Health Affairs Narrative Matters

Abortion Care Is Essential Medical Care

Health Affairs — Mon, 17 Apr 2023 01:00:00 -0400

An abortion care provider shares stories from the front line and urges physicians to defend abortion care access within their communities. Read by author Rachel Jensen.

If you enjoy this essay, order the Health Affairs February 2023 issue.

Keeping Quiet About Genetic Risk

Health Affairs — Wed, 29 Mar 2023 01:00:00 -0400

Failing to protect people at risk for genetic disease from discrimination may have a silencing effect and erode trust in the patient-provider relationship. Read by author Susanna Smith.

This article is a reworked excerpt from an unpublished book manuscript.

If you enjoy this essay, order the Health Affairs March 2023 issue.

Understanding Pandemic Experiences Among America’s Elders

Health Affairs — Thu, 09 Feb 2023 01:00:00 -0500

Older Americans’ experiences of the COVID-19 pandemic, including social isolation and loneliness, generosity, and resilience, must be studied and addressed. Read by authors Louise Aronson and Ashwin Kotwal.

If you enjoy this essay, order the Health Affairs December 2022 issue.

Standing Up For My Sister

Health Affairs — Fri, 14 Oct 2022 01:00:00 -0400

Integrating family caregivers into the health care team is particularly important for patients with intellectual disabilities. Read by author Duke University's Courtney Van Houtven.

If you enjoy this essay, order the Health Affairs theme issue on disability and health.

A Health System That Won't Learn From Its Mistakes

Health Affairs — Wed, 28 Sep 2022 01:00:00 -0400

When a patient dies from a medical error, there often is no recourse for the family. Read by author Chandra Keller.

If you enjoy this essay, order the September 2022 Health Affairs issue.

Echoes of Trauma: Post-Intensive Care Syndrome

Health Affairs — Wed, 31 Aug 2022 01:00:00 -0400

Post–intensive care syndrome affects many patients discharged from the acute care setting. Read by author Joanna Bayes.

If you enjoy this essay, order the August 2022 Health Affairs issue.

As Hospitals Restrict Visitors, What Constitutes A ‘Good Death’?

Health Affairs — Wed, 29 Jun 2022 01:00:00 -0400

During the COVID-19 pandemic, a narrow view of patients’ and families’ preferences has led to the unjust application of policies meant to accommodate dying patients and their families. Read by author Nora Osman Segar from Yale New Haven Hospital and Yale Medical School.

If you enjoy this essay, order the June 2022 Health Affairs issue.

Halfway Around The World, Echoes Of Physician Moral Injury

Health Affairs — Thu, 12 May 2022 01:00:00 -0400

A physician seeks respite from the injustice of US care delivery but encounters familiar signals of system failure abroad. Read by author Jason Prior.

If you enjoy this essay, order the May 2022 Health Affairs issue.

Surviving Two Pandemics

Health Affairs — Thu, 17 Mar 2022 01:00:00 -0400

A Washington insider discusses lessons learned from communicating about the HIV/AIDS pandemic and current failures to talk effectively about COVID-19. Read by author Richard Sorian from 340B Health.

If you enjoy this essay, order the March 2022 Health Affairs issue.

Honoring Dr. Shalon Irving, A Champion for Health Equity

Health Affairs — Mon, 14 Feb 2022 01:00:00 -0500

Shalon Irving’s 2017 death brought national attention to maternal mortality among Black women in the US. This essay remembers her life and legacy. Read by Wanda Irving, chair of the board of Dr. Shalon’s Maternal Action Project.

If you enjoy this essay, order the February 2022 Health Affairs Racism and Health theme issue.

After A Death, Bringing Stillbirth Prevention To The US

Health Affairs — Wed, 26 Jan 2022 01:00:00 -0500

A mother whose son was stillborn at thirty-six weeks is working to import stillbirth prevention policies from abroad. Read by author Marny Smith, assistant director of Graduate Career Services at the Austin W. Marxe School of Public and International Affairs at Baruch College.

If you enjoy this essay, order the January 2022 Health Affairs issue.

To Uncover My Mother's Genetic Disorder, I Had To Lead The Way

Health Affairs — Fri, 17 Dec 2021 01:00:00 -0500

A genetic counselor uses her own resources to identify the root cause of her mother’s changing personality. Read by author Shivani Nazareth, certified genetic counselor and product manager at Invitae, and a visiting lecturer at the Icahn School of Medicine at Mount Sinai.

When Nazareth’s mother became ill, symptoms pointed to dementia but potentially something more, and she suggested genetic testing to find the root cause of her mother’s illness. The fields of genomics and precision medicine are advancing rapidly, and many older adults are interested in genetic testing to help guide medical diagnosis or treatments when possible. Yet genetic counselors are not recognized as Medicare providers and cannot bill for their services under the program. Proposed legislation could change this.

If you enjoy this essay, order the December 2021 Health Affairs issue.

Opening Up About My Struggle With Recurring Depression

Health Affairs — Mon, 29 Nov 2021 01:00:00 -0500

A health care leader shares her story of living with major depression and calls for better treatments. Read by author Nora Super, senior director of the Milken Institute Center for the Future of Aging and the executive director of the Milken Institute Alliance to Improve Dementia Care.

“I decided to share my story because I think so many of us who live with depression live in the shadows,” Super says. “We’re afraid to tell our stories because of the tremendous stigma associated with depression and afraid something might happen to our career or our personal lives if others around us know that.”

If you enjoy this essay, order the November 2021 Health Affairs issue.

Perinatal Mental Illness Nearly Ended My Life

Health Affairs — Fri, 22 Oct 2021 01:00:00 -0400

A psychiatry professor’s recovery from perinatal depression drives her research to facilitate practice and policy change. Read by author Kara Zivin, a research career scientist at the Veterans Affairs Ann Arbor Healthcare System, and a senior health researcher at Mathematica.

Order the October Perinatal Mental Health Theme Issue.

‘Long COVID’: Making The Invisible Visible

Health Affairs — Fri, 01 Oct 2021 01:00:00 -0400

After recovering from acute COVID-19 infection, a physician is stricken with the debilitating symptoms of long COVID. Read by author Maria Victoria Bovo, a pediatric gastroenterologist at the Hospital Germans Trias i Pujol, in Badalona, Spain.

Order the September issue of Health Affairs.

"Long COVID": Hacer Visible Lo Invisible

Health Affairs — Fri, 01 Oct 2021 01:00:00 -0400

Después de recuperarse de una infección aguda por COVID-19, un médico sufre los síntomas debilitantes del COVID prolongado. Leído por la autora María Victoria Bovo, gastroenteróloga pediátrica del Hospital Germans Trias i Pujol, en Badalona, España.

Solicite la edición de septiembre de Health Affairs.

'Remain In Mexico': Stories Of Trauma And Abuse

Health Affairs — Wed, 21 Jul 2021 02:00:00 -0400

Two families’ stories—a separation at the border and an assault in a migrant shelter—show the horrific dimensions of US migration policy. Read by co-author Alfonso Mercado from the University of Texas Rio Grande Valley.

Order your copy of the July 2021 issue of Health Affairs.

As a mother with COVID-19, I faced stigma and shame

Health Affairs — Wed, 23 Jun 2021 02:00:00 -0400

Childbirth can be an extremely stressful time in any period. Imagine delivering a baby during a global pandemic, just hours after testing positive for COVID-19 despite taking public health precautions.

In this episode of the Narrative Matters podcast, Sara Edmond talks about testing positive for COVID-19 shortly before the birth of her daughter, and facing suspicion and stigma from her providers as a result.

Edmond, a clinical psychologist at the Veterans Affairs Connecticut Healthcare System, and an associate research scientist in the Department of Psychiatry at Yale School of Medicine, talks about why it’s so important not to “blame” COVID-19 patients for their diagnosis and instead support them.

Following an interview, Edmond reads her essay “As A Mother With COVID-19, I Faced Stigma And Shame.”

The hidden curriculum of hospice: die fast, not slow

Health Affairs — Thu, 13 May 2021 02:00:00 -0400

Hospice care is meant to optimize quality of life and minimize sources of distress at the end of life. In theory, enrollees are entitled to an unlimited number of days of hospice care, though they have to be recertified after 6 months. But in practice, some patients end up discharged alive rather than re-enrolled.

In this episode of the Narrative Matters podcast, Health Affairs’ Jessica Bylander talks to Krista Lyn Harrison, an assistant professor of geriatrics and health policy at the University of California San Francisco. In this month’s essay, Harrison writes about her stepfather’s experience with the hospice care system at the end of his life, and how the model ultimately failed their family and how it fails other patients who die more slowly than expected. After being discharged alive from hospice, Harrison’s stepfather’s health soon declined again and he died nearly eight months after his initial hospice admission.

Harrison, a former hospice administrator, says she has the utmost respect for her hospice clinical colleagues, but that the hospice system is not quite keeping up with what’s best for patients and families. Hospice, or its alternative, should better support different disease trajectories and functional needs for patients who are dying, she says.

Following the interview, Harrison reads her essay “The Hidden Curriculum Of Hospice: Die Fast, Not Slow.”

This podcast is part of Health Affairs' Age-Friendly Health series, with support The John A. Hartford Foundation.

Related Links:

The Hidden Curriculum Of Hospice: Die Fast, Not Slow (Health Affairs)
2020 Edition: Hospice Facts and Figures (National Hospice and Palliative Care Organization)
A Positive Association Between Hospice Profit Margin And The Rate At Which Patients Are Discharged Before Death (Health Affairs)

Charity care needs to be better than this

Health Affairs — Thu, 29 Apr 2021 02:00:00 -0400

Charity care is health care that is provided for free or at a reduced cost to eligible patients, with no expectation that the patient will pay. Under the Affordable Care Act, nonprofit hospitals are required to provide charity care to eligible patients, or risk losing their tax-exempt status. But data show large variation in how much charity care hospitals actually provide.

In this episode of the Narrative Matters podcast, Health Affairs’ Jessica Bylander talks to David Velasquez, a student of medicine, public policy, and business at Harvard University. In this month’s Narrative Matters essay, Velasquez writes about navigating the unclear system of charity care after his father’s costly hospital stay for a heart attack.

Velasquez says he wishes that low-income patients knew they have a right to ask hospitals to provide them with information about charity care. Ultimately, he hopes more patients gain access to health insurance coverage through actions of the Biden Administration, making the need for charity care less pressing.

Following the interview, Velasquez reads his essay, “Charity Care Needs To Be Better Than This.”

Related Links:

Charity Care Needs To Be Better Than This (Health Affairs)
Analysis Suggests Government And Nonprofit Hospitals’ Charity Care Is Not Aligned With Their Favorable Tax Treatment (Health Affairs)
Patients Eligible For Charity Care Instead Get Big Bills (Kaiser Health News)

General medical education should not be a commodity

Health Affairs — Mon, 22 Mar 2021 08:00:00 -0400

In June 2019, Hahnemann University Hospital, a teaching hospital that had served poor residents in Philadelphia for more than 170 years, filed for bankruptcy and, within months, closed its doors for good. The complex story of its closure, after being purchased by a private equity executive, highlights concerns with health care finances and how physician training is caught in the middle.

In this episode of the Narrative Matters podcast, Jessica Bylander talks to Sharon Griswold, a professor of emergency medicine at the Penn State Health Milton S. Hershey Medical Center, who writes about Hahnemann’s demise and what it meant for graduate medical education.

Following a short interview, Griswold reads her essay, “Graduate Medical Education Should Not Be A Commodity.”

Related Links:

Graduate Medical Education Should Not Be A Commodity (Health Affairs)
Hahnemann Hospital closure (WHYY)
The Closure of Hahnemann University Hospital and the Experience of Moral Injury in Academic Medicine (Academic Medicine)

COVID-19 through the eyes of a black medical student

Health Affairs — Thu, 18 Feb 2021 11:13:29 -0500

In the face of the racial health disparities made more visible during the COVID-19 pandemic, statistics tell only part of the story. Read by author Shuaibu Ali, a medical student at Dartmouth College.

Out of options for patients with serious mental illness

Health Affairs — Fri, 15 Jan 2021 10:35:53 -0500

A woman with serious mental illness cycles between a state hospital, shelters, nursing homes, and psychiatric units, with no permanent place to land. Read by the author Brian Scott Barnett, a staff psychiatrist at Cleveland Clinic.

Climate migration and the future of health care

Health Affairs — Mon, 07 Dec 2020 15:00:00 -0500

A physician treats two patients who were forced from their home countries by extreme weather associated with climate change. Read by author Katharine Lawrence from the New York University Grossman School of Medicine.

This, too, is what racism feels like

Health Affairs — Mon, 02 Nov 2020 13:00:00 -0500

After George Floyd’s killing, a physician reflects on how the health effects of racism become embodied for her and other Black Americans. Read by author Brooke Cunningham, originally published in November 2020.

A mother in wonderland: securing services for my blind child

Health Affairs — Sat, 31 Oct 2020 13:00:00 -0400

A parent navigates complex education policy to secure services and supports for her blind child. Read by author Carla Keirns, originally published in October 2020.

Challenges in ensuring the quality of generic medicines

Health Affairs — Sat, 12 Sep 2020 13:00:00 -0400

A refill of a generic attention deficit hyperactivity disorder prescription leads to new side effects and raises questions about the quality of generic drugs. Read by Kevin Schulman, originally published in September 2020.

A patient with COVID-19 is left behind as care goes virtual

Health Affairs — Mon, 03 Aug 2020 13:00:00 -0400

Virtual strategies for health care visits during a pandemic must not exclude marginalized patients. Read by author Kumara Sunday, originally published in August 2020.

An understaffed hospital battles COVID-19

Health Affairs — Mon, 03 Aug 2020 13:00:00 -0400

During the peak of the COVID-19 pandemic, staffing ratios reached untenable levels. Read by author David Scales, originally published in August 2020.

Protecting access to abortion during the COVID-19 pandemic

Health Affairs — Mon, 03 Aug 2020 13:00:00 -0400

Several states attempted to deem abortions nonessential during the COVID-19 pandemic, leaving some women with difficult choices. Read by author Maryl Sackeim, originally published in August 2020.

Finding time for compassion in a busy emergency department

Health Affairs — Mon, 06 Jul 2020 13:00:00 -0400

A medical error in the emergency department causes emotional trauma for a patient, who seeks compassion in the aftermath. Read by author Angela Blood, originally published in July 2020.

Racism in my medical education

Health Affairs — Mon, 01 Jun 2020 13:00:00 -0400

An Asian American physician calls for more diversity and a commitment to health equity in US medical schools. Read by author Michelle Ko, originally published in June 2020.

Held against our wills: reimagining involuntary commitment

Health Affairs — Thu, 14 May 2020 13:00:00 -0400

Involuntary psychiatric treatment for people with serious mental illness should focus on returning to health instead of reducing danger. Read by author Abraham Nussbaum, originally published in May 2020.

Poems - The Headache, Epidemic, Admission

Health Affairs — Wed, 01 Apr 2020 13:00:00 -0400

These three poems won the 2019 Narrative Matters poetry contest. Read by authors Anjali Jain, Ronald Valdiserri, and Alex Sievert, originally published in April 2020.

The power of access to affordable care

Health Affairs — Sat, 14 Mar 2020 13:00:00 -0400

A patient and student with severe asthma chases adequate insurance coverage until the Affordable Care Act provides something more. Read by author Rachel Stern, originally published in March 2020.

There’s no algorithm for empathy

Health Affairs — Fri, 14 Feb 2020 13:00:00 -0500

When physicians rely on a behavioral "recipe" to convey empathy, patient care can suffer. Read by author Hannah Wild, originally published in February 2020.

To treat my patient, I had to understand her trauma

Health Affairs — Wed, 01 Jan 2020 13:00:00 -0500

A patient who is a survivor of abuse benefits from a health care approach that acknowledges her past trauma. Read by author Eve Rittenberg, originally published in January 2020.

When people you love are the unintended consequences of opioid policy

Health Affairs — Sun, 01 Dec 2019 13:00:00 -0500

After the release of federal guidelines to curb opioid misuse, a patient is unable to obtain effective pain treatment and dies from complications. Read by author Mary Beth Foglia, originally published in December 2019.

Measles, mumps, and communion: a vision for vaccine policy

Health Affairs — Tue, 19 Nov 2019 13:00:00 -0500

A pediatrician offers a vision for vaccine policy that promotes public health while respecting religious beliefs. Read by author Joshua Williams, originally published in November 2019.

My struggle to access lifesaving mental health care

Health Affairs — Mon, 01 Apr 2019 13:00:00 -0400

A patient must overcome systemic hurdles to stay on the only effective treatment for her depression: ketamine. Read by author Ashley Clayton, originally published in April 2019.

'Go back to California': when providers fail transgender patients

Health Affairs — Sun, 10 Sep 2017 12:00:00 -0400

A transgender doctor is mistreated by a health care provider — and wants to make the system better for patients like her. Read by author Laura Arrowsmith, originally published in September 2017.

The importance of being

Health Affairs — Mon, 31 Oct 2016 12:00:00 -0400

Good patient care is found not on a computer screen but in being truly present with patients. Read by author Abraham Verghese, originally published in October 2016.

Asthma and injustice on Chicago's Southeast side

Health Affairs — Sat, 14 May 2016 12:00:00 -0400

A physician discovers a potential environmental link to asthma attacks in a poor Chicago community. Read by author Kohar Jones, originally published in May 2016.

'I don't want Jenny to think I'm abandoning her': views on overtreatment

Health Affairs — Thu, 01 May 2014 12:00:00 -0400

A palliative care physician helps a cancer patient cope with her coming death, while her oncologist struggles to give up treatment. Read by author Diane Meier, originally published in May 2014.

Undocumented immigrants and kidney transplant: costs and controversy

Health Affairs — Fri, 14 Feb 2014 12:12:00 -0500

A nephrologist's patient is ideally suited for kidney transplant — except that he is an undocumented immigrant. (read by author Vanessa Grubbs, originally published in February 2014)