Adolfo Aguilera is associate director of the Riverside County University Health System and University of California School of Medicine residency program and physician in charge at the Moreno Valley Community Health Center. s \u003ccite>(Elizabeth Aguilera/CalMatter)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Recruiting Physicians Where They Are Needed\u003c/h3>\n\u003cp>This kind of thinking is happening across the state in areas lacking physicians.\u003c/p>\n\u003cp>In Northern California, UC Davis has partnered with the Oregon Health and Science University in Portland and created a program called COMPADRE, or California Oregon Medical Partnership to Address Disparities in Rural Education. It focuses on the area between Davis and Portland to recruit kids to medical school and to provide a program that allows them to train where they are from.\u003c/p>\n\u003cp>“We’ll modify their curriculum to allow them to remain in their home community for a large part of their training to keep them connected to a community health center in the region,” Henderson said. “If we get physicians who actually grew up or have a connection to these communities they will be less burned out and will have meaningful relationships to the community and the hospital.”\u003c/p>\n\u003cp>In urban South Los Angeles, the MLK Jr. Community Hospital set up its own medical group in 2016 that recruits and hires physicians to practice in the neighborhood and is slated to start a residency training program in 2022, said Elaine Batchlor, CEO of the hospital.\u003c/p>\n\u003cp>“The strategy is to recruit doctors who have an interest in working in underserved communities, to offer them a state of the art practice environment with high quality colleagues,” she said. “We offer market compensation and the possibility of having loans forgiven because they are working in a medically underserved area.”\u003c/p>\n\u003cp>Bringing residency slots to communities is a strategy that costs money. These slots are usually paid for by the Medicare program but the federal government has not created new residency positions in years. So the program at MLK and other new training sites are being funded by the host institutions or insurers like LA Care Health Plan.\u003c/p>\n\u003cp>LA Care serves 2 million Medi-Cal patients in Southern California. Last year the insurer committed 5% of its reserves, about $31 million a year for five years, to a program called Elevating the Safety Net, said John Baackes, CEO of the organization. It includes scholarships for medical school students, funding for residency slots, grants to clinics and private practices to recruit primary care doctors into Los Angeles County and loan repayment up to $180,000 for those newly recruited physicians who stay three years.\u003c/p>\n\u003cp>“We’re hoping that when their three years is up they will have fallen in love with L.A. and their practice and they’ll stay on with us,” Baackes said. “We’re aimed at the safety net populations, those people who are on Medi-Cal or uninsured, and we think this is the right thing to do is invest in the future of this population.”\u003c/p>\n\u003cp>In Riverside, the residency program that produced Dr. Bajwa is also partly supported by the county. Riverside County funds 52 positions beyond what the federal government provides.\u003c/p>\n\u003cp>“We are over our cap, which means every resident that we add on top of that limit are entirely funded through the county,” said Leung, of Riverside University Health System. “Any improvement that we make in the Inland Empire area whether it is in workforce, education or in terms of policy or the way we think about developing neighborhoods, all of those things help make the Inland Empire the sort of area that people want to move to and that help us with recruiting doctors, resident physicians and medical school students.”\u003c/p>\n\u003cp>For patients, having access to a doctor over the long term that they know and trust pays off.\u003c/p>\n\u003cp>Before Dr. Bajwa, Cesilia Jimenez never knew who she was going to see at the clinic.\u003c/p>\n\u003cp>“It feels good to just come and he knows what we are going to talk about and not me explaining to the doctor what I’ve been through,” she said.\u003c/p>\n\u003cp>When she left their appointment Bajwa gave her a hug before she walked out on her own.\u003c/p>\n\u003cp>“Many programs talk about serving the underserved but here the focus that the faculty have on actually taking care of the community and doing outreach in the community is just unparalleled I think,” Bajwa said. “That was something I wanted to be a part of.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>CalMatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The doctor shortage is already acute in rural and inner city areas, especially in the Inland Empire, where the number of physicians needs to double just to serve the fast-growing population.","status":"publish","parent":0,"modified":1575081602,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":51,"wordCount":2212},"headData":{"title":"Med School Free Rides and Loan Repayments — California Tries to Boost Its Dwindling Doctor Supply | KQED","description":"The doctor shortage is already acute in rural and inner city areas, especially in the Inland Empire, where the number of physicians needs to double just to serve the fast-growing population.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"Med School Free Rides and Loan Repayments — California Tries to Boost Its Dwindling Doctor Supply","datePublished":"2019-11-29T17:00:07.000Z","dateModified":"2019-11-30T02:40:02.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"disqusIdentifier":"11788977 https://ww2.kqed.org/news/?p=11788977","disqusUrl":"https://ww2.kqed.org/news/2019/11/29/med-school-free-rides-and-loan-repayments-california-tries-to-boost-its-dwindling-doctor-supply/","disqusTitle":"Med School Free Rides and Loan Repayments — California Tries to Boost Its Dwindling Doctor Supply","source":"CALmatters","sourceUrl":"https://calmatters.org/projects/california-doctor-shortage-free-med-school-loan-repayment-recruiting-solutions/","nprByline":"Elizabeth Aguilera \u003cbr>\u003cstrong>CALmatters\u003c/strong>","path":"/news/11788977/med-school-free-rides-and-loan-repayments-california-tries-to-boost-its-dwindling-doctor-supply","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Primary care doctors are a hot commodity across California.\u003c/p>\n\u003cp>Students are being lured by full-ride scholarships to medical schools. New grads are specifically recruited for training residencies. And full-fledged doctors are being offered loan repayment programs to serve low-income residents or work in underserved areas.\u003c/p>\n\u003cp>These efforts are intended to ease or stave off the physician shortage expected to peak within the next decade in California. By 2030, the state will be short some 4,000 physicians, according to a study from the HealthForce Center at UC San Francisco.\u003c/p>\n\u003cp>The shortage is already acute in rural and inner city areas, especially in the Inland Empire of Southern California where the number of physicians needs to double just to reach the recommended amount to serve the fast-growing population.\u003c/p>\n\u003cp>“The Inland Empire region has one of the lowest ratios of physicians, including primary care physicians, and that creates a number of challenges,” said Dr. Geoffrey Leung, ambulatory medical director for the Riverside University Health System. “ When we have delays in care, that can result in sort of chronic illnesses or acute illnesses that become worse.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>With high student loans, medical school grads have been turning to better-paying specialties instead of primary care, such as family practice, pediatrics or obstetrics, leaving some areas in dire need.\u003c/p>\n\u003cp>“In California in particular, what’s unique is that the total number of physicians isn’t as big of a problem as where they are located,” said Mark Henderson, professor of internal medicine and associate dean of admissions at the UC Davis School of Medicine. “It’s really a maldistribution problem.”\u003c/p>\n\u003cp>Health insurers, medical professionals and community leaders are working on solutions. This summer, the state offered 250-plus doctors loan repayment plans in exchange for ensuring 30% of their caseloads were Medi-Cal patients.\u003c/p>\n\u003cp>Meanwhile, insurer LA Care is spending millions on recruiting new doctors and, in South Los Angeles, the Martin Luther King Jr. Community Hospital is working to create a new residency program. In the Inland Empire, leaders are working to create a “middle school to medical school” pipeline.\u003c/p>\n\u003cp>Because doctors tend to practice near where they trained, where they are from or where they have a family connection, resources are being poured into the expansion or creation of training programs that are situated where the need is.\u003c/p>\n\u003cfigure id=\"attachment_11789007\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11789007\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-3-800x594.jpg\" alt=\"\" width=\"800\" height=\"594\">\u003cfigcaption class=\"wp-caption-text\">Dr. Moazzum Bajwa completed his residency with Riverside County’s University Health System and stayed on as a full-fledged physician and faculty member of the residency. \u003ccite>(Elizabeth Aguilera/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Most Impacted Region In The State: The Inland Empire\u003c/h3>\n\u003cp>Inland Empire officials have been working on this for quite some time. A statewide report from The Future Health Workforce Commission released this year found the number of physicians is 35 per 100,000 people, compared to the recommended 70 doctors, making it the most impacted region in the state.\u003c/p>\n\u003cp>Because of that need the state approved a new University of California medical school that opened in 2013 at UC Riverside specifically to train doctors to serve the local area. It offers scholarships to students who promise to return after residency to practice in the area and reaches out to kids interested in health careers.\u003c/p>\n\u003cp>The county and medical school have partnered to expand long-standing residency programs by inviting more students to train in the area. And both institutions recruit with an eye toward geographic nativity, meaning if an applicant is from or has a connection to the area they get priority.\u003c/p>\n\u003cp>For cancer survivor Cesilia Jimenez these efforts by the county are paying off.\u003c/p>\n\u003cp>Recently Jimenez received the results of her latest scans at the Moreno Valley Community Health Center from Dr. Moazzum Bajwa.\u003c/p>\n\u003cp>She had been putting it off.\u003c/p>\n\u003cp>“I’ve been so nervous to hear those results, I knew I wanted to hear them from you,” she told Bajwa after he assured her that everything on the scans looked good.\u003c/p>\n\u003cp>It was Bajwa, who was a resident at the time, who diagnosed a cancerous tumor in her neck and got her treatment for it after she had sought answers for years as to why she was losing her ability to walk.\u003c/p>\n\u003cfigure id=\"attachment_11789006\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11789006\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-2-800x567.jpg\" alt=\"\" width=\"800\" height=\"567\">\u003cfigcaption class=\"wp-caption-text\">Dr. Moazzum Bajwa and patient Cesilia Jimenez hug after her recent appointment. Jimenez said he’s a godsend and that without him she might still be trying to figure out what was wrong. \u003ccite>(Elizabeth Aguilera/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Now, he is an attending physician and teaching residents through Riverside University Health System and the UCR medical school. Bajwa is considered a success story in Riverside County’s efforts to grow, recruit and retain primary care doctors in the region.\u003c/p>\n\u003cp>So far the county is seeing success, Leung said. About four out of 10 residents stay in the Inland Empire after their training and eight to nine stay in Southern California. While those numbers are not that different from other programs across the state, opening the medical school and expanding training slots have kept doctors in the area.\u003cbr>\nDr. Takesha Cooper is on the admissions committee at the medical school, where priority is given to applicants who have a permanent or active mailing address in the area or went to college or attended high school in the Inland Empire.\u003c/p>\n\u003cp>“We do a holistic review and don’t just look at test scores,” she said. “We call it mission fits.”\u003c/p>\n\u003cp>Cooper defines it as applicants with connections to the area and who believe in the school’s mission to help the medically underserved region and train a diverse workforce of physicians. “We have to focus and attract and try to keep people who are growing up in this area, who have ties and are more likely to stay,” she said.\u003c/p>\n\u003cp>So far, the medical school is seeing early success. Of its 128 graduates, about 31% are training as residents in the Inland Empire.\u003c/p>\n\u003ch3>“I Needed To Serve This Population\"\u003c/h3>\n\u003cp>Cooper is the kind of local student the school hopes to capture.\u003c/p>\n\u003cp>She grew up in Moreno Valley long before the medical school opened. She went away for college, completed medical school at the University of Southern California and moved to the Bay Area for her residency and a fellowship in child and adolescent psychiatry.\u003c/p>\n\u003cp>And, as statistics bear out, she set up her practice in Palo Alto, near Stanford where she finished her training.\u003cbr>\n“I did that for five years but I started to feel like I’m not really needed here,” she said. “My heart told me I needed to serve this population.”\u003c/p>\n\u003cp>So she came back to Riverside to practice and then she joined the faculty at UCR and has since helped start a residency in general adult psychiatry and a fellowship in child psychiatry as a way to train and keep much-needed mental health professionals in the area.\u003c/p>\n\u003cp>“If our residents had to go to UCLA or UC San Diego or Irvine, chances are they would have stayed in that area and practiced,” she said. “It’s what I did.”\u003c/p>\n\u003cp>It’s the same strategy the county uses in recruiting medical school graduates like Bajwa to its residency programs, said Dr. Adolfo Aguilera, associate director of the University Health System residency program, who also stayed on after he trained in Riverside more than two decades ago.\u003c/p>\n\u003cp>“When somebody has a connection to the area, you know, they are invested in what they’re going to be doing,” he said. “If they’re here to stay, they’re going to want to make sure that they are providing the best care that they can, that they are essentially trying to build the program so that we’re able to outreach to our community and serve their needs”\u003c/p>\n\u003cp>Bajwa is from the East Coast but the program’s goals matched his when he interviewed and Riverside was his first choice. He also had another reason for coming and staying: His wife is from Riverside and she’s also a physician.\u003c/p>\n\u003cp>“The connection with my wife is what brought me out here first,” he said. “But it was the community and identity of building something bigger than myself that I fell in love with.”\u003c/p>\n\u003cp>That’s what Leung, Aguilera and others in Riverside hope will happen with many of the students and residents they recruit. And they are not alone.\u003c/p>\n\u003cfigure id=\"attachment_11789008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-11789008\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2019/11/PHYSICIAN-SHORTAGE-SOLUTION-photo-4-800x566.jpg\" alt=\"\" width=\"800\" height=\"566\">\u003cfigcaption class=\"wp-caption-text\">Dr. Adolfo Aguilera is associate director of the Riverside County University Health System and University of California School of Medicine residency program and physician in charge at the Moreno Valley Community Health Center. s \u003ccite>(Elizabeth Aguilera/CalMatter)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003ch3>Recruiting Physicians Where They Are Needed\u003c/h3>\n\u003cp>This kind of thinking is happening across the state in areas lacking physicians.\u003c/p>\n\u003cp>In Northern California, UC Davis has partnered with the Oregon Health and Science University in Portland and created a program called COMPADRE, or California Oregon Medical Partnership to Address Disparities in Rural Education. It focuses on the area between Davis and Portland to recruit kids to medical school and to provide a program that allows them to train where they are from.\u003c/p>\n\u003cp>“We’ll modify their curriculum to allow them to remain in their home community for a large part of their training to keep them connected to a community health center in the region,” Henderson said. “If we get physicians who actually grew up or have a connection to these communities they will be less burned out and will have meaningful relationships to the community and the hospital.”\u003c/p>\n\u003cp>In urban South Los Angeles, the MLK Jr. Community Hospital set up its own medical group in 2016 that recruits and hires physicians to practice in the neighborhood and is slated to start a residency training program in 2022, said Elaine Batchlor, CEO of the hospital.\u003c/p>\n\u003cp>“The strategy is to recruit doctors who have an interest in working in underserved communities, to offer them a state of the art practice environment with high quality colleagues,” she said. “We offer market compensation and the possibility of having loans forgiven because they are working in a medically underserved area.”\u003c/p>\n\u003cp>Bringing residency slots to communities is a strategy that costs money. These slots are usually paid for by the Medicare program but the federal government has not created new residency positions in years. So the program at MLK and other new training sites are being funded by the host institutions or insurers like LA Care Health Plan.\u003c/p>\n\u003cp>LA Care serves 2 million Medi-Cal patients in Southern California. Last year the insurer committed 5% of its reserves, about $31 million a year for five years, to a program called Elevating the Safety Net, said John Baackes, CEO of the organization. It includes scholarships for medical school students, funding for residency slots, grants to clinics and private practices to recruit primary care doctors into Los Angeles County and loan repayment up to $180,000 for those newly recruited physicians who stay three years.\u003c/p>\n\u003cp>“We’re hoping that when their three years is up they will have fallen in love with L.A. and their practice and they’ll stay on with us,” Baackes said. “We’re aimed at the safety net populations, those people who are on Medi-Cal or uninsured, and we think this is the right thing to do is invest in the future of this population.”\u003c/p>\n\u003cp>In Riverside, the residency program that produced Dr. Bajwa is also partly supported by the county. Riverside County funds 52 positions beyond what the federal government provides.\u003c/p>\n\u003cp>“We are over our cap, which means every resident that we add on top of that limit are entirely funded through the county,” said Leung, of Riverside University Health System. “Any improvement that we make in the Inland Empire area whether it is in workforce, education or in terms of policy or the way we think about developing neighborhoods, all of those things help make the Inland Empire the sort of area that people want to move to and that help us with recruiting doctors, resident physicians and medical school students.”\u003c/p>\n\u003cp>For patients, having access to a doctor over the long term that they know and trust pays off.\u003c/p>\n\u003cp>Before Dr. Bajwa, Cesilia Jimenez never knew who she was going to see at the clinic.\u003c/p>\n\u003cp>“It feels good to just come and he knows what we are going to talk about and not me explaining to the doctor what I’ve been through,” she said.\u003c/p>\n\u003cp>When she left their appointment Bajwa gave her a hug before she walked out on her own.\u003c/p>\n\u003cp>“Many programs talk about serving the underserved but here the focus that the faculty have on actually taking care of the community and doing outreach in the community is just unparalleled I think,” Bajwa said. “That was something I wanted to be a part of.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>CalMatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11788977/med-school-free-rides-and-loan-repayments-california-tries-to-boost-its-dwindling-doctor-supply","authors":["byline_news_11788977"],"programs":["news_72"],"categories":["news_457","news_8"],"tags":["news_17606","news_27086","news_206"],"featImg":"news_11789005","label":"source_news_11788977"},"futureofyou_440409":{"type":"posts","id":"futureofyou_440409","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440409","score":null,"sort":[1521829213000]},"guestAuthors":[],"slug":"doctors-and-drugmakers-may-be-looking-at-your-social-media","title":"Doctors and Drugmakers May Be Looking at Your Social Media","publishDate":1521829213,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>When Allison Ruddick was diagnosed with stage 3 colorectal cancer in October 2014, she turned to the world of hashtags.\u003c/p>\n\u003cp>After her initial diagnosis it wasn't clear if the cancer had metastasized, so she was in for a nerve-wracking wait, she says. She wanted outside advice. \"But they don't really give you a handbook, so you search kind of anywhere for answers,\" Ruddick says. \"Social media was one of the first places I went.\"\u003c/p>\n\u003cp>Under the hashtags #colorectalcancer and #nevertooyoung on Facebook, Twitter and Instagram, other patients were sharing a fuller picture of their experience with cancer treatments.[contextly_sidebar id=\"cdQjHydnnhf1qm80VAQ5VOhZ1zDgEbZ8\"]\u003c/p>\n\u003cp>Later she found even more advice on specialized message boards. Patients posted everything from the details of their surgeries to the ice packs they liked best as they recovered. \"These weren't things that my doctor could tell me, and as much as I appreciate their expertise, it's also really limited by the fact that they've never really experienced any of this themselves,\" Ruddick says.\u003c/p>\n\u003cp>Partly because of that experience gap, doctors and drug companies are keen to learn from online communities, too. They're analyzing social networks to get a faster, wider look into how patients react to drugs, sometimes picking up information about side effects that clinical trials missed.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>The Rule of Three\u003c/strong>\u003c/p>\n\u003cp>Stanford University dermatologist \u003ca href=\"https://profiles.stanford.edu/bernice-kwong\">Bernice Kwong\u003c/a> specializes in skin conditions that tag along with cancer treatments. In her practice and on patient message boards, she's constantly on the lookout for symptoms that could be drug reactions.\u003c/p>\n\u003cp>In January 2017, a patient came to Kwong's office with an unusual complaint\u003cstrong>. \u003c/strong>\"I've noticed that when I work out, I just get really hot,\" he told Kwong. \"I don't sweat anymore, and I used to sweat so much.\" He was taking a drug called Tarceva, or erlotinib, that's used against lung cancer.[contextly_sidebar id=\"YV4ALpzrjOrylquldVmESZ1WsJYER2Bg\"]\u003c/p>\n\u003cp>At first, Kwong thought the problem might be hormonal. But soon after, two more of her patients at Stanford on the same drug reported that they'd also stopped sweating. \"Anytime something hits three, I think, OK, I gotta look into this a little bit more,\" she says.\u003c/p>\n\u003cp>But she hadn't seen any reports before of a lack of sweating — hypohidrosis — as a side effect for Tarceva. Her sample size of three patients was small. She'd need more data to figure things out.\u003c/p>\n\u003cp>From talking with patients and perusing online forums, Kwong knew people discussed their treatments and side effects online. In fact, hundreds of thousands of people participate in support groups and communities she'd looked at on the website \u003ca href=\"https://www.inspire.com/\">Inspire\u003c/a>. She partnered with the site with the idea that its trove of patient reports could connect more dots between hypohidrosis and Tarceva.\u003c/p>\n\u003cp>\u003cstrong>A Sharper Data Set\u003c/strong>\u003c/p>\n\u003cp>Inspire's focused groups are filled with patients' experiences with diseases and treatment, so analyzing posts requires less filtering than Facebook or Twitter data would, says \u003ca href=\"https://profiles.stanford.edu/nigam-shah\">Nigam Shah\u003c/a>, a Stanford University bioinformatics specialist who collaborated with Kwong. It also helped that the skin reactions they were interested in are relatively easy for patients to describe.\u003c/p>\n\u003cp>Still, the posts on Inspire's boards are less precise than insurance claims and health records typically used for studies on side effects.\u003c/p>\n\u003cp>Take loss of sweating. Most doctors would refer to that as hypohidrosis, so a records-based study could focus on that phrase. In online message boards there's a lot of variety. One person's \"I can't sweat anymore\" might be another's \"I'm overheating.\"[contextly_sidebar id=\"b60xAgKbNdenisEddidkCVcmMXTjd0Aj\"]\u003c/p>\n\u003cp>Kwong, Shah and their colleagues used a deep learning algorithm to process the phrases surrounding reports of symptoms, basically finding contextual clues to identify the different ways patients referred to side effects.\u003c/p>\n\u003cp>In 8 million posts on Inspire from a 10-year period, 4,909 users mentioned Tarceva, or erlotinib generically. Although clinical reports don't link the drug and hypohidrosis, 23 patients wrote about the medicine and loss of sweating in the same post — a statistically significant connection, Kwong says. The research group's findings \u003ca href=\"https://jamanetwork.com/journals/jamaoncology/article-abstract/2673831?redirect=true\" target=\"_blank\" rel=\"noopener\">were published\u003c/a> in \u003cem>JAMA Oncology\u003c/em> in March.\u003c/p>\n\u003cp>Using the same approach to monitor posts about a different class of immunotherapy cancer drugs, the researchers found mentions of autoimmune blistering that also predated the clinical reports of the side effect.\u003c/p>\n\u003cp>Given the stakes of cancer treatment, Kwong says she's inclined to help patients manage side effects instead of stopping a given drug. But earlier alerts from systems like this could have made a difference in her practice. \"If we had had this program already, I would've been looking out for [blistering] sooner and maybe I would've noticed it earlier in some patients,\" Kwong says.\u003c/p>\n\u003cp>\u003cstrong>How Clinical Trials Miss Side Effects\u003c/strong>\u003c/p>\n\u003cp>From numbers alone, it's no surprise that clinical trials for drugs don't pick up every side effect. The Food and Drug Administration first \u003ca href=\"https://www.accessdata.fda.gov/drugsatfda_docs/nda/2004/21-743_Tarceva_StatR.PDF\">approved\u003c/a> Tarceva in 2004 on the basis of a trial that enrolled 731 patients, 488 of whom received the drug. Uncommon effects might not show up in a group that size.\u003c/p>\n\u003cp>On Inspire's message boards, more than 10 times as many patients reported using Tarceva, so it's reasonable to imagine that online posts could include reports of rarer side effects.\u003c/p>\n\u003cp>And while drug trials do collect data on side effects, their overriding goal is to find out whether or not a drug works, says \u003ca href=\"http://bioethics.hms.harvard.edu/person/faculty-members/aaron-kesselheim\">Dr. Aaron Kesselheim\u003c/a>, a professor of medicine at Harvard University. \"After a drug is approved, it is absolutely essential to continue to observe, follow and study the drug rigorously as it's used in a larger population to try to really get a handle on the safety of the drug,\" he says.[contextly_sidebar id=\"JGYGYdpwADzgX2U5wdZePXnIkUOkoc8q\"]\u003c/p>\n\u003cp>Collecting data about a drug from insurance claims and health records typically happens with quite a time lag. So mining the Internet and social media for casual patient reports is tempting, Kesselheim says, because of its potential scale and speed. But the approach also has drawbacks. \"You just get this tidal wave of data, and it's hard to know how to assess it in a rigorous and thoughtful fashion,\" he says.\u003c/p>\n\u003cp>That hasn't stopped drug companies from wading in. Roche has \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29446035\">sampled\u003c/a> mentions of their products from Twitter, Tumblr, Facebook and blogs to learn more about drug safety. GlaxoSmithKline has tried it too, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26798054\">analyzing\u003c/a> millions of mentions of drugs from Twitter and Facebook.\u003c/p>\n\u003cp>Much of the work published so far has focused on drug reactions. But scraping public social media data isn't just a matter of product safety. The company \u003ca href=\"https://www.synthesio.com/social-listening-pharma-healthcare/\">Synthesio\u003c/a> touts its social data services for drugmakers as a way to answer customer questions, conduct market research and influence purchasing.\u003c/p>\n\u003cp>\u003cstrong>Surfing Responsibly\u003c/strong>\u003c/p>\n\u003cp>In terms of extending studies to mine even bigger networks, like Twitter or Facebook, for potential side effects, Kesselheim points to issues of representation and privacy. As with any analysis, a deep learning model like the one Shah used on the Inspire message boards can only make conclusions about the information it \u003cem>sees\u003c/em>.\u003c/p>\n\u003cp>And it's hard to guarantee that message boards and social media represent all patients. In 2012, researchers gave 231 breast cancer patients in rural Michigan and Wisconsin computers, Internet access and training to use an online cancer support group. The researchers \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3556823/\">found\u003c/a> that white women were much more likely to log on and post in the group than black women. Younger women were also more likely to post information.\u003c/p>\n\u003cp>While the long-standing approach to post-approval drug studies — using health records and claims data — may be slower, Kesselheim says, they're more established. \"There are methodologies and tools that you can use in claims data to try to make sure that you are making conclusions that can be generalizable across different races and ethnicity and genders and parts of America,\" he says.\u003c/p>\n\u003cp>There's also the issue of privacy — patients' health records are protected by the Health Insurance Portability and Accountability Act of 1996, whereas public data online aren't, Kesselheim says.\u003c/p>\n\u003cp>For Stanford researcher Shah, this wasn't an issue. Inspire's privacy statement tells patients their posts may be used for research if they're not private, and Shah feels comfortable following common sense rules when using public data. \"As in, if somebody did [something] with my data and I would be upset, don't do that with someone else's data,\" he says.\u003c/p>\n\u003cp>But the newness of social media makes Kesselheim wary. \"There are big questions that remain about how patient privacy is upheld in those social media contexts, and I think that's a really big issue to think about moving forward as people are trying to use those outlets to provide insight into drug safety and side effects.\"\u003c/p>\n\u003cp>As a patient, Ruddick isn't bothered by the idea of researchers and pharmaceutical companies studying data from social media and patient message boards, as long as the data are public or there's mention of data sharing in a privacy statement.\u003c/p>\n\u003cp>She works as a communications director in New York City, so she's thought a lot about the nature of information online. \"If I'm putting something out there on the Internet, it's for the Internet. I know the world is going to see it,\" Ruddick says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>She knows other patients might feel differently, but she's optimistic that analyzing patients' interactions online could improve the treatments available. \"It's one thing, being in a lab and developing these drugs,\" she says. \"But it's a completely different thing to see how they're being used out there in the world, and to see how they're affecting somebody's life.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+Social+Media+Can+Reveal+Overlooked+Drug+Reactions&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Doctors and drugmakers are looking at patients' experiences on social media for clues on problems.","status":"publish","parent":0,"modified":1521829246,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":38,"wordCount":1644},"headData":{"title":"Doctors and Drugmakers May Be Looking at Your Social Media | KQED","description":"Doctors and drugmakers are looking at patients' experiences on social media for clues on problems.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Doctors and Drugmakers May Be Looking at Your Social Media","datePublished":"2018-03-23T18:20:13.000Z","dateModified":"2018-03-23T18:20:46.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440409 https://ww2.kqed.org/futureofyou/?p=440409","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/23/doctors-and-drugmakers-may-be-looking-at-your-social-media/","disqusTitle":"Doctors and Drugmakers May Be Looking at Your Social Media","source":"DIY Health","nprImageCredit":"Roy Scott","nprByline":"Menaka Wilhelm\u003cbr />NPR Shots","nprImageAgency":"Getty Images/Ikon Images","nprStoryId":"593914075","nprApiLink":"http://api.npr.org/query?id=593914075&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/03/23/593914075/how-social-media-can-reveal-overlooked-drug-reactions?ft=nprml&f=593914075","nprRetrievedStory":"1","nprPubDate":"Fri, 23 Mar 2018 11:28:00 -0400","nprStoryDate":"Fri, 23 Mar 2018 11:28:32 -0400","nprLastModifiedDate":"Fri, 23 Mar 2018 11:28:32 -0400","path":"/futureofyou/440409/doctors-and-drugmakers-may-be-looking-at-your-social-media","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Allison Ruddick was diagnosed with stage 3 colorectal cancer in October 2014, she turned to the world of hashtags.\u003c/p>\n\u003cp>After her initial diagnosis it wasn't clear if the cancer had metastasized, so she was in for a nerve-wracking wait, she says. She wanted outside advice. \"But they don't really give you a handbook, so you search kind of anywhere for answers,\" Ruddick says. \"Social media was one of the first places I went.\"\u003c/p>\n\u003cp>Under the hashtags #colorectalcancer and #nevertooyoung on Facebook, Twitter and Instagram, other patients were sharing a fuller picture of their experience with cancer treatments.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Later she found even more advice on specialized message boards. Patients posted everything from the details of their surgeries to the ice packs they liked best as they recovered. \"These weren't things that my doctor could tell me, and as much as I appreciate their expertise, it's also really limited by the fact that they've never really experienced any of this themselves,\" Ruddick says.\u003c/p>\n\u003cp>Partly because of that experience gap, doctors and drug companies are keen to learn from online communities, too. They're analyzing social networks to get a faster, wider look into how patients react to drugs, sometimes picking up information about side effects that clinical trials missed.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>The Rule of Three\u003c/strong>\u003c/p>\n\u003cp>Stanford University dermatologist \u003ca href=\"https://profiles.stanford.edu/bernice-kwong\">Bernice Kwong\u003c/a> specializes in skin conditions that tag along with cancer treatments. In her practice and on patient message boards, she's constantly on the lookout for symptoms that could be drug reactions.\u003c/p>\n\u003cp>In January 2017, a patient came to Kwong's office with an unusual complaint\u003cstrong>. \u003c/strong>\"I've noticed that when I work out, I just get really hot,\" he told Kwong. \"I don't sweat anymore, and I used to sweat so much.\" He was taking a drug called Tarceva, or erlotinib, that's used against lung cancer.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At first, Kwong thought the problem might be hormonal. But soon after, two more of her patients at Stanford on the same drug reported that they'd also stopped sweating. \"Anytime something hits three, I think, OK, I gotta look into this a little bit more,\" she says.\u003c/p>\n\u003cp>But she hadn't seen any reports before of a lack of sweating — hypohidrosis — as a side effect for Tarceva. Her sample size of three patients was small. She'd need more data to figure things out.\u003c/p>\n\u003cp>From talking with patients and perusing online forums, Kwong knew people discussed their treatments and side effects online. In fact, hundreds of thousands of people participate in support groups and communities she'd looked at on the website \u003ca href=\"https://www.inspire.com/\">Inspire\u003c/a>. She partnered with the site with the idea that its trove of patient reports could connect more dots between hypohidrosis and Tarceva.\u003c/p>\n\u003cp>\u003cstrong>A Sharper Data Set\u003c/strong>\u003c/p>\n\u003cp>Inspire's focused groups are filled with patients' experiences with diseases and treatment, so analyzing posts requires less filtering than Facebook or Twitter data would, says \u003ca href=\"https://profiles.stanford.edu/nigam-shah\">Nigam Shah\u003c/a>, a Stanford University bioinformatics specialist who collaborated with Kwong. It also helped that the skin reactions they were interested in are relatively easy for patients to describe.\u003c/p>\n\u003cp>Still, the posts on Inspire's boards are less precise than insurance claims and health records typically used for studies on side effects.\u003c/p>\n\u003cp>Take loss of sweating. Most doctors would refer to that as hypohidrosis, so a records-based study could focus on that phrase. In online message boards there's a lot of variety. One person's \"I can't sweat anymore\" might be another's \"I'm overheating.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Kwong, Shah and their colleagues used a deep learning algorithm to process the phrases surrounding reports of symptoms, basically finding contextual clues to identify the different ways patients referred to side effects.\u003c/p>\n\u003cp>In 8 million posts on Inspire from a 10-year period, 4,909 users mentioned Tarceva, or erlotinib generically. Although clinical reports don't link the drug and hypohidrosis, 23 patients wrote about the medicine and loss of sweating in the same post — a statistically significant connection, Kwong says. The research group's findings \u003ca href=\"https://jamanetwork.com/journals/jamaoncology/article-abstract/2673831?redirect=true\" target=\"_blank\" rel=\"noopener\">were published\u003c/a> in \u003cem>JAMA Oncology\u003c/em> in March.\u003c/p>\n\u003cp>Using the same approach to monitor posts about a different class of immunotherapy cancer drugs, the researchers found mentions of autoimmune blistering that also predated the clinical reports of the side effect.\u003c/p>\n\u003cp>Given the stakes of cancer treatment, Kwong says she's inclined to help patients manage side effects instead of stopping a given drug. But earlier alerts from systems like this could have made a difference in her practice. \"If we had had this program already, I would've been looking out for [blistering] sooner and maybe I would've noticed it earlier in some patients,\" Kwong says.\u003c/p>\n\u003cp>\u003cstrong>How Clinical Trials Miss Side Effects\u003c/strong>\u003c/p>\n\u003cp>From numbers alone, it's no surprise that clinical trials for drugs don't pick up every side effect. The Food and Drug Administration first \u003ca href=\"https://www.accessdata.fda.gov/drugsatfda_docs/nda/2004/21-743_Tarceva_StatR.PDF\">approved\u003c/a> Tarceva in 2004 on the basis of a trial that enrolled 731 patients, 488 of whom received the drug. Uncommon effects might not show up in a group that size.\u003c/p>\n\u003cp>On Inspire's message boards, more than 10 times as many patients reported using Tarceva, so it's reasonable to imagine that online posts could include reports of rarer side effects.\u003c/p>\n\u003cp>And while drug trials do collect data on side effects, their overriding goal is to find out whether or not a drug works, says \u003ca href=\"http://bioethics.hms.harvard.edu/person/faculty-members/aaron-kesselheim\">Dr. Aaron Kesselheim\u003c/a>, a professor of medicine at Harvard University. \"After a drug is approved, it is absolutely essential to continue to observe, follow and study the drug rigorously as it's used in a larger population to try to really get a handle on the safety of the drug,\" he says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Collecting data about a drug from insurance claims and health records typically happens with quite a time lag. So mining the Internet and social media for casual patient reports is tempting, Kesselheim says, because of its potential scale and speed. But the approach also has drawbacks. \"You just get this tidal wave of data, and it's hard to know how to assess it in a rigorous and thoughtful fashion,\" he says.\u003c/p>\n\u003cp>That hasn't stopped drug companies from wading in. Roche has \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29446035\">sampled\u003c/a> mentions of their products from Twitter, Tumblr, Facebook and blogs to learn more about drug safety. GlaxoSmithKline has tried it too, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26798054\">analyzing\u003c/a> millions of mentions of drugs from Twitter and Facebook.\u003c/p>\n\u003cp>Much of the work published so far has focused on drug reactions. But scraping public social media data isn't just a matter of product safety. The company \u003ca href=\"https://www.synthesio.com/social-listening-pharma-healthcare/\">Synthesio\u003c/a> touts its social data services for drugmakers as a way to answer customer questions, conduct market research and influence purchasing.\u003c/p>\n\u003cp>\u003cstrong>Surfing Responsibly\u003c/strong>\u003c/p>\n\u003cp>In terms of extending studies to mine even bigger networks, like Twitter or Facebook, for potential side effects, Kesselheim points to issues of representation and privacy. As with any analysis, a deep learning model like the one Shah used on the Inspire message boards can only make conclusions about the information it \u003cem>sees\u003c/em>.\u003c/p>\n\u003cp>And it's hard to guarantee that message boards and social media represent all patients. In 2012, researchers gave 231 breast cancer patients in rural Michigan and Wisconsin computers, Internet access and training to use an online cancer support group. The researchers \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3556823/\">found\u003c/a> that white women were much more likely to log on and post in the group than black women. Younger women were also more likely to post information.\u003c/p>\n\u003cp>While the long-standing approach to post-approval drug studies — using health records and claims data — may be slower, Kesselheim says, they're more established. \"There are methodologies and tools that you can use in claims data to try to make sure that you are making conclusions that can be generalizable across different races and ethnicity and genders and parts of America,\" he says.\u003c/p>\n\u003cp>There's also the issue of privacy — patients' health records are protected by the Health Insurance Portability and Accountability Act of 1996, whereas public data online aren't, Kesselheim says.\u003c/p>\n\u003cp>For Stanford researcher Shah, this wasn't an issue. Inspire's privacy statement tells patients their posts may be used for research if they're not private, and Shah feels comfortable following common sense rules when using public data. \"As in, if somebody did [something] with my data and I would be upset, don't do that with someone else's data,\" he says.\u003c/p>\n\u003cp>But the newness of social media makes Kesselheim wary. \"There are big questions that remain about how patient privacy is upheld in those social media contexts, and I think that's a really big issue to think about moving forward as people are trying to use those outlets to provide insight into drug safety and side effects.\"\u003c/p>\n\u003cp>As a patient, Ruddick isn't bothered by the idea of researchers and pharmaceutical companies studying data from social media and patient message boards, as long as the data are public or there's mention of data sharing in a privacy statement.\u003c/p>\n\u003cp>She works as a communications director in New York City, so she's thought a lot about the nature of information online. \"If I'm putting something out there on the Internet, it's for the Internet. I know the world is going to see it,\" Ruddick says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She knows other patients might feel differently, but she's optimistic that analyzing patients' interactions online could improve the treatments available. \"It's one thing, being in a lab and developing these drugs,\" she says. \"But it's a completely different thing to see how they're being used out there in the world, and to see how they're affecting somebody's life.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+Social+Media+Can+Reveal+Overlooked+Drug+Reactions&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440409/doctors-and-drugmakers-may-be-looking-at-your-social-media","authors":["byline_futureofyou_440409"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_952","futureofyou_61","futureofyou_173","futureofyou_931","futureofyou_174","futureofyou_198"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440410","label":"source_futureofyou_440409"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. 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