CM Krishnan Q&A: Chokshi on prevention vs reactive medicine

Thank you.

And perhaps there are ways that, while not all of it is in your jurisdiction, but there are ways that we could work together to think about larger awareness campaigns around it.

My final question, just zooming out, you know, apart from your nomination too, but more broadly,

you know, one of the things that troubles me a lot is aside from healthcare becoming more and more unaffordable, insurance premiums going up, services being cut to allow, you know, billion-dollar insurance companies to further profit.

It's all stemming from a view that I'm seeing in medicine more and more of reactive care, where once someone gets sick or has a heart attack, there's a battery of tests, you're coded a certain way

under insurance company rules.

But before that, from a prevention standpoint, it's often very difficult to get the care that you need.

And that care really starts, as you know, a lot earlier, years before a health incident can happen.

But we don't focus enough on prevention in medicine, and that's driven a lot by insurance companies and larger profit measures and things like that.

And, you know, I think that the lack of focus on prevention really affects low-income communities of color especially.

And I think you speak about it too when you talk about racism in the context of public health.

These are all connected.

And so when we don't reach out and really inform people of the importance of prevention and offer preventative services, the disparate harms of that are felt by low-income communities of color.

And so I just wonder, you know, in your role in the Board of Health, as we think about community engagement and outreach too, how can the board work to help?

In its own way, shift perspective from reactive medicine to preventative care.

That's really well said, Councilmember.

Thank you for shining a light on that.

I've dedicated

my career to primary care and public health, which both have prevention at their heart.

And it troubles me also the degree to which the money does not follow that paradigm of investing in prevention.

And so that is, you know, a posture, a viewpoint that I will bring to deliberations on the Board of Health to ensure that prevention remains at the center,

that we, as we sometimes say in medicine, look upstream, not just to the reasons that someone comes with illness-seeking care, but the deeper, you know, causes.

That underlie that illness in the first place.

And all of that, I believe, is the remit of public health.

Thank you.

Thank you, Chair.

Thank you.

And now I'd like to pass it over to the majority of your aburial.