I have made it a tradition each December to look back over my reporting that year and pull out 10 quotes from interviews I have done or panel sessions I have covered that struck me as emblematic of the crucial trends facing healthcare. In this annus horribilis of pandemic and strife, it was an honor to be able to cover the efforts of front-line workers and health system and public health executives responding to the emergency. So my Top 10 quotes this year all focus on the pandemic response, addressing health equity and structural racism issues or the intersection of both. Here they are in no particular order:
“The pandemic reinforces what we already know. We can’t keep people healthy if they don’t have a roof over their head and food on the table.”
— Bechara Choucair, M.D., Kaiser Permanente’s senior vice president and chief health officer
“COVID is a funhouse mirror that is amplifying issues that have existed forever. People are not dying of COVID. They are dying of racism, of economic inequality and it is not going to stop with COVID.”
— Shreya Kangovi, M.D., M.S.H.P., associate professor of medicine at the Perelman School of Medicine at the University of Pennsylvania and executive director of the Penn Center for Community Health Workers
“In the aftermath of George Floyd I wrote that I was ashamed that we had been empathetic bystanders in the past to racial disparities. Even where we offer equality in treatment, which we are, we are not seeing equity in outcomes, and that is what matters. So we picked blood pressure control, because 22 percent of our African-American elderly patients have severely uncontrolled hypertension compared to 14 percent in our white seniors. We said we were going to cut that disparity in half. But we have to explicitly look at it, measure it, trend it, track it, and motivate against it if we want to make progress. Doing general population health isn’t going to fix it.”
— Farzad Mostashari, M.D., founder and CEO of Aledade Inc. and former national coordinator for health information technology
“We knew [COVID-19] was going to hit hard in jails and prisons. By the summer it was clear there had been major outbreaks. Nine of the largest outbreaks in the country were in prisons and jails. We have seen some increases in testing, but it has never been adequate. There has been some one-time testing in prisons to appease advocates, but we still haven’t seen any long-term testing plans by a majority of places.”
— Lauren Brinkley-Rubinstein, Ph.D., assistant professor of social medicine at UNC-Chapel Hill and co-founder of the COVID Prison Project
“We cannot treat our way out of these problems. We are never going to build enough medical services. Preventing suffering before it happens is the long-term answer for our country. Our goal is to create a community where everybody has opportunity to thrive.”
— Kelly Kelleher, M.D., M.P.H., director of the Center for Innovation in Pediatric Practice at Nationwide Children's Hospital in Columbus, Ohio, accepting the Hearst Health Prize for population health
“The current state of everyone staying home is clearly untenable — for sanity, the economy and other reasons. But flipping a switch and saying we are opening it back up would be extremely dangerous. We don’t want to do that. So we have this model of a dimmer switch to say what can we ease back into and when? That is what we are looking at now, and it comes down to part modeling and part politics, unfortunately.”
— Jessie Tenenbaum, Ph.D., chief data officer for the North Carolina Department of Health and Human Services
“Over the last eight months, I have diligently been working with our organization to try to get telemedicine privileges. A lot of our clinics are in rural areas, and I wanted to provide genetic counseling services for our entire Northern California region. Our organization has seven telemedicine locations set up. It had taken eight months and I was still no closer to seeing my first telemedicine patient. Yet once COVID-19 hit, within two weeks, we have been able to turn this whole thing around, and I am doing virtual consulting and testing. It has been amazing to see how quickly healthcare overall has been able to adjust and change and do what is right for our patients in the middle of a crisis.”
— Candace Westgate, D.O., founder of the Adventist Health Early All-Around Detection (AHEAD) program
“I have been in the telehealth space for 12 years and devoted time to convince doctors this is the right thing to do. It has been like pushing this large boulder up a steep hill. All of a sudden it turned into a snowball coming down the hill, taking me and my team with it.”
— Todd Czartoski, M.D., chief medical technology officer and chief executive of telehealth at 51-hospital Providence St. Joseph Health headquartered in Renton, Wash., describing the sudden explosion in telehealth visits
“COVID really challenged us to make sure that our virtual health solutions could have the same kind of equitable reach as our in-person care, so that meant connecting with folks who focus on medical interpretation to make sure we could provide medical interpreters to patients through the same channel. It also meant making sure that we thought about systems to engage our patients both into our electronic health record as the primary gateway to doing virtual visits, but also to think about the patients who for whatever reason were unable or reluctant to use that channel and provide alternative channels to connect those patients to their physicians.”
— Lee Schwamm, M.D., Mass General Brigham’s vice president of virtual care
“We need immediate and long-term solutions to address structural racism and health-related social needs that are among the root causes of health disparities. It is crucial for us to get outside our meeting rooms. If we have seen certain disparities, let’s talk to patients who are experiencing them and understand the root causes. Then we can get into prioritizing interventions we can co-develop with the community.”
— Vivian Anugwom, health equity manager for Minneapolis-based Allina Health
