Five people who make me feel hopeful about health care
Last time you heard from me, I talked about the “fraught year ahead.” Disinformation in health care accelerates at the pace of the technology that drives it—which is to say rapidly. Coupled with the countless systemic inequalities we discuss often here, the result is a growing breach between health care institutions and the communities they aim to serve. A widening trust gap.
Still, over the course of my career I’ve noticed a paradox: the most hopeful leaders are not oblivious to these inequities. Instead, they are the ones working right in that gap. Progress is always nonlinear, but by no coincidence, these voices also are the exact ones we should learn from to chart a path forward.
I would like to devote this issue of the Preprint—call it my Thanksgiving tribute—to these leaders. I’ve been lucky enough to call many of them colleagues, friends, and mentors. In our conversations, my favorite question before signing off is to ask what gives them hope. Here are just a few of the responses that have stuck with me.
Lois Quam argues that mothers have the answers we seek.
“There’s that phrase ‘necessity is the mother of invention,’ and I think we need more mothers to be inventors... It is really unlocking the energy and talent and inventiveness of the world’s women that is going to make a difference.”
—Lois Quam, CEO of Pathfinder International and author of the forthcoming book, Who Runs the World? Unlocking the Talent and Inventiveness of Women Everywhere
Dr. Marci Bowers believes in the power of medicine without binaries.
“It’s cliche to say, but history is on our side. The demographic that opposes [transgender rights] is smaller than we think and what we hear. They have a big voice, but they’re a small and declining number of the population. Whether it’s a PRIDE parade or a GLAAD awards celebration where large numbers of gender diverse people gather, you see the sheer joy of being unhindered by the limits of a gender binary in clothing, in music, in art, in dance. It’s explosive—and this is why we shouldn’t be discouraged. This is joy that cannot be contained.”
—Dr. Marci Bowers, Renowned gender-affirming surgeon, President-elect of World Professional Association for Transgender Health (WPATH)
Pamela Merritt imagines an interstate highway of accessible digital health care.
“Digital health is a huge part of the future of healthcare—and the reality is that reproductive care is healthcare. I see digital health as an opportunity, as an anchor of hope, for our ability to expand healthcare access to folks who, for whatever reason, cannot walk into a brick-and-mortar clinic.”
—Pamela Merritt, Executive Director of Medical Students for Choice
Dr. Stephanie Faubion envisions a Millennial generation without menopause stigma.
“I will tell you that Millennials aren't afraid to talk about menopause. They will tell you exactly what the heck is going on with them. They're not willing to suffer. This is a group of women that isn’t going to just deal with it and be patted on the head and told that their symptoms will go away eventually. And you know what? Good for them.”
—Dr. Stephanie Faubion, Chair, Department of Medicine, Director Center for Women’s Health of Mayo Clinic, Editor of The The New Rules of Menopause
Loretta J. Ross thinks truth fights in a heavier weight class than politics.
“The people who are opposed to human rights mistakenly think that they're fighting us, the human rights movement. I think they’re wrong. I think they’re fighting forces way beyond their control, because they’re fighting the truth. They’re fighting evidence, like science. They’re fighting history, and they're fighting time, and I have never imagined that a group could defeat truth, evidence, history or time. As a matter of fact, those things are on our side.”
—Loretta J. Ross, Reproductive Justice and Human Rights Activist, Professor at Smith College
The project of imagining a world with fully-accessible, inclusive, equitable health care is tough for good reason. After all, no one—not us, not our ancestors, and not our children—has ever lived in such a world before. But these leaders remind me there are glimpses of it all around us.
What my team is reading, considering, and building against:
President Joe Biden announced the first-ever White House initiative on women’s health research, to be led by First Lady Dr. Jill Biden. The initiative will be chaired by my colleague Dr. Carolyn Mazure, who I have had the pleasure of serving with for many years on the advisory board of the Office of Research on Women’s Health at the NIH. There are several pillars to this work, including a focus on the potential of public-private partnerships to drive wide-scale innovation.
The Apple Watch has promised health benefits since its inception, but until recently, the evidence trailed. Earlier this month my college friend Dr. Bronwyn Harris co-authored a randomized control trial showing that an asthma monitoring application can help Medicaid recipients avoid visits to the emergency room. Bronwyn, a pediatric cardiologist, designed the intervention while employed by Apple, who acquired her digital health startup in 2019.
In an op-ed for STAT, marketing executive Monica Coakley demands greater accountability and regulation in the egg freezing and storage industry. She recounts her own wrenching experience at a facility that lost her frozen eggs, as well as a recent, high profile case that subjected families to similar errors. The fertility industry has an important opportunity to proactively establish quality assurance standards at these facilities.
Michael Greeley and Dr. Gary Gottlieb of Flare Capital, a technology venture capital firm, sketched a portrait of the American hospital system that resembles a shaky house of cards. Numbers that struck me include: 4% of the $300 billion of hospital bonds outstanding are experiencing payment difficulties, and hospitals collectively hold more than $50 billion of bad debt. Like the authors, I believe better-deployed digital services will be a key solution here, by allowing us to reach people before they ever enter a hospital.
Lastly, this month my home city of Boston received a $4.7 million federal grant to fund community doula access. Doulas continue to garner momentum as a critical solution to otherwise absent maternal support, but the national supply of doulas among communities who need them most is limited. Hopefully, this grant will help. Maven recently produced evidence on the potential of virtual doulas to enable wide-scale access, as well as the impact on birth equity. More on that next time :)