Intern Blog

Earlier this week Melissa and I had the opportunity to attend a short seminar on antimicrobial resistance (AMR), hosted by the Global Health Policy Center at CSIS. This involved a keynote address from Dr. Vytenis Andriukaitis, who serves as the Commissioner for Health and Food Safety for the European Union (EU), followed by a panel discussion with Dr. Jean Patel, the Science Lead for Antimicrobial Resistance Coordination & Strategy at the Centers for Disease Control and Prevention (CDC).  

In a relatively short overview of the challenges that we face with AMR, Dr. Andriukaitis was able to touch on many of the issues that we have discussed in our infectious disease courses at Berkeley; incorrect use of antibiotics in humans and animals, lingering behaviors that exacerbate the issue, and the need for political and intellectual action to not only stop the spread of these strains but also to find new ways of treating disease caused by them. Other students and representatives of local organizations questioned the importance of the internet as a forum for spreading incorrect information, potential for greater school education on preventing resistance, and how specific diseases such as tuberculosis, malaria, and HIV play into worldwide efforts against AMR, though relatively perfunctory answers were given. However, these are all relevant issues to consider as we move forward, and should be addressed as future action plans and initiatives are developed.  

As Dr. Patel remarked during the panel discussion, we need to start using the term “untreatable infections” because that is the reality of many of these cases. Common, treatable infections are becoming more and more difficult to resolve, especially in the hospital setting. This is why it is more important than ever to have “political will,” as Dr. Andriukaitis put it, as the foundation of new and ongoing initiatives to contain the spread of antimicrobial resistance. Supportive regulatory agencies and leaders not only provide programmatic focus but also lend to perceptions of the credibility and importance of an issue. With the cooperation of governments both domestically and internationally, we can only hope to have some impact on the dispersal of drug-resistant pathogens in the near future.

I had the opportunity to attend a Congressional briefing on Capitol Hill on the Post-Election Outlook on Hospitals and the 340B Program. This briefing was coordinated by 340B Health, a membership organization that includes more than 1,200 hospital and health systems that participate in the federal 340B drug pricing program. The briefing included panelists that represented public, private, or non-profit hospitals that acted as safety net providers in their communities and was a discussion of how the 340B program enhances care for diverse patient populations and the future implications of adjustments to the program. The program, called 340B, was developed and implemented in 1992. The hallmark of the 340B program is a requirement that drug manufacturers sell pharmaceuticals at an approximate 20 to 50% discount to specific institutions. For the most part, 340B eligible clinics, hospitals, and health systems treat low-income or uninsured patients. A notable participant of the 340B program is the Veterans Health Administration.

On Friday, November 28th, I had the opportunity to attend the Women in Government’s Seventh Annual Healthcare Summit as a part of the Future Women in Government Program.  The program selects undergraduate and graduate students who demonstrate a passion for women’s leadership to participate in the conference, as well as network with current legislators. The programming was diverse in nature ranging on talks about rare diseases, Alzheimer’s, and the regulation of medical devices in the European Union. I appreciated being able to hear about different disease areas, as well as hear from a variety of patient advocacy groups. When I reflect upon my experience in the program, the most formative impact comes in the form of a reminder about why I am so passionate about health and, particularly, women’s leadership in health.

This reminder came in the form of presentations that were unapologetically focused on women. One particular presentation on bleeding disorders stood out to me. While bleeding disorders can affect both men and women, they are often not correctly diagnosed in women. Many clinicians will miss the warning signs and simply normalize the symptoms as a natural function of menstruation. Due to this, women with undiagnosed bleeding disorders will often suffer from chronic fatigue as a result of anemia, difficulties healing after sustaining cuts of injuries, and heavy and prolonged menstrual periods. While this is just one example, it reminded me of how fundamentally underrepresented and understudied women’s health issues are. So often in society women’s voices are lost or are systematically unheard. In the healthcare field it manifests in the lack of studies about women’s health, the lack of women in clinical trials, or how women’s pain is often downplayed. According to a study “The Girl Who Cried Pain,” there is a definitive gender bias when it comes to clinical pain management where women are “more likely to be treated less aggressively in their initial encounters with the health-care system until they ‘prove that they are as sick as male patients.’” The pervasive disregard of women’s pain and women’s health issues is a definitive example of how political power, or lack thereof, can have an impact on one’s health outcomes

On October 11, 2016, I went to the Supreme Court to hear oral arguments on two cases: Samsung Electronics Co., Ltd., et al. v. Apple, Inc. and Pena-Rodriguez v. Colorado. My day started  at 2 a.m. when I braved the brisk Washington, D.C. air to line up at the Supreme Court. Oral arguments are open to the general public, but seating in the court is available on a first come first serve basis. In addition to this, many of the seats are reserved by members of the Supreme Court Bar, school groups, and special guests of the Justices. Thus, it was crucial that I got in line as early as possible to heighten my chances of getting in. Much to my relief, when I arrived there was only one other person in line. Armed with a sleeping bag and a yoga mat, the person at the beginning of the line was infinitely more prepared than I was for the coming hours ahead. Within five minutes, two other people joined, and, within the next hour, there were at least thirty more individuals in line. As the sun slowly rose, the line outside the Court continued to grow. By 6 a.m. the line wrapped around the building, filled with enthusiasts eager to discover whether or not they would be seated for the case. At around 8 a.m., the security guards began handing out note cards that designated one’s place in line; I was second! Seating for the first argument began at 9:30 a.m. and the case promptly started at 10 a.m. After waiting for approximately 8 hours, I was seated in the Supreme Court ready to listen to the oral arguments.

On October 13, 2016, the Brookings Institution hosted an event called “How To Protect Patients From Surprise Medical Bills.” As someone deeply interested about the effects on healthcare access and how, ultimately, healthcare access is a proxy for positive health outcomes, I wanted to gain more perspective on how healthcare coverage does not necessarily  equal care; having health care insurance does not mean that you will receive adequate care. Surprise medical bills are the product of gaps in coverage or gaps in knowledge of insurance plans. They can also be a by-product of patients purposefully going out-of-network for care without realizing the full consequence of that action. This results in patients being saddled with unexpected medical expenses. The event was structured around two presentations and two panel discussions, all of which centered on proposing solutions for surprise medical billing. Panelists and presenters consisted of individuals representing health insurance providers, policymakers, and physicians.

Despite being from different backgrounds and representing different interest groups in the matter, the panelists and presenters wholly agreed that requiring consumers to go to mediation about their medical bills is bad idea. Presenters offered slightly different solutions to the issue. Some solutions set forth included:

The CSIS Global Health Policy Center hosted an event entitled, “Outcomes from the Durban International AIDS Conference” on Wednesday August 3, 2016. I went to this event to hear updates from the 2016 International AIDS Conference from some of the key players in attendance and to hear a perspective on what the outcomes of this conference were. Overall, the speakers seemed to have a message of positivity, and of moving in the right direction, despite some setbacks in the field which includes a decrease in worldwide funding.

Jeff Oxendine, the President and one of the founders of Health Career Connection (HCC) led a workshop at the HCC Mid-Summer Conference that I attended from July 21-22^nd, 2016. The workshop was on Life and Career Planning. This workshop greatly benefited me because I am in a stage in my life that revolves around making decisions that shape my future. Jeff Oxendine went through several activities that challenged my current thoughts on how to approach setting goals and making future plans. I will be graduating in May of 2017. I plan to take a year off in order to obtain work experience in my field before going to graduate school.

On Monday, August 1^st, the Forum for Collaborative HIV Research hosted its 4^th annual Washington Area Interns Networking Day. The purpose of the event is to allow interns working in the Washington area a chance to hear from and converse with experts in the fields of public health and policy in HIV/AIDS and Viral Hepatitis. Various organizations were represented by the attending interns, including The American Chemical Society, The American Psychological Association’s Office of AIDS, HealthHIV, The AIDS Institute, The Global Liver Institute, and the National Association of Social Workers. The event consisted of a panel, followed by a light reception and networking period.

On Tuesday August 4^th, I attended the Update on Hepatitis C in the United States. The event took place in the US Capitol Building Visitor Center in Washington and was held by the AIDS Institute. Presentations were given by four panelists encompassing academia, government, and patient representation. The panel was moderated by Carl Schmid, Deputy Executive Director of the AIDS Institute.

The 9th  Annual Graduate and Professional School Fair, sponsored by the National Institutes of Health (NIH), took place on July 14th at the Bethesda, Maryland campus. The all-day event included plenary sessions about a variety of graduate degrees and careers including biotechnology, psychology, medicine, and public health. A range of admissions workshops, socials, and information sessions filled the day with a wide range of opportunities. In addition to the organized sessions, well over 100 graduate programs from diverse universities were present with booths, information, and representatives. In between plenary sessions, the representatives of each program and university offered program specific information, as well as a point of contact for interested students to engage in more in depth conversations while making key decisions about which programs to apply. Although the fair was held specifically for interns with NIH, any interested student was welcome to attend. Both of us: Victoria Mason, an undergraduate intern from George Mason, and Megan McIntosh, a graduate intern from UC Berkeley attended the fair. Below we offer each of our perspectives on how the graduate and professional fair benefited us below.