"Unmasking Structural Racism in U.S." by Daryl O. Traylor et al.

"Unmasking Structural Racism in U.S." by Daryl O. Traylor, Eboni E. Anderson et al.: The COVID pandemic cast a harsh light on the structural and systemic health inequalities that exist in American society and in U.S. medical education. Black and Brown communities were disproportionately affected, and the pandemic highlighted the need for a diverse physician and healthcare workforce. Both the lack of equitable, high-quality healthcare in underrepresented communities and the obstacles that students who are underrepresented in medicine (URiM) experience in medical school are direct consequences of the structural racism that flourishes in U.S. medical schools and healthcare institutions. In this article, we explain structural racism and how it has manifested itself in medical education, including the lack of diversity among faculty and leadership, implicit biases and stereotypes about people of color, and discriminatory language used in evaluations of URiM students. We conclude with potential solutions for addressing structural racism in medical education. These include increasing diversity among faculty and leadership, implementing antiracist curricula, and providing mentorship and support for URiM students. Ultimately, we aim to promote discussion and action to eliminate structural racism in medical education in America.

"Family Medicine’s Role in Addressing" by Daryl O. Traylor, et. al.

"Family Medicine’s Role in Addressing" by Daryl O. Traylor, Eboni E. Anderson et al.: Redlining, the practice of discriminating against specific neighborhoods based on race and socioeconomic status, leads to persistent environmental hazards and socioeconomic inequalities that have lasting adverse health effects on their populations. Health disparities are further exacerbated through the concentration of environmental hazards, as well as the escalating impact of climate change, which poses an increased risk of respiratory illness, cardiovascular disease, mental health issues, heat-related illness, infectious diseases, food insecurity, and socioeconomic difficulties in redline neighborhoods. This paper examines the interplay of redlining, climate change, and health disparities, with an emphasis on the enduring consequences for these marginalized communities. Through our research, we hope to foster a more equitable and just society for all by making an urgent call to action to dismantle the historical legacy of redlining and its health impacts, including climate change, for marginalized populations. Our research found that family medicine physicians, as well as other interdisciplinary collaborators and stakeholders, are pivotal to the development of comprehensive and e

The Chilling Reality of Ethical Dilemmas in Medical Training

As a medical student, the journey into the world of healthcare is not merely about mastering the intricacies of the human body and disease but also about navigating the moral and ethical landscape that defines the profession. This blog post dives into the disheartening experience of medical trainees who face ethical dilemmas and the repercussions of advocating for what is right, inspired by a series of troubling events that came to light involving Dr. Melani Cargle and Dr. Louis Kwong at UCLA-Harbor Medical Center.

The Courage to Report Unethical Behavior

Several years ago, Dr. Melani Cargle, then an orthopaedic surgery resident, found herself in a precarious situation when she witnessed and anonymously reported unethical behavior by a senior physician, Dr. Louis Kwong. Instead of being protected as an anonymous whistleblower, her identity was disclosed by the administration, leading to severe consequences. Dr. Cargle was accused of fabricating her story, which eventually led to her dismissal from the residency program, tarnishing her professional reputation and derailing her career.

A Delayed Justice

It is profoundly depressing to learn that it took years for the truth to surface. Recent developments have revealed that Dr. Kwong was indeed guilty of the allegations Dr. Cargle had made, along with similar accusations from other physicians and staff over a decade. Despite the continuous unethical behavior, it appears that the institution had protected Dr. Kwong until overwhelming evidence made his dismissal inevitable.

The Culture of Silence in Medical Education

This incident is emblematic of a broader issue prevalent in medical training environments across the United States. Recent research, including a study conducted by myself and colleagues, highlights the reluctance among medical students and residents to report sexual misconduct and other unethical behavior. The fear of retaliation or being ostracized from the community discourages many from speaking out, perpetuating a culture of silence that conflicts starkly with the ethical doctrines taught in medical schools.

The Dichotomy of Medical Ethics and Reality

Entering the medical field, trainees are indoctrinated with principles of nobility, ethics, and advocacy. However, the reality often does not reflect these ideals. The discrepancy between what is taught and what is practiced can disillusion and deter trainees from taking a stand against wrongdoing. The lack of robust protective mechanisms for whistleblowers in medical institutions only exacerbates this issue.

Navigating the Path Forward

Experienced physicians often advise young trainees to navigate their training years with caution, suggesting that to survive the process and attain the coveted title of a physician, one must often turn a blind eye to malpractice and injustice. This pragmatic yet disheartening advice underscores a critical need for systemic changes within medical training institutions to foster an environment where ethical concerns are genuinely valued and addressed.

Conclusion

The firing of Dr. Kwong, albeit delayed, is a small step toward justice for Dr. Cargle and many others who have suffered under similar circumstances. However, it also serves as a stark reminder of the ongoing struggles within the medical community regarding ethics and integrity. For those of us still training, these revelations are not just stories but cautionary tales that shape how we perceive our future roles within this noble profession. We must strive to be part of the change, advocating for a system that upholds the true values of medicine and protects those who dare to speak the truth.

The Ominous Symphony of Flaring: A Call to Action for Environmental Health in Osteopathic Medicine

As dawn broke over San Antonio this morning, the serene silence was shattered by the roar of flaring from a nearby petroleum facility. This facility, merely blocks away from my medical school, UIW School of Osteopathic Medicine, stands in contrast to the mission of healing and health promotion championed within my medical schools walls. The sound from the flaring, akin to a jet engine, is not just a disruptive auditory occurrence but a harbinger of deeper environmental and health concerns that resonate through the community — one of the poorest in San Antonio, as characterized by the Texas Department of Health & Human Services. Moreover, this community is burdened with one of the highest cancer rates in Texas, a statistic that is hard to overlook as a mere coincidence.

The process of flaring, while a safety measure, emits a cocktail of pollutants, including volatile organic compounds (VOCs), sulfur dioxide, nitrogen oxides, and greenhouse gases like carbon dioxide and methane. The proximity of this facility to the San Antonio River raises grave concerns about potential runoff and the impact on aquatic ecosystems, which can affect water quality and biodiversity. It is not just the river that suffers but the very soil on which children play, and families build their lives—a soil that may carry the remnants of these pollutants.

This intersection of industry, health, and environment near my medical school where future osteopathic physicians are trained should provoke a profound reconsideration of the osteopathic philosophy. Osteopathic medicine has long recognized the interdependence of body, mind, and spirit. It is high time that this interdependence is extended to include the environment in which individuals are born, live, and pass away. The principles of osteopathy emphasize the body's ability to self-heal and self-regulate, but this natural capacity is compromised when the environment is laden with toxins.

Osteopathic medical students are taught to treat the patient, not the disease. Yet, when the environment itself contributes to disease, our approach must evolve. Environmental health needs to become a fundamental pillar of osteopathic medical education, encouraging students to consider the external factors influencing their patients' health. This approach aligns with the growing understanding of social determinants of health and their impact on patient outcomes.

To address this multidimensional challenge, I propose the adoption of a new osteopathic tenet: "Recognize the environment as a partner in health." This tenant would promote awareness and advocacy for environmental health as a component of holistic patient care. It would encourage future osteopathic physicians to consider how climate change and environmental degradation contribute to health disparities and to advocate for sustainable practices and policies.

Osteopathic medicine, with its holistic approach, is uniquely positioned to lead this charge. It has the potential to redefine the health narrative by including environmental stewardship as a component of compassionate patient care. As osteopathic physicians and educators, we must champion this cause, integrating environmental health into our curricula, research, and community engagement efforts.

The time for action is now. The roar of flaring at dawn should not be the legacy we leave but rather the alarm that awakens us to the urgency of protecting the health of our patients and our planet. It is our duty to respond, not only with concern but with a steadfast commitment to fostering environments that promote—not endanger—human health and well-being.