I’m a big fan of prevention, understanding that everyone dies of something, and not all health problems are preventable. That said, it’s crazy how our fears about illness and death overwhelm our better judgment from time to time, and how people with a service to sell sometimes let their ambition get in front of the […]
Michael Fine, MD
Michael Fine, MD, is a writer, community organizer, and family physician. He is the chief health strategist for the City of Central Falls, RI, and a former Director of the Rhode Island Department of Health, 2011–2015. He is currently the Board Vice Chair and Co-Founder of the Scituate Health Alliance, and is the recipient of the Barbara Starfield Award, the John Cunningham Award, and the June Rockwell Levy Public Service Award. He is the author of several books, medical, novels and short stories, including On Medicine and Colonialism, Rhode Island Stories, and The Bull and Other Stories, You can learn more about Michael at www.michaelfinemd.com
Posted inColumns
Dr. Michael Fine: What’s crazy about what insurance companies want – and a little about our politics
I was asked to look at a few bills about primary care that were presented this week for hearing in the legislature. One of these bills allows physicians to charge administrative or operational fees to support their overhead. Another allows physicians to charge optional fees for non-covered services. Another keeps insurers from requiring physicians to […]
Posted inColumns
Dr. Michael Fine: A new med school at URI is a crazy good opportunity
Some friends and colleagues from Brown University Health are arguing that Rhode Island doesn’t need a new medical school at URI – and that such a new medical school won’t help address Rhode Island’s primary care physician supply crisis. One part of that is true. If you dropped a medical school from outer space into […]
Posted inColumns
Dr. Michael Fine: What’s crazy about hospitals and money
It’s budget time again at the Statehouse. I’m hearing that Rhode Island’s hospitals are asking the legislature for money. Again. This happens every year, and usually the hospitals tell us about a crisis that provides a very good reason for those hospitals to get another $100 million of our tax dollars. This year the crisis […]
Posted inColumns
Dr. Michael Fine: What’s crazy about blood
As you may have read, the Rhode Island Blood Center has put out a call for blood donations – and it is extremely important that you donate if you can. Lives literally depend on these donations, for which there is no effective substitute. AI can’t donate. You can. Please consider it. That said, understanding how much […]
Posted inOpinion
Dr. Michael Fine: What’s crazy about paying for medical school
Before I describe the incredible cost of medical school, I want to mention how I paid for my medical education. I didn’t. You did, and I am very grateful for that. Like about 1800 other American medical students in 1979, I was lucky enough to get a National Health Corps Scholarship, which paid my tuition, […]
Posted inNews
Dr. Michael Fine: What’s crazy about getting into medical school. Part 1.
Ok. We are somewhere between 50,000 and 300,000 doctors short. Probably more, given our current approach to immigration, because 25 percent of all doctors in the US come from other countries – because we don’t send enough of our own students to medical school. Instead, we import our doctors from elsewhere, from places who need […]
Posted inColumns
Dr. Michael Fine: What’s crazy about keeping Roger Williams and Fatima Hospitals alive?
We are now seeing the predictable twisting in the wind as our state leadership struggles with what to do about Roger Williams and Fatima Hospitals, which are bankrupt. Nobody in state government likes to see hospitals close, in part because people work at hospitals and those people vote, and their unions have lobbying power. That […]
Posted inEnvironment & Health
Dr. Michael Fine: What’s crazy about medicine
This week’s column is about two apparently unrelated events: my re-reading of The Citadel, by AJ Cronin, a classic novel/tearjerker about a British General Practitioner, written in 1937, and the new nutrition guidelines from HHS put forward by RFK Jr. There is a common thread, I promise, which is that medicine and health are not the […]
Posted inColumns
Dr. Michael Fine: What’s crazy about the work we ask healthcare workers to do
I spent the last few weeks studying and taking tests so I can continue my Board Certification (in Family Medicine). Physicians and other health care workers are licensed by the State of Rhode Island and must pay a hefty fee for that privilege, as well as show evidence that we have studied the new developments […]
Posted inColumns
Dr. Michael Fine: What’s crazy about the Hepatitis B Vaccine and SNAP
This has been two weeks of particular craziness in health care, in which everyone, on all sides, did their level best at missing the boat. First, our friends at CDC’s Advisory Committee on Immunization Practices went ahead and changed the recommendation for Hepatitis B vaccine for newborns, a crazy change if ever there was one. […]
Posted inColumns
Dr. Michael Fine: What’s crazy about vaccines and RFK Jr., redux
First, now is the time to get a flu shot if you haven’t gotten one already. Flu is spreading in some southern and western states. Holiday travel will bring it here. Don’t delay. That said, I got the bill for the COVID-19 shot I had last month. Or rather, I got a record of the […]
Posted inColumns
Dr. Michael Fine: What’s crazy about healthcare in the developing world
I am writing from the Island of Brava, in Cape Verde, where I worked for a week with a great little organization called Project Health CV, which brings American volunteers to Cape Verde a few times a year to augment the health care that people in Cape Verde get from the government and the tiny […]
Posted inColumns
Dr. Michael Fine: What’s crazy about COVID-19 and the flu vaccine now
I had a COVID-19 vaccine last week. I’m traveling in 10 days and wanted to make sure I don’t get sick when I’m traveling. Better safe than sorry – better jabbed than stuck in a hotel room for five extra days, unable to go out. Or hospitalized. The COVID-19 vaccine was easy to get and […]
Posted inColumns
Dr. Michael Fine: Three things that are smart, not crazy, about health care
Three logical, smart, and hopeful things happened in health care in the past few weeks. I’m glad to be able to tell you about them. The first good thing is that the Rhode Island Department of Health joined Connecticut, Massachusetts, Vermont, Maine, Maryland, Delaware, New Jersey, Pennsylvania, and New York to form the Northeast Public Health […]
Posted inColumns
Dr. Michael Fine: What’s crazy about public health and gun violence
Crazy might not be the right word. Heartbreaking or heartrending would be better. But even heartrending isn’t strong enough. In these United States, our rate of gun death is 4.42 deaths per 100,000 population, the sixth highest in the world – but many times the rate in other developed nations. Of developed nations, only Greece, Austria, […]
Posted inColumns
Dr. Michael Fine: What’s crazy about COVID-19 in the fall of 2025
We are in the middle of a COVID uptick. These upticks now happen a few times a year. It will likely be a few more years before COVID-19 infections settle into a more stable pattern, like influenza, so it is worth commenting when an uptick happens, so people know what to expect and how to plan. […]
Posted inColumns
Dr. Michael Fine: What’s crazy about RFK, Jr. and nutrition
In a recent Wall Street Journal Opinion piece, published just before he fired the CDC Director, our HHS Secretary, Robert Kennedy Jr, argued that physicians should be taught about nutrition. He cited some very nice statistics about how little nutritional education physicians get. Poor diet kills 500,000 people a year, RFK Jr wrote. So, he […]
Posted inColumns, Opinion
Dr. Michael Fine: Two kinds of crazy
The first part of this week’s comment is about health, not health care. RIPTA, the organization that runs the buses in Rhode Island, is planning the largest set of route cuts in its history – to save $17.6 million. (There was a public hearing on this in Newport on Tuesday.) These cuts seem like a […]
Posted inCity & Government
Dr. Michael Fine: What’s crazy about maternity care
Kudos to everyone in Newport who turned out at the city council meeting Tuesday night, and to the city council for passing a resolution asking Brown Health to keep the maternity unit at Newport Hospital open. It’s crazy we are at this point in the US, where we have to worry about providing something as […]
Posted inColumns
Dr. Michael Fine: What’s crazy about who is what?
I went to physical therapy on Monday for my messed-up shoulder, and was a little disturbed when the receptionist said, Dr. X will see you now. A part of my brain said, I haven’t come to see a doctor — I’ve come to see a physical therapist. And then the other part of my brain […]
Posted inColumns
Dr. Michael Fine: What’s crazy about paying $10 per month for primary care
First, the good news: kudos to our legislature for focusing on primary care. Thanks to the work of Senator Pam Luria, Speaker Joe Shekarchi, Senate President Valarie Lawson, Attorney General Peter Neronha and many many others, some critical primary care bills – funding a new family medicine residency for Woonsocket, improving primary care reimbursement under Medicaid by […]
Posted inColumns
Dr. Michael Fine: What’s crazy about RFK Jr. and the ACIP
The news from Monday is that Robert F. Kennedy Jr. (RFK Jr.), the Secretary of U.S. Department of Health and Human Services (HHS), just “retired” all 17 members of the Advisory Committee on Immunization Practices (ACIP). He published an editorial in the Wall Street Journal to explain this. I’m not sure which is worse, his […]
Posted inColumns
Dr. Michael Fine: What’s crazy about medical school debt
Holy Harry and Louise, they are at it again. Now, everybody is talking about the health care mess in Rhode Island. You know it’s a mess when politicians, who are almost all lawyers, give news conferences and talk about how they are going to fix health care, and the experts they trot out are all lawyers as well, none […]
Posted inColumns
Dr. Michael Fine: What’s crazy about the Surgeon General of the United States
We have a new Surgeon General nominee, Casey Means, a health influencer and former doctor who replaces Janette Nesheiwat, an urgent care doctor and Fox News host, as the nominee. Dr. Nesheiwat was suddenly reassigned to help RKF Jr., the erstwhile HHS secretary, in other ways, because she was criticized by Laura Loomer (who apparently […]