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

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

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

Continue reading ““On the Decline”: A Look into the Impact of the COVID-19 Pandemic on Medical Student Wellness”

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

Continue reading “Letter from the Editor-In-Chief”

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

Continue reading “The COVID-19 Infodemic: A Reminder of the Importance of Health Literacy”

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

Continue reading “The Complex Effects of COVID-19 on the Special Needs Community: Short- and Long- Term Implications for Medical Care Providers”

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

Continue reading “The Risks and Benefits of Prehospital Use of Ketamine”

Shreya Nalubola

Abstract
The COVID-19 pandemic has drastically limited international travel. Now that vaccines have been developed, many countries are considering ways to rework lockdown restrictions so that travel may resume. One proposed strategy involves the implementation of vaccine passports, which would allow those with digital or physical certification of COVID-19 vaccination to resume unrestricted travel. The introduction of such passports involves a number of important ethical, scientific, and legal considerations. This piece aims to elucidate some of the challenges and consequences regarding the use of vaccine passports, such as practical concerns about the length of vaccine immunity and post-vaccine viral transmissibility. Vaccine passports may also have damaging effects on those without adequate vaccine access, especially given the context of COVID-19 having already exacerbated harm towards disadvantaged and minority communities.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1

Continue reading “Vaccine Passports and COVID-19: Ethical, Scientific, and Practical Considerations”

Huzefa Diwan

Abstract
Over the past year, the death of George Floyd and the recent shooting of Jacob Blake, among countless others, by police have ignited massive protests against systemic racism and police brutality. Numerous instances of excessive use of force by law enforcement against protestors started conversations about the role of police in our communities. Police brutality, especially against minorities, is a well-discussed phenomenon and yet the medical documentation of such events is often rare or inaccurate. Hospital personnel, especially physicians, need to document these instances to help create a public record of excessive use of force by police. By crafting a framework in the medical ethics concept of justice, physicians can begin training to report police brutality when it appears in their emergency departments and help to eliminate one facet of systemic racism.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1

Continue reading “To Tolerate No Harm: Medical Documentation of Excessive Use of Force by Police”

Brinda Raval

Abstract
This paper explores how COVID-19 has impacted farmworkers and demonstrates the way a community in the Mid-Hudson region of New York State, the Black Dirt area, has responded. It provides both a historical and sociological framing of the global systems of food production and a discussion of the vulnerabilities of H-2A workers. The main challenges seen in the Black Dirt region included crowded living conditions, fear of testing and/or sickness due to immigration status, financial instability, food insecurity, and transportation challenges.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1

Continue reading “The Impact of COVID-19 on Farmworkers: With Special Focus on the Black Dirt Region (Orange County, NY)”

Yazan Nagi

Abstract
The COVID-19 pandemic dramatically reshaped the world we live in and how we interact with it, and although its disastrous impact may have been shocking and unexpected to some, its effects continue to operate along very distinct patterns that have existed for centuries. The pandemic exposed the deep-seated inequalities in wealth, health status and access that exist and define daily life in the United States especially to many of its most marginalized groups.

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Roundtable Journal on Health Policy  |  Volume 3  |  Issue 1

Continue reading “The Roots of the Pandemic: How Structural Racism Facilitated the Spread of COVID-19 in Marginalized Communities”