Healthcare Reform: COVID & Admin Harm | Dr. Charulata Ramaprasad & Dr. Mary Meyer
Today’s guests are the kind of physicians who kept healthcare standing during one of its greatest tests — and who are now working to heal the system itself.
Dr. Mary Meyer is an emergency physician and public health leader with over two decades of frontline experience. From 2018–2024, she directed disaster preparedness for a major Northern California healthcare system, responding to wildfires, power outages, infectious outbreaks, and regional crises. Her global deployments have taken her to Haiti, Venezuela, Sri Lanka, and beyond. She also writes the MedPage Today column Calamities, Codes, and Crisis.
Dr. Charulata Ramaprasad is an infectious disease specialist and former Regional Chair of Infectious Disease for a large managed care organization in Northern California. She earned her MD from Northwestern University and completed fellowship at the University of Chicago before leading a systemwide infectious disease and COVID-19 response — work that earned her the Sydney R. Garfield Exceptional Contribution Award.
Together, these two physician leaders coordinated clinical protocols, triage systems, and massive care teams during the COVID-19 pandemic — helping keep hospitals functioning through unprecedented uncertainty.
Now, they’re turning that experience into a deeper conversation about something most patients never see but deeply feel: administrative harm.
How They Met — and How the COVID Response Began
Dr. Meyer and Dr. Ramaprasad first connected in early 2020, when reports of a mysterious virus overseas began circulating.
At the time, Dr. Meyer was directing disaster preparedness across multiple hospitals. Dr. Ramaprasad had just stepped into her role as Chair of Infectious Disease. What started as small monitoring meetings quickly became daily crisis response sessions as COVID spread.
They describe those early months as surreal — balancing the need to prepare for a massive public health emergency while trying not to panic colleagues or leadership.
Very quickly, it became clear this would not be a contained outbreak.
It would change everything.
Leading Through Crisis: From Daily Briefings to Systemwide Protocols
As cases surged, they built frameworks for care across inpatient units, outpatient clinics, emergency departments, and vulnerable communities — accounting for everything from housing instability to staffing shortages.
They led:
Daily clinical task force meetings
Nightly infectious disease leadership calls
Rapidly evolving treatment and PPE protocols
A centralized COVID Clinical Library so thousands of clinicians could access real-time guidance
Daily “COVID casts” to ensure consistent messaging across hospitals
Their goal was simple but massive:
make sure every clinician had the same information, and every patient received equitable care.
This meant long nights, minimal sleep, and trying to translate complex epidemiology into actionable guidance for administrators making financial and operational decisions.
When Medicine Meets Metrics
One of the most powerful parts of this conversation is their reflection on what happened after the acute crisis passed.
Like many clinicians, they believed the pandemic would become a turning point — a portal into a more humane, equitable, and functional healthcare system.
Instead, many old structures returned.
Rigid metrics replaced flexibility. Administrative silos reformed. Corporate priorities again began to outweigh bedside realities.
Both physicians noticed something deeply troubling:
Patients were increasingly frustrated.
Clinicians were increasingly burned out.
And the people making many care decisions were farther than ever from the bedside.
What Is “Administrative Harm”?
Dr. Meyer and Dr. Ramaprasad use the term administrative harm to describe injuries caused not by clinical errors — but by bureaucratic systems:
Insurance denials overriding physician judgment
Arbitrary appointment time limits
Delays in imaging or treatment driven by protocols, not patients
Anonymous decision-makers with no accountability
In medicine, clinicians undergo peer review, morbidity and mortality conferences, and quality improvement processes when outcomes aren’t ideal.
But administrative decisions that delay care or worsen outcomes?
Those rarely face the same scrutiny.
And that disconnect matters.
As they explain, proximity to patients changes everything. When you’re at the bedside, you see nuance. You hear stories. You understand complexity.
Spreadsheets don’t capture that.
Why This Matters for Patients and Providers
This episode highlights a hard truth:
Your doctor is often not the final decision-maker in your care.
Yet they’re the one sitting in front of you — absorbing your frustration when imaging is denied, medications are delayed, or appointments feel rushed.
That disconnect fuels anger on both sides.
Dr. Meyer and Dr. Ramaprasad emphasize that healthcare does not suffer from a lack of money — it suffers from misallocation of resources away from patient care and frontline clinicians.
How Healthcare Can Begin to Heal
Rather than simply naming the problem, they also offer solutions:
More clinicians in leadership roles
Leaders maintaining real, ongoing clinical practice
Term limits for leadership positions to encourage fresh perspectives
Greater accountability for administrative decisions
Breaking down silos between decision-makers and bedside care
Their vision is a system where leadership stays connected to real patients, real workflows, and real consequences — and where safety culture applies to administrative decisions just as much as clinical ones.
A Conversation Every Patient Should Hear
This episode is about more than COVID.
It’s about how healthcare actually functions behind the scenes — and why so many patients and clinicians feel disillusioned right now.
If you’ve ever wondered why care feels harder to access, why appointments feel rushed, or why your doctor seems constrained by forces outside their control, this conversation offers clarity, compassion, and hope.
You can learn more about Dr. Mary Meyer’s work through her writing at MedPage Today, and follow her on LinkedIn, where she shares thoughtful perspectives on emergency medicine, public health, and the realities of modern healthcare.
You can connect with Dr. Charulata Ramaprasad on LinkedIn to learn more about her work in infectious disease and healthcare leadership, where she shares insights on physician advocacy, systems reform, and patient-centered care.