Interviews

Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?

Some of my earliest memories relate to my experiences as part of a worldwide growth monitoring project. My parents enrolled my brother and me in the project. The project researcher had to pick us up from home monthly to visit their research center on the premises of a teaching hospital. We hung out with doctors and nurses as they weighed us and measured other parameters. I suspect that experience might have something to do with my medical career choice.

Can you share the most interesting story that happened to you since you began your career?

My mother was a young widow and struggled financially to get her children through school. As each of us graduated from college, it was for her, one down; how many remaining to go? She was away when I sat for my medical exams, and when I went to pick her up at an international airport, I told her that I had passed all my exams. She leaned over and whispered, “so you are now a medical doctor?” I nodded in affirmation. And right there in the cavernous arrival hall of the airport, she knelt and began to pray and tear up! Giving her that relief was fantastic!

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

Coming to work in the U.S. had its challenging moments. One night, the Emergency Room folks called me to admit some patients to the pediatric floor. As I read through their charts on the computer, I eyeballed them from a distance. I approached those that looked easy first and left the seemingly difficult ones for the last. The child I admitted last had parents who looked like they would give me a lot of trouble. Dad had dreads, earrings, and massive gold chain necklaces, and Mom had a clean-shaven head and tattoos on both arms. But, to my pleasant surprise, they were my model family for the night. Dad had detailed notes of when he administered their child’s medications, and Mom was on top of how well their child responded to treatments, vitals signs and all. The dad came to chat with me during the long night watching over their child. I discovered that both parents were college professors and writers. I learned to be more open-minded about the parents of the children under my care.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Seest thou a man diligent in his business? He shall stand before kings; he shall not stand before mean men” (Proverbs 22:29). This bible verse was one of my parents’ favorite verses. My parents taught us not to seek shortcuts but to work diligently at every task. It got me through medical school and the rigors of a medical career.

How would you define an “excellent healthcare provider”?

An excellent healthcare provider must be a competent practitioner who is a good listener with a lot of compassion for patients and their families.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

I am an avid reader of the KevinMD website and sometimes listen to its podcast. This is because I like to read from other doctors, and the short articles on KevinMD are about how much attention I can pay to general interest reading.

Are you working on any exciting new projects now? How do you think that will help people?

I am working on another book that focuses on transitioning from being a medical student to being a medical doctor in charge of people’s lives. One day you are a student without official responsibilities, and the next day after graduation, you suddenly have a heavy load of responsibilities dropped on your shoulders. I will invite some doctors who trained in different countries to contribute two stories each, and I will edit the book.

Ok, thank you for that. Let’s now jump to the main focus of our interview. According to this study cited by Newsweek, the U.S. healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the U.S. is ranked so poorly?

The fundamental problem is that in the U.S., health is not a human right. In other high-income countries, access to healthcare services is a right of citizenship.

Consequently, health in America is a purchasable commodity. Rich folks can get as much of it as they want, and the rest of us may have to become bankrupt due to an adverse diagnosis. When you have to decide between paying a co-pay at the doctor’s office or paying your rent, you may choose to pay the rent while permitting the festering of an easily treatable condition in its early phases.

Health insurance corporations declare billion-dollar profits annually. From where do those profits come? Health insurance executives have multimillion-dollar compensations. How is the insurance corporation able to afford these? Health insurance subscribers pay for all of these profits and salaries. The more services they deny, the more funds the corporations can return to their shareholders and the better their executives’ compensation. It is wrongheaded to put the health and well-being of the American population in competition with executive compensation and shareholder dividends.

We certainly do not have enough healthcare providers, especially in inner-city and rural areas.

As a “healthcare insider”, if you had the power to make a change, can you share 5 changes that need to be made to improve the overall U.S. healthcare system? Please share a story or example for each.

1. When we acknowledge that health is a human right, the new ethos informs all activities of government. The government must continually improve its citizens’ access to health, including quality healthcare services.
2. Health services should be prepaid and free of all costs at the point of need.
3. Delink health services from employee status. If health is a human right, we shouldn’t have to depend on employers’ benevolence to access health services.
4. Profit-driven corporations should not be in charge of pooled health insurance funds.
5. We need to recruit and retain more primary care practitioners, trained locally or recruited from other countries, to make health services accessible. Other cadres requiring fewer years of training can provide some of the services doctors provide; we should encourage such associate clinicians in all aspects of medicine.

What concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

The COVID-19 pandemic has put intense pressure on the American healthcare system, leaving some hospital systems at a complete loss as to how to handle this crisis. Can you share with us examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these issues moving forward?

Just as we are beginning to develop a fuller understanding of the Covid-19 pandemic, we are faced with two pandemics, although not yet at the level of a Public Health Emergencies of International Concern (PHEIC). We are seeing higher than usual rates of viral hepatitis in several countries, and monkeypox is showing up in unusual places among people who have never traveled to areas of the world where it is endemic. Again, a health system that doesn’t depend on the ability to pay for services during a health crisis is essential for an effective pandemic response. Remember that pandemics result from failures of epidemic response in local communities worldwide.

The so-called essential workers of the lockdown phase of the Covid-19 pandemic response were primarily from minoritized populations. They couldn’t stay at home because their services were needed, but more importantly, they were wage earners, paid by hours worked or deliveries made. So if they must feed their children, they had to work through a deadly pandemic, even if they felt ill.

The solution is to make paid sick leave the norm and provide health services to all without out-of-pocket payment at the time of need. Instead, we must prepay for health services through taxes.

One of the other challenges of the Covid pandemic was that as many workers were let go, they also lost their health insurance coverage right in the middle of the pandemic. So we need to delink employment and health insurance coverage.

How do you think we can address the problem of physician shortages?

In the global health field, and in my book, we talk of task shifting and task sharing. For example, some tasks done by doctors can be safely “shared” with nurse practitioners, nurse anesthetists, and psychotherapists. Or we could create new cadres to take on some of the roles that health workers do. An example is the use of doulas to take over some of the compassionate care that midwives and nurses provide during childbirth. Doulas even add home visits to the new mother and the newborn as part of their services.

One of the approaches I recommended in my book is for rich nations to support medical schools and other health training institutions in developing countries to train more for the local and global markets. Essentially, they will be outsourcing the training of health workers to countries that are more efficient at producing them. I think India, Pakistan, Nigeria, Ethiopia, and the Philippines are countries that will gladly accept such an offer.

How do you think we can address the issue of physician diversity?

I like when we talk of minoritized communities in contrast to minorities. The lack of diversity is by design. If we are serious, we will redesign our recruitment and retention processes to give a fair chance to all.

How do you think we can address the issue of physician and nurse burnout?

We need to reduce the redundancy of paperwork in everyday life of the health worker. We like seeing patients and solving problems, but we hate the administrative paperwork the insurance industry and sometimes the government demand.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I would want us to give equal value to all human life on Earth. An American child does not deserve healthcare, education, nutrition, or peace and security more than any other child in the world.