Central PA Medicine Fall 2024

Your Community Resource For What’s Happening In Healthcare

FALL 2024

Official Publication of the Dauphin County Medical Society

Global H e alth Schol ars PAGE 13

PLUS

Scott A. Gunder, MD, DCMS Presidential Scholarship PAGE 11

I Am Latina: What Hispanic Heritage Month Means to Me PAGE 18

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ORTHOPAEDIC EXPERTS NEAR YOU: Annville Carlisle Chambersburg Enola Hanover Harrisburg Hershey Hummelstown

Lancaster Lebanon Lewisberry Lititz Mechanicsburg Newport Shippensburg

Central PA

Dauphin County Medical Society P.O. Box 53 • Robesonia, PA 19551

717-798-9420 • dauphincms.org

2024 DCMS BOARD OF DIRECTORS Joseph Answine, MD President Andrew Lutzkanin, III, MD Vice President Everett C. Hills, MD Secretary/Treasurer Shyam Sabat, MD Immediate Past President

MEMBERS-AT-LARGE Michael D. Bosak, MD Robert A. Ettlinger, MD John Forney, MD John D. Goldman, MD Virginia E. Hall, MD, FACOG, FACP Saketram Komanduri, MD John C. Mantione, MD Mukul Parikh, MD Gwendolyn Poles, DO Andrew J. Richards, MD, FACS, FASCRS Jaan Sidorov, MD Andrew R. Walker, MD William Wenner, Jr., MD

EDITORIAL BOARD Gerard Egan, DCMS Executive Director Joseph F. Answine, MD, Editor in Chief Robert A. Ettlinger, MD Gloria Hwang, MD Puneet Jairath, MD Mukul L. Parikh, MD Meghan Robbins Shyam Sabat, MD

MEDICAL STUDENTS/ RESIDENTS/PENN STATE AMA REPRESENTATIVES

FALL 2024

Contents Features 6

The Membership Numbers Game: Is it Worth Playing?

8

Memberʼs Spotlight: Mary A. Simmonds, MD

11

The Gunder Family makes substantial contribution to grow the Scott A. Gunder, MD, DCMS Presidential Scholarship

13

Global Health Scholars

18

I am Latina: What Hispanic Heritage Month Means to Me

In Every Issue Editorʼs Message. . . . . . . . . . . . . . . . . . . 4 Executive Directorʼs Message . . . . . . . 5

Legislative Updates. . . . . . . . . . . . . . . . 21

Denise Ocampo, President Mariya Starostina

Central PA Medicine is published by Hoffmann Publishing Group, Inc. Reading, PA | HoffmannPublishing.com | 610.685.0914

SPREAD THE WORD #PACentralMedMag FOR ADVERTISING INFO CONTACT: Tracy Hoffmann | 610.685.0914 | Tracy@hoffpubs.com

The opinions expressed in this publication are for general information only and are not intended to provide specific legal, medical or other advice or recommendations for any individuals. The placement of editorial opinions and paid advertising does not imply endorsement by the Dauphin County Medical Society. All rights reserved. No portion of this publication may be reproduced electronically or in print without the expressed written consent of the editor.

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EDITOR’s Message

THERE IS NO REASON TO JOIN A

By JOSEPH F. ANSWINE, MD, FASA

I have been an active member of numerous medical societies throughout my career. I have probably sat through a thousand society meetings over my near 40 years in the business. My lifetime dues paid could have bought me a Tesla and probably a spare battery too.

I would estimate that 10% of the time spent during those meetings involved perseverating over membership, or the lack thereof. So many schemes concocted and each was going to be that one great plan to entice colleagues to open their wallets and join. You call two friends and then they call two friends. I did call those two friends, and they chose not to join, and they didn’t call anybody. Or, let’s send all physicians stethoscopes embossed with the society emblem along with a billing statement. Now there are hundreds of nonmembers with society stethoscopes.

The excuses are always compelling. “I don’t agree with the society’s stance.” Yea, that whole protect doctors and patients thing is hard to rally around. Or, “My money is wasted on board members for travel to meetings, or to have wine and cheese parties for fat cat legislators.” It is true. I spent the equivalent of a whole year of vacation time over the past 40 spending your money traveling to exotic places like Pittsburgh to have wine and cheese with legislators that make policy which could make you or your patients’ lives easier or harder. And, then the truth hurts. “Why should I spend my money since you will still do all that stuff with or without my membership?” Yep, we will. Until we run out of money, and we are getting close. Furthermore, what we do for you, policies and guidelines fought for and implemented are without your input, so don’t complain. Lastly, “My institution doesn’t cover society dues.”

I’m perplexed as to why not. They should be quite willing to sell an airplane to cover your dues so you can fight for autonomy from them, and to not be just a widget in their monstrous machine.

Yes, by the way, there are membership benefits if you look for them such as continuing medical education opportunities, programs to assist you and your department or group, support when needed whether with negotiations or involving a liability claim, and so on. The societies bend over backwards to provide such benefits.

I’m not here to convince you because historically it doesn’t work.

And I am happy to make decisions for you. Just don’t whine about it. You only get that right when you join.

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Medical Society

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A MESSAGE FROM THE DCMS EXECUTIVE DIRECTOR, GERARD EGAN Dear DCMS Members, As we welcome a new season, I hope you’re enjoying all it has to offer! I want to take a moment to highlight some important information.

Membership renewal is just around the corner! Renewing your membership today will keep you connected to the dynamic resources our society offers. It’s also important to renew your medical license before the year ends and ensure you’re up to date with your CME requirements. PAMED has provided a handy checklist to help you stay organized and avoid last-minute stress, but don’t hesitate to reach out if you need any assistance.

I’d like to highlight our current scholarship, the Scott A. Gunder, MD, DCMS Presidential Scholarship, for medical students through PAMED. This scholarship honors Dr. Scott A. Gunder, a Dauphin County gastroenterologist and past president of the Dauphin County Medical Society, who dedicated his career to compassionate patient care and leadership in the medical community before his passing at the young age of 39 in 2000. This year, we’re excited to share that the committee is reviewing significant enhancements to the scholarship for the 2024-2025 school year, made possible by the generous support of the Gunder family. To learn more about their legacy, please check out page 11.

Finally, don’t miss the feature on page 18 about Dr. Mary A. Simmonds, a fourth-generation physician with a distinguished career in medical oncology. She notably served as the first woman president of the National American Cancer Society.

Now retired from clinical practice, she continues to support medical initiatives and education, including establishing a scholarship for female medical students at Drexel College of Medicine and remaining active in community service. If you know a physician who would be interested in being featured, please let us know!

In our next issue, we’ll also provide a recap of the House of Delegates, highlighting key discussions and outcomes.

As always, thank you for your continued support of our society. Together, we can make a positive impact in our community and within our practices!

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FEATURES

By JOSEPH F. ANSWINE, MD, FASA

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I wrote this article and published it in the Pennsylvania Society of Anesthesiologists newsletter, Sentinel, 10 years ago. (Answine, J. F., The Membership Numbers Game, Is It Worth Playing? Sentinel: Pennsylvania Society of Anesthesiologists Newsletter, Fall, 2014) As you can see, nothing has changed. Enjoy!

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aving the ability to be personally involved with three medical/medical specialty boards, I am quite aware of the time spent and the topics covered. One never-ending discussion is membership. What are our membership numbers? How do our membership numbers compare to those of previous years or other societies? What can we do to recruit new members, reacquire previous members and maintain current members? In my opinion, so much time is utilized discussing, worrying, fretting over membership that we have little time to prove our worth to the existing members.

Membership is an individual decision that forces potential members to consider both presumed benefits and membership costs.

Since money is more difficult to come by in recent times, the benefits must be ever more enticing to individuals contemplating membership. To guarantee membership, a society must provide at least one of a few things: 1) A necessary benefit that cannot be obtained otherwise. 2) A requirement needed in order to achieve something of personal importance, such as employment.

3) A prestige that is so important and needed that not being a member could ostracize individuals within their specialty.

The problem is that we, based on our mission statements, represent ALL physicians or physician specialists in the state or county regardless of membership. Medical society membership, for the most part, does not come with a change in status among our peers or is required for staff privileges. Furthermore, if membership is needed in the future in order to enroll in a program or obtain a particular benefit, an individual may join at any time without renewing their membership when that service or benefit is no longer required. There is also no sense of pride or need for belonging felt by physicians. And, as with the Pennsylvania

Society of Anesthesiologists (PSA) and the American Society of Anesthesiologists (ASA), membership in one requires membership in the other along with the membership expenses of both. Therefore, if an individual does not want to be a member of one, they cannot be a member of either. Lastly, membership dues have been maintained or, in most cases, increased over the last few years even though salaries are declining. In fact, as with the ASA, the dues have increased substantially and the member benefit costs, such as admission to the annual meeting, have increased as well.

The next question is, “Is a certain level of membership required for the solvency of the organization?” The three boards that I am involved with are actually quite financially stable. In fact, the Pennsylvania Medical Society (Pa Med Soc) is one of the wealthiest medical societies in the country. The ASA is not considered financially strapped either.

One argument as to why they continue to worry about membership regardless of financial need is that the yearly budget must be “neutral.” Not sure why if the money is in the bank or investment portfolio to keep the organization running for decades. Another is that a high membership number promotes respect from those on the outside, such as legislators. If the latter is true, then we can say we represent all the physicians in the state, because we do, when asked.

Pa Med Soc is about 30%.) This has left the organization frantic to correct the problem; a level of concern that is felt by the majority of medical organizations that are undergoing similar declines.

In my opinion, societies should not care about the numbers and should do no more than “usual” to promote membership. If 100% membership is desired, make it free. If that cannot or will not be done, then societies must do their best job to serve the physicians of the state or the specialty and let the merits of their work drive membership. If there are benefits that societies can reasonably offer to members, such as free or discounted CME acquisition or discounts for programs such as the ASA’s Anesthesia Quality Institute, then so be it; otherwise, they should get back to business as usual.

By the way, I do have an issue with those that choose to decline membership and allow the rest of us to shoulder the weight in costs, time and sweat to promote and defend our specialty. They should feel some level of remorse for accepting the benefits of the work of those few in the minority that are active members. Hopefully, they use the money they save to cure cancer, feed the hungry or promote world peace.

Membership is an individual decision that forces potential members to consider both presumed benefits and membership costs.

The Pa Med Soc has about 25% of Pennsylvania physicians as members with a 1% decrease yearly over the last couple of years. (Interestingly, the proportion of anesthesiologists that are members of the Central PA Medicine Fall 2024 7

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MEMBERʼS SPOTLIGHT 2026 will represent the 160th anniversary of the founding of the Dauphin County Medical Society. The society has a rich and storied past that is closely intertwined with the history of Dauphin County and the Susquehanna Valley.

On the occasion of the 1966 centennial anniversary of the Medical Society, a volume titled History of Medicine in Dauphin County Pennsylvania, was written by George Lauman Laverty, MD, Society Historian, and published by The Telegraph Press in Harrisburg. To read this book, is to marvel at the earlier generations of physicians who strove to give to the community “the full measure of their medical knowledge and surgical prowess.” No doubt, someday, future physicians will look back at the profession and practice methods of our current times. Hopefully, their bemusement will be balanced by regard and appreciation for the current efforts of our generation to advance medicine. With this in mind, it seemed like a promising idea to spotlight current members of the Dauphin County Medical Society who have spent the bulk of their professional life in central Pennsylvania. The intent is to make this spotlight a regular feature in the Central Pennsylvania Medicine magazine and to allow readers the opportunity to benefit from the insights and wisdom of our senior physicians. To start off this new feature, the editors have selected Mary A. Simmonds, MD, to be the inaugural physician member. We hope the readership will enjoy getting to know Dr. Simmonds and look forward to meeting many other physicians who have played a significant role in the delivery of medical care in central Pennsylvania.

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r. Mary A. Simmonds holds the remarkable distinction of being the 4th generation of a medically focused family from Pennsylvania. Her great-grandparents were pharmacists who established their practice in Shamokin, PA, with the Simmonds Pharmacy.

Her grandfather was of a generation that could graduate from high school and be directly admitted to medical school. He went on to become a general practitioner in the Shamokin area where he practiced this specialty his entire career. Dr. Simmonds has in her possession, the certificate he received for performing 50 years of continuous medical practice. Following in his footsteps was Dr.

It was through her father’s long and numerous connections in the medical community that Dr. Simmonds grew to form her interest in pursuing medicine.

Simmonds’ father, Henry T. Simmonds, MD, who attended medical school during WWII and served in the military. Afterwards, he trained to become a radiologist. According to Dr. Simmonds, her father was hired by Dr. AZ Ritzman to become only the second radiologist in Harrisburg. It was through her father’s long and numerous connections in the medical community that Dr. Simmonds grew to form her interest in pursuing medicine. She was introduced to Herbert S. Bowman, MD, a hematologist renowned for his clinical and teaching skills who became her inspiration 8

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and mentor for pursuing hematology as a career specialty.

TRAINING AND PROFESSIONAL CAREER

Dr. Simmonds attended Smith College, a private liberal arts college in Massachusetts, graduating in 1971 with a bachelor’s degree in biological sciences. Her parents, probably recognizing the limited availability of transportation, permitted Dr. Simmonds to have a car for school and steered her towards an Oldsmobile dealership in Lemoyne where they bought their cars and knew the owner. Richard Stewart was the salesman at this dealership. They struck up a friendship that eventually led to matrimony but first Richard would go on to attend Duke Law School while Mary matriculated at the Medical College of Pennsylvania (MCP) in Philadelphia. This allopathic medical school, originally chartered in 1850 as the Female Medical College of Pennsylvania and renamed Women’s Medical College of Pennsylvania in 1867, was the first medical college in the world to train women only to earn the MD degree.

In 1970, male students were accepted and the school dropped Women from its title. MCP would merge with Hahnemann University in 1993 to become MCP Hahnemann School of Medicine. In 2002, Drexel University acquired MCP Hahnemann University and renamed it Drexel College of Medicine. Dr. Simmonds graduated from MCP in 1975 and is looking forward to next year when the 175th-year celebrations will be held.

Dr. Simmonds pursued her internal medicine training at Geisinger Medical

MARY A. SIMMONDS, MD

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MEMBERʼS SPOTLIGHT

Center in Danville, PA, and followed residency Dr. Simmonds has successfully woven a rich and varied career with a two-year fellowship in hematology at as a clinician, researcher, teacher, and national leader in her Thomas Jefferson University, in Philadelphia, the same institution where her mentor Dr. specialty of medical oncology.

Bowman had trained. Medical oncology being a relatively new specialty in the late ’70s and Dr. Simmonds now married to her female medical students at Drexel College attorney husband/car salesman and looking of Medicine. She remains gratified with the to return home to central Pennsylvania, made efforts made by Drexel University to help it possible for her to complete an additional preserve the legacy of MCP and Hahnemann year of fellowship training at the Milton S. – two distinguished schools of medicine that Hershey Medical Center. She would spend the contributed to the greatness of Philadelphia’s next nine years practicing academic medical medical history. Dr. Simmonds also graciously NOTES TO MYSELF oncology and pursuing clinical research in donates time to the Penn State College of pain management and palliative care. Dr. Medicine to interview prospective applicants. (A few thoughts about medicine and Simmonds entered private practice in the late Closer to DCMS, Dr. Simmonds served as retirement from Dr. Simmonds.) ’80s with a multispecialty group for 7 years the 131st president of the Dauphin County before leaving to join the oncological practice Medical Society. of Drs. A. Thomas Andrews and Shashikant “I had a wonderful career and I Patel where she remained until 2022.

PERSONAL would want to become a physician Dr. Simmonds describes herself as a if I was re-born. No matter how passionate knitter, which is no small wonder AMERICAN CANCER SOCIETY far medical science advances, In 1981, the Pennsylvania Division of the considering how rich and detailed the tapestry fundamentally the physician is American Cancer Society (ACS) happened to of personal and professional achievements she responsible to safely integrate this be across the street from the medical center. has accomplished. Dr. Simmonds continues knowledge to heal the individual She and some colleagues went over to check to reside in the same house since age 7 in New patient. It is a great responsibility. it out and she ended up being recruited to Cumberland, PA. She is involved in many It is also a privileged relationship be on a committee. This first assignment lead community activities and continues to travel with the patent and their family. to becoming the chair of the committee and extensively. Dr. Simmonds is proud to be a I have been privileged to be in a within 7 years, Dr. Simmonds became the member of the Dauphin County Medical family legacy of medicine. This second woman president of the Pennsylvania Society Alliance, an organization that she Division of the ACS. Her trajectory continued reports will celebrate its 100th anniversary in legacy included “you die with upward with national committee assignments 2026. Mary and Richard have one daughter, your boots on” and that was the culminating in her ascendancy to become The Reverend Doctor Anne W. Stewart, who case with my grandfather and the first woman president of the national is the Executive Vice President of Princeton father. As I approached the age of Theological Seminary.

American Cancer Society in 2003. retirement and fortunately finding

SERVICE

Dr. Simmonds has successfully woven a rich and varied career as a clinician, researcher, teacher, and national leader in her specialty of medical oncology. Through the ACS, she has traveled around the United States and throughout the world, helping to promote a greater recognition for cancer research and care delivery that has resulted in higher cancer survival rates. Although formally retired from active clinical practice, Dr. Simmonds continues to devote her time to important medical endeavors both locally and beyond central Pennsylvania. She currently chairs a development committee in the Penn State Cancer Institute at the Hershey Medical Center. She has created and established the Mary A. Simmonds Endowed Scholarship for

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The editors of Central Pennsylvania Medicine hope you have enjoyed this spotlight on Mary A. Simmonds, MD, which is the first of many more articles to come that celebrate the remarkable heritage of our colleagues in the Dauphin County Medical Society. Thank you, Dr. Simmonds, for sharing your story!

myself in good health, I needed to define my own philosophy. There is a time to retire and to retire with grace. Life evolves as we all grow and age. The time of retirement can bring so many additional experiences. We can continue to nurture our family and friends.

It is time to continue to develop skill and knowledge and passion in fields of personal interest.”

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THE GUNDER FAMILY MAKES SUBSTANTIAL CONTRIBUTION TO GROW THE

Scott A. Gunder, MD, DCMS Presidential Scholarship

By JESSE GUNDER

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he Scott A. Gunder, MD, DCMS Presidential Scholarship and the Dauphin County Medical Society are excited to announce a generous contribution from the Gunder Family along with changes to the scholarships’

Continued on page 12

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administration, allowing for larger scholarship awards and for the first time giving multiple annual awards to deserving medical students at Penn State College of Medicine.

The Scholarship is named for and honors the legacy of Dr. Scott A. Gunder, a Dauphin County Gastroenterologist and past President of the Dauphin County Medical Society (2000).

A native of central Pennsylvania, Dr. Gunder received his Doctor of Medicine from Hahnemann University and subsequently his internal medicine residency was completed at Pennsylvania State University. He was also a clinical instructor of Gastroenterology at Penn State University. Dr. Gunder had an enduring dedication for providing compassionate care for his patients and at the same time providing leadership to the medical community. In May of 2000, Dr. Gunder lost a brief but courageous battle with cancer and died at the young age of 39. His wish was to continue his contributions to the community even after his far-too-early passing.

Dr. Gunder recognized the challenges faced by many medical students, one of them the financial costs associated with entering the profession.

The scholarship was his vision to ease some of that burden and support passionate and deserving medical students in their 2nd year of learning at the Penn State College of Medicine.

Eligible candidates must also be residents of Pennsylvania. “ T h e Gu n d e r Fa m i l y i s delighted to be able to help in the continuance of Dr. Gunder’s wishes with this contribution,” said Scott’s brother, Jesse K. Gunder, III. “My brother had a heart for medicine and a love 12 Fall 2024 Central PA Medicine

of people that our family is delighted to perpetuate through this scholarship. We see the gift as a means of paving the way for a new generation of Pennsylvania physicians well into the future.”

The Scholarship is named for and honors the legacy of Dr. Scott A. Gunder, a Dauphin County Gastroenterologist and past President of the Dauphin County Medical Society (2000).

The committee is reviewing significant enhancements to scholarships for the 2024–25 school year, with the goal of providing awards to second-year PSCoM students.

“On behalf of the Dauphin County Medical Society, we express our deep gratitude to the Gunder Family for their tremendous support of students, the community, and the medical profession here in Pennsylvania,” said Dr. Joseph Answine, current President, DCMS. “Our county has always been a place where medical professionals can thrive, and at DCMS we have the pleasure of supporting physicians throughout their entire careers.

Supporting a thriving medical community in Pennsylvania is our core mission. Thanks to the Gunder Family’s generous philanthropy, we’re excited to inspire even more young talent in the practice of delivering high quality healthcare in the state of Pennsylvania.”

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FEATURES

GLOBAL HEALTH SCHOLARS The Global Health Scholars program at the Penn State College of Medicine invites medical students to participate in immersive trips to several sites around the world. This provides educational opportunities for students interested in international health, including challenges that commonly present a greater burden to disadvantaged populations. Students travel to their site at the end of their first year of medical school and return during their fourth and final year. The global health scholars of the MD Class of 2027 completed their first trip abroad, and we asked them to reflect on their experience.

If you had to choose one word to describe your global health experience this summer, what would it be? Reflect on how this word encapsulates your journey and its impact on your understanding of health equity and advocacy in healthcare locally and/or globally.

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IMPACT

PERSPECTIVE

By RICHA SANDEEP, VIETNAM

By MIZUHO OBAYASHI, NEPAL

If I had to describe my global health experience to Nepal in one word, I would choose impact. We were fortunate to meet many healthcare trailblazers, oftentimes the first to put a voice to a shortcoming in their community and acting on that need. Among those were pioneers in the fields of mental health, infertility, health IT/integration, and community medicine, not to mention the countless working in community mobilization and outreach at local facilities.

While these leaders made a profound impact on the lives of their respective communities, the medical students I met made a more personal impact on mine. I witnessed the impact of their genuine compassion and curiosity as they met with patients at their

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homes, focusing on understanding factors that may be affecting a patient’s ability to have equitable access to care and how they could help to mediate those. To see students my age having a visible impact on their patients was inspiring, and gave me the confidence that I could do the same even this early in my career.

My trip instilled in me the belief that I can do something that impacts lives in a positive manner, whether that be via advocating for an entire community or simply providing a voice to the patient in front of me. I came back from my trip with a new appreciation that a single person can make a significant difference, a core belief that had drawn me to this profession in the first place.

Perspective. I will never forget the view from the public hospital in Hanoi, Vietnam.

Through the smudged window, towering in the distance, stood the sleek, modern archetype of the private hospital — a place where I struggled to see more than five patients a day. The polished marble floors, the hushed hallways, and the empty waiting rooms echoed a stark irony. Just down the street, the public hospital overflowed. Beds spilled into hallways, and patients crowded around, pleading for care from anyone who had a moment to spare.

That image, a pristine, state-of-the-art private hospital taunting the starkly contrasted public hospital, encapsulates my experience in Vietnam. Perspective is the word that defines this journey. It’s about seeing the world through a different lens and realizing that access to healthcare isn’t just about proximity to a hospital; it’s about trust, affordability, and deeply rooted societal factors.

As I moved between these two worlds, my understanding of health equity expanded. The disparities weren’t just in resources; they were in the very fabric of how people approached their own health. In many Vietnamese communities, a local hospital visit may not be a patient’s first choice due to long-standing mistrust of rural and suburban healthcare, as well as access issues. This journey changed the way I think about healthcare, not only abroad but also at home. It reminded me that advocacy isn’t just about providing care — it’s about ensuring that care is both accessible and culturally meaningful, no matter where you are.

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FEATURES

REVEALING

My global health trip to Macha, Zambia this past summer was deeply revealing. In my first week, I was struck by a wave of doubt and sadness as I confronted the harsh realities of the world I had stepped into. I remember staring at the NICU board, trying to convince myself that the reported mortality for the past month was wrong. In my mind, it was impossible that so many mothers left the hospital, their arms empty of the babies they had hoped would come home.

In the hospital, and through conversations with doctors and nurses, I began to unravel the complexities of the healthcare landscape. I saw the impact of limited diagnostic testing, scarce drugs, and inadequate equipment. I also witnessed the less obvious effects of the tension between traditional healing practices and Western medicine. Distrust between the two led to deception and misunderstanding, leaving patients caught in the middle, their care suffering for it. I learned that health disparities are not just about resource shortages but also about integrating cultural practices.

In the following weeks, my perspective on health equity and advocacy shifted. I realized that addressing health challenges requires more than awareness of systemic issues; it demands a nuanced understanding of how cultural, economic, and systemic factors intersect.

By BRIGID DECK, ZAMBIA

My time in Zambia was invaluable and revealing. I now better appreciate what was only a concept to me before: considering broad cultural contexts with empathy and respect is fundamental to delivering equitable healthcare.

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RECIPROCAL

INSPIRING

By AMAR KASSIM, BRAZIL

By AKHILA KONDAKA, GHANA

If I had to choose one word to describe my global health experience this summer, it would be “reciprocal.” In Ghana, I witnessed how their tiered healthcare system is meticulously structured to serve both urban and rural populations, ensuring that even those in the most remote areas can access essential health services. The system’s foundation lies in community-based care via the health centers and CHPs compounds, supported by district hospitals and regional medical centers, creating a referral process that addresses healthcare needs at all levels.

This approach to healthcare equity shocked me. It reinforced the idea that effective healthcare must be tailored to meet the needs of each community it serves, and Ghana has precisely that. Ghana has perfectly set up a healthcare system that works for them, emphasizing community-based

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care, traditional herbal medicine, and a standardized EMR system. This tiered system also perfectly addresses a challenge most would need help with: resource scarcity.

Using nurses and physician assistants to run community health centers and CHPs compounds reduces the burden on larger district and regional hospitals and their physicians and is ultimately critical in early diagnosis and prevention.

Reflecting on the U.S. healthcare system, I realized we can learn much from the Ghanaian model. Implementing a more structured, tiered approach like the one in Ghana could significantly improve healthcare access, particularly in underserved rural areas.

By strengthening community-based healthcare and ensuring a smoother transition between different levels of care, we could address some of the disparities that plague our system.

Inspiring — the one word that perfectly encapsulates my global health experience this summer. Traveling solo to São Paulo, Brazil, as part of the global health program at PSUCOM, I found myself immersed in both cultural and academic inspiration.

Having never been to South America, I was captivated by the rich blend of tradition and innovation that the city had to offer.

Academically, I contributed to tuberculosis research and rounded at the trauma center of São Paulo’s largest hospital.

When I rounded at the hospital, I saw patients with bullet wounds, victims of roof collapses, and suicide victims. In the midst of all this suffering, the doctors stood as beacons of hope. Their resilience and unwavering dedication to their patients were nothing short of inspirational.

However, the greatest inspiration came from the international medical students I met through the Winter Schools at the University of São Paulo. Seeing the obstacles my friends face in their home countries made me even more appreciative of the opportunities I’ve had in the U.S. As a Yemeni immigrant, I felt that my transition to the U.S. had spared me many of these challenges and allowed me to maximize my potential. This experience has strengthened my gratitude and fueled a renewed sense of purpose as I enter my second year of medical school.

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FEATURES

EMPOWERING

By JULIA FAUST, AUSTRALIA

With billions of words at my disposal, the one that keeps returning to me when reflecting on my time in rural Australia is empowering.

The three weeks I spent in Mildura exposed me to the resilience of Aboriginal communities as they navigated health challenges rooted in systemic inequalities.

It was empowering to witness the blend of traditional knowledge with modern healthcare, where cultural practices—such as the use of medicinal herbs from the Bush—were integrated into patient care. This collaboration not only enhanced healthcare delivery but also rebuilt trust with a population

historically neglected and discriminated against. Along the same lines, Aboriginal Health Workers, serving as liaisons between the community and clinics, played a crucial role in empowering Indigenous voices to shape their own healthcare solutions.

This experience empowered me as well.

I saw how deeply health disparities are intertwined with social determinants like education, housing, and economic opportunity. Cultural immersion outside the clinic, particularly through participating in NAIDOC Week events celebrating the Aboriginal community, allowed me to connect

with the community beyond just a patientprovider relationship. These interactions, built on trust and understanding, were among the most meaningful connections I made in Australia.

I left Mildura with a renewed understanding of advocacy in healthcare. True health equity requires listening to, learning from, and amplifying the voices of marginalized communities. Empowerment is not just about providing care, but about fostering deeper cultural respect and collaboration.

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I AM LATINA

What Hispanic Heritage Month Means to Me

By DENISE OCAMPO, NORTHERN ARIZONA UNIVERSITY – B.S. BIOMEDICAL SCIENCE 2020, PENN STATE COLLEGE OF MEDICINE – M.D. CLASS OF 2027

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B

eing Latina is something that until recently, I didn’t know what it meant. When standardized forms ask for your race, often you see 5 boxes. White, Black, Native American, Pacific Islander, Asian… none of the above, I think to myself. Yes, some of my ancestry comes from Spain and Portugal… thank you colonialism. However, calling myself White seems inaccurate. My parents come from Yucatán, the oasis that exists in the southeastern peninsula of Mexico – or so I’ve heard. I have not been to Mexico since I was 2 years old, far too young to remember.

According to my Ancestry DNA results, I am 59% Indigenous American to the Yucatán peninsula, with ties to Mayan ancestry. Does that make me Native American even though I am not affiliated with a tribe? The Mayans haven’t been around for a long time; I have no idea if I’m considered Native American.

I check the “Other” box and write Mayan.

But even writing Mayan feels wrong. I was born in east Los Angeles, and my parents decided to move to Maui, Hawaii when I was 5 years old. My formative years were spent there, and although I cherished growing up in such a special place, I always felt that I was missing that sacred bond others had with their culture. I had lost the Spanish language, which was evidently my first language, evidenced by home videos of me as a toddler. It was rare to meet other Latinos, especially other Mexicans, on Maui. There were many people of partial Puerto Rican descent back from the sugar cane plantation days, however, many of those people were also separated from the Latino community, having been subjected to colonization and capitalism many decades ago. I had never been to a quinceañera or a baile before. For many years, I felt judgment and disappointment when people found out I was a Mexican who did not speak Spanish.

On the other hand, I found it difficult to find a community in Maui where I felt truly accepted.

When I moved to Flagstaff, Arizona for college, I made many Latino friends. Some of them would invite me to their homes for Thanksgiving and Christmas, where it was exciting to see my culture vibrant in people and celebrations. I attended a Mexican wedding and saw a traditional marriage ceremony. My good friend’s mom even taught me to make tamales – yet another experience

I felt robbed of. These made me feel excited and connected to my roots. However, I still couldn’t help but feel like an outsider looking in. What kind of Mexican has never made a tamale before? What kind of Latino does not know how to speak Spanish? These are the questions that ran through my mind and provided me with imposter syndrome of who I was and my true identity.

As I lived in Flagstaff preparing for medical school, I worked with many patients. However, I took a large interest in the Indigenous community, given our proximity to the Navajo and Hopi reservations. Health disparities ravaged through these communities, and I felt that empathy was lacking in healthcare for this population who was clearly in need.

I spent many hours on the phone with patients, scheduling with reservation clinics, and mailing letters in order to get these patients their appointments and assist in transportation efforts. It made me angry about the injustices they faced at the beneficence of colonization. I wanted there to be empathy for these populations who were so clearly suffering from the injustices served to their ancestors. I wished to see humanity. It was then that I knew I wanted to focus on issues faced by minority populations and right history’s wrongs.

Denise Ocampo

I wanted there to be empathy for these populations who were so clearly suffering from the injustices served to their ancestors. I wished to see humanity. It was then that I knew I wanted to focus on issues faced by minority populations and right history’s wrongs.

Coming to medical school, I was eager to get to work on these issues. I came in, your typical bright-eyed 1st-year medical student, ready to change the world. Little did I know, I would find that agent of change in the Latino community. I became involved in the Latino Medical Student Association chapter at Penn State. We were small — having just a few Latino medical students in our 150-person class. Nevertheless, we had a fire. We became a tight knit crew, recruiting allies and other Spanish-speaking classmates into our chapter.

Fellow Latino medical students welcomed me with open arms, accepting me for my journey and separation from our culture.

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They were willing to teach me and give me grace in my steep learning curve. Soon after, I became involved in advocacy efforts through the American Medical Association and the Latino Medical Student Association.

I quickly discovered the disparities the Latino community faced, and the striking similarities that I saw in the Navajo and Hopi communities I served. In medicine, I saw connections between the Latino community and my identity all too clearly. The prevalent medical issues disproportionately affecting

Being Latino means being resilient. In medicine, we fight a huge lack of representation – where only 6% of physicians are Latino, despite the population being nearly 20% and continuing to increase. the Latino community were diagnosed in my parents. I saw evidence of providers lacking cultural humility to Latinos when my dad’s trust in a provider was broken following poor informed consenting practices. I witnessed the lack of empathy and subconscious bias to the Latino experience, when my mom tried to communicate medication side effects and she was dismissed.

With these experiences, I had opportunities to reflect on what it meant to be Latino. Being Latino means being resilient. In medicine, we fight a huge lack of representation – where only 6% of physicians are Latino, despite the population being nearly 20% and continuing to increase. With many Latino being first generation and having grown up in immigrant communities, we face unique barriers in achieving higher education. Many Latinos in medicine – myself included – continue to advocate against systemic financial and social barriers to improve the process of achieving higher education for the generations that come after us. Being Latino also means being courageous. We break the molds of what we are expected to do. Ourselves and our ancestors took risks to be where we are today. We don’t settle for what we are given – we seek improvement for ourselves and our families. My dad loves to brag that in a single generation, we went from a high school dropout (him) to a soon-to-be doctor (me). That was thanks to his courage to leave behind his job in LA and start a business in 20 Fall 2024 Central PA Medicine

Hawaii, instilling hardwork and grit into me at a young age. Finally, being Latino means community. Our culture creates an innate feeling in us to collaborate with our others for the greater good. We are a family-centered culture, focused on making sure the ones we love are comfortable and safe. I did not grow up around extended family, but I had my immediate family and chosen family – and I treated them in this way. I realize now, I carry all these values with me. I have always been part of this community, even if it was not in a traditional way. Being Latino is much more than just speaking Spanish or traveling to Mexico every year. It is the values and attitudes my parents instilled in me, passed down each generation and becoming an inherent part of who I am.

As we celebrate Hispanic Heritage month, I continue to embrace my Latina heritage and explore the ways I can uplift this community.

I am continuing to learn Spanish, and hope to become fluent one day, in order to communicate with my patients and create an inclusive and comfortable environment for these patients. I plan to continue my advocacy efforts through the Latino Medical Student Association for increased Latino representation amongst medical students.

Furthermore, I plan to continue my work with the American Medical Association Minority Issues Committee on advocating for health protections and basic healthcare for immigrants, as well as pursuing health equity by acknowledging the rampant health disparities faced by Latinos. I have rediscovered my community, and I look forward to continuing this lifelong journey as a proud Latina.

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LEGISLATIVE UPDATES

PAMED

LEGISLATIVE UPDATES With this legislative session coming to an end, there was a flurry of activity on bills that relate to PAMED’s legislative priorities.

One area to highlight is PAMED’s continued vigorous opposition to bills that would expand the scope of practice to non-physician providers throughout the Commonwealth.

Senate Bill 25 (Bartolotta) and House Bill 1825 (Guenst), bills that would allow for the independent practice of nurse practitioners, were both reintroduced.

At the time of this writing, Senate Bill 25 passed out of the Senate Consumer Affairs and Professional Licensure Committee.

Senate Bill 25 is currently awaiting final consideration from the PA Senate. House Bill 2037 (Bullock) was introduced, which would allow pharmacists to vaccinate children as young as age three, and we expect a Senate companion bill to be introduced in the near future. We have also seen a push to allow psychologists to prescribe medications in House Bill 1000 (Frankel). PAMED, and our

physician specialty partners, will continue to advocate for physician-led team-based care.

The Pennsylvania Senate recently considered Senate Bill 739 (Vogel), legislation which would require health insurers to cover and pay for health care services provided via telemedicine. Senate Bill 739 passed the PA Senate with a vote of 49-1 and then passed the PA House with a vote of 194-8. The bill was then signed by Governor Josh Shapiro.

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Another advocacy priority for the Pennsylvania Medical Society is restrictive covenant legislation. As mandated by the PAMED House of Delegates, we continue to discuss the issue of non-compete agreements in physician contracts with a number of legislators. Interest in this area seems to be growing as lawmakers learn more about how these contractual agreements negatively impact patient access and continuity of care. Rep. Dan Frankel (D-Allegheny) has introduced House Bill 1633, a proposal that would outright ban the use of non-compete agreements in all physician employment contracts.

On April 17th, the Pennsylvania House of Representatives passed House Bill 1633

by a vote of 150-50. The bill had previously passed out of the House Health Committee on March 27th with a vote of 21-4. The bill was amended in the Health Committee to include a rural exemption, which PAMED had agreed to in previous sessions. PAMED pursued an amendment on the House floor, sponsored by Representative Torren Ecker, that would exempt private practices from the prohibition. The amendment failed with a vote of 99-102. House Bill 1633 was recently unanimously approved by the Senate Health and Human Services Committee. House Bill 1633 was then passed by the full PA Senate and signed into law by Governor Shapiro in July.

PAMED will continue to advocate for further

non-compete protections for physicians, including a private practice exemption.

The 2023-2024 Pennsylvania General Assembly legislative session is quickly coming to an end. There are only about five legislative session days between now and the end of 2024. While there are only a few number of days left this session, PAMED will continue to monitor legislative activity and advocate for you. Please keep an eye out for future versions of the Legislative Version of The Dose for a complete run-down of the entire 2023-2024 session.

Stay up to date on PAMED’s legislative priorities at

www.pamedsoc.org/Advocacy

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