“Nature abhors a vacuum.”

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Evans-Rosedale Plaza, Fort Worth Texas, Pre-COVID19

In the laws of physics, unfilled spaces are “unnatural” and so any matter surrounding the empty space tends to fill it.

Communication about the COVID pandemic is no different. I’ve been absolutely floored, angered, and deeply ashamed at how inconsistent communication has been from the government (federal, state, & local) and (worse) the medical establishment. We have a national informational vacuum and no one’s stepping up to fill it. [ABIM, instead of having barbers give medical advice, how about we support Black physician entrepreneurs with business capital to start direct primary care practices throughout the country?]

Black people, your society is (once again) failing you. …

I’m a Democrat-leaning Black doctor with a ton of white conservative friends. If we are to survive the pandemics of COVID and systemic racism, we need all hands on-deck: especially the Black ones. Here are ten ways to save Black lives:

  1. Get a Doctor, Part 1: Give $100,000 grant to physician-led direct primary care practices that enroll at least 80% Black people.
    Direct primary care is a model of healthcare finance that cuts out the middleman (health insurers.) Patients pay their clinician directly; this creates a very important fiduciary relationship between the clinician and the patient. These relationships (clinical, fiduciary, compassion) improve adherence to treatment plans and health outcomes. Our current 3rd party payor system is opaque and biased against Black people, who have less money (due to inequities of wealth and income.) Since most DPC practices have a transparent fee (around $100 a month) this is the fastest affordable option to get Black people into a long-term medical home. To supercharge the rollout of getting Black folks care in a DPC practice, I suggest a 5-year interstate medical agreement, allowing physicians in any state to treat Black patients in any other state via telemedicine. (How can Black folks afford to pay $100 bucks a month? …

Hate healthcare? It’s your fault.

Paradigm shifts are hard and the human psyche is primed to be cautious of “the new”. The American psyche is even more headstrong — we’re an entitled mishmash of merit and charity that changes on a groupthink dime.

So when I launched a one-man crusade to shift our system from a health insurance-centric model to a patient-provider model, I knew I had my work cut out. Little did I realize the toll our unique American brand of passive-aggressive apathy would take on me.

I approached from the academic perspective. Emails, hand written letters, tweets, and Facebook posts to economists, think tanks, professional associations and peer reviewed journals. …

After 4 years of undergrad, 4 years of medical school, 5 years of residency in pediatrics and child psychiatry, $200K of debt, and 3 years of being a staff “front-line” psychiatrist, I almost walked away from medical practice.

I couldn’t understand how the greatest country on the planet could create and then maintain a health care system that wasn’t focused on health, but on profit, obfuscation, and worsening inequality. I fully believed that I was “working myself out of a job” as a career goal. But each day I went to work, I was reminded that I was not the norm; in fact, when I did speak up about ways to improve the system, to make things more efficient, I was admonished. …


Dr Brian J Dixon

We can save ourselves from ourselves…if we want to. www.DrBrianDixon.com

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