Monica Bharel Tells HMS, HSDM Graduates Medical Innovation Must Reach Vulnerable Patients

Monica Bharel urged Harvard Medical School and Harvard School of Dental Medicine graduates to confront systematic inequalities in health care at Thursday’s Class Day ceremony, telling them medical innovation would mean little if it failed to reach the world’s most vulnerable patients.

Bharel, a former commissioner of the Massachusetts Department of Public Health and former vice chair of the Harvard’s Board of Overseers, delivered the Class Day address in heavy rain. She currently leads Google Health’s clinical work in global health, public health, and public sector health.

Bharel opened her speech by pointing to major advances in medicine over the past few decades, including progress in HIV treatment, cancer research, vaccine development, and access to health information.

“This potential is amazing and a cause for optimism for advancement in human health,” she said.

She told graduates that many of them would help drive the next generation of advances in “basic science, clinical care, translational implementation science, and dental and physician care.”

But Bharel warned that innovation alone would not be sufficient.

“There is immense potential here, but also risk, and we will need to stay engaged to ensure appropriate guardrails in our collective goal of ‘do no harm,’” she said.

In particular, Bharel said that there was still a severe gap in access to global healthcare.

“We have the technology to map a protein in minutes, but globally a woman dies every two minutes in childbirth,” she said.

She also pointed to inequities closer to home, noting that life expectancy varies sharply by neighbourhood in Boston, even in the shadow of some of the world’s leading medical institutions.

“In this two mile distance, surrounded by the best health care systems in the world, a person’s zip code is still a more accurate indicator of life expectancy than their genetic code,” she said.

“Not enough has changed,” Bharel added.

Bharel urged graduates to take a public health approach to their work by looking beyond individual diagnoses. She called on them to identify barriers to care and advocate for individual patients, before pushing for broader structural change.

“You take the lesson learned from one vulnerable patient and use it to rewrite the rules for everyone to benefit by doing the job of today,” she said.

She closed by asking graduates to go on to be responsible health policy decision makers.

“In the leadership positions I know you will have, please ask, who is missing?” Bharel said. “Who is not walking through the clinic door? Who is not the decision maker at the table?”