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The Financial Assessment
My Nicaraguan pediatrician friend astutely summarized her work: First you make the clinical assessment, then you make the financial assessment. In other words, a clinician may know the right treatment, but what good does that do the patient if the treatment is entirely out of reach financially?

#KeepAmericaCovered
Amrita Seehra
About the artist:
“Krithika Kavanoor (left) and I are both family-medicine residents at Montefiore Medical Center in the Bronx. As primary-care providers in one of the poorest urban counties in the US, we see firsthand the impact that access to health care–and the lack thereof–can have on our patients. The narratives we share are the personal stories of people who’ve been able to receive health care through the Affordable Care Act (ACA) and combined Medicaid/Medicare coverage. Repealing the ACA will deal a serious blow to health justice. The US is the only developed nation that does not recognize health care as a fundamental human
Late Again
Paul Gross
One thing I love deeply about being a family doctor is that I get to take care of people–body and soul. A patient comes into my exam room with a litany of physical symptoms (“My shoulder…my knee…my stomach…so tired…this nausea…”) and then, in response to a questioning look, suddenly bursts into tears.
It’s all mine to deal with. The shoulder. The stomach. The tears. I get to gather the pieces and see if we can’t put this broken person back together again.
What a privilege.
And yet the joy of primary care is also its curse. With each patient, I have to keep track of everything–the trivial and life-threatening, the physical and mental, the acute, the chronic and the preventive. And
Halloween Horrors
Paul Gross
One October evening last year, I went to our local pharmacy to pick up a prescription for my daughter. I made sure to bring Cara’s insurance card because my employer had switched us to a new health plan.
I wasn’t sorry about the change. Our prior plan had been operated by incompetents–although they might only have been crooks, I couldn’t be sure–who also managed our flexible spending accounts. These accounts, you may recall, collect pre-tax income from your pay and then return it to you to pay for out-of-pocket medical expenses.
With that plan, nothing ever worked as advertised. I would submit a dental bill for reimbursement and the company would review it for three months before sending me a denial notice, stating