Primary Care Champion: Megan Douglas, Morehouse School of Medicine NCPC

This Q&A is republished here from the February 2022 Executive Member Update, the enewsletter for PCC members. Each month in the newsletter, the PCC provides a short profile of an individual who works in primary care. It is a way of recognizing the dedication and passion that clinicians, advocates, and others have for primary care and connecting people in the PCC community to people like them.

Megan Douglas, JD

Assistant Professor, Department of Community Health and Preventive Medicine and Research and Policy Director, National Center for Primary Care at the Morehouse School of Medicine

Why are you passionate about primary care?
 
I am an attorney and health equity advocate. I was first drawn to primary care as a law student intern in a medical-legal partnership. All of our clients had complex health issues, which were further complicated by the legal and social systems they were forced to navigate in order to gain access to health services, disability benefits, quality housing, and education.
 
This experience opened my eyes to health inequities and how laws and policies drive these outcomes. I developed strong partnerships with primary care physicians by collaboratively addressing the needs of patients and communities. It is the dedication to patients, trust, and relationships at the core of primary care that drew me in.
 
Now, I am fortunate to serve on the faculty of a medical school committed to health equity and primary care. And my passion for primary care continues to grow! Working with and learning from our next generation of primary care physicians inspires me to continue the research, advocacy, and community-building needed to prioritize and strengthen primary care. I am more confident than ever that primary care holds the solutions to many of our nation’s health, health inequity, and health care access problems—and that we are developing a primary care workforce that has the persistence, perseverance, and passion to achieve health equity.      
 
If you had a magic wand that you could wave to change one thing in primary care, what would it be?
 
I would make health equity the number one priority across the entire spectrum of our health system. Health inequities by race, ethnicity, geography, income, education, insurance status, and so many other factors are the result of longstanding structural inequities driven by racism and discrimination. Health inequities are costly—to quality of life, health outcomes, and economically. They are also preventable. By centering equity as the key outcome, we could then develop and implement policies that actually incentivize it, including finance and delivery models, workforce development, and community engagement. I would position primary care to lead this effort and ensure the resources to succeed are available and properly allocated.    
 
What one thing about your work do you want people working outside primary care to know or understand?
 
We know that health systems built on strong primary care foundations have better and more equitable outcomes, yet we fail to align our healthcare finance, delivery, and workforce development policies to maximize these outcomes. The COVID-19 pandemic amplified the effects of our historical under- and dis-investments in both primary care and public health. And it exposed critical vulnerabilities in our current system. It should not take a global pandemic to discover this misalignment, but it will require bold leadership, political will, and multi-disciplinary collaboration to learn from past mistakes.
 
Looking back on your career, what’s the most significant contribution to primary care that you or your team have made?
 
I am incredibly proud of the research and policy contributions our team at the National Center for Primary Care has made to advance health equity. Personally, I find the most joy and motivation in teaching medical students and residents about advocacy and the policymaking process. I have found that many early-career professionals are intimidated by the process and uninterested in the politics, which I completely understand! However, highlighting why their voices are critical and showing them the many ways they can integrate advocacy into their practices empowers them to act. Most primary care physicians are advocates at their core—and are trained to advocate for their individual patients. I find training the next generation of primary care physicians to advocate at the community-, population-, and policy-levels incredibly fulfilling, and it gives me tremendous confidence that we will achieve health equity.

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