Once upon a time, the American healthcare system was entirely controlled by doctors. Nurses, pharmacists, and therapists of all types were their subordinates, dependent on “doctor’s orders” to authorize the exercise of their professional discipline. Hospitals were owned by, or run almost entirely in-service to, their medical staff.

Over time, many of these other professions matured and evolved their own distinct scientific and clinical perspectives about the nature of health, illness, healing and wellness. …


One of the objections we’ve heard to the COVID-19 vaccines is related to the timeline of its development. “Most vaccines take 7–10 years” touted the experts. No wonder people were concerned about a vaccine that didn’t exist 24 months ago…

But the facts speak otherwise.

While we did not have the specific genetic sequence required for the COVID-19 vaccine until recently, the the Messenger RNA (mRNA) vaccine technology behind the Pfizer and Moderna vaccines is far from ‘new” — it has, in fact, been in development for decades. …


My grandfather was an active and proud Republican; he was also a little bit racist. Not N-word racist (that would be my biological father), but it was pretty clear he saw people of color as lesser individuals, and problematic as a community. A little bit “feel sorry for them” and a little bit “wish they would go away”.

However, the Republican Party my grandfather held so dear has now clearly embraced N-word-level racism in deed, if not in language. …


The death of Dr. Susan Moore. The death of Dr. Susan Moore. The Death of Doctor Susan Moore. Should make our ears ring and blood boil.

Medicine failed her, not just because she was a ‘fellow physician’, but because we’ve failed in our practice; her death is an object lesson in how racism trumps humanity, not just professional identity.

The very nature of healthcare practice is tradition: not ‘art and science’ but a social construct shaped by history and culture. Training in the healthcare professions is an exercise in submission to authority in order to achieve acceptance: we unconsciously shape…


With the poorest urban congressional district in the United States, the Bronx has long been held as representative of the challenges, and consequences, of health inequities. It should then come as no surprise that the Bronx has been especially hard hit by COVID-19 since, for the last seven years in a row, it has been deemed New York State’s “unhealthiest” county in annual rankings by the Robert Wood Johnson Foundation (RWJF).[1]

However, the Bronx is far from “underserved”: there are 9+ advanced teaching hospitals, an internationally renowned medical school, and more than 4,000 physicians who work within in its 42…


[This is a transcript of a video I recorded after conversation with my family — about the murders of Ahmaud Arbery, Breonna Taylor and George Floyd] https://youtu.be/3MtoLk0HTL8]. ; Artwork by Leah Merahn

Growing up I really didnt know any Black people — we lived in a a homogeneous white neighborhoood and even college was predominately white. However, as a white adult, I grateful that my family and social circles are very diverse.

This began largely by circumstance; my early career was in organizations and geographies in which I was a minority, and my majority non-white colleagues became friends. Through them…


In a full page ad in the Wall Street Journal, a conservative jobs-oriented think tank took aim at Dr. Fauci as if he was responsible for “shutting down the economy”; ONCE, AND FOR ALL, HERE ARE THE FACTS:

1/18. The “shutdown” was not the primary pandemic strategy, but a fail-safe move to protect American citizens in the face of an inability to contain the virus.

2/18. The inability to contain the virus was grounded in two decisions by the Executive Branch: 1. The upstream incapacitation and marginalization of public health professionals, and 2. …


When looking back on the 2003 mission to eliminate perceived weapons of mass destruction from Iraq, then-Pentagon Chief Paul Wolfowitz has said that it misjudged the “the tenacity of Saddam’s regime”, but denied it was grounded in any attempt to deceive the American people, saying “A mistake is one thing, a lie is something else.”

The biggest risk to our well-being would be to underestimate the tenacity of the virus and declare ‘mission accomplished’ without rational, evidence-based scientific benchmarks. Historically, the public health imperative has prioritized preventing physical over economic harm.

This means we must increase public health literacy about…


In the shadow of political debate over “Medicare for All” and other health-related proposals by presidential candidates, last month’s ruling by the US Court of Appeals reconsidering the “coverage mandate” of the Affordable Care Act adds more to the chaos over how to productively and efficiently address the healthcare needs of Americans.

With the persistent distraction about how to pay for care, we are ignoring a far more fundamental question that needs to be answered, not by elected officials, but in the hearts and minds of Americans: as a society, do we want people to be sick or well? …


The medical community was surprised and disappointed by the recently reported results of a randomized controlled clinical trial of the “hotspotting” program created by the Camden Coalition of Healthcare Providers. The ex post facto analysis pointed to system-level complexities as being barriers to the expected study outcomes of targeted interventions.

However, the study revealed two fatal flaws, and they offer a profound lesson to all of us working to improve the capacity of our systems of care to improve the quality of health of individuals and communities.

The first flaw was the use of utilization as a patient selection model…

Steven Merahn, MD

Physician-leader; health strategist; Founded www.unioninaction.org Former Chief Medical Officer; public-health official; communications executive

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