The state of healthcare in Tennessee: not good

The legislature’s continued failure to take Medicaid expansion funds and interference in physicians’ performance are corrosive to healthcare professionals

February 20, 2023 6:02 am
COVID-19 deaths in Tennessee have surpassed 29,000 since the pandemic began. (Source: Centers for Disease Control and Prevention)

COVID-19 deaths in Tennessee have surpassed 29,000 since the pandemic began. (Source: Centers for Disease Control and Prevention)

It is becoming increasingly hard to be a healthcare provider in Tennessee. 

From the COVID-19 pandemic, gun violence, the opioid epidemic, dismal maternal mortality rates, a mental health crisis, rural hospital closures and the failure to accept Medicaid expansion, there are so many ways Tennessee leaders have failed — and continue to fail — their citizens.

The Tennessee state legislature hampered our future response to pandemics by limiting the control and decision making capabilities of local public health departments. Legislators have also hindered efforts to vaccinate Tennesseans by listening to anti-science out of state doctors, some who have been censured by their state medical licensing boards and have now had their board certification stripped for spreading disinformation.

Tennessee has now surpassed 29,000 COVID-19 deaths, according to the most recent data from the Centers for Disease Control. Our state has the 7th highest death rate in the U.S. If Tennessee were its own country, we would have the 8th worst death rate from COVID in the world.

In August, a month after the U.S. Supreme Court overturned federal protection for abortion inherent in Roe v. Wade , the “Human Life Protection Act” went into effect here. My colleagues and I became targets for criminal prosecution for doing our jobs. 

It is currently illegal in Tennessee for physicians to treat ectopic pregnancies and other emergencies that occur during  pregnancy due to the affirmative defense clause of the act. This threat of criminalization has struck fear in the hearts of many Tennessee physicians and has led to delays in necessary care for several pregnant patients thus far. Many physicians have left the state rather than practice medicine in an environment where they are forced to provide subpar healthcare. Medical students and residents are rethinking coming to Tennessee to train and to establish their careers.

Memphis is ranked 7th among U.S. cities for number of HIV infections, yet the Tennessee Department of Health will not accept federal funding for HIV testing and prevention.

The Tennessee Department of Health announced a decision to reject federal funding for HIV testing and prevention, which will no doubt lead to an increase in HIV infections. 

Memphis has ranked in the top 10 cities for HIV infections over the past few years. Decreasing funding for testing and prevention will hamper our efforts to combat this outbreak. This shortsighted policy, seemingly based on retribution and religious ideology, will no doubt cost the state millions of dollars when HIV rates rise and infected individuals need treatment in the form of expensive medications and therapies. Apparently the folks at the top of Tennessee’s government have forgotten that an ounce of prevention is worth a pound of cure. 

Tennessee lawmakers started the new year by filing several bills attacking transgender healthcare. I have seen my colleagues at Vanderbilt Medical Center come under attack for providing healthcare to some of the most vulnerable children in Tennessee. Many physicians are afraid to speak up, lest they become targeted as well. I know physicians who are thinking of leaving the state as a result of this persecution. 

Fewer doctors will worsen healthcare for everyone.

 COVID-19 Nurses at Vanderbilt University Medical Center in protective gear. (Photo: John Partipilo)
COVID-19 Nurses at Vanderbilt University Medical Center in protective gear, in 2020. (Photo: John Partipilo)

If we want to improve healthcare in Tennessee, our legislators need to stop the attacks on doctors and medicine. Let doctors do their jobs and care for their patients without the interference of the government. We are already regulated by our medical societies and medical boards. Doctors are trained to provide high quality, compassionate and evidence based healthcare to their patients. 

Unfortunately our legislators are currently doing the opposite with Senate Bill 1 and its House companion, putting Tennessee’s transgender youth at risk of mental health crises and suicide. 

When these young people inevitably end up in the emergency department seeking care for their mental health after being turned away for seeking necessary, appropriate healthcare, my fellow emergency physicians and I will be there to provide care and support. I only hope that by the time they arrive in my emergency department it’s not too late to save their lives. 

When will the persecution of the medical profession end? When will the Tennessee legislators let doctors practice medicine the way we have been trained? I hope more people start to see through the harmful policies and political rhetoric and demand our leaders protect and expand access to healthcare. 

The question is, will we right the course of Tennessee healthcare before we see more physicians leave the state and before thousands more Tennesseans die unnecessary, preventable deaths.

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Dr. Katrina Green
Dr. Katrina Green

Dr. Katrina Green is a board certified emergency physician who practices in Nashville and Lawrenceburg. Her degree in medicine is from Wayne State University and she completed a residency in emergency medicine at Indiana University. She lives in East Nashville with her husband and two cats.