My medical school is in a city at a boundary between two states. I live in the state opposite my school’s city. Because of this, there are lots of instances, especially in healthcare, where there are notable differences between the types of health services and execution of policies between the two states. I love my home state. I don’t agree with all of the laws and policies, but I love my home state. I don’t agree with all of the laws and policies of my school’s state either, but we have to function in a way that serves patients from both states well.

I am currently on child psychiatry and let me tell you… oh my goodness, the systemic problems are rampant. There isn’t a single child that we have had that hasn’t had at least one major problem/difficulty/delay in some form or another. These kids have some serious issues, and mostly not due to their own fault. It is so frustrating trying to get these kids the assistance they need when we repeatedly run into obstacle after obstacle. Psych is, by far, the singular specialty I have experienced that has this volume of barriers. It is unbelievably frustrating to have to hear each morning what new barriers we are waiting to overcome to give our patients the help they need.

To top things off, I overheard my attending this morning talking about the poor state of care patients from my state receive if they have the Medicaid my state offers. How my state is known for simply “not caring” about these people at all. That he is frustrated with his home state’s methodology for caring for patients, but that my home state is, despicably, even worse. It is enraging. I am so disappointed in my home state.

Disappointment isn’t enough. I want to do better for the people of my state, and every state, that has these sorts of issues. These issues are a systematic problem. There must be a way to fix these problems. That is not to say that the problems will be easy or fix, or that one particular group is responsible for the issues as a whole. As a medical student, I feel like not much that I do from day to day really matters, because at this point in my career my job is simply to learn so that I can be a great physician once I start practicing. I have a hard time accepting that I am not in a position that can make much change at this point. I have seen student-led groups reach amazing conclusions when they assemble for a common cause.

One person can’t do much alone. But if a group of passionate people with a cause work together to effect positive change…. THAT is what it is going to take to make these problems become less of a burden for the patients that depend upon the system to work for them. I want to start now. Not after I walk across the stage to get my diploma, not a decade later when I’m finally an attending, but now.

So, dear friends and readers…. how do we begin to tackle a systemic problem? How do we get those in power to care enough to be called to action? It is hard for me to see where all of the real obstacles are. These things, though, are immanently important.


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