The following is a transcript of the podcast episode:
Rachael Robertson: Hey, listeners. Welcome back to MedPod Today, the podcast series where MedPage Today reporters share deeper insight into the week's biggest healthcare stories. I'm your host, Rachael Robertson.
First up this week we're talking with Sophie Putka about her reporting on reproductive healthcare in New Mexico. Then, I'll share about a new research letter about film portrayals of physicians. Finally, Kristina Fiore shares the latest updates on vaccine recommendations.
It's been a little over a year since the Supreme Court overturned Dobbs v. Jackson Women's Health Organization. Texas passed strict bans right away, leaving patients there with no access to abortion care. New Mexico is the only state bordering Texas that hasn't also banned abortion. The states share a long border, and patients sometimes drive over 1,000 miles from Texas to New Mexico to get care. Planned Parenthood of New Mexico has actually had to cut back on its other services to keep up -- but not only because of Dobbs.
Sophie Putka brings us a report from New Mexico. Sophie, can you start by telling us a little about New Mexico's history with reproductive care?
Sophie Putka: Sure. So I talked with Adrienne Mansanares, the head of Planned Parenthood of the Rocky Mountains, who said that New Mexico has a long history of protecting reproductive healthcare. But more recently, during the pandemic, they made abortion care an essential service and Texas did not. So when the Supreme Court decision happened, they doubled down and set aside government funds to build a new clinic across the border from El Paso to prepare for what they knew was coming from Texas.
Robertson: What happened in New Mexico once Texas started to ban abortions?
Putka: So Texas' abortion bans started even before the Supreme Court decision -- all the way back in September of 2021 with a bill known as SB8 that banned abortion after 6 weeks. Right after SB8, New Mexico started seeing patients from Texas flooding in. It got even worse after the Dobbs decision in June of 2022 when Texas' trigger ban took effect.
So in the 10 months after, New Mexico saw more abortion patients from Texas alone than all the state's abortion patients combined in the 10 months before SB8. And this is all on top of a huge strain on healthcare workers and staff shortages from the pandemic.
Robertson: How has Planned Parenthood been handling reproductive care services in the region recently?
Putka: Well, so those three things -- SB8, Dobbs, and the pandemic -- have made it so Planned Parenthood in New Mexico has actually had to limit its reproductive services over the last few months. Things like routine wellness visits, STI [sexually transmitted infections] tests, visits for pain or infection, birth control, and post-exposure prophylaxis for HIV.
Somewhere between three to four of the five Planned Parenthood locations in the state have had to cut back on reproductive health services in the recent weeks and months. For now, they're prioritizing abortion care. But even so, when I last talked to Planned Parenthood, only one location was able to offer procedural, or surgical, abortion. They just don't have enough clinicians to meet the need. And last time I checked, only a few of the five were offering medication abortion. But people can also get telehealth appointments for some things.
Planned Parenthood has been redirecting patients to New Mexico's independent clinics for those other services. The University of New Mexico's clinic along with Whole Woman's Health, which relocated from Texas, both told me that their wait times are very short -- not only for those other services, but also for abortion care.
Robertson: Thanks so much, Sophie.
Putka: Thank you.
Okay, Rachael, now it's my turn to ask you questions about a new research letter in JAMA Internal Medicine. So a team of researchers analyzed movie portrayals of doctors from the past three decades -- 1990 to 2020. There were about 2,300 characters in total, and the authors found that women made up less than 20% of physician characters and movies.
So why did researchers decide to quantify this trend in the first place?
Robertson: Yeah, so it's not particularly surprising that women physicians are underrepresented in film. I spoke with two of the study authors and they both emphasize how seeing yourself represented is important. Bismarck Odei, who was one of the authors, told me that seeing a Black physician in film affected his own decision to pursue medicine.
In real life, women are more than half of medical students, and a growing percentage of practicing doctors; 2022 data from the Association of American Medical Colleges show that about 37% of physicians are women -- and that is growing. In sum, media portrayals of doctors don't actually reflect what the profession looks like.
Putka: Got it. So what other trends did their analysis reveal?
Robertson: A whopping 80% of physician characters were men, and the vast majority of those characters were white. In the past three decades, there were only 22 instances where women physicians were a lead character. In 20 of those cases, that woman was white, and only twice was the lead physician character a woman of color.
The researchers also found that 70% of movies with a physician character only had men represented as doctors. And if there was more than one doctor portrayed, it was more likely that there would also be a woman doctor. Plus, movies that are rated G or PG were more likely to portray all physician characters as men compared to movies rated PG-13 or R.
Putka: Wow. So how does this research letter line up with previous research?
Robertson: I spoke with Professor Vesta Silva, who teaches both communication and global health, and she says that movies tend to lag behind TV -- and that's both scripted TV and reality TV shows. So it makes sense that film doesn't reflect what the medical profession actually looks like.
Silva also pointed out some interesting limitations to the study. For instance, the authors used binaries when categorizing both race and gender, and using just white or non-white doesn't capture the nuance of the racial breakdowns of movies. Other research on TV has shown that international characters, Asian, and Hispanic doctors are all underrepresented compared to the actual numbers in the field. The research also didn't say whether the representation of a physician character was positive or negative, and Silva says obviously that really impacts how that representation matters. The authors say that future research should look at more specific identities like different races, ethnicities, and genders, and look at some trends broken down that way.
Putka: Really interesting. Thanks, Rachael.
Robertson: The FDA and CDC have yet to weigh in on fall COVID boosters. However, experts in infectious disease and public health are already talking about who should get them and who might not need them. With us now is Kristina Fiore to talk about her story about who should get a COVID vaccine this fall.
So Kristina, where do we stand with fall COVID boosters at this point?
Kristina Fiore: Hey, Rachael. So back in June, an FDA advisory committee recommended that all boosters target the XBB lineages of COVID -- in particular, XBB.1.5., but that's no longer the dominant variant. But we're still seeing Omicron lineages dominate. And so experts think that this monovalent boost will be a good match.
The FDA still has yet to authorize these boosters. And then after that, the CDC's Advisory Committee on Immunization Practices, or ACIP, will have to make their recommendations on who should get them. So ACIP recently scheduled a meeting for September 12, so we can expect that the FDA will authorize the booster just shortly before that.
Robertson: Hmm. So what do the experts think that the CDC is going to recommend?
Fiore: So, of course, there's hesitancy to predict how the CDC and the ACIP will act, but one doctor told me that there will likely be, quote, "risk discussion about whether to make a more graded recommendation for younger people."
So I spoke with experts from the Infectious Diseases Society of America and the American Public Health Association. And even there, I was quite surprised to find that they didn't necessarily think that everyone needs a COVID booster this season.
So there's no doubt that high-risk people, including the elderly, people with chronic conditions, people who are immune compromised, and even pregnant people -- those people should get a definitive recommendation to get the latest booster.
But when it comes to younger, healthier people, experts said it's not clear that they need one. So I'll give you a quote from Dr. Georges Benjamin, who is the executive director of the American Public Health Association, and he said, quote, "the good news is that if you've had the full primary series of the vaccine and bivalent booster, or you are vaccinated and infected, you have substantial protection against getting very sick and dying."
Robertson: So how about young kids? Are they going to need a booster?
Fiore: So again, the sentiment seems to be that they don't need one. Paul Offit, of Children's Hospital of Philadelphia, has argued that the intention of a vaccine is to prevent hospitalization and death, because we're just not going to prevent transmission and mild illness. So here's a quote from Offit: He said, "Why does a healthy 12-year-old with three doses of vaccine need another dose? There would have to be protection against severe disease, and I just don't see that evidence."
And a lot of other experts agreed with him, and they all noted that a child who is sick or immune compromised -- now that's a different story, and they should definitely be protected with a booster. So that's where the experts in infectious disease and public health stand, and we'll see what CDC says on September 12.
Robertson: Awesome. Thank you so much, Kristina. We'll talk to you again then.
And that's it for today. If you like what you heard, leave us a review wherever you listen to podcasts, and hit subscribe if you haven't already. I'll see you again soon.
This episode was hosted by Rachael Robertson and produced by Greg Laub. Our guests were MedPage Today reporters Sophie Putka, Rachael Robertson, and Kristina Fiore. Links to the stories are in the show notes.
MedPod Today is a production of MedPage Today. For more information about the show, check out medpagetoday.com/podcasts.