One thing I’ve noticed in the last fifteen years is how aware Americans have become of health policy issues. When I first told people as an undergrad that I wanted to pursue a career in health policy, I almost always received glazed looks in response. “What would that look like exactly?” Now, virtually everyone I meet (Lyft drivers, new friends at get-togethers, strangers on the plane, new colleagues) has an opinion, when they learn that I am a nephrologist and health policy researcher.
One thing I’ve noticed in the last fifteen years is how aware Americans have become of health policy issues. When I first told people as an undergrad that I wanted to pursue a career in health policy, I almost always received glazed looks in response. “What would that look like exactly?” Now, virtually everyone I meet (Lyft drivers, new friends at get-togethers, strangers on the plane, new colleagues) has an opinion, when they learn that I am a nephrologist and health policy researcher.
As I reflected on this change in America’s consciousness, I came to the conclusion that healthcare has become so complex and so expensive that everyone has either been directly affected or knows someone who has been affected by the rising cost of healthcare.
Sometimes, I think we forget that we are providers who provide healthcare but that this doesn’t necessarily translate into health. We forget that patients are impacted by everything we do. I’ve heard so many times from colleagues “it doesn’t hurt to order this extra test” or “to get this unnecessary consult” or “to try this expensive medication.” We forget that everything we do costs our patients not only money, but time – our patients’ most precious commodity. As nephrologists, we are all first-hand witnesses to the impact of asking our patients on hemodialysis to spend half their lives with us.
I believe that our fragmented system is a product of a provider- and payer-centric model that emphasizes healthcare, but not health. Though we are not entirely at fault, I believe we have gotten tangled up in fighting for us. To be fair, many of these fights are critically important: how do we attract more candidates to nephrology, how do we ensure reimbursements are fair, how do we develop more efficient ways to organize our specialty? However, sometimes we need to take a step back and remember that we became physicians because first and foremost we wanted to advocate for our patients’ health.
As a member of ASN’s Policy and Advocacy Committee, I am proud to contribute my voice to ASN’s advocacy agenda. Our patients are some of the sickest and most vulnerable in the American population. From advocating for more nephrology research, to developing improvements in care delivery, to ensuring that policies make healthcare accessibility easier and more affordable for patients, ASN continues to be one of the main leaders in pushing for better nephrology care for patients with kidney diseases.
Fighting for our patients is hard but paramount. While the challenges ahead are daunting, I am optimistic that we can build something that is better for our patients and our society.