Dr. Patrice Harris: President of the American Medical Association (Raise the Line)
Hi, I'm Doctor Risha. I'm the Chief medical Officer at Osmos.
And for this episode of raise the line, I'm happy to be joined by Dr Patrice Harris, president of the American Medical Association.
She also chairs the ama's task force on health equity and on reducing opioid abuse. We're going to ask her about a role with the a a in supporting front line providers and what this crisis is telling us about the state of health care in general and the health of Americans.
So, thank you so much for being with us today, Dr Harris. Oh, thank you for having me.
So, Patrice to start with, can you please tell me a little bit about yourself and your role as the president of the American Medical Association?
Absolutely. And let me just start out by saying what a privilege it is to be the president of the American Medical Association.
I'm the 174th president of the AMA. I believe the third psychiatrist, uh the first African American woman and the role of the president of the AMA is to be the chief spokesperson uh for the organizations and our policy.
A and just a personal note. Uh I have always wanted to be a physician.
Uh Marcus Welby, uh the young folks are gonna have to Google that. But was my uh my, my role model.
But what I liked about Marcus Welby was he not only cared about his patients inside the exam room, he cared about them outside the exam room and had a platform to improve the community.
So never did I ever dream that I would have the platform of the AMA to uh make sure that we are advocating for physicians a and our patients.
It's, it's a wonderful opportunity. So you and the American Medical Association have shown a lot of leadership and supporting physicians on the front lines as they fight against COVID-19.
Can you talk a little bit about the initiatives the AMA has implemented to support and protect physicians and increase capacity of our health care system?
Yes. A and this has been a, a privilege uh to uh be able to amplify the concerns and the voices of physicians a as you might imagine I receive as and the other members of the AMA board receive a lot of emails and texts.
Many of us are um Facebook friends, of course, with our colleagues and we are really and have since the beginning heard the concerns of physicians on the front line but also physicians across this country uh who are in private practice.
I think we know what the physicians on the front lines are doing. Um And we've been working to make sure they get the equipment that they need.
And I had an opportunity to have a meeting with the president along with some other physician leaders. And we talked about um the importance of the administration using all the levers of federal government to get the PPE um and to make sure their ventilators are, are there for, for health systems and the test.
And so we've been of course advocating on the front lines, but I think um others may not appreciate that physicians practices large and small are bearing uh the brunt of this uh pandemic as well in um not seeing their patients, uh you know, and postponing surgeries and all those are appropriate in this moment, but they are impacting uh physicians.
So the AMA um has been hearing this, we've been advocating for funds uh for PPE uh systemic uh review and, and coordination of getting PPE to the front lines um as well as the small business loans and again, all sorts of uh financial support uh Medicare advance payments.
So, um and that's sort of the financial side. Uh I've written a couple of articles about how physicians uh can take care of themselves and family.
So we've been hearing the concerns and really trying to meet the needs of the physicians as they meet the needs of patients.
What is your sense on what the members of the AMA need the most right now to feel safe as they go to work. Well, you know, it, it's, it's PPE uh, you know, we know that this has improved and let's, uh, be candid about that.
I'm sure you heard uh what I heard that physicians were reusing them early on and in pre COVID times, reusing that would have been grounds for dismissal, right, violating infection control policies and procedures.
And so we just uh did not have the supply and it wasn't a coordinated supply. You know, we again called on the president to invoke invoke the Defense Production Act really.
Um So we could make sure that not only these uh supplies were manufactured but also distributed in a manner where the areas hotspots as we have seen, um that had the greatest needs, would, would receive that equipment.
So that was an early request from us at the AMA. And is this, is it your sense that that work is what has led to the PPE starting to get into uh the hospitals and clinics where it's needed?
Is that what ee eventually got it done? I think so, you know, this is an all hands on deck uh pandemic, of course, and, and certainly it was the voices the course of voice, voices, of physicians on the front line.
It was our work, it was the work of other, uh, physician organizations, you know, it was the work of the media amplifying, you know, this, this issue.
Um, and so I think all of these and probably much more that maybe I'm not even aware of elevated, uh, this, uh, to the level where there's some improvement.
But I, but I still think, um there are some issues, for instance, if you just have a couple of days on hand, um that's still an issue if you are one of the cities uh where a model says that you still may have surge and you don't have uh what you need.
So it's better, but it still remains a concern. We cannot uh uh put our let our foot off the gas if you will on getting the PPE uh to our caregivers on the front line, but also uh physicians in their offices.
Yes, physicians have reduced the number of days, right? But there are some uh needs urgent health needs that uh still need to be addressed.
And so physicians are again judiciously and carefully and appropriately seeing patients and they need PPE in their offices.
And so again, from the hospitals we know, but also physicians need support in getting PPE in their offices. And you've been calling on public health officials and public officials in general to emphasize science and evidence based, evidence based data when they talk about COVID-19, what has prompted you to make that effort?
Well, at the end of the day, right, everything that we do in medicine is informed by science and the evidence, not personal opinions or, or whims.
And um you know, I, and I, in fact, I just on Tuesday gave an address uh that urged everyone, um you know, elected leaders, um people on the front lines, the public uh to make sure they are getting credible um evidence based information.
I'm sure you have seen and I have seen there's a lot of misinformation out there. Um II talked about for the first couple of weeks of this pandemic.
Um I spent not necessarily in my role as Ama President, but in my personal role, a dispelling myths among family and friends that african-americans could not be, you know, could not become infected with COVID-19.
And we've seen, I believe the misinformation play a role in the disproportionate um impact. So, you know, it's all of these um areas, the the credible sources of information and making sure that that information is science and evidence based.
So the the AMA wanted to highlight that and amplify uh that it is always necessary right to follow the science and the evidence.
But in a time of crisis, it's even more important uh that we elevate the importance of allowing and, and ensuring that science and evidence rules today.
So I'm curious to know what, what do you think the Coronavirus crisis has revealed about our health care system and about the health of Americans in general?
You know, I'm thinking about, you know, things like level of chronic disease and you mentioned, you know, racial disparities and things like that, that we can now focus on going forward.
You know, II think that certainly there will be a lot of lessons learned about our system pre COVID-19, uh particularly your points about the level of chronic disease.
You know, I've been asked several times if I was surprised about the results and the disproportionate impact. And I was not uh because, and I work at the AMA and of course, my work throughout my career knew that communities of color um had a disproportionate impact uh regarding these.
Uh We saw uh increased levels of physician burnout uh in our uh community. And of course, that is just being exacerbated uh by uh this pandemic mental health, right?
Uh And public health, both of those systems have been woefully underfunded for decades, right? And now we are seeing uh some of the results of that.
Uh So those are just a few one more I would say, as you know, pre COVID-19, we were um in the physician community and others were dealing with workforce shortages, right?
And so COVID-19 and this pandemic is amplifying those. So those are just a few of the sort of preexisting conditions if you will uh that are further uh being amplified by this current pandemic.
It's an interesting point you bring up around the fact that we already had a shortage in the health care industry of, of new clinicians.
There was a huge gap in the growing of America. I'm just curious, what role do you think things like e learning resources have in terms of building that healthcare capacity, both for COVID-19.
But even afterwards, well, I think it's critical and uh we are going to have to certainly look and have conversations about technology and e-learning and how this all fits in.
You know, um I had already uh uh been using telepsychiatry in my practice. Um More people are using telepsychiatry uh today and, and thankfully CMS relaxed a lot of the regulations and looked at pay parity and looked at um the use of the telephone previously, you know, it had to be sort of an eye to eye and there were all these rules and regulations about location.
Um and, and, you know, here's the other issue, another issue that it raises is broadband access. And I think that's why it was very important for CMS to relax the rules around telephonic communication because you and I both know that in some rural areas, um there is a lack of access.
And so even if you had the willing um to want to use uh telemedicine, you didn't have the infrastructure there. So and uh uh you may or may not know that the AMA has been very engaged in a I and a lot of technology in the future.
And of course, we know there's promise in parallel in that uh we have to look at privacy and confidentiality um issues. So right now in the midst of this, um we are all doing what you need to do and making sure that everyone, well, we can't ensure that we're working hard so that folks get the care that they need.
And here's what we'll need to do after this. We'll have to guard in my, this is my personal opinion.
We'll have to guard against knee jerk reactions to, oh, well, this worked or did not work during the ca pandemic. So we should continue it or not continue it, but we should be ready uh soon after to have thoughtful evidence based and science based conversations about what we learned, what we should continue to do and what we should not do.
Do you just playing off that a little bit? Do you feel like there are certain resources in addition to your current work with A I that our audience should be made aware of uh that they should look into and maybe explore what the AMA has available right now.
Well, I think right now, you know, we should all be, uh, you know, focused on, uh, the pandemic and by the way, uh I'll put, uh, throw this in, in case I forget everyone should stay home.
You know, I have to just, just say that in every, um, interview because I think people uh, probably minimize or don't appreciate the importance of staying home and how your individual action of staying home and hand washing and only going out when necessary really has a collective impact and really keeps everyone safe.
So, so I'll put that out there. Uh But I think uh going forward, uh let me just say that Ama has a COVID-19 resource page.
It is mostly for physicians, but there is some uh information from the public out there. But we do to encourage folks to go to the C CDC website and NIH and you know, other trusted sources of credible information.
So we should be focused on that right now. But I think we should all be prepared to engage in conversations about the new normal.
You know, we, we won't get back to a pre uh COVID-19 normal. Um There will be again, opportunities for learning from this pandemic.
Uh also amplifying what we knew before this pandemic. And then I think if we all participate in those conversations again, uh based on the signs and the evidence, I th I think we can forge, forge a new normal regarding health care and really uh regarding a lot of other um issues.
You know, it's funny you mentioned new normal, I think for a lot of young med students that are coming out or early on health professionals, this is the only normal they may know.
And I'm curious to know what advice you would have for them during this time. Uh You know, the first thing I want to point out is that uh we are looking at um all of the uh life cycle of the career of a physician and we have uh resources for our learners.
You know, it's no surprise that medical students uh want to help in any way that they can. And I think you are aware that uh some states are allowing medical students to graduate early and, and begin to be in the fray.
But the AMA wants to make sure that these learners, medical students and residents and fellows are protected. And so we have a, a resource page uh for our, our, our learners to make sure they have the resources that they need.
And I'll just mention actually on the other side of the career spectrum, if you will, uh we know that our retired uh physicians have been called into action or volunteering.
Not, not, not surprised. Um You know, that's, that's what we do right in this wonderful profession.
Uh But we all so have a resource page for them because we know that our, that our retired physicians are in the age cohort uh that is at increased risk, right of for the most severe consequences of COVID-19.
So, uh we have information for everyone. I II really am so proud of the AMA and that our commitment to um physicians, medical students learners across the their career lifespan.
And we're trying to again listen to the concerns and make sure we do our best to address those concerns um for the diversity of folks who are our colleagues.
That's fantastic. I'm I'm uh I impressed that you guys have that set up and I'm sure it's really useful to those groups that are coming back.
One thing you mentioned earlier and we talked about uh very, very briefly, but is that you have worked on uh health equity issues and I'm curious to know your thoughts on a vulnerable populations, specifically kids and now kids are gonna be affected by COVID-19.
I think it's critical that we look at special populations, right? And first of all, we have to have the data in order to get back to uh the data and the science and the evidence.
And uh I'll say a brief uh uh make a brief point about the data that has come out regarding again, the disproportionate impact on african-americans.
Uh But as you well know, uh that data is not standardized and we are not receiving it from uh you know, all 50 States and I think there's been a, a brief improvement.
Um but we uh the AMA sent a letter to HHS um asking for that data to be collected by race and ethnicity and then we can use that data to target interventions, whatever they may be, you know, wherever the data and the science leads us.
Um I also think and uh yeah, I know you are a pediatric specialist and I am a child psychiatrist. So we're both a pediatric specialist.
It's important that we also make sure we are thinking about the Children. And II will say both inside the COVID-19 pandemic and external to the COVID-19 pandemic.
Now, we know um that Children thus far are less impacted, right? Regarding um severe uh hospitalization and deaths, although we know they are not immune and unfortunately, uh you know, we have a couple of Children um who have died and certainly been hospitalized.
So, you know, we need to make sure that the myth uh that we perhaps heard early on that Children were immune. Uh and young folks too uh that we dispel those myths.
But another piece of this and sort of external uh to the COVID-19 is certainly is and related to mental health is our Children are not in school, right?
Their routines, their lives have been disrupted. Um They see their parents probably worrying and may not know why they they just know and that there's no more birthday celebrations and no more ability to play with their friends.
And so I think we should just take a moment always and think about how this is impacting Children, you know, external to uh COVID-19.
Uh parents again uh recommended that they of course talk to their Children in age appropriate ways. I always say, don't ascribe feelings to your Children.
Like don't say I know you're scared, they may not be scared until you say I know you're scared. So just you know, ask those open ended uh questions of Children model good coping, you know, fear as I've said, fear and anxiety and worry are normal human emotions.
And so we need to experience those emotions but then channel those emotions that fear and that worry like you and I used to do before an exam, right?
We we were worried or at least I was maybe you weren't uh in medical school, but I channeled that into action, which was studying.
And so we want everybody to channel that into any action that they can take. And of course, that's staying at home, but parents should uh be keen to develop new routines, new schedules uh since the typical schedules are disrupted and we just need to make sure that we're thinking about the Children.
You know, a colleague of mine said, who has eyes on the Children. So we just need to stick a pin in that and make sure we're always thinking about that as we are appropriately uh thinking about the, the COVID-19 pandemic.
Well, that seems like a good note to end on obviously, Children being the future and we're always trying to figure out what the future holds for us here with COVID-19 uh descending on the country and the world.
You know, I want to say thank you so much for joining us, Dr Patrice Harris uh from the AM and dropping all this wisdom on us.
It was fantastic having you. Well, thank you.
And in fact, one more point that I don't want to forget regarding health equity, the AMA has recently established a Center for Health Equity and we hired our first Chief Health Equity Officer, Doctor Ali, the Maybank.
So we will certainly be leading uh future conversations on equity. And thank you so much uh for, for having me.
I'm a big fan of yours and it, it's really been a wonderful opportunity. Oh, thank you.
So with that, I'm Doctor Sai. Thanks for checking out this episode of raise the line.
You can join osmosis to raise the line and flatten the curve by simply going to osmosis.org/covid-19. Thanks a lot.
Take care.
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