Some healthcare coverage gaps around the world are so large that they could be considered chasms. AUA alumna Dr. Erin Kirkegaard doesn’t just talk about fixing healthcare and addressing these gaps on a global scale – she does it. This year alone, she traveled to Rwanda as a volunteer physician and Washington, DC as an advocate for more residency positions in U.S. teaching hospitals.
Passion for Primary Care
Currently, Dr. Kirkegaard is an Internal Medicine Resident at Providence Sacred Heart in Spokane, WA and teaches Internal Medicine at the University Of Washington School Of Medicine. She has also been heavily involved in medical research since her undergraduate years at the University of Washington. As an undergraduate researcher at Stanford University, she studied the interaction and replication of polio enzymes. Despite her love of research, she enjoys interacting with patients more.
“I’m not a big fan of sitting behind a lab bench all day – I prefer working with people,” said Dr. Kirkegaard. “That’s why I want to go into hospital medicine and global health.”
Working with Congress
Earlier this year, Dr. Kirkegaard traveled to Washington, DC with the American College of Physicians (ACP) to meet with lawmakers and advocate for Medicare reimbursement changes, more residency positions, and medical education reforms. She argued that the current Medicare reimbursement system, which compensates teaching hospitals for training residents and provides a fixed amount for services covered under the program, is unsustainable for doctors entering primary care positions, who are adversely affected by rate cuts.
“Student loan debt is a huge problem and partly the reason why there’s a shortage in primary care physicians,” said Dr. Kirkegaard. “Students opt to go into higher paying specialties because of the burdens of repaying their loans and lack of funds from Medicare to cover their expenses.”
The Complexities of Practicing in an Unfamiliar Culture
Recently, Dr. Kirkegaard returned from a three-week trip to Rwanda with Healing Hearts Northwest, where she assisted an intra-thoracic cardiac surgery team with peri-operative management of open-heart surgeries. In total, she helped with 16 procedures that repaired congenital heart defects and replaced valves that would have led to rheumatic heart disease. Her contribution was significant, as there were only four cardiologists available for the twenty million people in Rwanda. Many of the patients she worked with had no access to antibiotics and walked two hours to get to the clinic.
“Many people there could have died from strep throat,” said Dr. Kirkegaard. “The sequelae of strep throat eventually attack the heart valves if left untreated. It was an eye-opening experience.”
While working with these patients, social status complicated health decisions. One patient was hesitant to receive much needed heart surgery because there was a risk that she might become infertile. In Rwandan culture, women who can’t bear children are treated as outcasts.
“Our treatment options were limited due to the financial, cultural, and logistical confines of the Rwandan medical infrastructure,” said Dr. Kirkegaard. “It was clear, however, that this young girl’s failing heart, through no fault of her own, could not withstand a pregnancy and she would die without surgical intervention. She ultimately decided for the surgery.”
Dr. Kirkegaard is currently applying for a Global and Rural Health Fellowship, which focuses on improving healthcare in underserved communities around the world. She advises students seeking to follow her career path to study hard, ask questions, and be confident.
“There’s a misconception that Caribbean medical school students aren’t qualified to be physicians, but you can prove to your attendings that you’re as good as any U.S. medical student,” said Dr. Kirkegaard. “Through my outreach this year, I proved that any Caribbean medical graduate could make positive change throughout the world.”