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This week’s Making Rounds spotlights Aditya Chandrasekhar, a physician at Boston-based federally qualified health center Fenway Health and medical director at software company Primary.Health. The company designs software that helps schools, employers, public health entities, and other organizations run testing and vaccination programs for conditions such as Covid-19, flu, sexually transmitted diseases (STDs), and respiratory syncytial virus (RSV).
Chandrasekhar spoke about burnout and the healthcare industry’s slow adoption of new technology.
This interview has been lightly edited for length and clarity.
How are your two jobs related?
The community health center I work for focuses on LGBTQIA+ health. I do a lot of work and have a lot of experience working in this space and STD care in general—so not just treatment but also a lot of preventive services. And at Primary.Health, I essentially work on their current offerings, which are largely on sexual health, so home-based testing for various entities and linkage to care after that. I’m able to advise them on what their public health partners would be looking for because I have that clinical background and am doing the same at my clinic.
What is the biggest misconception people might have about your job?
Patients imagine that the industry has already made a lot of technological changes that may not have actually percolated to the ground level. I often hear my patients assuming—because we have electronic medical records (EMRs)—that I have access to their records from multiple hospital systems or previous providers. The reality is EMRs are still pretty fragmented. It’s improving over time, but they’re still pretty fragmented. We don’t always have that access at the click of a button, and I feel like that’s something a lot of patients assume would have already happened. They’re horrified to find out that doctor’s offices still use fax machines; I don’t know who else uses fax machines.
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What healthcare trend are you most optimistic about and why?
Healthcare has really moved beyond the traditional brick-and-mortar clinic, which is where most people imagine getting healthcare. Some of that was because the pandemic forced us to reimagine that border. Some of it is just innovation that happens—whether that’s access to your provider via telehealth, having test kits that come directly to your house, or now even remote patient monitoring, which allows providers to monitor your vital signs or labs without you having to leave your house. That’s a trend I’m very optimistic about, and it would truly enhance the ability of a lot of patients who live in areas where they’d otherwise struggle to access healthcare.
What healthcare trend are you least optimistic about and why?
We know that burnout is forcing a lot of providers—not just clinical providers, but clinic staff as well—to leave, and that’s a huge problem. Because historically, primary care has relied on that strong one-on-one relationship that exists between a provider and a patient, with a longitudinal continuity to it. And the fact that we are struggling to staff and maintain staffing is something that is of great concern.
Burnout is a very multifaceted thing to tackle. I wouldn’t say people are not doing enough, but I think sometimes our responses are slow and are not really getting to the root causes of what is causing burnout—whether it’s administrative burden, whether it involves flexibility that some providers might need to balance their work alongside their home or other activities.