Member Spotlight: Dr. Adam Milam Is a Public-Health Triple Threat

  

The standard of medical care shouldn’t change depending on who and where you are in the U.S., but that’s the reality for millions of Americans. Young physician Adam Milam, MD, PhD, has made it his mission to study the underlying factors that contribute to health inequity, earning an alphabet of degrees in public health and medicine to do it. In this ASA Community Member Spotlight, he shares what he’s learned so far.



BA in public health and history of science and medicine, master’s degree in health science, doctorate in public health, medical doctor…that’s a mighty impressive CV! How have your non-clinical studies informed your approach and practice as a physician?

My non-clinical studies and time spent in the community exposed me to all the factors that impact health which are often beyond the control of physicians. During graduate school, most of my work focused on the impact of the built and social environment on children’s exposure to violence, alcohol, tobacco, and other drugs. These studies found that children and adolescents were consistently exposed to toxic stressors in their neighborhood and lacked access to clean parks, playgrounds, and grocery stores that sold healthy food. These factors, which we refer to as the social determinants of health, have a huge impact on the health and well-being of certain segments of the population.

I think this experience provided me with an additional perspective when caring for patients, not only do I get to know my individual patient, but I often have a more holistic view of the patient. I understand why they may not be complaint with their medications or how difficult it is to maintain a healthy diet. This is important as physicians can assume patients are non-complaint because the patient does not care or are not taking their health seriously; there are many obstacles for maintaining a healthy lifestyle among many segments of the populations.


Tell us about your research into health disparities and substance abuse. What first drew you to these areas of inquiry and what are you learning?

I grew up in Baltimore, MD, so I was aware of many of the health challenges that the city faced. Baltimore was known for its high prevalence of residents addicted to heroin and other drugs as well as being plagued with violence. This was also reflected in the TV shows, ‘The Corner’ and ‘The Wire.’

During my undergraduate studies I majored in public health and joined a research study that examined characteristics of the built and social environment in every neighborhood in Baltimore City. The study sought to understand the features of the built and social environment that may contribute to youth exposure to violence, alcohol, tobacco, and other drugs with the goal of developing interventions and policies that would reduce youth exposure to these hazardous aspects of the environment.  I continued this line of research because I thought it would have a significant impact on the health and well-being of youth in Baltimore and similar areas. This research helped inform legislation and was used in Baltimore’s zoning rewrite. I have continued to study risk factors and preventive strategies for substance use in adolescent populations.

Similarly, my interest in studying health disparities started with after volunteering in the community and observing the stark difference in health and access to healthcare by race and income. I later worked with the health department and helped develop neighborhood health profiles that found a 20-year gap in life expectancy in two communities less than five miles apart. My goal since then has been to bring attention to racial disparities in health and the lack of access to quality healthcare in minority and impoverished populations.


You were just finishing up your residency at Cedars-Sinai Medical Center in Los Angeles when COVID-19 hit. What was your experience during the early days of the pandemic, both personally and professionally?

The early days of the pandemic were tough, both personally and professionally. Similar to everyone across the globe, the social distancing completely altered my life. I loved living in Los Angeles because of all the outdoor activities - going to the beach or a quick hike with amazing views at Runyon Canyon. Suddenly, I could not do any of these activities; it was a huge adjustment! Additionally, not being able to visit family and friends was equally frustrating.

Professionally, the pandemic brought another set of problems and obstacles. While elective cases at the hospital were cancelled, the ICU and OB floors remained busy and we had to adjust to the new normal to manage patients at the hospital with constantly changing guidelines.

My public health background and my work in the area or health disparities also thrust me into additional responsibilities - I worked with several national organizations to develop strategies to address the racial disparities in COVID-19 testing, cases, and mortality. My evenings were consumed with Zoom meetings and conference calls which I did not mind because the work was important and meaningful.

By April, Los Angeles had established two dozen or so emergency shelters to reduce the spread of virus. Several health centers were asked to provide medical services at these emergency shelter. I had the opportunity to serve as the medical lead from the Cedars-Sinai team, providing medical care at four emergency shelter. The team included two nurse practitioners, three nurses, two social workers, and a dental hygienist. This was one of my most rewarding experiences during residency - assisting this often-overlooked community access care and connecting them to medical homes. At the same time, it was frustrating reminder that segments of our population are unable to fulfill basic needs or access necessary medical and dental services.


You’ve been very active in the California Society of Anesthesiologists, serving as Director of their In-Training Practice Forum, among other leadership roles. Why do you think it’s important to get involved with your state component society at such an early stage in your medical career?

I’ve always been interested in the intersection of policy and health. The CSA devotes resources and time to advocating for policies and legislation that protects our patients. I got involved in CSA and subsequently ASA to help advocate for our patients and learn more about challenges facing our specialty. I was able to meet with legislators in Sacramento and Washington DC to advocate for my patients and our specialty.

I also had the opportunity to be mentored by leaders in anesthesiology through my involvement with CSA; this was a welcomed surprise. The support I received from the organization especially while applying for fellowship and faculty positions was invaluable. Working with the CSA and state component societies also helps with professional development and provides another networking opportunity; many of the leaders that I look up to became involved in their state societies and ASA early in their career and I believe that early involvement was one of the keys to their success.


Is there anything else you’d like to discuss that we haven’t yet touched on?

No, great questions!



Adam Milam, MD, PhD, is a Cardiothoracic Anesthesiology Fellow at Cleveland Clinic. He completed residency at Cedars-Sinai Medical Center. He holds a MHS as well as a PhD in Public Health from the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health. His research is rooted in practices, policies, and interventions to address health disparities and health inequities.


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ASA Community Blog is published as a benefit for ASA members. The views expressed on this blog are those of the individual contributing writers only and do not necessarily represent the opinions of ASA.

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Comments

17 days ago

Great interview. Best of luck to Dr. Milam and his career in anesthesiology. He brings an amazing background to our field and we are lucky to have him as a fellow anesthesiologist.