In February of this year, the Centers for Medicare and Medicaid Services (CMS) announced its “Universal Foundation” for aligning quality measures across its own programs. The CMS effort is not specific to primary care, but it defines an initial list of measures that falls almost entirely on primary care to capture and comply. It is also directly opposed to recent recommendations to reduce clinician burden, to align measures with the purpose and function of care delivery, and to promote person-centeredness.

The District’s dire health disparities were on the mind of D.C. native Madeline Taskier, M.D. ’19, when she chose a career in family medicine as the best way to help her community. After earning her degree at George Washington University, she pursued a family medicine residency―and encountered the tremendous barriers her patients often faced in health care.

“The other trainees and I were constantly frustrated by the way our patients were treated within the system,” Taskier said. “I’d think, ‘why is the medicine I’ve prescribed not covered by insurance? Why does my patient have to wait a month and a half for this test?’ This all relates to health policy, and I came away from residency wanting to understand why this doesn’t work for us and our patients.”

As recent extreme weather events demonstrate, climate change presents unprecedented and increasing health risks, disproportionately so for disadvantaged communities in the U.S. already experiencing health disparities. As patients in these frontline communities live through extreme weather events, socioeconomic and health stressors are compounded; thus, their healthcare teams will need tools to provide precision ecologic medicine approaches to their care. Many primary care teams are taking actionable steps to bring community-level socioeconomic data (“community vital signs”) into electronic medical records, to facilitate tailoring care based on a given patient’s circumstances. This work can be extended to include environmental risk data, thus equipping healthcare teams with an awareness of clinical and community vital signs and making them better positioned to mitigate climate impacts on health.