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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“The Note is Dead, Long Live the Note”: Assessing the Past, Present, and Future of Medical Charting

Elias Kahan

Abstract
The medical note is a crucial tool for health care providers to manage longitudinal patient care, communicate with each other, and accumulate information for billing purposes. However, recent developments in medical charting perspectives and practices have detracted from the value of the medical note. Studies suggest that the administrative burden of medical documentation reduces the time available for physician-patient interaction and contributes to physician burnout. Some potential solutions to improve the medical note include reordering its framework, streamlining it to include only pertinent information, and involving patients in note-writing. While the effectiveness of these proposed interventions remains to be seen, we must find a way to make the medical note an asset for health care providers rather than a liability.

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Roundtable Journal on Health Policy  |  Volume 4  |  Issue 1
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“On the Decline”: A Look into the Impact of the COVID-19 Pandemic on Medical Student Wellness

Sara R. Rubino & Sarah L. Solomon

Abstract
Wellness is a multidimensional concept that includes the aspects of depression, burnout, anxiety, and stress. Compared to the general population, medical student wellness has been found to be significantly decreased in terms of these four aforementioned domains. Within the topic of medical student mental health, there are known at-risk groups, such as students in more junior class years and those who identify as female. However, the onset of the COVID-19 pandemic has brought about numerous stressors that have further decreased medical student wellness and slightly altered the at-risk groups. Additional research is needed to further understand the impact that COVID-19 has had on medical student wellbeing. Medical school administrators should consider this research and acknowledge these dynamics when designing and adjusting their medical schools’ curricula in the post- COVID-19 era.

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Roundtable Journal on Health Policy  |  Volume 4  |  Issue 1
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Letter from the Editor-In-Chief

Rajkumar S. Pammal

Dear Readers,

This edition of the Roundtable Journal on Health Policy (RJHP) comes as the global medical community mourns the recent passing of Dr. Paul Farmer, a pioneer in the fields of global health and medical anthropology. Dr. Farmer was the Co-Founder and Chief Strategist of Partners in Health, and Chair of the Department of Global Health and Social Medicine at Harvard Medical School. His international public health work and initiatives are of paramount influence to countless lives. Whether it was going door to door delivering antiviral medication during the AIDS crisis in Haiti, or lecturing my fellow undergraduate classmates and I during his Case Studies in Global Health class, Dr. Farmer always emphasized the importance of treating each and every human life with dignity and respect. To me, one of his most poignant quotes is “In a world riven by inequity, medicine could be viewed as social justice work.”

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Roundtable Journal on Health Policy  |  Volume 4  |  Issue 1
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The COVID-19 Infodemic: A Reminder of the Importance of Health Literacy

Mina Iskander

Abstract
In an era of widespread internet and social media usage, the COVID-19 pandemic has taken these outlets by storm. While there are obvious positive aspects of the wide availability of medical and public health information, it can be argued that an overabundance is burdensome. Although it may be attributable to the lack of knowledge surrounding a new pandemic, contradictory information being put forth by federal health agencies has also been worrisome and contributed to confusion. Delineating between fact and fiction during the pandemic has been a momentous task, even for those who are well-educated. It is of utmost importance for individuals to be able to understand, navigate, and make appropriate decisions as it relates to their health. Therefore, we must focus on improving health literacy on both an individual and societal level in order to provide an informed, unified front against the pandemic.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 2
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The Complex Effects of COVID-19 on the Special Needs Community: Short- and Long- Term Implications for Medical Care Providers

Sarah Solomon

Abstract
The complex consequences for healthcare delivery prompted by the effects of coronavirus disease 2019 (COVID-19) on the general population are not yet fully understood. At the time of writing, there are only five meta-analyses and literature reviews, the most comprehensive of which includes a total of 32 papers. Of these five reviews, four focus on telehealth and only one on personal protective equipment (PPE) (Anthony Jnr, 2021; Chaudhry et al., 2021; Galanis et al., 2021; Gao et al., 2020; Monaghesh & Hajizadeh, 2020). There is furthermore a scarcity of research on the impact that these COVID-19 healthcare delivery changes may have on patients with physical and/or intellectual disabilities; no meta-analyses or related reviews on this matter have been published. This at-risk group has experienced adverse short-term effects, but potentially favorable long-term outcomes, due to four major pandemic-related healthcare delivery modifications: (1) the widespread proliferation of telemedicine, (2) increased use of personal protective equipment (PPE), (3) COVID-19 testing requirements and (4) patient-physician relationship (PPR) adjustments. All four of these modifications have complicated the ability of the special needs population to access medical care in the immediate term. However, some consequences of COVID-19 – especially the growth of telemedicine and the resultant transformations in PPR dynamics – may generate lasting beneficial changes in how the healthcare system interacts with the disabled community.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 2
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The Risks and Benefits of Prehospital Use of Ketamine

Faris Katkhuda

Abstract
On August 24, 2019, Elijah McClain was unlawfully detained, and after two carotid holds by the police and a 500 mg injection of ketamine by Aurora Fire Rescue paramedics, he died in police custody. This literature review will discuss the benefits of prehospital use of ketamine, including short time to onset of effects and decreased risks of apnea and hypotension, as well as its risks, including hypersalivation, emergence reaction, laryngospasm, and high intubation rates.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 2
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