As future physicians training at medical schools across the country, we welcome the opportunity to respond to Sen. Barrasso and Sen. Coburn’s open letter to medical students about health care reform
. We all chose medicine with a common purpose — to serve our patients. Entering medicine today is not the same as entering medicine a generation ago. While Sen. Barrasso and Sen. Coburn highlight their 50 years of experience behind them, we look forward to the over 500 cumulative years of patient care ahead of us.
Early in our medical school careers, we have quickly come to see where our health care system profoundly fails our patients. We see hypertensive patients who are not on basic anti-hypertensive medications because they lack access to insurance or a physician and finally present to the emergency room following an acute stroke. We see diabetic patients requiring foot amputations following poor control of blood sugars. We see patients complaining of chest pain sent for unnecessary and expensive cardiac catheterization because the ER lacked the patients’ prior medical records. We are taught to build rapport with our patients, to interview and exam them, and yet we see the impossibility of providing responsible care in 15 minute clinic visits. We see so clearly the acute needs in our health care system for generalists and rural practitioners, yet burdened by hundreds of thousands of dollars in debt and averse to unending paperwork, many of us pursue specialist paths.
Our generation of physicians is entering a broken system, and as medical students, we support the Patient Protection and Affordable Care Act as a first step to improving health care for our patients. We are excited to be a part of the future of American medicine during this time of unprecedented health reform. Where the Senators see fear and destruction, we see hope and progress.
We believe that reform will help, not hurt, our patients by providing protections against insurance companies, expanding coverage options for the uninsured and underinsured, and strengthening the safety net of community health centers. Rather than cling to a reimbursement system of the past, the Center for Medicare and Medicaid Innovation tests and evaluates new delivery and payment systems to better meet our nation’s future needs.
The Senators cite the basic tenet of medicine is that nothing should come between a doctor and a patient. We entered medical school believing in another tenet of medicine – everyone has a right to quality health care, regardless of their background. As advocates for our patients, we have a professional and moral obligation to ensure access to care. A key component of reform is to expand access to primary care providers through the National Health Service Corps program. For medical students considering a primary care career in underserved areas, reform makes this a realistic option. Over 7 million patients rely on NHSC clinicians, and we support expansion of this program to provide care to those who need it most. The benefits of NHSC go well beyond the year or two of financial support; 80% of clinicians continue working in an underserved community after completing their initial commitment.
On behalf of the health of our patients and the strength of our health care system, we respectfully disagree with the Senators and support implementation of critical provisions of the Affordable Care Act. We, medical students and future physicians, will fight to improve health care in America by returning to our core values of compassion and equity.
Students of America’s Medical Schools
Richard Bruno, Oregon Health & Science University School of Medicine
Connie Chen, University of California at San Francisco School of Medicine
Meghana Desale, Johns Hopkins University School of Medicine
Carol Duh, Vanderbilt School of Medicine
Jonathan Dudley, Johns Hopkins School of Medicine
Ian Hsu, Johns Hopkins University School of Medicine
Kristin Huntoon, PhD, New York College of Osteopathic Medicine
Haylee Finkel, Touro University Nevada College of Osteopathic Medicine
Colin McCluney, University of Washington School of Medicine
Amir Mohareb, Johns Hopkins University School of Medicine
Bipasha Mukherjee, Johns Hopkins University School of Medicine
Ani Ramesh, Johns Hopkins University School of Medicine
Brian Walderson, Johns Hopkins University School of Medicine
Elizabeth Wiley, George Washington University School of Medicine
Sean Wrenn, Rush Medical College
Jessica Yang, Johns Hopkins University School of Medicine
Updated signatures from original post:
Mark Bernardi, University of California of San Diego School of Medicine
Ruben Carmona, University of California of San Diego School of Medicine
Anna Fiskin, Case Western Reserve University School of Medicine
Whitney McFadden, University of California of San Diego School of Medicine
Kevin Phan, University of California of San Diego School of Medicine
Ben Seligman, Stanford University School of Medicine
Rachna Vanjani, The George Washington University School of Medicine and Health Sciences
Hannah Watson, The Warren Alpert Medical School at Brown University