"With the first cut of the scalpel, excruciating pain exploded in my foot, and I was shocked speechless. I froze, paralyzed, terrified that any movement would jostle that knife digging into my flesh." Angelika Byczkowski, a patient suffering from Ehlers-Danlos Syndrome (EDS) has felt multiple surgeries through anesthetics.

Hospitals are beginning to follow in the footsteps of the American Hospital Association and are suing the Trump Administration for its decision to institute site-neutral payments.

Social determinants of health (SDOH) started becoming more mainstream of a concern for the greater healthcare system in 2018. An individual's socioeconomic status can put their health at risk. Locally, this has become even more apparent since Hurricane Michael hit the panhandle last October. SDOH is defined by the Centers for Disease Control and Prevention as “conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes.” These conditions can determine the health of people.

People have been living in unimaginable conditions since Hurricane Michael hit on October 10th, 2018. We are now in 2019, and many are still unable to live in their homes. Without proper housing and the many hazardous conditions around the panhandle that extend farther than just at home, there has been an increased rate of injury and illness. This hurricane has provided us with a prime example of social determinants impacting health.

The healthcare system has avoided addressing the issue of social determinants for a long time. In 2018, newly launched initiatives, as well as studies showing the need for these initiatives, have caused the healthcare system to take a new look at social determinants and how to address them.

Factors such as housing, transportation, food assistance, and personal finances have been taken into account to begin the process of reassessing healthcare's take on social determinants. People with limited access to transportation and housing are at a higher risk of injury or illness, especially when they have limited ways to get to a physician. Medicaid plans on helping to offer affordable housing to those who need it. Patients without transportation often forego making an appointment or miss them when they do have them. Uber recently launched a “health dashboard” to provide free rides for those unable to get to a doctor when they need to.

In addition to this, Geisinger Health System started “Fresh Food Farmacy,” which cut costs among diabetic patients from anywhere between $48,000 to $240,000 per member. This caused the risk of serious complications or death for people with diabetes to drop to 40%, a great win for those working with diabetics. Cigna is also planning on offering financial planning services for their group members, as announced in December 2018. Financial stress can take a significant toll on a person’s physical and mental health.

With many physicians claiming social determinants “aren’t their problem,” there is still a long way to go with maintaining equity among Americans. However, now that the panhandle is experiencing even more of these social determinants than usual, we have been provided a new chance to tackle these determinants and make the panhandle a healthier place for everyone. These social determinants will continue to play a significant role in local health for everyone involved with the hurricane, but choosing to see the positive side of this great opportunity is best for our county's health.

The recent legal changes increased national attention to financial difficulties arising from patients receiving surprise, unexpected medical bills has led to a group of insurance, business and consumer groups announcing they have joined forces in an attempt to create solutions to reduce the frequency of this occurrence.

A recent uproar in the media was the National Rifle Association telling doctors in a tweet to “stay in their lane” when addressing the issue of gun violence. As you know, doctors see the aftermath of gun violence; you have to tell the family whether their loved one is alive or dead from this senseless act of violence. An immediate tweet back to the NRA from the Annals of Internal Medicine simply said: “Doctors are in our lane.” In addition to this, the AIM also decided to collaborate with the American Foundation for Firearm Injury Reduction in Medicine (AFFIRM) to fund new research supporting new practice recommendations.

It is a known fact among all of our members that patients often do not do what their physician advises them to after seeing them. As frustrating as it can be, it is important to us at Emerald Coast Medical Association to make our members know that this is not a failure on your part, as you can only do so much. Our meetings are open for our members to discuss these frustrations without judgment, and allow them to discuss among each other how to better address these types of situations.

Physicians, nurses, and healthcare professionals everywhere are experiencing burnout due to stress related factors. The suicide rate among physicians is more than double that of the general population. Burnout and depression can lead to medical error, something no patient wants to experience.

In May, Health and Human Services Secretary Alex Azar told us that he planned to use his pen to make significant and hopefully positive changes to the healthcare industry in the United States. Staying true to his word, the HHS Centers for Medicare & Medicaid Services (CMS) has issued a proposal that could have a drastic, positive impact on doctor-patient relationships in the U.S.