How Can Others Improve Health Outcomes for Sickle Cell Disease?
More Programs and Publications Featuring Dr. Alexander Glaros
In this program:
Sickle cell disease expert Dr. Alexander Glaros shares advice for aspiring medical students who want to improve sickle cell health outcomes in this Heart Behind the White Coat (HBWC) program. Watch as Dr. Glaros explains the differences in health equities between adult and pediatric sickle cell disease patients.
Read Transcript
Antonia Marsh:
Regarding your experience with medicine, have you noticed any different inequities for pediatric sickle cell patients versus adult sickle cell patients?
Dr. Alexander Glaros:
I focus mostly on pediatric patients at the moment. The differences I think are, unfortunately, based a lot in two areas, one is insurance and repayment because a lot of the adults we take care of unfortunately don't have insurance versus pediatric patients they're often or pretty much always have Medicaid and they can get – they can pay for their preventative visits. Everyone's going to be taken care of in the emergency room, but really, it's those preventive visits, getting ahead of sickle cell disease, routine screening for organ damage and all that kind of thing, that's really what's going to make an impact, and that's what's improved the care of sickle cell so much, and that's easier in pediatrics than it is in adults. The other reason it's easier in pediatrics is because there's a lot better access because there's pediatric hematologist who take care of sickle cell patients in addition to a number of other diseases and in adults, there's not a lot of people who take care of patients with sickle cell disease.
It's really hard for us when patients turn 18 and 19 and they graduate from our clinic, and then they end up going out into the world and we're sort of left in, you have to find another doctor, but we can't always give them a good doctor who's very informed on sickle cell disease, we were lucky to have an adult hematologist who took care of sickle cell in Detroit, but there are so many patients that we need more and those patients need more, so it's really an access issue, access to care and payment for the care that they need. The things I mentioned earlier about school, some of those kids have problems with learning and they have problems not going to school, because they have pain episodes where they have to be in the hospital, and there's not enough support out there from the school system to kind of help catch them up, always. So it's very easy to get behind, and that just makes everything more stressful. And stress can create more problems with sickle cell disease, so we really have to get the word out and promote understanding of the disease.
Antonia March:
Do you have any advice for aspiring students in medicine who want to make a difference in sickle cell health outcomes?
Dr. Alexander Glaros:
I think the advice I would have is just to continue having that interest, that's half the battle is just having the interest, because there are not enough people out there taking care of sickle cell disease, and I would say, start talking about it now, start advocating, start being an ally to those patients because it's very – like I said, even going through medical school, I barely heard about sickle cell disease, it wasn't until residency, a little bit and even fellowship that I really started to learn about sickle cell disease because my residency, for instance in pediatrics, I think I only saw two patients, in the entire three years with sickle cell disease, so it just depends on where you end up.
But if you have that interest from the start, it's really important to talk about it with your friends, talk about it with your family, learn about the inequities that they face, learn about the misunderstandings, just learn about what they go through and talk to those patients, talk to the communities. Because without keeping it at the forefront of your mind, it's going to get lost, and you're going to start veer in different directions, because you're not going to hear about it a lot, unfortunately. It's something we would like to change in the medical education, but we're not necessarily there yet, so I think just maintain that interest and maintain that passion.
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