"It's Heartbreaking" - Emergency Medicine Professionals Actively Oppose the Aggressive Harm to Public Health and Safety by the Party of Convicted Felon Donald J. Trump
An interview with Emergency Medicine physician Dr. Halleh Akbarnia by Kimberly J. Soenen | February 24, 2025
(Dr. Halleh Akbarnia.)
Dr. Halleh Akbarnia is an Emergency Medicine physician practicing primarily at Advocate Lutheran Medical Center in Park Ridge, Illinois. Much of her career has been devoted to teaching and resident education, a passion developed during her own residency program at Virginia Commonwealth University, where she went on to serve as faculty and as Assistant Program Director for the Emergency Medicine Residency Program before relocating to Chicago 17 years ago.
She is also dedicated to improving Public Health, and has committed much of her time giving back throughout the years by serving on various hospital committees, including her Incident Command involvement, Emergency Disaster Preparedness, Critical Care and various educational Residency Committees.
She enjoys providing students with information about medical careers and promoting STEM pathways for young women; and through involvement with projects in the greater Chicago area, such as Operation Prom (drunk driving prevention education in high schools).
She received her undergraduate and medical degrees from Tufts University and the University of Vermont Larner School of Medicine, respectively, and completed her residency in Emergency Medicine at the Virginia Commonwealth University (VCU) College of Medicine.
More recently, she has been involved with Illinois Medical Professionals Action Collaborative Team (IMPACT) and vaccination efforts in Chicago. Together, they have been publishing information to healthcare providers and the public about COVID, giving lectures, community talks, and holding clinics. Dr Akbarnia has also spoken on gun violence prevention from a personal perspective; on treating gun violence patients as a physician; and on being a leader in Moms Demand.
She is also active with Doctors for America, the organization that first pushed back on the current United States administration’s cuts to healthcare and research funding.
We jumped right in by phone and email immediately after convicted felon Donald J. Trump was elected as President of the United States.
(Doctors for America advocating in Washington, D.C. for firearm safety, violence prevention, trauma reduction and Common Sense Gun Laws.)
Soenen: How have the federal funding cuts and censorship by the current United States administration under the leadership of convicted felon Donald J. Trump impacted your work, staff and hospital in recent weeks and how will it impact resources, medical residents and all else in the weeks and years ahead?
Dr. Akbarnia: We are already stretched thin, and feel the effects of our already broken health system every day, and they’re only going to get worse.
Emergency Medicine departments operate on the front lines of healthcare - we’re the safety net. When funding for Public Health initiatives is slashed; when Reproductive Healthcare access is restricted; when social services are gutted…all of that lands in the ER.
Patients who should have had access to Primary Care, Mental Health services, or affordable medications are instead showing up in crisis, often sicker and with fewer options for care.
Wait times are already high, and they will get higher. Access to preventative care is not easy to get, and it will get harder.
Cuts to generalized research funding and diversity research will hit hard. This will mean fewer MD and PhD candidates and fewer research positions. Folks who are going into research fellowships feel uncertainty and the best and the brightest are not choosing this career because of this uncertainty.
Censorship in medical education, particularly around topics like Reproductive Healthcare rights and gender issues, is a major concern. We are being asked to practice medicine in an environment where evidence-based care is being politicized and essential Public Health measures are being dismantled.
Soenen: You recently wrote to me late at night about violence in your ER. What would you like the public to know about violence by patients and the risks of your work that is often invisible to the public? So many patients use the ER as Primary Care because they cannot afford maintenance and consistent care.
Dr. Akbarnia: The public doesn’t see how common violence against healthcare workers has become. People don't often think of us in Emergency Medicine as targets for patients anger towards something we may not have control over and the physical and verbal abuse just keeps increasing.
We are seeing a rise in patients assaulting staff, throwing punches, spitting, threatening our lives and being verbally abusive. Some are under the influence, some are in a Mental Health crisis, but some are just angry at the system and take it out on us.
Just a few days ago here in Chicago, an ER physician was stabbed by a patient at his place of work, and sent to a trauma center to be treated. I myself have been spit on, punched by a patient, and even knocked out once by someone. I honestly don't know anyone working in Emergency Medicine who has not had at least one event that has affected them personally.
Soenen: What is being done to reverse course?
Dr. Akbarnia: In the last few years, there is data that shows that healthcare settings account for over 70% of all injuries related to workplace violence with Emergency Departments leading those numbers. Imagine the one place where you should feel safe, when you are helping people heal, or trying to save a life, where you also might be kicked, strangled, or have a gun pulled on you. And yet, there is very little protection in place for us. If a patient assaults a nurse or doctor, there are often no legal consequences due to many reasons, and often many incidents do not get reported.
The problem is, this violence is adding to the loss of our workforce as well. In an already stretched thin emergency workforce, people are leaving for safer positions in healthcare, or leaving healthcare all together. And, with the political climate growing more hostile, particularly toward Public Health and medical professionals, the stress is compounding.
Soenen: Cuts to funding and staff, workplace violence, moral injury, burnout… What is the morale of Emergency Medicine professionals now and how are you all managing the current political climate?
Dr. Akbarnia: I love what I do but It’s tough. We’re exhausted, and many are disillusioned. There’s a pervasive sense that no matter how hard we work, we are fighting a system that is crumbling around us.
Often, we have patients here on their worst days, and we are the ones they turn to for help. We never get questioned about how we help treat patients when they are here and their lives truly are at risk. Yet it seems like when it comes to Preventative Care and what may help patients from ending up in our Emergency Departments, our answers and the science we rely on for information are being questioned daily.
What’s happening outside the hospital walls does affect everything we do. If we cannot also rely on the information that we need access to—for example, knowing where infectious disease outbreaks are happening and what to be looking for--it will make it even harder to care for patients and their loved ones.
Doctors used to be seen as people who you could trust with your health, who wanted the best for you, and, yes, there is no question that there are folks out there like any profession that may not be the best doctors or healthcare professionals, but the majority of us have dedicated our lives to helping others, and that will not change.
(Dr. Akbarnia with former United States Surgeon General Vivek H. Murthy, M.D.)
Soenen: These historic cuts, the intentional misinformation, propaganda and verbal attacks on healthcare professionals are occurring hourly now. What is front of mind for you now and how do you get through each day during this onslaught?
Dr. Akbarnia: Regarding Mental Healthcare, we’re failing patients and providers. There are not enough inpatient psychiatric beds, and we’re holding patients in the ER for days, sometimes weeks, while we try to find care, there are not enough outpatient Mental Health programs and professionals to treat our patients. At the same time, the Mental Health of doctors and nurses and those in healthcare is deteriorating. Physician suicide is real, and it’s a crisis.
Regarding the State of the Country and the current administration, we are watching health, healthcare, and Public Health be dismantled in real time.
It’s heartbreaking.
The idea that medicine could be censored and that we could be punished for discussing science, for recognizing the differences between all of us, is not theoretical anymore. It’s happening.
We have an administration that has openly stated it wants to deconstruct the federal government, including agencies that safeguard Public Health, and that is a direct threat to every patient I see.
Wanting good health for our patients, communities and families is not something new to us. This is what we fight for every single day. We need to ensure all patients have access to care, that rural communities and underserved populations get preventative care, and that they have affordable and full access to insurance to help folks with chronic illness and to help prevent them. We want to make sure medications do not cost patients their life savings, that (commercial health) insurance companies do not deny life saving treatments.
We need to ensure that our kids have the ability to exercise, eat healthfully and. have access to nutritious foods. These are all things that previous administrations tried to do and have been prevented by politics in the past. Focusing on the changes that will really shift our country's health should be our main priority at this time.
(Dr. Halleh Akbarnia Speaking about Covid and infectious disease prevention and containment.)
Soenen: Are Emergency Medicine physicians getting politically active now? What would you like to see in the year ahead? Or, is that not the responsibility of physicians?
Dr. Akbarnia: More doctors are getting involved than ever before, but it’s still not enough. The idea that physicians should “stay out of politics” is a dangerous fallacy. Everything about our work is political even though it should not be, from funding for research, to (commercial health) insurance coverage to reproductive rights and gun violence prevention...even our ability to discuss medical facts with our patients is political.
I’m a part of a grassroots advocacy organization called Doctors for America, which mobilizes physicians, medical students, and medical professionals from all specialties to advocate for policies that improve healthcare access, equity, and Public Health. We work on issues ranging from expanding Medicaid, and access to affordable medications to Public Health issues like addressing the gun violence epidemic because we see firsthand how policy failures impact our patients.
We showed up for the recent HHS Secretary confirmation hearing, and also filed a lawsuit that we won asking to restore the removed pages from the publicly accessible government websites that included vital information for physicians and researchers. Joining groups like ours--and there are others out there as well--helps physicians find a place and a voice among colleagues who believe in putting the health of our nation before anything else.
Soenen: Would you like to see more medical students, nurses and physicians engage on legislation and activism?
Dr. Akbarnia: I’d like to see more doctors running for office, speaking out publicly, joining advocacy organizations, and voting with healthcare in mind. The public trusts physicians, and we need to leverage that trust to push for policies that protect patients and the practice of medicine.
(Dr. Akbarnia Speaking in Springfield, Illinois in support of Common Sense Gun Laws.)
Soenen: What would you like to see change about the American approach to, and model of, healthcare in the US?
Dr. Akbarnia: Honestly, our healthcare system, as much as it tries to address the needs of most, feels like it’s built to fail the majority of the public.
We tend to be very reactive and we wait for people to get sick or injured instead of putting so much more focus on prevention. And, by prevention, I mean truly investing in the root causes that lead to health issues, and especially those that involve access and equity.
This is where social determinants of health and making sure every individual has what they need is addressed, from food insecurity, to housing, to education, to access to health professionals and even case workers that are set up to guide individuals that may not know how to navigate the system. Investing in prevention is truly forward thinking. We need a system that always prioritizes Public Health fundamentals like prevention, access, and equity.
“We need a healthcare system that focuses on prevention, equity, and Public Health at its core. People shouldn’t have to fight to survive in a system that’s supposed to heal them. If we really want a healthier, stronger country, we have to invest in our people, in their health, and in the communities they live in.”
— Dr. Halleh Akbarnia
Soenen: What concerns you the most in recent week?
Dr. Akbarnia: I’m worried about the policies under this new administration that are already being put in place. In an effort to make things “efficient” and to “improve the budget,” the policies under the administration of Donald J. Trump will only made things worse. Cuts to the NIH (National Institutes of Health), funding freezes for federal health agencies, and pulling out of the WHO (World Health Organization) does not just hurt research or pandemic preparedness; the cuts make it harder for communities to access care, especially the most vulnerable ones. And it removes the ability to quickly communicate to the public when the need is there, and to do it immediately.
Soenen: Is Single Payer Universal Healthcare a discussion among ER docs?
Dr. Akbarnia: I’d love to see Universal Healthcare enacted, where everyone gets access to the care they need, no matter their income. That includes Mental Health (which we are lacking so much…there are days that I have patients waiting in my Emergency Department to just try to get them admitted somewhere), Preventive Care, and affordable medications.
Soenen: What would you like to see Chicago and Illinois do in 2025 to address the barriers to care?
Dr. Akbarnia: In Chicago and Illinois, we need to similarly tackle health disparities head-on. It’s heartbreaking that people on the South and West Sides die much younger than those in some of the wealthier neighborhoods. Let’s expand community health clinics, support Medicaid programs, and bring more resources to underserved areas to meet people where they are instead of expecting them to find their own way.
I remember during Covid, we lost some of our translation services and case workers in the department in an effort to help keep more people safe. By doing these things, we were unable to communicate effectively to many of our non-native English speakers, sending them home without the instructions needed to keep their families safe.
I would also like to see a robust system set up so that community helpers and volunteers can provide services, and we can tap into that and show patients what they have available so that if there is never another situation like the Covid pandemic showed us. We need to take the time to create these avenues, to ensure there is a system in place we can use immediately by partnering with our state partners in IDPH (Illinois Department of Public Health) and CDPH (Chicago Department of Public Health) and every other public entity we have.
Soenen: Two years ago, I attended the March for Our Lives rally in Washington, D.C. interviewing victims of violence on site. During the rally, there was a shooting scare where a perpetrator threatened to shoot. He was apprehended by security immediately after the crowd scattered in horror and police learned the “gun” he was waving was a toy. He was yelling and threatening an already traumatized crowd. Recently, David Miles Hogg was elected as the Democratic National Committee Vice Chair. He also started an organization called Leaders We Deserve, encouraging survivors of mass shootings and other young people to run for office. Will this sea change of younger leadership move the dial on Common Sense Gun Laws?
Dr. Akbarnia: Gun violence is another huge issue for me. Thankfully, it has been identified by our outgoing United States Surgeon General as a true Public Health crisis.
I’ve seen firsthand what it does to people and communities. We need to continue to invest in violence prevention programs and trauma-informed care, and we need stronger gun safety laws to keep people out of my ER in the first place.
With all the programs we have had in place, we are finally seeing actual reduction in numbers in homicide events in the United States, thanks to these measures.
I worry that this administration, which has already dismantled the White House Office of Gun Violence Prevention, will continue to unravel all the hard work and accomplishments that were well underway.
In Illinois, we have millions of dollars that have been granted years ago to provide education in FRO and safe storage, and these funds have not been used to their full capacity.
And let’s not forget about our hospitals and healthcare workers. Burnout, both locally and nationally, is at an all-time high. We need Fair Staffing, better Mental Health support, and affordable education so more people can enter the field. If we don’t take care of the workforce, we can’t take care of our patients.
(This is Our Lane is a physician-led grass roots organization that educates citizens about Common Sense Gun Laws, violence reduction and trauma prevention nationwide.)
Soenen: What keeps you up at night?
Dr. Akbarnia: What’s keeping me up at night is how political decisions directly impact my patients.
The Trump administration’s cuts to Public Health programs, lack of support for scientific research, and rollbacks on healthcare policies are hurting everyone, but especially the most vulnerable, and often the most in need of help.
There are far too many demands on us. We are pushed to see more patients and speed up how fast we treat them. We are limited on how many tests we order. (Commercial Health) Insurance companies often deny medical claims, and have control over the type of care I give…which, although there should be some oversight, it should not be coming from them.
I’m very frustrated seeing how broken our system is, and how so many physicians are leaving careers. They are either finding new ways to earn their living, moving on to Concierge Medicine or retiring early. This brings even more patients into the ERs, and we are daily seeing patients in hallways, boarding patients who need to be admitted in the ER, and not being able to do our jobs in the way we were trained to do it.
We need a healthcare system that focuses on prevention, equity, and Public Health at its core. People shouldn’t have to fight to survive in a system that’s supposed to heal them. If we really want a healthier, stronger country, we have to invest in our people, in their health, and in the communities they live in.