New World, New Interns, New Hope

Well, it’s that time of year again. Or is it?

As happens every year, the new class of interns is arriving to begin their week-long orientation. Next week they start on their clinical rotations — on the hospital wards or in outpatient clinics. This is a rite of passage that has happened year after year, intern class after intern class, something we’ve all been through.

But somehow, tellingly, this year feels different. The new class of freshly minted physicians is arriving in a world drastically changed from so many previous year’s classes, and in some ways, they may be better prepared for what stands before them.

This past year, the year like no other, has seen terrible tragedy and gut-wrenching changes, laying bare the need for revamping the healthcare system probably more than ever before. The residents who have been working in the hospital since the pandemic began have faced horrors and hardships they probably never dreamed of, and have risen to the challenges to fight this terrible disease.

So many of the medical students were chomping at the bit to get to work last summer, and last year’s intern class joined us in the middle of some of the worst of it. This year, as we all begin to feel like we’re coming out the other end of something — whether it’s the first wave, second, third, or fourth — none of us are really sure of what’s to come, what the future will hold.

Will vaccine hesitancy in our country allow variants to sneak in and come roaring back, even in communities that we thought were safe? Will the political divides that have only widened put huge parts of our country at risk? Will the fact that we’ve only begun to vaccinate most of the world have repercussions here at home as well, and lead to challenges that we can only imagine? And will the glaring inequities that the pandemic helped bring to light, revealing communities that we’ve left behind, injustices built into the healthcare system, flaws that we’ve only begin to chip away at, hopefully make us work even harder to make things right, to not accept the status quo?

The new class of interns entering medical residencies around the country brings with it a new hope, a drive for change, an unwillingness to accept that we will do anything but the best for our patients and our communities. We need to make sure that the system changes right along with them, at every level — and stands with us, not in our way.

We need to ensure that practicing medicine is once again a joy, that administrative and bureaucratic barriers are torn away, that every physician and nurse and all other providers can practice up to the top of their licenses.

It’s time to demand that we be allowed to build a medical system we are all proud of, one that takes care of everybody, one that reaches out to every community, one that helps our patients overcome whatever stands in their way of getting to optimal health. We need to bring access to everybody, bring telehealth to all communities, and recognize and overcome our internal and external biases. We need to find a way to make healthcare something that our patients don’t fear, make sure that they want to come to us for vaccines, for medications, for treatments, for surgeries. And it should never be something that is kept from them because of their inability to pay.

As this country struggles with huge issues around what it means to be a safe and just community, with how to build a better world, we need to make sure that healthcare is moving right along with it. Healthcare is such an incredibly important part of people living a full and rich life, up to their potential, that it needs to take its place alongside everything else that matters in this country: social justice, improving the climate, creating safe and thriving communities, affordable and available housing, employment for a living wage, food security, safe drinking water, and so many others. Fixing healthcare can go a long way to fixing much of what ails our society.

As the new interns arrive and start off on their clinical voyages, we owe it to them and the generations to come to demand that we put healthcare right. Let us build a better healthcare system, let us make it all about our patients, all about our providers, all about healing.

Welcome to a new world.

Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what’s going on in the world of primary care medicine from the perspective of his own practice.