Delivery of Care

“Do not let the spin cycle wear you down”

Why a clear mind, kind heart, and strong back are essential

Photo by Richard Asinof

Dr. Megan Ranney at the groundbreaking in 2022 for the new state public health lab in Providence.

By Megan Ranney, MD, MPH
Posted 11/18/24
Dr. Megan Ranney, MD, MPH, Dean of the Yale School of Public Health, offers words of wisdom on how to push back against the no-nothing health policies promised in a second Trump Administration.
What is wrong with the local news media and why has it failed to report and to cover the future of health care in Rhode Island? How committed are Senate President Dominick Ruggerio and House Speaker Joseph Shekarchi to increasing Medicaid rates for health care providers, or will they yield to Gov. McKee’s proposed budget cuts under the false promises of austerity and no new taxes, as detailed in research by state Sen. Sam Bell? How many elected leaders, communications professionals, and corporate leaders in Rhode Island are in long-term recovery from substance use disorders, including alcohol abuse? How many Rhode Island patients are confused by all the signage and billboards surrounding the branding switch to Brown [University] Health from Lifespan and Coastal Medical? How much does Brown University now regret its failures to invest in furthering the careers of Dr. Ranney and Dr. Elizabeth Goldberg?
For those of us who are old enough to remember the 1972 landslide victory by President Richard Nixon over Sen. George McGovern and the 1984 landslide victory by President Ronald Reagan over Sen. Walter Mondale, it may also be helpful to recall that both the Nixon Administration and the Reagan Administration self-destructed in the months following the landslide victories.
In both cases, it was the legal shenanigans and criminal enterprise, first by Nixon and his cronies that led to his forced resignation from office in 1974, and second by Reagan and his cronies, that led to their eventual downfall.
If history is a stern guide, the likelihood is that Trump and his cohorts may find themselves headed to jail because of their continual, corrupt, criminal exploits.

Editor’s Note: In the aftermath of the election of former President Donald Trump, there has been an avalanche of commentary across numerous social media platforms, all attempting to provide political insights about what happened and then to make suggestions about how to cope moving forward. The spin cycle has been working overtime, even if the nation’s mind has been on vacation.

A recent insightful post on LinkedIn by Dr. Megan Ranney, MD, the Dean of the Yale School of Public Health, provided exactly the kind of wisdom that has been missing from the dialogue and the news reporting, particularly in light of some of the horrific nominations by Trump for his cabinet posts.

The question is: Why have Rhode Island’s health care, legislative and academic leaders missed their moment to speak out?

PROVIDENCE – Some thoughts, as the U.S. Department of Health and Human Services has suddenly risen to the top of everyone's discussion topics for the weekend:

  •    Safety and health is the primary goal of every public health and health care professional that I know.

We all know that Americans' health is under threat. Nearly three-quarters of American adults are overweight or obese. Rates of mental illness are rising. Opioid overdoses and gun violence deaths are decreasing, but are still a magnitude higher than in any other developed country.

Health care is increasingly expensive, fragmented, and difficult to access. There is real work to do on chronic disease prevention, access to high-quality food, reducing environmental toxin exposure, improving health care access, and more.

BUT/AND: Let's not throw the baby out with the bathwater. In the last century, literally millions of lives worldwide have been saved thanks to safe and effective childhood vaccines.

I’ve never seen a case of polio in 20+ years as an ER doctor. HPV vaccines have virtually eliminated new cases of cervical cancer amongst vaccinated women. I’m grateful for Federal Drug Administration [FDA], the Centers for Disease Control and Prevention [CDC], particularly the Advisory Committee on Immunization Practices and the Vaccines for Children program [VFC], the Health Resources and Services Administration [HRSA], and many other federal agencies that make this possible. Equally importantly, clean water, food, and medications are the norm in the U.S. rather than the exception.

At the turn of the last century, medications were often snake oil at best - and poison at worst. Now, thanks to the FDA, we are assured that pharmaceutical products go through rigorous safety & efficacy testing ... and know that if something goes wrong, there WILL be an investigation (cf the contamination of baby formula at a plant in Indiana a couple years ago).

Access to health insurance    
Today, all Americans can get insurance, whether or not they have pre-existing conditions. That wasn't true when I graduated from med school. Lots more to do on this front, granted.

And the National Institutes for Health and CDC research have led to unprecedented advances and innovations for the American public. Everything from HIV treatment, to new cancer detection methods, to new understanding of chemicals’ impact on human health, have been made possible in recent decades thanks to federal funding. There's more in the works, too!

Can we do better?    
OF COURSE. So, let’s empower and fund our health partners and our scientists appropriately. Let’s help them be efficient as well as effective, eliminating bureaucracy where possible and helping them sort signal from noise.

Let’s commit to ensuring that the health of families and kids is the top priority – and make sure that this work is informed by real data, not pseudoscience.

Let’s train our students and professionals to LISTEN TO and communicate well with the American public about the nuances behind our science.

I'm personally committed to doing this work. I know that many of you are, too. But a clear mind, kind heart, and strong back are essential.

So please, take a breath, know your data, and don’t let the spin cycle wear you out.

Dr. Megan Ranney, MD, MPH, and emergency room physician, is the dean of the Yale School of Public Health. Previously, she served as the Deputy Dean  of the School of Public Health at Brown University and the founding Director of the Brown Center for Digital Health.

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