In Sickness and In Health

Above: Emergency room physician Gina Piazza (D.O. '99) is among the thousands of NYIT alumni who have dedicated their lives to providing health care solutions to patients around the world.

NYIT graduates speak out on the future of medicine

By David McKay Wilson

As an emergency room physician, Gina Piazza (D.O. ’99) serves on the front lines of America’s health care delivery. Day after day, uninsured citizens show up seeking her care at the MCGHealth Medical Center in Augusta, Ga.

“There are so many heart-breaking situations,” says Piazza. “There may be someone with a job, but no insurance, or someone with a job who can’t afford the premiums. Then there are people without jobs, or those who are disabled and can’t get on Social Security. I see everybody who falls through the cracks.”

Those cracks have widened so much that an estimated 47 million Americans—roughly 20 percent of the population under age 65— lack health care coverage. At the same time, health care costs—at more than $2.2 trillion a year—continue their inexorable rise, now comprising 16 percent of the U.S. gross domestic product. Federal officials, meanwhile, have been struggling to find consensus on a reform bill to provide access to quality, affordable health care. 

Piazza began her medical career with a firm grounding in health care issues after earning a certificate at NYIT’s Training in Policy Studies (TIPS) program while a medical resident in 2002-2003. Since then, she has traveled annually to Washington, D.C., to lobby for health care reform. 

“Over the years I’ve gone to Capitol Hill, I’ve come to learn that the voices of physicians really do matter,” says Piazza, who serves on the Emergency Medical Services Committee of the American College of Emergency Physicians. “It’s important to provide education to members of Congress. We go speak for our patients, and if they can help our patients, that’s what matters most.”

Piazza is among the thousands of NYIT alumni who earn their living in the sprawling U.S. health care system as doctors, nurses, physician’s assistants, physical and occupational therapists, researchers, policy makers, and others. Each brings his or her own perspective to the unfolding saga of health care reform in a nation struggling to care for all its citizens in a time of economic stress and high unemployment.

“I am optimistic that they’ll come up with a compromise in Washington,” says Sonia Rivera-Martinez (D.O. ’02), who practices family medicine at the Medisys East New York Diagnostic and Treatment Center in Brooklyn, N.Y. “It’s not all going to be favorable for physicians, but you need to look at these issues from a higher ground and a wider perspective, not just one that will hit our pocketbook. If you are looking at creating a system that provides access and improved quality while still being cost-efficient, you have to take into account many things.”

But Yevgeny Zadov (D.O. ’07) is concerned that lawmakers may move too quickly, resulting in legislation that creates more problems than it resolves.

“Going too fast could lead to errors and unforeseen circumstances,” says Zadov, a third-year resident working at Long Beach Medical Center in Long Beach, N.Y.

Bette Coppola, NYIT coordinator of health policy programs, and Professor Norman Gevitz of the Center for the Culture and Humanism in Medicine help ensure that medical students understand the intricacies of health care legislation.

Norman Gevitz, professor of the history and sociology of medicine at NYIT’s College of Osteopathic Medicine (NYCOM) and director of the university’s Center for the Culture and Humanism in Medicine, says legislation under review in Washington could go a long way toward reaching the goal of universal coverage in the United States. The compromise bill under consideration as of mid-January would cover an estimated 94 percent of Americans, still leaving 23 million without coverage. Gevitz reports this would be the biggest expansion of coverage in the nation since the 1960s, when the Medicare program for the elderly and Medicaid program for the indigent were established.

“When Medicare was adopted, the elderly who didn’t have insurance suddenly had it, and they came to doctors’ offices in droves,” says Gevitz, author of The DOs: Osteopathic Medicine in America. “They were hospitalized in greater numbers as well, and the great beneficiaries, along with the patients, were physicians and health care providers. The trick now is, what will be done to decrease unnecessary utilization? People need to be seen when they really need to be seen in order to control costs.”

These are among the issues that Gevitz discusses in the TIPS program, which helps second- and third-year residents improve their understanding of health policy. That understanding provides a foundation for leadership roles in professional organizations involved in health policy and offers students additional expertise so they speak with broad-based authority to government officials.

“More than ever, it’s important for physicians to learn the background and mechanics of our health care system,” says Bette Coppola, coordinator of health policy programs at NYIT. “With all the confusion about health care in America, these physicians will be the people who will educate policy makers and the public, and be advocates for their patients.”

Bernadette Riley (D.O. ’05), chief resident for family practice at Long Beach (N.Y.) Medical Center, says TIPS has opened up her eyes to the intricacies of the health care system, which she has experienced first-hand in treating low-income patients served by Medicaid.

“In the TIPS program, we have learned to look at both sides of the issue,” Riley says. “It’s important to realize as a physician, it’s not always about reimbursement and tort reform.”

It is tort reform, however, that could help expand access, says Vijay Sidhwani (B.S. ’01, D.O. ’04), who participated in TIPS in 2008. As he enters private practice, he is faced with potential malpractice insurance rates that range from $5,000 to $200,000 a year, depending on what specialty he decides to pursue. Lawsuits against physicians have driven up rates and encouraged them to practice “defensive medicine,” leading to unnecessary medical tests just to make sure that their bases are covered in case a diagnosis proves inaccurate.

“Practicing defensive medicine contributes to the way health care costs have skyrocketed,” says Sidhwani. “The threat of lawsuits can be a huge stress on physicians.”

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