Cohen shared a poignant story from when she was a young doctor in training in Boston. She saw a patient, who was 24, a college student with insurance. The patient complained about unexplained weight loss and hair loss and said she was tired. Cohen ordered a battery of blood tests and even a CAT scan. All the tests came back normal. Cohen was talking to one of her teachers about the next steps and sending the patient to specialists when a nurse technician interrupted the conversation.
“She says, ‘You know I really think you need to ask your patient if she has enough to eat,’” said Cohen. “At first, I got really defensive. No, that’s not the answer. That’s not a thing. I know my patient. Well, I didn’t ask all the questions I needed to for my patient. ... It turned out that her home was her car. She was a full-time student and had just left an abusive relationship.”
Cohen said she was well-intentioned but fell short.
She said that patient’s experience in the health care system is not unique but speaks to the need to address underlying issues that can impact health and the need for partnerships to help a person be well. This work extends well beyond the walls of a hospital or doctor’s office, Cohen said.
The pandemic was a constant theme at the gathering — how a virus enormously stressed the health care system but how it also sparked a collaborative spirit so that agencies and facilities helped each other with ideas and resources.
“Many people said at the end of COVID, we are going back to normal,” said Dr. Carlos del Rio, interim dean of the Emory School of Medicine, at a session about the future of academic medicine. “I think we can’t go back. We have to go forward. I think the disruption that occurred is ... unsettling and a lot of us are trying to understand how to chart the way forward.”
Del Rio said “more than ever” attending medical school to become a doctor has become an “elite profession.”
“People going to medical school are in general well off and people who graduate from medical school are generally graduating with tremendous debt.”
Over the last 20 years, there’s been little to no increase in the share of Black and Hispanic graduates of medical school, he said.
“So we have to think about how we change the playing field in significant ways,” he said.
Morehouse School of Medicine President Valerie Montgomery Rice also spoke about the challenge of attracting students to the medical field. She said the school saw a “Fauci effect” in 2021 when applicants jumped 25%, impressed by the public health work of Dr. Anthony Fauci. The applicants dropped back again in 2022. Montgomery Rice said COVID highlighted the state’s shortage of health workers, from doctors to nurses and all other staff workers who touch the patient.
At one session, hospital executives spoke on a panel about health systems’ community impact. They expressed concerns about the price they’re paid for the services they provide. Candice Saunders, president and CEO of Wellstar Health System, said that hospitals face inflation but the reimbursements they receive are fixed by contract. She said that Wellstar provided more than $1 billion in charity and uncompensated care last year.
Wellstar is the largest hospital system in Georgia, and is investing more than $300 million to build a new hospital in affluent Columbia County. She did not mention Wellstar’s controversial decision last year to shut down two Atlanta Medical Center locations — hospitals that served thousands of lower-income patients in Atlanta and East Point.
”The not-for-profit hospitals, health systems, are there. Every minute, of every hour, of every day … when you need us. 365 days a year,” Saunders said. “And we work together to ensure that if something happens in one of our local communities, that we’re working to get care access continued.”
The topic of health equity and care accessibility surfaced repeatedly: It’s the idea that all people, regardless of race or ethnicity, have the opportunity to achieve their healthiest self.
Dr. Leandris Liburd, acting director of the CDC’s Office of Health Equity, noted the heightened awareness around health equity and the increased adoption of principles connected to it, which she attributed to the pandemic.
“We know that COVID really exposed in a big way long-standing historical patterns of health inequities,” Liburd said. “We knew that some population groups were going to be hit harder than others, and we saw that play out.”