College of
Human
Medicine

Dean's Update | August 7

Friends,

I have been back in the hospital this week seeing patients with an excellent resident team. (My thanks to sagacious senior residents, Drs. John Cherian and Nadine El-Ayache, as well as our intrepid junior residents, Drs. Issa Haddad and Mahmoud Abdelsamia.) In many ways, working in the hospital is much the way it was before the pandemic: the physician parking lot is full again, our patient census is back to normal, MRI schedules have tightened, and patients are allowed a small number of visitors.

Some of the hospital experience is still very different: we are all wearing masks and shields, we take the stairs more often because elevators have low capacity, and there is a floor dedicated to patients with COVID-19 and ruling out for COVID-19.

I have no real data, but my impression from rounding is that we are already seeing more patients without insurance, which is an expected result of the historic unemployment accompanying the pandemic. Without insurance, even straightforward health care decisions become more difficult.

Patients and their families cannot reasonably confront huge hospital bills when their finances are already ravaged by unemployment. The health crisis that brought them to the hospital is the first of many struggles that put homes, education, and future opportunities at risk. Our health system also suffers when people are uninsured.

Often, a lack of insurance makes patient care more expensive for the system, and we have a couple of examples on our service right now. These are people who could get their care at home, but because they do not have insurance, they have no way to pay for this home care. Without access to care at home, patients remain inpatients and the system bears the price of care at the most expensive setting in our system – the hospital.

The importance of access to insurance and access to care are key advocacy issues for many medical professional societies (ACP, AMA, AAFP, AAP, etc.). And, our students have been involved in advocacy around this issue as well. Last week, I wrote about the importance of voting, and really, that issue is huge. But advocacy through public intellectual work is a higher order activity, and it is important for the students and faculty of a medical school to engage in public intellectual advocacy.

Whether it should be the case or not, medical school faculty and students can reach a larger audience than those in many fields, and we can help provide for the public good through writing and speaking aimed at the public audience. This work also helps the reputation of the school, which allows more faculty and students to conduct effective public intellectual advocacy, and thereby, makes it possible for us to do even more good work in the world. It’s the closest we are going to get to a perpetual motion machine.

As an example, you can read about our own Jon Gold, MD, pediatrician and Director of the CHM Academy, as he explains concerns about the decrease in childhood vaccination during the COVID-19 pandemic. This is important public intellectual work for our students and faculty to be doing. You can see a list of the recent similar work of our faculty and students here as a part of MSU Med News.

Finally, just a word or two of appreciation for how CHM people are being good to each other. We have been at this a long time, and as the university brings people back to campus and local schools remain online, I know the balancing act families face is very difficult. At today’s Town Hall, Dr. Claudia Finkelstein discussed some of the resources available to help people through these challenging times. Thank you for your patience, your caring, and your love for each other.

Serving the people with you,

Aron Sousa, MD
Interim Dean