"Beyond the Fill Rate" is an ongoing series examining what the pediatrics workforce data is actually telling us. This is Part 1.

This year’s NRMP Match has come and gone, and on its face, the numbers might suggest a well-known crisis is improving.

The statistic most commonly cited in medical education circles, is the residency fill rate and right now for pediatrics, it looks reassuring enough to silence alarm bells.

The fill rate functions as a report card metric across specialties: a shorthand signal that graduates are choosing a field, that seats are being filled, that things are okay.

In the 2026 Main Residency Match, pediatrics filled 94.4% of its categorical positions down slightly from 95.3% in 2025, but well above the troubling low of 91.8% in 2024.

To those drawn to headline statistics, this reads like an underdog bounce back story.

And to anyone outside of medicine, a 94.4% fill rate probably doesn’t sound like a crisis.

That’s an A minus on a report card, not too shabby.

But to those who look past this vanity metric, the picture is far more troubling and in our current political climate, it is one that will not improve on its own.

In fact, it may get significantly worse.

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The Statistic We Should Actually Be Talking About

While many viewed the 2024 NRMP categorical pediatrics statistics as a failure, I saw them as the first canary in the coal mine.

While others focused on the fill rate underperforming, my attention shifted to something more revealing: a fundamental change in who was filling those categorical positions.

That shift has not reversed. It has only widened.

The fill rate tells you how many seats got filled.

It doesn’t tell you who filled them.

That’s where the story deepens.

The story of US MD seniors, those who graduate from American allopathic medical schools tell us everything we need to know.

1,889 US MD seniors in 2015. 1,464 in 2024. A 22% decline in a single decade. Family medicine went up 8%. Internal medicine went up 8%. Pediatrics went the other way.

The 2026 Match makes this trend impossible to ignore.

US MD seniors filled just 45% of categorical pediatrics positions this cycle, the lowest percentage in the last five match cycles.

To put that in context: in 2022, US MD seniors filled 58% of those same positions.

That is a 13-percentage-point collapse in four years.

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One fluctuating fill rate headline does not reverse a structural trend of this magnitude, and the forces pushing US MD students away from pediatrics remain firmly in place.

So who is filling those seats?

Here is where the numbers become sticky and concerning.

While US MD seniors have steadily retreated from pediatrics, interest among other domestic applicant groups has remained remarkably stable.

Over the past five match cycles, US DO seniors have consistently filled roughly 20% of categorical pediatrics positions, and US citizen IMGs approximately 7%.

The desire to enter pediatrics among those graduates has not wavered.

What has changed significantly is the share of positions being filled by non-US citizen international medical graduates (non-US IMGs).

The numbers tell a striking story.

In 2022, non-US IMGs filled 350 categorical pediatrics positions. In 2026, that figure had risen to 684, a near doubling in just five years.

In 2024, non-US IMGs crossed the 15% threshold for the first time, while US MD seniors had fallen to filling just 48% of positions.

By 2025, non-US IMGs accounted for approximately 19% of filled positions while US MD seniors fell to 47%. In 2026, that figure climbed again to 22% and 45% respectively.

From my assessment, if this trajectory continues (little reason to believe it won’t) we are approaching a threshold where 1 in 4 categorical pediatrics positions is filled by a non-US IMG.

Why this matters right now, in 2026

It does not matter to me who fills these categorical pediatric positions.

I am happy to welcome anyone who wants to provide quality healthcare to our next generation of Americans

But I would be naive to believe we are living in a normal times, where this distinction does not matter.

With the political climate as it is, I am genuinely concerned for my non-US IMG colleagues.

To be training in an environment ripe with anti-immigrant sentiment, I am concerned about their safety and whether the pediatric profession is equipped with the resources to help them thrive, not merely survive.

As they match into these US based residency programs they deal with many challenges from visa sponsorship, work authorization, and in many cases figuring out a pathway to remain in the US to practice after training.

Broader anti-immigration policy shifts have already begun to affect international medical graduates at every stage of training.

In my view, the situation in which this trend reverses, where immigrant-born physicians stop filing pediatric positions, is one where the environment becomes so inhospitable they simply stop coming.

That outcome would not only close the door on these amazing majority overqualified physicians, but will gut an already stretched pediatric workforce.

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An Indictment of Apathy, Not of Physicians

To be plain: this article is not written to condemn non-US IMG physicians.

It is a call out to the American pediatric profession to reckon with its collective apathy towards aggressively solving its domestic recruitment crisis, while congratulating itself on a vanity metric year after year.

We are now dealing with the consequences. The data poses the uncomfortable question that fill rate never brought accountability in us to ask.

What would happen to American pediatrics if the international pipeline dried up overnight?

In this political climate, that question deserves an immediate and direct answer.

That answer can only come from us starting much earlier than match day.

It starts at the level of K-12 education, college, medical school, and the pediatric clerkship.

In the next article, we will look at what’s actually driving US MS seniors away from pediatrics and more importantly whether any of it is reversible.

"Beyond the Fill Rate" Series Part 1: Pediatrics Is Filling Its Residency Spots. So Why Am I Alarmed? (You are here) Part 2: What Is Quietly Pushing America's Best Medical Students Away From Treating Children? (Coming soon)

As a pediatric endocrinology fellow, I spend a lot of time around medical students and residents who are still figuring out what kind of physicians they want to become.

Over time, I have noticed a pattern.

They admire pediatrics.

They respect pediatricians.

Many of them genuinely love caring for children.

But the same concern keeps coming up.

They are not convinced that pediatrics allows for a sustainable life, not after the years of sacrifice it takes to get here.

That belief is reshaping our field.

And we are watching it show up in the data.

The pipeline is sending us signals. Are we listening?

In the 2025 NRMP Match, pediatrics offered 3,193 residency positions and filled 3,043, leaving roughly 150 unfilled. The fill rate rebounded slightly to 95.3% after a sharp drop the year before, when it fell from 97.1% to 91.8%, one of the largest single-year declines the specialty had seen in years.

At first glance, that might not seem alarming.

It should.

The residency Match is only the first signal.

The real problem shows up when you follow the pipeline further: into fellowships, into subspecialty care, into the communities that will be looking for pediatric specialists five and ten years from now.

The fellowship data is the warning siren

The 2025 NRMP Medicine and Pediatric Specialties Match data should be required reading for every pediatric leader in this country.

Across all pediatric subspecialties combined, nearly 35% of programs went unfilled and over 21% of positions sat empty.

But when you look at individual specialties, the picture gets worse:

Pediatric nephrology: 78% of programs unfilled, with over 61% of positions unmatched.

Pediatric endocrinology: 65.6% of programs unfilled, with more than half of all available positions going unmatched.

Adolescent medicine: 58.6% of programs unfilled.

Pediatric infectious disease: 55% of programs unfilled.

Pediatric pulmonology: 48% of programs unfilled.

Developmental-behavioral pediatrics: nearly 43% of programs unfilled.

Now compare that to the adult medicine side. Adult cardiology filled 100% of its positions. Adult gastroenterology filled 99.7%. Adult hematology-oncology filled 99.5%.

These physicians train in the same hospitals.

They graduate from the same medical schools.

They carry the same debt.

They are simply making different decisions.

And when you look at the numbers, it is hard to argue they are making the wrong ones for themselves.

When subspecialty fellowships go unfilled, wait times grow longer. Families travel farther. Primary care physicians manage complex conditions without the specialist support they once had. In some regions, pediatric specialists are already hard to find. When shortages grow, children do not simply shift into another specialty. They wait.

The harder truth inside our field

We could blame this entirely on outside forces: chronic underfunding, Medicaid reimbursement rates, political neglect of children’s health.

Those things are real and they matter.

But there is something else that is harder to say out loud.

We have not been advocating for ourselves.

Pediatrics has always prided itself on sacrifice for children.

The problem is that over time, we became uncomfortable fighting for our own profession.

We watched the warning signs pile up: declining interest among medical students, fellowship programs struggling to recruit, inpatient pediatric beds disappearing across the country.

In 2022, Tufts Children’s Hospital closed, converting its pediatric beds into adult ICU capacity.

Most of medicine treated it as a sad but isolated story.

It was not.

It was a sign of where we were headed.

And as my co-author Jared Boyce and I wrote in STAT News in 2024, the combination of underfunding, political neglect, and our own silence has turned pediatrics into medicine’s largest skeleton crew.

We have known what was coming.

We just have not acted like it.

We have to get comfortable talking about money

When medical students hesitate about pediatrics, the explanation we reach for is usually the same: they must not truly love children.

They must not have the passion for it.

That explanation is a way of avoiding something harder.

Most trainees do love working with children.

What they are questioning is whether loving children should mean accepting financial instability that physicians in other specialties are not asked to accept.

Whether they say it out loud or not, many trainees are hearing a version of this message:

If you really love children, you should be willing to accept the financial consequences of that. And if you won’t, maybe pediatrics isn’t for you.

We need to stop sending that message.

Medical students are making career decisions while carrying substantial educational debt. They are looking at salaries, loan repayment timelines, housing costs, and whether they will be financially stable in ten years.

That is not greed.

That is common sense.

And pediatricians should feel comfortable having those conversations openly, whether it is about loan repayment strategies, retirement planning, or what a financially viable career in our field actually looks like.

The pay gap between pediatrics and adult medicine comes down to payer mix, not what other physicians earn.

Pediatrics depends heavily on Medicaid, which pays far less than commercial insurance or Medicare.

47% of Medicaid and CHIP enrollees are infants, children, and adolescents, yet only about 17% of Medicaid dollars go toward pediatric care.

Cutting an adult cardiologist’s salary does nothing to fix that.

Those physicians should be standing next to us making this argument to insurers, to CMS, to state Medicaid programs, to Congress.

We need their voices on our side.

That is a shared advocacy fight, not an internal one.

Fragmented effort is not a strategy

Across the country, people are working on pieces of this problem. One hospital launches a pipeline program. A professional society publishes a workforce report. An academic center pilots a fellowship incentive. A community group builds a mentorship network.

Each effort has value. But they rarely connect.

When everyone is working separately, we end up with a lot of activity and not much change.

Pediatrics does not need more isolated programs.

It needs a real coalition: academic medicine, community pediatricians, health systems, and industry partners, working from a shared plan with shared goals and shared accountability.

None of these groups can fix this on their own.

But together, there is a real chance.

A field that thinks long-term must act long-term

Pediatricians think in decades. That is part of what makes the work meaningful.

We follow our patients through childhood, through adolescence, into adulthood.

We understand that the decisions made early have consequences that last a lifetime.

We need to apply that same thinking to our own field.

The children who will need a pediatric nephrologist or an adolescent medicine specialist in 2035 are in elementary school right now.

The physicians who will care for them are in college, or high school, or not yet born.

What those future physicians decide to do with their careers will depend, in part, on what we do next.

Workforce problems do not appear overnight. They build through years of signals that are easier to ignore than confront.

We have been ignoring them long enough.

Pediatricians show up for children every day. It is time we showed up for our profession too.

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I plan to keep writing about this.

I hope some of you will keep reading, and that more of you will start pushing on this from wherever you are in the field.

There is a question most institutions refuse to ask out loud:

How long is too long to hold a leadership seat?

And perhaps the more uncomfortable question:

Who gets to decide when someone’s time is up?

The people who have the power to answer that question are often the same people occupying the seats.

(Spicy, I know. But it’s time we talk about it.)

In academic medicine, leadership seats often remain occupied for decades.
Not because there are no capable successors, but because the structure of advancement was built in a different era of medicine.

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Whether institutions want to acknowledge it or not, this conversation is already happening.

It happens in hallways.
In mentorship meetings.
In the quiet frustration of brilliant mid-career professionals who have been told, year after year, that their time is coming without anyone specifying when.

And while that frustration is real, something far more consequential is unfolding.

The generations expected to step into those seats Millennials and Gen-Z are quietly walking away from them.

Not because they lack ambition.

But because the system has spent two decades teaching them that the climb may not be worth it.

This is not a pipeline problem.

It is a warning signal.

And if institutions fail to hear it clearly, the workforce consequences will not simply be inconvenient.

They will be a generational crisis.

To understand why this is happening, we have to talk about the unspoken rules of institutional leadership.

The Workforce Dimension

Extended Tenure is a Structural Crisis

Both in academia and outside of it, senior leadership roles are increasingly defined by bottlenecks with fewer transitions.

Leadership turnover alone does not determine opportunity.

What matters is the bottleneck created when senior positions remain stable while the number of aspiring mid-career leaders continues to grow.

The once 8 to 10 year norm tenure has become a 15 to 25 year standard often without formal succession timelines, transition planning, or any structured mechanism for developing the leaders who will eventually need to follow. ( ie. Rep. Jim Clyburn)

Leaving the workforce to deal with the quietly compounding consequences.

When senior positions do not turn over, the vacancy signal that drives advancement disappears.

Indefinite holding patterns develop leaving talented professionals in their 30s and 40s in a time lurch where they are missing the essential leadership developmental window therefore unable to effectively build those needed skills.

They end up in the cycle where performing leadership-adjacent work is done:

• Without leadership authority.

• Without leadership compensation.

• And without leadership visibility

Academic medicine offers one of the clearest illustrations.

Department chair tenures now frequently extend well beyond a decade.

Deanships span entire generational shifts in student demographics.

National professional associations often rotate governance among the same small cohort of senior leaders.

And while medicine offers a sharp example, this pattern is NOT unique to our field.

It is increasingly visible across nearly every major leadership sector in the United States.

Which means we should confront a problem few institutions are willing to address openly.

Until now.

As expertise and tenure continue to be rewarded, the systems designed to transfer knowledge, authority, and opportunity to the next generation of leaders have quietly eroded.

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THE GENERATION THAT STOPPED CLIMBING

What Happens When the Pipeline Loses Faith in the Destination

For Millennials and Gen-Z, simply observing institutional leadership has been enough.

And what many have seen has changed their ambitions.

Institutions continue to assume that younger professionals are merely waiting their turn.

But that assumption is increasingly wrong.

Millennials and the generation behind them are not delaying leadership ambitions.

Many are walking away from them entirely and they are doing so because of what they have witnessed.

They watched talented predecessors spend a decade or more waiting for a seat that never opened.
They watched senior leaders hold power indefinitely while speaking at conferences about mentorship and succession.
They watched colleagues who did everything right:

• Publish

• Build credentials

• Network

• Serve

but still plateau in associate roles for years with no clear pathway forward.

And from those observations, many made a rational calculation:

The traditional leadership climb, in its current form, does not deliver what it promises.

Instead, it too often leaves people suspended in a kind of professional purgatory working within leadership structures without ever fully entering them.

But should young professionals expect leadership roles right out of the gate?

No. And most do not.

What they do expect are functional leadership pipelines systems that clearly demonstrate how leadership transitions will occur and who is being prepared to step into those roles.

Right now, those signals are often missing.

The path forward is rarely communicated, and even more rarely visible.

The result has been a quiet but significant workforce shift.

Across academia and healthcare, younger professionals are increasingly prioritizing :

autonomy over authority,

impact over title,

and flexibility over the kind of institutional loyalty that previous generations were expected to trade their best years for.

This is not a generational character flaw.

It is a rational response to a system that has repeatedly shown that the return on the investment of climbing is not what was advertised.

When institutions ask why they struggle to develop the next generation of leaders, the answer is often simpler than they expect:

The next generation watched the previous one wait and decided not to.

Even when this reality is pointed out directly, it has not yet moved the previous generation to take meaningful action.

The question is why.

Do they believe the next generation is not equipped to lead?
Or do they believe their own leadership remains indispensable?

These are questions that deserve honest answers.

But while institutions continue to avoid them, the long-term workforce implications of this shift are already unfolding.

Academic medicine and healthcare institutions are facing mounting challenges: health equity crises, tightening research funding, declining public trust, and persistent workforce shortages.

And yet, at the very moment these pressures are intensifying, the pipeline of professionals willing and prepared to lead institutional responses is narrowing precisely when it should be deepening.

Institutions that fail to address the structural causes of this disengagement will not simply lose talent.

They will lose the next generation of visionary leadership at the exact moment it is most needed.

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Why Trailblazers Feel They Cannot Leave — And What That Costs

When leaving means risking the very progress they fought to build.

For the generation of foundational, trailblazing leaders from underrepresented racial and ethnic groups, the tax is ongoing.

For many of these professionals individuals who achieved senior leadership often as the first in their institutions or fields the decision to step back carries a weight that their majority peers rarely face.

These leaders did not simply advance their own careers.
They opened doors for those who followed.
They shifted institutional cultures that had never before included them.
And in many cases, they served as the singular line of defense for equity-focused policies and practices.

In the current political environment marked by legal challenges to diversity programs, legislative attacks on equity initiatives, and the rapid dismantling of DEI infrastructure across higher education and healthcare many of these leaders have made a rational calculation:

Stepping back now could mean leaving behind progress that has no guaranteed successor and no meaningful institutional protection.

That fear is not irrational.

It is a reasonable response to a real threat.

But it carries a structural cost that compounds over time.

When trailblazing leaders remain in place without intentionally building and preparing successors who share their values and commitments, the progress they protect becomes entirely dependent on their continued presence.

The moment they step away for any reason the vacuum is real.

And it is often devastating.

Progress that depends entirely on one person’s presence is not institutionalized progress.

It is borrowed time.

And borrowed time, eventually, runs out.

The Succession Vacuum

When There Is No One Ready, Everyone Suffers

When a long-serving leader exits without a prepared successor, institutions enter a period of visionless organizational vulnerability.

This dynamic is well documented in management research and is immediately recognizable to anyone who has lived through it.

Decisions get deferred.
Vision goes unstated.
Junior colleagues who once relied on leadership for direction find uncertainty instead.

The new leader whether promoted internally or hired externally then spends their first one to two years learning what should have been transferred years earlier.

During that window, institutions are poorly equipped to navigate external pressures, respond to policy shifts, or retain the junior talent that needed leadership and instead found absence.

When this pattern occurs across multiple institutions at the same time, the cumulative effect becomes significant.

Without intentional succession infrastructure, leadership transitions produce a generational leadership deficit that can take decades to correct.

In academic medicine, that deficit is not merely inconvenient.

It is a crisis in slow motion.

The challenges facing these fields do not pause for leadership transitions.

Health equity does not wait.
Workforce diversity does not wait.

And the professionals who needed leadership to hold the line will not wait either.

They will leave for institutions that have it.

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THE PATH FORWARD

I believe in action, not just analysis.

If institutions are serious about addressing the leadership transition crisis, structural change is required. And structural change means moving beyond aspirational conversations about mentorship and leadership development toward policies that actually produce successors.

Here are a few places to start.

• Institutions should adopt term-limit frameworks for senior leadership roles, with structured transition periods of 18 to 24 months built into those timelines. Leadership transitions should be planned events, not sudden vacancies.

• Succession planning should be embedded directly into senior leadership performance reviews. Developing future leaders should not be treated as a courtesy or an informal expectation. It should be measured, evaluated, and contractually expected.

• Senior leaders from underrepresented backgrounds must be specifically supported in building successors who share their commitments to equity. That work requires institutional resources, time, and protection NOT personal sacrifice.

• Mentorship accountability must also be redefined. The measure of mentorship should not be the number of hours spent advising junior colleagues, but the number of successors who are actually prepared and advanced into leadership roles.

• Institutions must also build real leadership pipelines. Formal deputy and associate roles should exist with clear authority, visibility, and explicit timelines for advancement.

Leadership development programs must evolve as well. If institutions want Millennials and Gen-Z professionals to see leadership as worthwhile, programs must reflect the values that shape how these generations approach work: flexibility, purpose, autonomy, and realistic timelines to authority.

And finally, professional associations must examine their own leadership structures. Leadership tenure, demographic composition, and advancement patterns should be audited and publicly reported.

Without transparency, structural change rarely occurs.

What’s next?

The leadership transition crisis unfolding across academia and healthcare is not the result of individual failure.

It is the predictable outcome of institutions that have never treated succession as a strategic priority.

It is shaped by a political environment that has made stepping back feel like surrender.

And it is reinforced by a system that has spent an entire generation signaling to its most talented emerging leaders that the climb is not worth the wait.

Until those structures change, the seat will not simply remain full.

It will remain unwanted.

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If you’re a physician in training, start with the free guide:

Attending Money Is NOT a Plan

This short guide explains why waiting for attending income creates financial stress and what to build before that paycheck arrives.

Attending Money is NOT A Plan

The Myth No One Wants to Say Out Loud

Ready for a hard truth?

What if I told you that you are more likely to become a broke physician than a wealthy one?

That earning a medical degree, even from a top medical school, does not guarantee financial stability?

That a high school teacher has better odds at becoming a millionaire than an Ivy League top-10 medical school physician?

Not because physicians earn too little, but because no one teaches them how wealth works.

Medicine is often seen as a guaranteed path to financial success.

But income alone does not build wealth and many physicians are never taught how wealth is actually created.

The “Unofficial” Wealth Motto of Medicine

Most physicians have the same financial plan:

It sounds reasonable.

Training is busy.
Money is tight.
Life feels temporary.

So money becomes something to deal with later.

Then attending life arrives and nothing else has changed.

No systems.
No habits.
No plan.

Just a bigger paycheck landing in the same unprepared account.

Attending money is not a financial plan.

Financial skills start during training.

If You’re a Physician in Training, This Is For You

Wealth Dose is for:

• Medical students learning how money works for the first time

• Residents and fellows building financial stability

• First-generation physicians creating financial knowledge from scratch

• Physicians who want to feel prepared before attending income arrives

Most physicians are never taught how money works.

Wealth Dose exists to make those conversations easier to start.

The Problem No One Teaches Physicians to Solve

Medical training teaches you how to diagnose disease and manage complexity.

It does not teach you how to manage money.

So many physicians finish training feeling uncertain about:

• How to organize their money

• How to build consistent habits

• How to prepare for higher income

• How to make financial decisions with confidence

Many physicians assume that earning more money will solve financial uncertainty.

But income alone does not create financial stability.

Systems matter.

And the best time to build systems is during training.

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The Hidden Curriculum of Wealth in Medicine

In medicine, we often talk about the hidden curriculum the unwritten rules you learn to survive training.

How to navigate evaluations.
How to present yourself on rounds.
How to adapt socially and professionally.

But there is another hidden curriculum that almost no one talks about:

How to build sustainable wealth in medicine.

As a first-generation physician, I learned this the hard way.

No one told me that building financial systems during training mattered.

No one explained how money should be organized.

No one showed me what a financial system even looked like.

Like many trainees, I assumed wealth would come later when attending income arrived.

But what I eventually realized was that the physicians who feel most financially secure are not necessarily the ones who earn the most.

They are the ones who built systems early.

Wealth Dose exists to make this hidden curriculum visible.

What Wealth Dose Is

Wealth Dose is a space where we talk about personal finance skills for physicians in training.

Here we explore practical ways physicians can think about money from managing loan disbursements in medical school to beginning to invest during residency.

The goal is not to provide individualized financial advice.

The goal is to help physicians:

• Understand how money works

• Build financial confidence

• Develop systems early

• Feel prepared for attending income

Financial education during training makes the transition to attending life much easier.

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The Wealth Dose System

Financial skills should match your stage of training.

At Wealth Dose, we talk about The Wealth Dose System financial systems that evolve with you:

Medical Students → Learn to manage money

Residents and Fellows → Learn to grow money

Because wealth is not built in one moment.

It is built step by step.

The Medical Student Wealth System

The Two-Account Foundation

Medical school is often seen as too early to think about money.

But medical school is the best time to learn how money moves.

Before investing and before retirement accounts, medical students can begin by building simple systems to manage cash flow.

One approach many students find helpful is organizing money into two types of accounts.

Wealth Account (High-Yield Savings)

This account can function as the primary place where money is held.

Loan disbursements or income may be deposited here whenever possible.

This account might hold:

• Loan funds

• Emergency buffer

• Short-term savings

• Irregular expenses

High-yield savings accounts allow money to earn interest while remaining accessible.

Many medical students keep large balances in checking accounts that earn little or no interest.

Learning how to organize money in savings early can help build financial awareness and confidence.

Bills Account (Checking)

A checking account can be used primarily for regular spending and bill payments.

Examples include:

• Rent

• Groceries

• Transportation

• Utilities

• Subscriptions

Some students choose to transfer a planned amount from savings into checking each month to cover expenses.

This structure can help create:

• Spending awareness

• Better planning

• Fewer surprises

• More control over cash flow

Investing often becomes possible later in training.

Financial awareness can begin now.

The Resident and Fellow Wealth System

The Three-Account Engine

Residency and fellowship are often the first time physicians have consistent income.

With regular income comes the opportunity to begin building long-term financial habits.

Many residents and fellows choose to organize their finances into three general categories of accounts.

Bills Account (Checking)

This account can be used for everyday spending and routine bills.

Examples include:

• Housing

• Utilities

• Insurance

• Groceries

• Transportation

• Autopay expenses

Some residents keep enough here to cover about a month of expenses.

This helps keep daily finances predictable and organized.

Wealth Account (High-Yield Savings)

This account may hold cash reserves and short-term savings.

Examples include:

• Emergency funds

• Planned expenses

• Financial buffers

High-yield savings accounts allow cash to remain accessible while earning interest.

Savings can help protect financial stability during training.

Future Account (Investing)

Residency and fellowship are often when physicians begin learning about investing.

Examples of investing accounts include:

• Roth IRA

• Employer retirement plans

• Brokerage accounts

Even small contributions during training can grow over long periods of time.

Learning about investing is often the next step after building stable cash-flow systems.

What Happens When You Build Systems Early

When financial systems are in place, money becomes less stressful.

You understand where your money goes.

You know what you can afford.

You make decisions more calmly.

Personally, having financial systems in place means I do not worry about the price of things in the same way.

I can enjoy the life I want to live in medicine without constantly second-guessing financial decisions.

And I can do that without relying on lifestyle creep or future income increases.

Financial systems create freedom long before attendinghood.

So where should you start?

Financial skills develop step by step.

You do not have to do everything at once.

Starting with one system is enough.

Step 1 — Learn the Core Idea

Start with the free guide:

Attending Money Is NOT a Plan

Download the Free PDF → Attending Money is NOT a Plan: Med Student Edition

Step 2 — Build Your First System

Choose the system that matches your stage of training.

Medical Students

• Open a high-yield savings account

• Use it as your primary account

• Transfer planned spending into checking

Residents and Fellows

• Separate bills, savings, and investing into three accounts

• Learn how each account functions

• Build consistency over time

Final Thought

Attending Money Is NOT a Plan Guide

Don’t wait for attending money to figure out money.

Start with Attending Money Is NOT a Plan.

Get the free guide

Attending Money is NOT A Plan

Important Note

Wealth Dose is intended for educational purposes only and does not provide individualized financial advice. Financial decisions should be made in consultation with a qualified financial professional.

As a pediatric endocrinology fellow, there are months where your life is just dedicated to the job.

That’s what happened in March… and April.

And God it was miserable.

As I slowly come out of my endocrinology hole, I am excited to spend more time writing.

But as I was sitting on the sidelines watching the world fall apart

I was devastated and overwhelmed.

I long for the times where, we do not hear from Washington everyday.

I long for the peace we had as Americans, that seems to be hidden since January 20th, 2025

And through all of this,

the medical world has treated this as business as usual,

leaving me to scratch my head wondering why?

That was until March 30, 2025 7:00 pm EST.

When 68-year-old Cory Booker decided the world needed to stop.

We needed to stop treating this moment as business as usual

We needed to stop acting as though people were not getting harm

That norms were not being changed

And that our freedoms were not being placed at risk.

Though, the moment was brief, the impact was long.

Bringing needed attention to government programs such as Medicaid and Medicare with new tune, but it is still under threat.

For me, it was enough to remember why I needed to finish this story about why Medicaid and Medicare are important and foundational to American health care system.

Just to recap, we discussed the following:

🔹 The Story of Medicare & Medicaid – The President Who Changed History
🔹 The Story of Medicare & Medicaid – The Lone Black Doctor Who Demanded Change
🔹 The Story of Medicare & Medicaid – How Black Health Changed for the Better

We will end the journey around, The Story of Medicare & Medicaid – How We Have Shortchanged the Fight for Health Equity. I am excited to be able to finish this series with a bang and cliffhanger as we need to continually think about how we can not only keep these programs but also reform and improve them.

To end this long prologue, I am excited to switch gears and talk about how children’s health insurance (CHIP) came to be.

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The Birth of the Children’s Health Insurance Plan (CHIP)

If you’ve been following health care headlines like I have, chances are you’re sick of hearing the name Kennedy.

And no, it’s not because of the measles making a comeback.

It’s because one Kennedy in particular has taken “wellness” and warped it into a weapon against public health.

But not all Kennedys have carried that torch.

In fact, if RFK Jr.’s uncle, the great Sen Ted Kennedy knew what was happening in his name, he’d be doing somersaults in his grave.

And not the kind you clap for.

While most people remember Ted Kennedy for his role in passing the Patient Protection and Affordable Care Act, known widely as Obamacare.

His legacy in children’s health care, like children’s health itself, is overlooked.

Before the ACA, before the headlines, there was CHIP.

The Children’s Health Insurance Program.

And Ted Kennedy helped build it.

The Children’s Health Insurance Program

Signed into law on August 5, 1997, when bipartisanship was still a thing, CHIP was the product of an unexpected alliance between Senator Ted Kennedy (D-MA) and Senator Orrin Hatch (R-UT)—a true “for the kids” moment.

Together, they co-sponsored the State Children's Health Insurance Program (SCHIP), established under Title XXI of the Social Security Act.

It was inspired by a state-level initiative in Massachusetts, and it followed the Goldilocks principle of health policy:

Not too much.
Not too little.
Just right.

CHIP was designed to cover children in families that earned too much to qualify for Medicaid but not enough to afford private insurance—the kids who fell right through the cracks.

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Kid-Centered Health Policy, By Design

Think of CHIP as the kid-friendly cousin of Medicaid—a federal-state partnership with enough flexibility for each state to shape it in their own way. States could:

• Expand their Medicaid programs

• Build a separate CHIP program

• Or do a hybrid of both

Both the federal government and the states chipped in (pun fully intended), with the feds matching state funds and throwing in a little bonus.

But here’s the catch—unlike Medicaid, CHIP funding is capped.

That means both the money and the number of children who can be covered are limited. And every time reauthorization rolls around, CHIP becomes a pawn in budget politics.

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CHIP Under Fire (and Still Standing)

Let’s talk receipts.

📈 2009: The Children's Health Insurance Program Reauthorization Act (CHIPRA) expanded coverage to an additional 4 million children and pregnant women.
📈 2018: The Bipartisan Budget Act extended CHIP’s authorization through 2027.

Even as it gets tossed back and forth by both parties, CHIP’s success is undeniable.

The Numbers Don’t Lie

Since CHIP’s inception in 1997:

✔️ Uninsured rates for children have dropped from 14.2% into the single digits
✔️ As of May 2025:
→ Over 7 million children are enrolled in CHIP
→ Over 37 million children are enrolled in Medicaid

From routine checkups and immunizations to emergency care and hospital stays, CHIP has transformed the way children receive healthcare in the U.S.

This is anti-poverty healthcare at its finest.

It’s not perfect. It’s not fully protected. But it’s working.

The System Keeps Changing—But Who’s Still Being Left Behind?

CHIP didn’t come out of nowhere.
It was built on the foundation Medicare and Medicaid laid—programs born from struggle, protest, and policy courage.

We’ve looked at how these programs forced hospital integration, lowered infant mortality, and brought health care to Black and low-income communities once completely locked out of the system.

But access is only part of the story.

Because as CHIP and Medicaid expanded coverage, another reality came into view:

🩺 Coverage doesn’t always mean care.
📉 The gaps didn’t vanish—they evolved.
🧬 And the roots of racial health disparities run deeper than eligibility and enrollment.

So in the next dose, we’ll ask harder questions:

🔍 Who still gets the short end of the stick when it comes to quality care?
📊 How do these programs reinforce—or resist—structural inequities in the healthcare system?
📜 And what role did the Affordable Care Act really play in closing the gap… or leaving it wide open?

Because a changing system means nothing if it still fails the communities it was supposed to protect.

💊 See you in the next dose.

And if you haven’t already, now’s the time—subscribe to The Advocacy Dose so you don’t miss a single truth bomb.

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For weeks, I’ve been watching from the sidelines as the science community refuses to fight back against the relentless attacks on medicine and scientific research.

They’re either waiting for a savior or pretending that the ivory tower will protect them from the world outside.

Academic leaders—those who should be sounding the alarm—act as if everything is fine.

But it isn’t.

And even if they did decide to fight back, they don’t have the tools.

Because academia trained them not to.

For decades, the system has made its own people inert to self-advocacy, stripping them of the ability to resist when the moment demands it.

Now, in just a matter of weeks, a hostile government administration has slashed research funding, frozen grants, and rescinded PhD program acceptances—all with the stroke of a pen.

Failure of Our Scientific Leaders

As medical students, we were told to focus on our studies—to stay in our lane.

Master anatomy, physiology, and pharmacology.

Learn the science and stay away from politics.

But for those of us who actually engage with patients beyond the 15 minutes allowed by insurance, that was never enough.

Science has always been deeply intertwined with policy, equity, and access.

You cannot treat diabetes without acknowledging food deserts.

You cannot combat cardiovascular disease without addressing environmental racism.

The same should be true for our scientific leaders.

Yet, the individuals running America’s research institutions have allowed this destruction to unfold under their watch.

Worse, they have silenced the very people—the canaries in the coal mine—who warned them decades ago about the rise of anti-science rhetoric.

They dismissed advocacy as a hobby, something as trivial as knitting in one’s spare time.

They believed that if they sacrificed a little—let go of diversity programs, erased focus on equity, stayed silent on attacks against LGBTQ+ scientists—then the “real” science would be left alone.

They were wrong.

Because once you give an inch, they take everything.

A Moment of Reckoning

The Trump administration’s NIH funding cuts, which have slashed overhead costs on grants from 60% to 15%, are poised to disrupt critical research and clinical trials .

Universities are already scrambling, some rescinding PhD program acceptances entirely.

The National Science Foundation has even paused grant payments, leaving researchers unpaid and halting key studies .

This is not just an attack on a budget—it is an attack on the future of medicine and science itself.

And the worst part?

The people who should have been prepared for this moment are paralyzed, watching from the sidelines.

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The Path Forward

Until our scientific and medical leaders start valuing all science—not just the work that brings in the most grant money—this will keep happening.

Until advocacy is seen as essential to the survival of medicine, not just an extracurricular, we will continue losing ground.

Until we learn that protecting the most vulnerable in academia—minority scientists, LGBTQ+ researchers, and those studying topics deemed “controversial”—is the only way to protect all of science, we will keep repeating the same mistakes.

The time for waiting is over.

Academia must stop looking for a savior.

It must become the defense it so desperately needs.

Are we ready to fight for the future of science, or will we watch as another generation of researchers is erased?

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Why The Advocacy Dose Matters

This is exactly why The Advocacy Dose exists.

Right now, the voices willing to push back against these attacks on science and medicine are few—and often drowned out. Traditional institutions are failing us, and many of the loudest voices in academia have either been silenced or have chosen silence themselves.

That’s why independent platforms like this newsletter are more important than ever. The Advocacy Dose is here to call out the erosion of medical and scientific leadership, to provide a space where advocacy is not just an afterthought but a core part of our work.

If you believe that science and medicine deserve to be defended, if you refuse to stand by while research is defunded and entire fields are gutted, then supporting spaces like this is critical.

Subscribe. Share. Speak out.

Because if we don’t build the platform to fight back, no one else will.

You have to understand this…

For Black Americans, Medicare and Medicaid is more than just health insurance programs—they are lifelines programs.

As mentioned multiple times before…

Before 1965, Black Americans were largely shut out of the healthcare system, forced to rely on segregated, underfunded, and often neglectful hospitals. This wasn’t just an inconvenience—it was a death sentence for many.

Take Black infant mortality rates, as just one example:

📉 1916: Black infant mortality was 184.9 deaths per 1,000 live births, a staggering 87% higher than white infant mortality.
📉 1920: Black infant mortality was still 43% higher than white infant mortality.
📉 2017: It dropped to 10.8 per 1,000 live births—a massive improvement since the passage of Medicare and Medicaid.

But hold on—Black babies are still dying at disproportionately high rates.

In 2017, Black Infant Mortality Rate was 122% higher than the white infant mortality rate of 4.9 per 1,000 live births.

So no, Medicare and Medicaid didn’t fix everything, but they closed health disparities the size of the Grand Canyon.

For all the physicians who complain about the inefficiencies of Medicare and Medicaid, there are those who understand the alternative—a country where entire communities were left to die without care.

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Who’s Holding Up the System? URiM Physicians.

In 2024, the The Annals of Family Medicine (Fancy medical journal name) released a paper called …

A Few Doctors Will See Some of You: The Critical Role of Underrepresented in Medicine (URiM) Family Physicians in the Care of Medicaid Beneficiaries

They highlighted three truths about URiM physicians:

1. Black and Latino family physicians are more likely to participate in the Medicaid program compared to their white and Asian counterparts.

2. URiM physicians tend to care for a higher number of Medicaid patients, addressing a critical need in underserved communities.

3. The study suggests that URiM physicians play a crucial role in providing healthcare to socioeconomically disadvantaged populations, potentially reducing health disparities.

Translation? Not enough doctors are accepting Medicaid patients—but those who do? They are disproportionately Black and Latino physicians.

Why do these doctors take on this burden?

Because they know the history. They understand that Medicare and Medicaid were hard-won victories, designed to protect the people that the healthcare system had ignored for centuries.

And without them?

This country’s healthcare system would be in shambles.

Because as money, power, and greed continue to take over healthcare, it’s these doctors who are holding the line.

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But What Happens If That Line Breaks?

On February 25, 2025, the House of Representatives voted to include steep Medicaid cuts ($880 Billion Dollars) in the next federal spending bill.

So let’s be clear about what’s at stake:

🛑 If these programs are cut…
❌ Black communities will lose access to vital healthcare services, reversing decades of progress.
❌ More Americans could be pushed into medical debt, deepening racial wealth disparities.
❌ Without federal funding tied to civil rights laws, hospitals could be less accountable for discrimination, setting back healthcare equity by decades.

The dismantling of these programs would be a direct attack on racial justice in healthcare.

We know this because we’ve seen it before.

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Will We Let History Repeat Itself?

Dr. W. Montague Cobb. Dr. George Simkins. So many others.

They fought for a future where healthcare was a right, not a privilege.

But today, the very programs that broke down racial barriers in medicine are under attack.

Medicaid protects over 72 million people.
34 million of them are children.

If we stay silent, that future disappears.

So now, Dose Squad, the question is:

💊 What will we do to protect the future of healthcare in America?

Take Action—Right Now.

This isn’t just another headline. This is a call to arms. Here’s how you can fight back:

📞 Take 5-10 minutes and call your United States Senator’s office
✍🏾 Write your Congressperson—at the federal, state, AND local level.
📢 Flood their offices with your concerns. Demand that they protect these programs.

Remind them: their job is to represent their communities—not corporate healthcare interests.

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The System Keeps Changing—But Who Does It Serve?

We’ve seen how Medicare and Medicaid forced hospitals to desegregate.
We’ve seen how Black health outcomes started to shift when access to care expanded.
We’ve seen how the physicians who fought for these programs shaped a future they weren’t sure they’d live to see.

But the system didn’t stop evolving.

Because while Medicare and Medicaid changed the game for Black health, they weren’t the final chapter.

The next frontier? Children’s health.

So in the next dose, we’re diving into:

👶🏾 How these programs transformed children’s health in the U.S.
📜 The policies that expanded and threatened their impact.
🏥 And how it all set the stage for the Affordable Care Act.

The system keeps changing—but is it changing for the better?

Get ready for your next dose. 💊🔥 #TheAdvocacyDose

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Sources:

Singh GK, Yu SM. Infant Mortality in the United States, 1915-2017: Large Social Inequalities have Persisted for Over a Century. Int J MCH AIDS. 2019;8(1):19-31. doi: 10.21106/ijma.271. PMID: 31049261; PMCID: PMC6487507.

Anushree Vichare, et al. lA Few Doctors Will See Some of You: The Critical Role of Underrepresented in Medicine (URiM) Family Physicians in the Care of Medicaid Beneficiaries. The Annals of Family Medicine Sep 2024, 22 (5) 383-391; DOI: 10.1370/afm.3140

Their challenges to get our nation to value everyone lives is always inspirational and helps me to continue on the journey to being a better physician, advocate and overall human being.

Being a Black physician, or just a Black health care worker at times places you in predicaments where if you do not speak up people will get harm

If you do not challenge someone’s belief, someone might lose their life.

It’s a blessing and a curse to have this responsibility,

Unlike some of our colleagues we cannot just focus on the “objective” science/medicine.

But it’s a responsibility Black health care workers understand is a part of who they are.

And as the famous line goes … “With great power comes great responsibility”.

With that, let’s dive deep into the story of Dr. W. Montague Cobb

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Breaking the Color Line in Medicine

Imagine spending your life learning medicine, training for years to heal the sick, only to be told you cannot enter the hospital—not because of your skills, but because of the color of your skin.

And when rushing your loved one to an emergency room, you are turned away—not because there aren’t enough beds, but because the hospital doesn’t treat Black patients.

This was the reality for Black doctors and patients in America before Medicare and Medicaid.

Dr. Cobb decided that had to change.

Integrating Washington, D.C. Hospitals in the 1940s and 1950s

Dr. Cobb wasn’t just a doctor—he was a warrior for health equity.

As the first Black person in the U.S. to earn a Ph.D. in physical anthropology, he understood that racism wasn’t just a social issue—it was baked into the very institutions that determined who lived and who died.

And nowhere was this more evident than in the hospitals of Washington, D.C.

Dr. Cobb, as president of the Medico-Chirurgical Society of the District of Columbia ( local medical society of DC) in the 1940s and 1950s, led a relentless fight to integrate hospitals in Washington, D.C.

And in 1952, he won.

For the first time, Black physicians were granted access to white hospitals, and Black patients were no longer turned away.

A seismic shift.

His work in Washington, D.C., became a blueprint for national desegregation efforts.

In 1957, Dr. Cobb would successfully organize the first Imhotep National Conference on Hospital Integration.

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Advocacy for Medicare and Medicaid in the 1960s

By the 1960s, Cobb’s influence extended beyond Washington, D.C.

As president of the National Medical Association (NMA)—which represented Black physicians—Dr. Cobb was the only medical leader to testify in favor of Medicare and Medicaid during the congressional hearings leading to their passage.

At a time when the AMA aggressively opposed Medicare, Cobb stood alone in advocating for it, recognizing it as a tool to expand healthcare access and dismantle racism in medicine. His testimony directly influenced the passage of these programs.

Because of his unwavering advocacy, Cobb was invited to the signing ceremony of the Medicare and Medicaid Act by President Lyndon B. Johnson—an acknowledgment of the critical role Black medical leaders played in the passage of this legislation.

His legacy is a reminder that the fight for healthcare is inseparable from the fight for civil rights.

But why was the creation of Medicare and Medicaid so impactful for Black health? How did these programs uplift the Black community in America?

The Generational Health Care Impact

We’ve talked about the fight to create these programs.

We’ve talked about the lone Black physician who stood in the room when history was made.

But here’s the real question: What happened next?

Because Medicare and Medicaid weren’t just healthcare policies—they were civil rights victories.

They forced hospitals to desegregate.

They gave Black Americans access to care that had been denied for generations.

So in the next dose, we’re diving into the receipts.

🩺 How did Black health outcomes shift after Medicare & Medicaid?
🏥 How did hospital desegregation change the game?
📉 What progress was made—and what’s still at risk today?

The next dose is coming in hot. 🔥

Subscribe now so you don’t miss the next hit of truth. 💊💡 #TheAdvocacyDose

Today is supposed to be a day to honor those who have sat behind the Resolute Desk, shaping the course of American history, making decisions that ripple through generations.

But let’s be honest—we’re not living in normal times.

(I mean I got a flat tire today … not normal times…sigh)

And while we could spend today reflecting on the usual Presidential achievements—wars fought, economies built, policies passed—there’s one battle that should have been won decades before it was.

Healthcare.

Imagine for a moment: What if America had reformed its healthcare system right after World War II?

What if, in the booming years after the war, when highways were built and industries flourished, we had also decided that every American deserved the security of medical care?

We almost did.

In fact, one president saw the future—he knew exactly what needed to be done.

But he couldn’t change it.

It would take two more decades, political fights, civil rights activism, and an economic shift before the nation finally caught up to what should have been obvious.

So why did it take so long?

Why was a healthcare system that protected millions delayed until the 1960s?

And most importantly—what does that history tell us about the fight we’re in today?

We are going to dive into this for the next couple of days but first…

Let’s take a journey back to the beginning.

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Right or Privilege? The Story of Healthcare in America

Picture this: It’s 1945.

The War is Over.

The world is trying to rebuild itself after its devastation. Factories that once produced tanks are now making cars. Soldiers are returning home, hopeful for a fresh start.

The American economy is booming.

But beneath the surface of this post-war optimism, there’s a crisis that no one wants to talk about.

Healthcare as a privilege reserved for those who can afford it.

Doctors’ visits? Hospital stays? Prescription medicine? If you’re not wealthy or lucky enough to have employer-based insurance, you’re on your own.

The elderly, the poor, and even working-class families live in fear of a medical emergency that could send them into financial ruin.

One man decided to fix this problem.

President Harry S. Truman knew that if America was truly to prosper, its people needed a safety net—a healthcare system that didn’t punish the sick for being sick.

So in November 1945, just months after the war ended, Truman stood before Congress and delivered a bold, unprecedented vision:

"All citizens should be able to get medical and hospital service, and the economic barriers to the prevention and treatment of illness should be removed."
—President Harry S. Truman

His vision?

A national health insurance program that would cover every wage-earning American. Workers would pay a small tax or fee to guarantee medical care—no one would be denied treatment because they couldn’t afford it.

Working with Senator Wagner and Murray and Rep. Dingell they introduced the National Health Act.

Patients could choose their own doctors, and hospitals would remain independent—this was not the "socialized medicine" that fearmongers would claim.

But with American politics, it’s never just about the policy—it’s about who holds the power.

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The American Medical Association (AMA) launched an all-out war against his plan.

They called it "socialism" and warned of government overreach, flooding the media with propaganda designed to terrify the public.

They compared Truman’s plan to communist healthcare models in the Soviet Union, playing on Cold War fears.

As usual, congress—filled with lawmakers with ties to the medical lobby—folded under the pressure.

Truman’s national health insurance plan never even made it to a vote.

Though they attempted again in 1948, the bill would die again.

But ideas that are ahead of their time, don’t die.

Truman’s fight for healthcare may have ended, but it planted a seed.

Two decades later, that seed finally took root.

In 1965, President Lyndon B. Johnson signed Medicare and Medicaid into law, calling Truman the "real Father of Medicare."

But 60 years later, in 2025, Medicare and Medicaid—the very programs that proved Truman right—are once again under attack.

And the question remains: Will we let history repeat itself?

Well let’s dive deeper into history to see.

The Fight to Create Medicare and Medicaid

By the mid-20th century, America faced a healthcare crisis.

Medical advancements were improving health outcomes, but access to care remained deeply unequal.

Efforts to create a national health insurance system continued in the years after Truman’s presidency but were repeatedly met with resistance.

The AMA once again opposed these efforts, branding them as "socialized medicine" and stirring fears that government involvement in healthcare would destroy medical practice as they knew it.

But seeds always grow, despite the opposition, momentum grew.

With a good economic boom, post-World War II, Americans wanted the disparities in medical access addressed

And the civil rights movement brought further attention to systemic inequalities in healthcare.

Then, in 1965, President Lyndon B. Johnson seized the political moment.

With a Democratic-controlled Congress and a public eager for progress, he championed the Social Security Amendments of 1965, which established Medicare and Medicaid.

The signing ceremony on July 30, 1965, was held in Independence, Missouri, in honor of former President Harry S. Truman, recognizing his early efforts toward a federal health insurance program.

As a symbolic gesture, Truman was enrolled as Medicare’s first official beneficiary.

So Pause… Wasn’t This Series About Black People, Medicine, and Civil Rights?

And it still is.

Because you can’t talk about healthcare in America without talking about the fight for civil rights.

You can’t talk about Medicare and Medicaid without talking about how it forced hospitals to desegregate overnight.

( most successful systematic integration in America .. by the way)

And you definitely can’t talk about who fought to make that happen without talking about the lone Black physician was invited to the signing ceremony.

The signing of Medicare and Medicaid wasn’t just about expanding healthcare access.

It was about breaking barriers, defying the medical establishment, and forcing a system built on exclusion to finally open its doors.

And while nearly every major medical association tried to stop it, he stood firm.

So in the next dose, we’re talking about Dr. W. Montague Cobb—the man who refused to let hospitals remain segregated, and one of the most influential Black physicians in American history.

Get ready for your next dose.

Because history isn’t just something to remember—it’s something to learn from.

Don’t miss it—subscribe to The Advocacy Dose and make sure you’re always on the right side of the fight. 💊🔥

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Growing up as a Black girl in Connecticut—especially in a time when low-to-middle-class Black girlhood was overlooked, unseen, and undervalued—I often felt like I was slipping into the void.

You spend so much time proving you belong in the room that it drains you.

The constant effort to be seen, to be heard, to be considered… it’s exhausting.

Racing thoughts. Heavy emotions.

A paralyzing need to achieve—because failure isn’t an option.

My Mother’s Question That Grounded Me

Whenever I found myself spiraling, my mother would pull me aside, lower her voice, and ask:

"Faith, how do you eat an elephant?"

Even as a child, I knew the answer.

"One bite at a time."

Now, obviously, no one is out here eating elephants, nor would I want to.

But that question always brought me back to myself.

It forced me to stop drowning in the big picture and start seeing the steps in front of me.

One bite at a time. One step at a time.

That lesson stuck with me.

Breaking Down Big Ideas: The Story of Medicare & Medicaid

And I’m reminded of it every time I try to explain the history of Medicare and Medicaid—because this is a story that needs to be broken down piece by piece,

Or rather dose by dose.

I didn’t fully understand its impact until my 3rd year of medical school.

Learning this history shook me.

The years 1964 and 1965 stood out to me—not just as moments in time, but as personal milestones.

As those were the years my parents were born.

That meant that I was the first generation in my family born under Medicare and Medicaid.

The first to grow up in a world where hospitals were desegregated.

The first to assume that walking through the front doors of a hospital as a Black physician was normal—when, in reality, it was a privilege that had been fought for.

Because the truth is, most people don’t know the fight it took for Black physicians to be treated as equals.

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The Forgotten Fight of Black Physicians

We talk about Jim Crow and how Black patients were barred from white hospitals—but what about Black doctors?

Where did we go?

Where were we allowed to train, to practice, to heal?

So much of our history has been swallowed by the void.

But not today.

Today, we bring this story forward.

For many Black physicians and healthcare providers, the names of those who fought for change are familiar—if you dare to study beyond your anatomy and physiology textbooks.

But to the greater world, they are unknown.

And that’s exactly why I want to share them with you.

How the story of Change in Healthcare Will Unfold

This is how Lesson Three will be given dose by dose:

🔹 The Story of Medicare & Medicaid – The Presidents Who Changed History
🔹 The Story of Medicare & Medicaid – The Lone Black Doctor Who Demanded Change
🔹 The Story of Medicare & Medicaid – How Black Health Changed for the Better
🔹 The Story of Medicare & Medicaid – The Evolution of a System That Keeps Changing
🔹 The Story of Medicare & Medicaid – How We Have Shortchanged the Fight for Health Equity

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Yes, this is a mini-lesson within a lesson. But if we’re going to truly understand this history, we have to break it down—dose by dose.

So throughout the week, these lessons will land directly in your inbox.

Ready for you to engage with the story, and take away something new.

I’m excited to share this with you.

To change the way this history is taught.

To make sure we never forget.

And if this is your first time seeing my post or email—welcome to The Dose Squad.

You’re right on time!

See you in class !

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✅ The political fight to pass Title VI and the Civil Rights Act
✅ Why hospital desegregation was driven by policy and funding
✅ Why racial health disparities persist despite Title VI
✅ Why Title VI remains powerful but poorly enforced

Beyond Desegregation: The Fight for Health Equity Continues

In our last lesson, we discussed Dr. George Simkins Jr., a Greensboro dentist and civil rights leader who played a pivotal role in challenging segregated healthcare facilities.

Quick Recap: In 1962, Dr. Simkins, along with other Black physicians and patients, filed a lawsuit, Simkins v. Moses H. Cone Memorial Hospital, which became a landmark decision, with the Fourth Circuit Court of Appeals ruling that "separate but equal" racial segregation in publicly funded hospitals was unconstitutional.

If you have not check out Lesson one click here!

Despite this legal victory leading to the subsequent passage of Title VI of the Civil Rights Act of 1964, significant health disparities still persist.

If equality was achieved, why does healthcare still feel so unequal?

Because equality gives everyone the same rules—equity ensures those rules work for everyone.

Title VI was a landmark victory, but it was only the beginning.

Let’s explore its origins, the political battles that shaped it, and why the fight for health equity continues.

The Political Battle Behind Title VI

The journey to passing the Civil Rights Act was fraught with intense political struggle.

In June 1963, President John F. Kennedy proposed comprehensive civil rights legislation in response to nation widespread resistance to desegregation and the assassination of civil rights leader Medgar Evers.

Yet, the bill faced strong opposition in Congress, particularly from Southern legislators who employed filibusters and other tactics to block its progress.

No memorial oration or eulogy could more eloquently honor President Kennedy's memory than the earliest possible passage of the civil rights bill for which he fought so long,"

Then, serving notice on his fellow southern Democrats that they were in for a fight, he said: "We have talked long enough in this country about equal rights. We have talked for one hundred years or more. It is time now to write the next chapter, and to write it in the books of law."

- President Lyndon B Johnson to Congress after JFK’s assassination

After President Kennedy's assassination in November 1963, LBJ took up the mantle, leveraging his political capital to push the bill forward.

He emphasized the moral imperative of the legislation, stating, "Let this session of Congress be known as the session which did more for civil rights than the last hundred sessions combined."

Even with a president pushing for this agenda, the bill encountered significant hurdles.

In the House of Representatives, it was stalled in the Rules Committee, leading supporters to threaten bypassing the committee to bring the bill to the floor.

In the Senate, a coalition of 27 Republicans and 44 Democrats overcame a prolonged filibuster, marking the first time in history that the Senate voted to end debate on a civil rights bill.

Yet they persisted and won.

On July 2, 1964, President Johnson signed the Civil Rights Act into law, marking a pivotal moment in the fight against institutionalized and systemic racism.

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What Title VI Did Right: The End of Hospital Segregation

Before Title VI, hospitals were brazenly discriminatory and engaged in racist tactics.

Black patients were often:

• 🚫 Denied care outright if a hospital was whites-only

• 🚫 Forced into overcrowded, intentionally underfunded “colored” wards with fewer doctors and outdated equipment

• 🚫 Treated as medical afterthoughts, receiving lower-quality care than white patients

When Medicare and Medicaid launched in 1965, the federal government used funding as leverage—hospitals had to integrate if they wanted access to those dollars.

Within two years, hospital segregation was (officially) over.

Dr. Simkins and his colleagues had fought tirelessly for this moment.

On paper, Title VI delivered equality—hospitals could no longer openly discriminate.

But equality does not equal equity.

Where Title VI Fell Short: Healthcare Disparities Didn’t Disappear

Title VI could end legal segregation, but it couldn’t undo centuries of embedded medical racism.

Here’s what we’re still dealing with today:

• Black and Brown patients still receive lower-quality care. Studies show that doctors are less likely to believe Black patients' pain or take their symptoms seriously.

• Language barriers still prevent non-English speakers from getting proper care. Hospitals are required to provide interpreters under Title VI—but many fail to do so.

• Hospitals that serve Black and Brown communities are still underfunded. While wealthy, predominantly white neighborhoods have top-tier medical facilities, Black and Brown communities often rely on hospitals with fewer specialists, outdated equipment, and long wait times.

This is the difference between equality and equity.

Why Title VI Still Matters—And Why We Need More

Title VI is still a powerful tool—but it’s only as strong as its enforcement.

Right now, too many hospitals get away with violating Title VI without consequences. That’s why we still see:

• ❌ Hospitals failing to provide interpreters for non-English-speaking patients

• ❌ Black mothers being ignored in labor, leading to preventable deaths

• ❌ Discriminatory treatment decisions, like Black patients receiving less pain medication than white patients with the same conditions

If hospitals refuse to follow Title VI, they should lose their federal funding.

But Let’s be real, how often does that actually happen?

Title VI isn’t enough on its own—it’s up to us to demand stronger enforcement and push for policies that address these ongoing disparities

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Next Lesson: The Fight for Healthcare Access Isn’t Over

Title VI forced hospitals to desegregate, but access to healthcare didn’t become a reality for millions until the creation of Medicare and Medicaid.

These landmark programs changed the game—giving elderly, disabled, and low-income Americans the healthcare coverage they’d long been denied.

But here’s the thing:

Medicare and Medicaid didn’t just happen—they were fought for.

And today, they’re still under attack.

🧐 Why did some politicians resist Medicare and Medicaid in the 1960s?
⚖️ How did these programs help enforce Civil Rights laws?
🚨 Why are Medicare and Medicaid STILL facing cuts and restrictions today?

The fight to protect healthcare access is just as urgent now as it was then.

Don’t miss our next lesson—subscribe to stay in the know! 👀💡

Let’s get this straight: The NFL—yes, the multibillion-dollar football league known for its concussion scandals and ownership controversies—is now defending Diversity, Equity, and Inclusion (DEI) more boldly than the American scientific community.

Let that sink in.

While research institutions and scientific associations, buckle under political pressure and quietly dismantle DEI programs, the NFL is standing firm.

Commissioner Roger Goodell recently reaffirmed the league’s commitment to DEI, making it clear that diversity is not up for debate—even as politicians take aim at it.

Meanwhile, leading science agencies? They’re folding, like a pancake. Diversity offices are being shut down. DEI language is disappearing from websites. They are openly turning their backs on colleagues from diverse backgrounds who have become targets under this new administration.

The institutions that claim to pursue truth and progress are choosing silence instead of taking a stand.

But Let’s be clear: When the NFL is outpacing science in defending DEI, something is deeply wrong.

Why Is Football Doing What Science Won’t?

For all its flaws, the NFL understands something that the scientific community seems to have forgotten—diversity is not a political trend. It’s a strategic advantage.

Despite mounting political pressure, the NFL continues to expand and defend itsDEI initiatives , reinforcing inclusive hiring practices, strengthening minority-focused coaching fellowships, and upholding the systemic accountability measures it established across all 32 teams over five years ago

Yet, over in the world of science, institutions that should be leading the charge on equity are instead dismantling progress in real-time.

Programs and organizations designed to increase access and representation in science, research, and medicine are being erased without a fight.

The scientific community’s willingness to sacrifice their own colleagues in the name of "protecting science," while failing to recognize that the very institution itself is at risk, reveals what they truly value—and what they believe—at the core of this crisis.

The irony? These same institutions demand "evidence-based science and decision-making " while ignoring decades upon decades of research proving that diverse teams create better science.

So, what message does this send?

• That scientific progress is only for the privileged?

• That inclusion is optional?

• That when power is challenged, even academia will cave?

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What the Science and Health Communities Must Do—Now

Enough with the silence. The science and health sectors must step up immediately or risk losing the credibility they claim to uphold.

1. Rebuild What Was Dismantled – Reinstate DEI offices and strengthen their power. No half-measures.

2. Refuse to be Politically Complacent – Issue public commitments to DEI and stand firm in the face of external pressure.

3. Put DEI in the Budget – If funding disappears when times get tough, it was never a real priority. Secure long-term financial commitments to DEI programs.

4. Speak Up—Loudly – Scientists love to say, “Let the data speak.” Well, the data is clear—diversity makes science better. So why are so many institutions staying quiet?

The Silence is Deafening

If you work in medicine, research, or academia and you're staying silent while DEI programs are being erased, your silence is a statement.

You’re saying you can live with an exclusionary system.
You’re saying that football understands inclusion better than you do.
You’re saying that progress is optional when it's inconvenient.

Is that really the legacy you want?

The NFL isn’t perfect. But right now, it's leading in a way the scientific community refuses to.

It’s time for science to catch up.

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✅ How Dr. George Simkins Jr. fought to desegregate hospitals
✅ How his legal victory paved the way for Title VI of the Civil Rights Act
✅ Why hospital desegregation wasn’t just about morality—it was about federal funding and policy enforcement
✅ Why racial disparities in healthcare persist today

Picture this...

A Black mother rushes her feverish newborn to the nearest hospital, desperate for help. But at the entrance, a nurse shakes her head. "We don’t treat Negroes here." The child is turned away. Hours later, the newborn passes away. Not because there wasn’t a doctor who could have saved her. But because that doctor wasn’t allowed inside the hospital either.

This wasn’t a rare tragedy before the 1960s, it was reality. Across the Jim Crow South, hospitals took federal tax dollars while openly denying Black patients care.

Black doctors who trained for years to save lives? They were locked out of residencies and barred from admitting their own patients to white hospitals. And for decades, the government let it happen.

Until one Black dentist named Dr. George Simkins Jr. said, Enough.

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The Forgotten Civil Rights Battle in Medicine

When we reflect on the Civil Rights Movement, the focus is often on voting rights, school desegregation, and fair housing—the landmark battles that dominate history books and classroom discussions.

But what about healthcare?

What about the reality that Black Americans were dying—not because medicine lacked the ability to save them, but because hospitals refused to treat them?

The Medical Civil Rights Movement was one of the most overlooked yet transformative fights of the Civil Rights era.

Despite being one of the most effective racial integration efforts in American history, the desegregation of hospitals is rarely taught in schools.

It is missing from history textbooks, absent from medical, nursing, and pharmacy school curricula, and barely mentioned in mainstream discussions of civil rights.

Why?

Because the desegregation of hospitals wasn’t framed as a moral victory—it was framed as an economic and political issue.

The legal battles weren’t fought on the premise that healthcare is a fundamental human right; they were fought on the principle that hospitals taking federal funds must comply with civil rights laws.

It was federal funding, legal leverage, and economic pressure—not ethical responsibility—that forced the change.

This movement also exposed the deeper systemic inequalities within the healthcare system, revealing how racism had long dictated who had access to life-saving treatment and who did not.

To fully understand racial health disparities today, we must acknowledge this buried history. Because when we fail to recognize the past, we set the stage to repeat it.

And if you’ve been paying attention to the world around you—it’s already happening.

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A Law That Protected Segregation

This injustice wasn’t just allowed—it was protected by law.

In 1883, the Supreme Court ruled that private businesses could legally discriminate, even if they were the only hospital in town.

And as long as segregation wasn’t government-enforced, it was untouchable by the Equal Protection Clause of the 14th Amendment.

This meant that hospitals could take federal money, build new facilities, and still refuse to treat Black patients.

And they did. For nearly 80 years.

Until Dr. Simkins changed everything.

The Hill-Burton Act: A Law That Helped—and Hurt

In 1946, Congress passed the Hill-Burton Act, which provided federal funds to build and expand hospitals across the country.

The goal: To ensure that every American had access to healthcare.

But there was a catch.

The law allowed hospitals to receive federal funding while still maintaining "separate but equal" facilities for Black and white patients.

In reality, this meant that Black patients were often treated in overcrowded, underfunded, and poorly equipped hospitals—or denied care altogether.

Even worse, hospitals built with Hill-Burton funds were not required to desegregate, despite using taxpayer money.

Black communities had paid into a federal system that actively excluded them.

So how did hospitals get away with this for so long?

By the 1950s, the federal government had spent billions on hospital construction, yet racial disparities in healthcare were worsening.

But in Greensboro, North Carolina as president of the Local NAACP chapter, Dr. Simkins had seen enough, it was time to hold the health care systems accountable.

He along with several others, sued local hospitals Moses H. Cone Memorial Hospital and Wesley Long Community Hospital, knowing they weren’t just fighting against local policies

But challenging the entire structure of federally funded segregation.

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The Moment That Changed Everything

It wasn’t a lawyer or a politician but a dentist, Dr. George Simkins Jr. that became enraged by how his patients were treated.

One night, a Black man came into Simkins' office with a severe tooth infection. If left untreated, it could be deadly.

Simkins stabilized him and then sent him to the nearest hospital for further treatment.

But the hospital had a policy: No Black patients allowed.

The man was denied treatment.

Simkins knew he had two choices: accept this as the way things were—or fight back.

The Lawsuit That Shook the Medical System

In 1962, Dr. Simkins and a group of Black doctors sued Moses H. Cone Memorial Hospital and Wesley Long Community Hospital in Greensboro, North Carolina.

Their argument? If a hospital takes federal tax dollars, it must serve all citizens.

Sounds logical, right?

But the hospitals fought back, claiming they were private institutions and could refuse service to anyone they wanted.

The first ruling? The courts sided with the hospitals.

But Simkins wasn’t done.

He appealed the decision to the Fourth Circuit Court of Appeals.

And now, the federal government had a choice:

Side with the hospitals? Or rewrite the rules of American medicine?

The Landmark Decision That Changed Medicine Forever

In November 1963, the Fourth Circuit ruled in Simkins' favor.

This was the first time a court declared that hospitals accepting federal funds could NOT discriminate.

Dr. Simkins, a dentist, had done what generations of Black doctors were told was impossible. He had taken on the system—and won.

This victory would become the foundational win needed to create Title VI of the Civil Rights Act of 1964 and eventually—Medicare.

Why This Still Matters Today

Please know desegregation didn’t fix everything.

The racial disparities in healthcare today are direct results of decades of segregation and systemic racism:

• Black maternal mortality is still 2-3x higher than for white women.

• Medical bias in pain management and treatment is still rampant.

• Black communities continue to face doctor shortages.

Yet, we must continue to fight for better access for all.

📢 Share your thoughts! Do you think federal funding should still be used as leverage to enforce health equity? Let’s discuss in the comments.🚀

Leave a comment

Sources:

• University of North Carolina’s Southern Oral History Program Collection

• Hill-Burton Act

• Simkins v. Moses H. Cone Memorial Hospital, 211 F. Supp. 628 (M.D.N.C. 1962)

Next Lesson:

Dr. Simkins' case set the stage for something even bigger: Title VI of the Civil Rights Act and the creation of Medicare and Medicaid.

But how did these policies force over 1,000 hospitals to integrate overnight?

And how did they transform healthcare access in America?

🔹 Stay tuned for the next lesson to find out!

🚀 Subscribe for more Civil Rights and Medicine 101!

Imagine a world where your zip code, skin color, or income didn’t determine your health outcomes. Now, ask yourself: How did we get here—and how do we fix it?

That’s exactly what Civil Rights and Medicine 101 is about. This course unpacks how the Medical Civil Rights Movement shaped health care—and why those battles are STILL being fought today.

What You’ll Learn

Over 11 power-packed lessons, we’ll cover:
✅ How a landmark court case desegregated hospitals
✅ The Civil Rights Act’s impact on healthcare equity
✅ How Medicare & Medicaid revolutionized access to care
✅ The activism behind free clinics & patient rights
✅ The hard truth about how integration harmed Black hospitals

And because this isn’t just history—it’s strategy—you’ll leave with the tools to connect past movements to today’s continued fight for health justice.

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Course Breakdown

💡 Lesson 1: Intro to Civil Rights in Medicine – Simkins v. Cone
➡️ Why does civil rights still matter in healthcare? (Spoiler: It always did.)

💡 Lesson 2: Title VI of the Civil Rights Act
➡️ The law that made health care discrimination illegal—but is it enforced?

💡 Lesson 3: Medicare, Medicaid & Equity
➡️ How two government programs transformed access to care (and who got left out).

💡 Lesson 4: Hospital De-segregation
➡️ Activists fought to break hospital color lines—but at what cost?

💡 Lesson 5: National Medical Association & Student National Medical Association
➡️ The Black medical organizations that held the door open for future doctors.

💡 Lesson 6: Medical Committee for Human Rights (MCHR)
➡️ When doctors and activists teamed up to make healthcare a human right.

💡 Lesson 7: Black Panthers & Free Clinics
➡️ The radical approach to community healthcare—before "health equity" was a buzzword.

💡 Lesson 8: Lincoln Hospital & Patient Rights
➡️ What happens when patients fight back for their rights?

💡 Lesson 9: The Harm to Black Hospitals
➡️ The unintended consequences of desegregation—did it help or hurt Black healthcare?

💡 Lesson 10: Review & Reflection
➡️ Connecting history to NOW—because the fight isn’t over.

💡 Lesson 11: Final Project
➡️ Your turn to teach the people—summarize a key lesson to educate others!

Why This Course? Why Now?

Because racial health disparities aren’t a glitch—they’re by design.
Because you can’t fix what you don’t understand.
Because health justice is civil rights.

This course is designed to educate, challenge, and inspire action. And we’re not just talking—we’re DOING. '

Every lesson includes interactive assignments like reflections, research, and TikToks to spread the knowledge.

📢 Ready to Learn?

Subscribe now

Drop a 🔥 in the comments if you're joining the Dose Squad movement.

First lesson drops TODAY—let’s get into it! 💊

His work in places like Selma, Alabama—a state deeply tied to my family’s lineage—stands as a testament to his courage and vision. Each January, I’m reminded of his profound contributions, but my commitment to honoring and respecting his work extends far beyond a single month.

It’s something I carry every day, whether I intend to or not.

Yet, every MLK Day feels like faith without action. I sit through lectures and attend events that focus on the past, offering reflections but no real strategies to address today’s challenges or prevent tomorrow’s harms.

As a child, I was forced to listen; as a medical student, I nodded along; and now, as a physician, I ask: Is this all we’re meant to do with his legacy?

I hope not.

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A Crossroads for America and King’s Vision

Once again, our nation stands at a pivotal crossroads. The dream of America—so central to Dr. King’s vision—is facing the same challenge it always has: will we rise to fulfill that dream, or will we allow the harsh realities of the world to paralyze us into inaction?

President Biden’s farewell speech delivered a stark warning about the challenges we face with the incoming presidency—a familiar figure surrounded by troubling moral energy, poised to creep back into the White House. Under the guise of a so-called “revolution of common sense,” this administration’s ultimate goal seems aimed at undermining the American dream.

Over the past two months, their vision has become clear: a foundation built to benefit the ultra-wealthy, leaving the poor and underserved behind, all while cloaking inequity as “common sense.”

But let’s be clear: common sense is shaped by what a society allows, accepts, and promotes.

We must reject any call to return to a time when “common sense” meant being physically, emotionally, and spiritually divided by hate and greed.

Classism: The Greatest Threat to King’s Dream

This is not the first time we’ve been here as a nation. Dr. King recognized this same threat toward the end of his life.

In the final years of his work, King understood that the fight for racial equality was deeply intertwined with classism. His Poor People’s Campaign sought to address the systemic poverty, economic exploitation, and class-based oppression that he saw as the greatest barriers to achieving true equality.

With bold action, King’s campaign aimed to unite people across racial and cultural lines to demand an “economic bill of rights” that included fair wages, affordable housing, and access to quality education—issues that remain at the heart of our struggles today.

If we ignore the ways classism continues to shape modern society, we risk failing not only King’s vision but also the future of the American dream.

Classism in Healthcare: A Systemic Crisis

The American healthcare system offers a stark example of how classism undermines King’s vision. Access to care, affordability of medications, and availability of preventative treatments are often dictated by economic status.

Social determinants of health—factors like housing stability, education, income, and access to healthy food—play a far greater role in shaping health outcomes than medical interventions alone. For those in low-income communities, these inequities lead to higher rates of chronic illnesses, preventable diseases, and shorter lifespans.

King understood that addressing the root causes of inequity was essential. True economic justice in healthcare means creating systems where outcomes are not predetermined by ZIP codes or income brackets. It means policies that expand Medicaid, invest in community health programs, and ensure equitable access to the resources needed for wellness.

Guidance for the Future: Solidarity and Action

So, what can we take from King’s legacy as the next presidency looms? His Poor People’s Campaign offers a blueprint for addressing classism in our time. Advocating for universal healthcare, livable wages, and affordable housing must be central to our fight.

In healthcare, this means supporting initiatives that reduce disparities, like funding for community health centers, food-based pharmacies, and universal maternal and infant care. These are not lofty ideals—they are necessary steps toward honoring King’s vision and achieving health equity.

Let’s Move from Nostalgia to Impact

This MLK Day, let us commit to more than reflection. Let us act. King’s dream calls us to dismantle classism, address social determinants of health, and create a more just and equitable system for all.

How will you take action? Share your thoughts and plans below, and let’s inspire each other to turn nostalgia into impact.

Subscribe to The Advocacy Dose for more conversations like this—where we move beyond reflection to explore the policies, practices, and stories that drive real change. Together, we can honor King’s legacy not just in January, but every day of the year.

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What’s Going On with the ERA?

Here’s the Policy Tea: The Equal Rights Amendment (ERA) was created to guarantee equality under the law, regardless of gender. Which in 2025 makes sense right? Yet journey to ratification has been anything but.

After Congress passed the ERA in 1972, it needed 38 states to ratify it before a 1982 deadline. By the deadline, only 35 states had signed on . But in recent years, Nevada (2017), Illinois (2018), and Virginia (2020) stepped up, hitting the magic number. Then-President Biden declared the ERA as the 28th Amendment within last 9-5 hours left of his administration on January 17th, 2025. Victory, right?

I wish. The National Archives—the folks responsible for officially publishing amendments in the Constitution—said good one, but nope. Why? Because of the expired deadline. According to the archivist, Congress or the courts still need to clear the legal haze before the ERA can officially be added.

Black Women Deserve Better, and the ERA Could Deliver

Here’s where things get real: if the ERA becomes official, it could change the game for Black maternal health in the U.S.

Around the world, maternal mortality rates fell 44 percent 1990-2015, but in the US, maternal mortality jumped 16.7 percent, making the United States the only developed country with a rising maternal mortality rate. This isn’t just a health crisis; it’s a health justice crisis rooted in systemic inequities—bias in treatment, lack of access to quality care, and the absence of accountability.

An official Equal Rights Amendment would make it harder for these inequities to hide. It would:

• Force accountability: Healthcare providers and institutions could be held to constitutional standards of equality.

• Push for better policies: Governments would have to prioritize equitable access to healthcare.

• Give legal power to advocacy: The ERA would give advocates a constitutional foundation to demand better protections and resources.

Imagine a future where addressing racial disparities in maternal health isn’t just a good idea—it’s a legal requirement. That’s the potential of the ERA.

So …What’s Next?

Here’s the frustrating part: it’s still a waiting game. Opponents argue the ERA’s expired deadline invalidates the recent ratifications. Supporters are pushing Congress and the courts to settle the issue once and for all .

Meanwhile, the ERA sits in a weird limbo—technically ratified but not officially activated. It’s like putting the key in the ignition but not turning it.

Your Advocacy Dose

This isn’t just about politics or procedure; it’s about lives. Equality shouldn’t be this hard to lock in.

If you care about making equality real for everyone—and using the law to back it up—subscribe and stay plugged into The Advocacy Dose. We’ll keep you updated on the ERA’s journey and show you how to take action in the fight for justice and equity.

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Hey Dose Squad,

Welcome to The Dose by Faith Danielle MD.

I’m so glad you’re here.

I created The Dose to be a thoughtful space for writing about medicine, money, history, and the bigger questions that shape how we live, work, care, and grow. Some posts will offer commentary on healthcare and policy. Some will explore the histories that still shape the present. Others will make room for honest conversations about wealth, personal finance, and building a meaningful life in and beyond medicine.

This space is rooted in a simple belief: good writing can help us make sense of what matters. It can clarify big ideas, connect the past to the present, and give us language for the things we are still trying to understand.

Here’s what you can expect from The Dose:

💡 Dose of Opinion
Thoughtful commentary on medicine, policy, and equity, along with practical guidance on writing impactful opinions in healthcare.

📖 Legacy Dose
Stories from the history of medicine, justice, and inequality that help us better understand the present.

💸 Wealth Dose
Honest reflections on wealth, personal finance, and building stability in medicine and beyond.

My hope is that each post leaves you with something real. Maybe it is a new perspective. Maybe it is a clearer understanding of a policy issue or a historical moment. Maybe it is a practical takeaway you can apply to your own writing, work, or financial life. Maybe it is simply a reminder to think a little more deeply about the world around you.

More than anything, I want The Dose to feel like a space you can return to for clarity, context, and thoughtful conversation.

Thank you for being here and for joining the Dose Squad. I’m excited to build this space with you.

Welcome to The Dose.

Always with purpose,
Faith Danielle, MD
Your Dose Squad Leader

P.S. Want to help the Dose Squad grow? Share this newsletter with a friend or two. Big changes happen when we work together. Let’s spread the word! ✨