HEALTH CARE
Prescriptive Paths Three Fielding School students and three recent graduates share what compelled them to address health care through a public health lens, why they chose their area of focus, and what they hope to achieve.
Michelle Keller, MPH ’14, PhD ’19 Research Scientist
WHEN I WAS IN ELEMENTARY SCHOOL, my mother had an episode of debilitating back pain, which eventually morphed into chronic pain. As she shuttled from doctor to doctor with few answers, she was prescribed a medley of medications — some with potential for dependence and many of which weren’t helpful, despite their significant risks and side effects. My family’s experience in navigating the medical system for chronic pain highlighted the challenges that many patients and their families face. These experiences shaped my desire to study how clinicians make decisions about prescribing medications for pain as a doctoral student in FSPH’s Department of Health Policy and Management. For my dissertation, I interviewed clinicians at one health system to understand how they made
Sebastian Ramirez MPH Student
decisions about patients’ risk for opioid addiction or misuse, and about adding new patients to their practice who have been taking opioids for a long time. I also analyzed more than 20,000 patient records to see whether clinicians were prescribing opioids appropriately.
I ENTERED PUBLIC HEALTH AFTER RECOGNIZING the commonalities in my experiences with helping others. I earned my undergradu-
Today, I work as an embedded research scientist at
ate degree in medical imaging, then worked as an X-ray technologist
Cedars-Sinai Medical Center, where I apply findings
at large health care systems in Philadelphia. At the same time, I
from my research to inform patient care. My current
volunteered for community organizations that served Philadelphia’s
research focuses on helping to identify patients
LGBTQ+ population. Seeing and learning about the inequities experi-
who might be taking medications (such as opioids
enced by this population — and living some of them as a gay man
and benzodiazepines) that place them at high risk
of color myself — it became easy for me to see the same inequities
for addiction, dependence, or overdose, and who
within health care. That led me to seek ways to improve the cultural
could benefit from patient-centered medication
competency of health care professionals and promote inclusion in
management programs. I’m also working closely
health care practices, toward the goal of better serving not only
with pharmacists and physicians to develop com-
LGBTQ+ people, but any marginalized or underrepresented group.
munication tools that improve discussions about medications between patients and clinicians. My
To achieve this, I taught health care professionals about intercul-
goal is to reduce the use of inappropriate or unnec-
tural communication, intersectionality, and systems of oppression.
essary medica-
Attempting to do this while still an X-ray technologist, my reach was
tions, tests, and
limited. Additionally, helping one patient at a time, while important,
procedures in
wasn’t enough for me. I felt that I needed to do more, and I found
health systems
public health to lie at the intersection of my career and service expe-
while maintain-
rience. Public health can teach me effective ways to pursue social
ing empathetic,
justice within a broken U.S. system that can harm those who need
high-quality care
the most help. With that knowledge, I can create systemic changes
for patients with
to help entire communities. Following my Fielding School education,
chronic pain.
I hope to earn a position in strategic planning and operations at a health care institution, where I can work to create these changes. 18
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