“Steps Toward Inclusivity”: How to Improve the MRI Experience for Patients on the Autism Spectrum

Sara R. Rubino & Sarah L. Solomon

Abstract
Inclusion in healthcare management continues to be researched, developed, and integrated into practice. Hospitals can be an overwhelming experience for any patient, but they can be almost unbearable for patients with sensory sensitivities and communication difficulties such as autism spectrum disorder (ASD). More specifically, this commentary explores issues that often arise during an MRI scan for patients with ASD and methods that healthcare workers can implement to better accommodate these patients. Three main themes of accommodation during MRI scans for individuals with ASD are communication, sensory friendly environment, and pre-visits. Additional research is needed to evaluate these methods in the adult population and better refine their use to develop broad guidelines for practitioners.

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Roundtable Journal on Health Policy  |  Volume 5  |  Issue 1
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Tenuous Balancing Act: Finding the Right Roles for Anesthesia Providers

Huzefa Diwan

Abstract
In anesthesiology, addressing midlevel encroachment and finding an optimal mix of various anesthesia providers (e.g., Anesthesiologists and Certified Nurse Anesthetists (CRNAs)) has numerous implications to patient care, cost-effectiveness, and physician shortages in certain communities. While there has been significant disagreement between two major professional groups, the American Society of Anesthesiologists and the American Association of Nurse Anesthetists, there may be collaborative solutions that benefit rural communities, resource- constrained environments, and critically ill patients. This article discusses considerations central to this topic and posits potential solutions.

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Roundtable Journal on Health Policy  |  Volume 5  |  Issue 1
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Inequity in Access to ECMO During COVID-19

Sarah Wu

Abstract
Extracorporeal membrane oxygenation (ECMO) emerged during the COVID-19 pandemic as a therapy for advanced cases that had progressed to severe acute respiratory distress syndrome (ARDS). However, demand for the treatment exceeded capacity in many regions, and the resource-intensive nature of ECMO meant that it was mostly feasible only at specialized centers or other tertiary-care facilities. This shortage served to exacerbate preexisting inequities implicit in the healthcare landscape of the United States. Regionalization, a philosophy of organizing medical services through collaboration between separate facilities and providers in a given area, was utilized by various regions to maximize available resources, and may be able to be targeted to address and reduce inequities in access.

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Roundtable Journal on Health Policy  |  Volume 5  |  Issue 1
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Microplastics and the Prevention of the Next Environmental Health Hazard

Parvathy Retnakumar

Abstract
Plastic pollution is a well-known environmental concern through its accumulation in landfills, harm to ocean ecosystems, and deadly effect on wildlife. Microplastics (MPs) are a subset of plastic pollution that has gained attention recently due to novel studies that suggest possible health implications, causing many to wonder if MPs are the asbestos of our generation leading to disease decades down the line. Research on health implications is ongoing and while there are some policies in the US concerning MPs, there is a large gap in regulation compared to other countries. Physicians and medical students should increase their own knowledge on the subject of MPs to become better advocates for their patients and increase public awareness.

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Roundtable Journal on Health Policy  |  Volume 5  |  Issue 1
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Gender Affirmation Surgery: A Case for Increased Access and Coverage for Transgender and Gender Non-Conforming Patients

Sara E. Islam

Abstract
The transgender and gender non-conforming population has long been a marginalized group with significant barriers to medical care. Despite mounting evidence that gender- affirming surgery improves psychological distress and quality of life, these patients still experience difficulty accessing treatment and incur substantial financial burden. This article explores policies influencing access to and coverage of gender-affirming surgeries in the United States and proposes potential solutions to improve the health disparities prevalent in this population.

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Roundtable Journal on Health Policy  |  Volume 5  |  Issue 1
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Emergency Department Overcrowding is a Public Health Crisis: Detailing the Causes, Consequences, and Potential Solutions

Rajkumar S. Pammal

Abstract
The long-standing issue of Emergency Department (ED) boarding and overcrowding continues to persist despite public calls to action from emergency physicians and numerous studies detailing patient safety risks and poorer health outcomes. ED boarding is associated with increased in-hospital mortality, higher probability of patients leaving the ED against medical advice, and increased adverse events and preventable errors. Some key factors contributing to this issue include financial incentives that set up hospitals for ED overcrowding, nursing and staffing shortages, and lack of healthcare facilities for safe discharge of admitted patients. Ultimately, meaningful intervention to the public health crisis of ED boarding needs to occur at the federal public policy level in order to protect our nation’s patients and physicians.

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Roundtable Journal on Health Policy  |  Volume 5  |  Issue 1
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The Rise of Private Equity in Medicine: A Welcoming or Worrisome Partner?

Richard Shi

Abstract
Private equity firms have become increasingly involved in physician practice acquisition, recently focusing on procedural and surgical specialties such as orthopedics, urology, and vascular surgery. These companies leverage business and marketing expertise to create operational efficiencies and maximize profitability. However, their involvement in medicine may compromise physician autonomy and lead to increases in health care expenditure without commensurate quality improvement. Trainees and medical students should familiarize themselves with this private sector involvement in medicine, to subsequently avoid business partnerships that may hinder high-quality, patient-centered care.

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Roundtable Journal on Health Policy  |  Volume 4  |  Issue 1
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The Widening Technology Gap in Prostate Cancer Diagnosis and Management

Yuval Elkun

Abstract
Disparities between racial and socioeconomic groups exist in the diagnosis and management of prostate cancer. This has been further exacerbated by the development of advanced technologies such as MRI-ultrasound guided fusion biopsy for diagnosis and Robotic Assisted Laparoscopic Prostatectomy for treatment. This article explores these disparities and provides potential solutions to mitigate them, including legislative measures to support public hospitals as well as implementation of performance-based incentive payment models.

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Roundtable Journal on Health Policy  |  Volume 4  |  Issue 1
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The Importance of Using Electronic Health Records to Mitigate Public Health Crises, Including COVID-19

Amit Krishnan

Abstract
The usage of electronic health records (EHRs) in the United States (US) has led to increased patient safety, an improved ability to leverage big data to analyze public health trends, and better accountability for medical practitioners. However, increasing usage of EHRs has also led to increased self-reported physician burnout, along with data privacy and confidentiality concerns. Nevertheless, the United States government has released policies incentivizing adoption and continued usage of EHRs by medical practitioners and hospitals. As the COVID-19 pandemic continues to impact society at large, it is important to utilize EMRs to both combat this present pandemic and prepare for future public health crises. This piece aims to briefly synthesize government policy, methods for improvement of EHRs, and the benefits of EHR usage in mitigating individual and public health issues, including COVID-19.

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Roundtable Journal on Health Policy  |  Volume 4  |  Issue 1
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Fighting the Infodemic: Social Media and the Physician’s Role in COVID-19 Literacy

Alexandra Schulz

Abstract
The COVID-19 pandemic has brought a relentless stream of news and information that continues to spread rapidly through social media. Physicians and public health officials alike have lamented the proclivity of false information to disseminate widely through these networks, as it has led to a fragmented social response to public health measures proven to mitigate the pandemic. This calls into question the role of physicians in engaging with social media platforms in a professional capacity. It appears that one promising way of combating medical misinformation is by diluting it with fact-driven content from credible sources. Young physicians and student doctors who are uniquely positioned to contribute to these efforts should take advantage of such opportunities.

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Roundtable Journal on Health Policy  |  Volume 4  |  Issue 1
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