- A frontline doctor says the medical establishment is failing monkeypox patients.
- Many don't have access to testing or vaccines, said Dr. Eric Kutscher.
- The response is relying heavily on the goodwill of doctors exhausted by COVID-19, he said.
The US medical system is "failing" monkeypox patients on every level, a physician on the frontlines of treating the disease told Insider.
Eric Kutscher is a primary care physician at NYU Langone Health who has been seeing monkeypox patients in his clinic and in the emergency room.
He told Insider his patients have struggled to get access to testing, vaccine, and appropriate medication for the excruciating pain that is a common symptom.
Many of his patients are from poorer communities, who have to overcome too many barriers to access care, he said.
A few of his patients acquired painkillers illegally to manage the pain, he said. "I'm seeing people who the entire system has been failing," he said.
Exhausted doctors
Kutscher said he was seeing people in New York City who were turned away by doctors or labs, so were showing up in desperation to the ER in the hope of getting a test.
Healthcare providers have had to go the extra mile to access testing and antiviral treatment for their patients and many don't have the energy, said Kutscher.
"That's not time that doctors are reimbursed for, that's not time protected from dealing with other patients or dealing with other things that are happening in their lives."
"I think that people are coming at this with: I can't do that extra step for you right now, because I just do not have it in me," he said.
Underserved communities suffer most
"The sad reality is what we have seen time and time again: whenever there is an infectious disease outbreak, it ends up hitting and disproportionately impacting the most underserved and vulnerable people," Kutscher said
Kutscher said his patients are mostly from populations that don't have good access to medical care.
"Many of my patients are minorities, Black and brown people are disproportionately being influenced by this epidemic," he said.
According to NYC Health, twice as many cases were reported among Black and Hispanic communities compared to cases among white people as of August 11.
"A lot of them are currently traditionally medically underserved, so lower access to primary care and preventive care, that tend to have more working-class jobs," he said.
Because of this, he said that it is very difficult for them to get any kind of care, he said.
Vaccine rollout dictated by privilege
Kutscher said none of his patients have been vaccinated.
"The rollout here has been very problematic in terms of allowing privilege to really dictate who gets vaccines," he said.
In New York City, the vaccine was first rolled out in a clinic in Chelsea, "an affluent white gay neighborhood," said Kutscher.
Appointments were only released 30 minutes ahead of time, per The New York Times. Information about availability spread through word of mouth and on social media.
"Our system just isn't working to get the people who actually need the vaccine," he said.
The vaccine has now been rolled out further, but the needs of underserved communities have not really been taken into account, said Kitscher.
"You have to actually sign in and give your name and date of birth and identifying factors, which for a lot of people who are undocumented, who are not 'out,' or who don't have a cell phone number or other things is a huge barrier. Let alone the literacy components of that and the technology components," said Kutscher.
Isolation too expensive for many
Kutscher said doctors often recommend three weeks of isolation for monkeypox cases. For many of his patients, this is something they can't afford.
"A lot of men who I've worked with who have roommates and who don't wanna get their roommates sick, they're trying to figure out: okay, where can I go? And how can I isolate? There are no options," said Kutcher
"There are no free hotels. There are no free isolation venues. And on top of it, they're being asked not to go to work and they're not being given paid sick leave," he said.
Black market for pain relief
A couple of Kutscher's patients told him they turned to illegal channels to find pain killers, he said.
"A lot of people who I've worked with, this is some of the worst pain that they've had," Kutscher told Insider.
"That makes me very concerned as an addiction medicine provider because one of the reasons many people with addiction wind up using different pain medications is because of inappropriately and unmanaged pain to begin with," he said.