Niran S. Al-Agba, MD

Niran S. Al-Agba is a pediatrician and can be reached at her self-titled site, Dr. Niran Al-Agba.

Is there hope for COVID with home visits?

Conditions

January 1, 2021

Health care has been hanging by a thread for some time — in our community and across the nation. The COVID-19 pandemic exposed weaknesses inherent in an underfunded public health system, a monopolized hospital, and a fractured medical supply chain.

At the beginning of this pandemic, I wrote, “Our lives will not be saved by the government. And lives will not be saved by elected officials or large institutions. Lives will …

A tale of two epidemics: COVID and obesity

Niran S. Al-Agba, MD

Conditions

November 13, 2020

Millions worldwide have had COVID-19. The largest obstacle to reining in this virus’s spread is that the range of symptoms is unpredictable, from minimal to severe respiratory compromise with diffuse lung damage and death.

As COVID-19 initially marched across China and Italy, scientists honed in on factors, such as old age, hypertension, diabetes, and coronary artery disease, which placed specific populations at higher risk. Unfortunately, one risk factor has proven to …

Delivering health care at a retail clinic isn’t something to be proud of

Niran S. Al-Agba, MD

Physician

August 9, 2020

When I describe it, many of you will instantly recall the Norman Rockwell painting of a doctor holding a stethoscope to the chest of a little girl’s doll.

Historian Neil Harris described that iconic image, published in a 1929 edition of the Saturday Evening Post, beautifully: “Such a willingness to place professional expertise at the feet of childhood magic serves to remind us, again, of things we …

The impact of economic inequality on the incidence of mass shootings

Niran S. Al-Agba, MD

Policy

February 20, 2020

Gun violence has become a public health epidemic. Despite countless deaths in mass shootings over the last two decades, the Dickey Amendment—a provision inserted into the 1996 spending bill which blocked federal funding for research on gun violence—remains on the books. While every politician, media pundit, and policy expert “know” the solution, the answers are not that simple.

In reality, the factors which have fueled the rise in gun violence across …

The health effects of structural racism

Niran S. Al-Agba, MD

Policy

November 15, 2019

In the United States, the health of African-Americans lags behind most other racial minority groups. Compared to whites, black men and women face higher risks of chronic illness, infection, and injuries. Taken altogether, the average life span for African Americans is six years less compared to whites. If we can begin to acknowledge that health outcomes are often dependent on factors outside of the control of individual patients, their physicians, or their health …

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The health effects of structural racism

When we ignore a child’s preventable suffering, we lose a piece of our humanity

Niran S. Al-Agba, MD

Policy

October 25, 2019

Sometimes an image captures the heart of a nation by putting a face on a human crisis. The one of Óscar Alberto Martínez Ramírez and his 2-year-old daughter Valeria lying face down in the Rio Grande after drowning was powerful. Their family had been turned away from crossing the border and decided to take their chances and swim across the river. They were not successful.

Why did this picture seize our attention? Is it because …

4 significant misconceptions about universal health care systems

Niran S. Al-Agba, MD

Policy

October 21, 2019

Recent polls show a majority of Americans support Medicare for all, but few seem to realize that no other system in the world operates like the current single-payer proposals in Congress. I addressed the concept of single-payer health care, with Cuba’s system as an example. Today I’m writing more about the ideas being discussed now in our country and how those compare to other nations that provide …

Understanding the distinction between universal health care and a single-payer system is critical

Niran S. Al-Agba, MD

Policy

July 4, 2019

The World Health Organization describes universal health coverage — a system coupling health care access with financial protection for all residents — as the “single most powerful concept that public health has to offer.” The goal of universal care is to give all people the equal opportunity to enjoy the best health possible.

I wholeheartedly endorse universal health care, though not a single-payer system like “Medicare for all” because there is …

A physician suggests how to improve Medicare

Niran S. Al-Agba, MD

Policy

May 23, 2019

This is a brief explanation of Medicare from a physician’s perspective, as well as my thoughts on how Congress could make adjustments that would bring us closer to universal care and provide the private market the freedom to improve health care outcomes.

Medicare is a national health insurance program that provides health insurance for Americans ages 65 and older, and those who are disabled or have specific chronic conditions. Medicare covers …

Lawmakers should stop trash-talking health care professionals

Niran S. Al-Agba, MD

Physician

May 15, 2019

Washington state Sen. Maureen Walsh (R-Walla Walla) became a national headline for alleging that “[nurses] probably play cards for a considerable amount of the day” during debate on legislation mandating break periods. Many nurses have mailed decks of cards to Walsh and posted pictures of blood-spattered emergency department walls in order to call attention to “last night’s card game,” driving home the point that they aren’t “playing” anything …

Medicare for all doesn’t look like single payer in the rest of the world

Niran S. Al-Agba, MD

Policy

May 9, 2019

Recent polls show a majority of Americans support Medicare for all, but few seem to realize that no other system in the world operates like the current single payer proposals in Congress. Recently, I addressed the concept of single-payer health care, with Cuba’s system as an example. Today I’m writing more about the ideas being discussed now in our country and how those compare to other nations …

How an insurance company auditor tried to destroy a physician’s career

Niran S. Al-Agba, MD

Physician

February 6, 2019

It’s no secret that in today’s health care market, insurance companies are calling the shots. As a pediatrician in private practice for almost two decades, I’ve seen insurance companies transform into perhaps the single most powerful player in today’s health care landscape — final arbiters whose decisions about which procedures or medications to authorize effectively end up determining the course of patient care.

Decisions made by insurers, such as MassHealth, have …

Why is Medicaid reimbursement below sustainability?

Niran S. Al-Agba, MD

Policy

January 15, 2019

Recently, a child was on a waitlist for five months to get into my practice. For this article, I will call him Tiny Tim.

Tiny Tim, now five years old, has a skin condition known as eczema or atopic dermatitis. When we first met, virtuously every area of his body was covered with wounds from constant scratching. Skin that breaks easily and heals poorly can give bacteria access to other parts …

Free medical school isn’t necessary a silver bullet

Niran S. Al-Agba, MD

Education

November 13, 2018

The New York University School of Medicine stunned the nation by announcing tuition for all current and future medical students will be free, irrespective of merit or financial need. Dr. Robert Grossman, dean at NYU, commented: “This decision recognizes a moral imperative that must be addressed, as institutions place an increasing debt burden on young people who aspire to become physicians.” NYU says their scholarship — which begins in the …

A physician’s breakthrough against prior authorization

Niran S. Al-Agba, MD

Meds

October 15, 2018

A few weeks ago, I saw a young patient who was suffering from an ear infection. It was his fourth visit in eight weeks, as the infection had proven resistant to an escalating series of antibiotics prescribed so far. It was time to bring out a heavier hitter. I prescribed ciprofloxacin, an antibiotic rarely used in pediatrics, yet effective for some drug-resistant pediatric infections.

The patient was on the state Medicaid …

When should insurance companies be held responsible for medical malpractice?

Niran S. Al-Agba, MD

Physician

September 25, 2018

In July, 2009, the family of Massachusetts teenager Yarushka Rivera went to their local Walgreens to pick up Topomax, an anti-seizure drug that had been keeping her epilepsy in check for years. Rivera had insurance coverage through MassHealth, the state’s Medicaid insurance program for low-income children, and never ran into obstacles obtaining this life-saving medication.

But in July of 2009, she turned 19, and when, shortly after her birthday, her family …

Can direct primary care save us from the tapeworms of insurance?

Niran S. Al-Agba, MD

Policy

August 24, 2018

When Amazon, Berkshire Hathaway, and JP Morgan (AmBerGan) announced their health care partnership, Berkshire CEO Warren Buffett declared “the ballooning costs of health care act as a hungry tapeworm on the American economy.” He is right. Our broken system is infested with tapeworms. Tapeworms are parasites; they exploit their hosts, drain resources, and suck the life out of their prey. Unfortunately, Buffet failed to call attention to the tapeworms specifically; …

This pediatrician supports the National School Walkout. Here’s why you should, too.

Niran S. Al-Agba, MD

Physician

March 13, 2018

The National School Walkout is planned for March 14, 2018 at 10 a.m. and will last 17 minutes in honor of the 17 students and staff members killed at Marjory Stoneman Douglas High School in Parkland, Florida, on Valentine’s Day. The heart of the nation has seemed to shift overnight regarding the debate on guns, but this change has been almost two decades in the making. United and Delta Airlines …

A 16-page note with little information to help physicians

Niran S. Al-Agba, MD

Physician

January 19, 2018

My pediatric practice is one which harkens back to days long ago when physicians knew their patients and pertinent medical histories by heart. My 81-year-old father and I were in practice together for the past 16 years; he still used the very sophisticated “hunt and peck” to compose emails. The task of transitioning to an electronic record system seemed insurmountable, so we remain on paper. Our medical record system has …

Can the dwindling numbers of primary care physicians explain decreased life expectancy?

Niran S. Al-Agba, MD

Policy

January 15, 2018

Newborns born in 29 other countries of the world have life expectancies exceeding 80 years; yet, an infant born in the U.S. in 2016 is expected to live only 78.6 years according to recently released statistics. While death rates fell for 7 of the 10 biggest killers, such as cancer and heart disease, they climbed for the under-65 crowd. The irrefutable culprit is the unrelenting opioid epidemic.

Last year, life expectancy …

Niran S. Al-Agba, MD

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