Umbereen S Nehal, MD, MPH, MBA Profile picture
Founder, MIT Sloan, coach, fmr Chief Med Officer & Medicaid med dir, Top Voice 4x, data nerd, digital health, MedEd, humanist, Tweets personal, RT🚫endorsement

Jul 24, 2020, 22 tweets

What if the money 💰💰💰 spent by #academia & #hospitals on hiring people to spy on #SoMe, to police & shame nurses & doctors (even getting some fired for speaking up on #PPE shortage), this policing disproportionately affecting BIPOC, instead spent on hiring BIPOC & on pay gap

This is pay gap I am talking about. What kind of “#professionalism” accepts that Black women must work 7 extra months for same pay?

Professionalism on “you wore..” is used in sinister ways against Black women in particular

#blackintheivory #MedTwitter

aauw.org/resources/arti…

Puritanism in #medicine, being taught to med students who are given middle author status on a publication conceived and supported by senior faculty and junior editors, is part of this harm. Many Black girls are criminalized & punished for natural hair.

npr.org/sections/ed/20…

Keep in mind #disparity by race

white women’s outrage on being shamed as a nurse or doctor for #Medbikini or alcoholic drink pic on her personal #SoMe

for a Black girl or woman, is a fight to be allowed to exist in white spaces at all #Blackintheivory
trace.tennessee.edu/utk_graddiss/5…

I hear a lot about #empathy so let’s use this opportunity to understand why “safe space” is a concept BIPOC women never get. In fact ways “safe space” is defined, if it is Amy Cooper defining it, then is sinister & harmful - let’s use stop this too

https://t.co/wWiBq4iYUG

That med student was wrong, yes. But what did he do? He accepted a middle author role, likely scutted out for free, to further interests of senior author/faculty, responding to incentives to publish.

But some ppl, often women, paid in these policing roles https://t.co/VfGCrbK17k

When I was a state official on the Provider Review Committee to discipline & remove credentials

I was the one reviewing reports on others supposedly violating “professionalism” standards

too often this type of reporting tho

=waste of state resources

latimes.com/opinion/story/…

This kind of 🤢😡 waste to police & shame others is common

There was this drug testing of welfare recipients ...to discover that it was not a problem

So if you are outraged by #MedBikini the use your empathy to understand this is same (worse)

clasp.org/press-room/new…

🧵 (looooong) touches on why female #Medtwitter leadership needs to do a better job on being ethical and inclusive to #URM & #BIPOC

I can “pass” in many ways so my experience is not like that of @uche_blackstock @DrOniBee @DrDaniJackson @cclareMDMPH

https://t.co/B5xpeglb2w

Much of #MedBikini focuses on the woman shaming aspects
Agree

We also need to be aware: a dearth of female leaders able to resist the pressures from their bosses on incentives/rewards, punishment
So, how was that med student’s incentives different?

taketheleadwomen.com/blog/whats-the…

We don’t need more “#professionalism
Need #ethics

Except that what is being taught
in ethics
during a #pandemic
not: how to cope with #moralinjury inducing system failures & rationing

But here @DGlaucomflecken’s #TikTok was a “lesson”

(my responses)

https://t.co/jV6LoMe9x3

Have been open on my writing to institutions to stop paying people to police & shame over so-called “professionalism.”

waste of state resources when part of my time assigned to review complaints on clinician #SoMe when these stats

But, glad I could dismiss many frivolous ones

On the other hand some people in #compliance - a role described as one filled with women and where women can advance
if not there for
#populationhealth
#quality
#safetyculture of @TheIHI & @AHRQNews

If Puritanical
then contributing to harm

law.com/corpcounsel/20…

Missing from #feminism convo

is misuse of female emotion & agency

-“my body, my right” of anti-mask
-Amy Cooper who had a clear change in tone in calling 911
-Salem witch trials of young women histrionics when going after women

policing women dangerous

tandfonline.com/doi/abs/10.108…

So, am “calling out” the trend
of “professionalism” shaming

Seen across multiple people, institutions, fields

utilizing
-women
-“model minority”
-gunner med student
-non-clinician with entire career of “medical professionalism”
-etc

=opportunists

Generating these outcomes

If want fewer opportunists

advancing a career based on anti-BIPOC, anti-woman, anti-#mentalhealth shaming others with lack of consistent standards

address *the system*
creating opportunity & rewards
thru

-budgets
-jobs
-publications
-speaker invites

#MedTwitter #MedBikini

This has always mattered

any career *built* on shaming others

=career of harm that makes everyone less safe, particularly in #healthcare particularly in a #pandemic when already experiencing a #mentalhealth crisis

remove rewards to those who shame

https://t.co/LqqJg4GX8J

Call out trend & eradicate incentives

When worked for the state
I was doing peer review
if sent clinician #SoMe to review
using clear standards
I vetted & verified

If insufficient evidence of harm, dismiss

Versus marketers hired for “optics”/revenue

https://t.co/5nlp9p2NK0

Optics, reputation, prestige, revenue (targets/goals of marketing)

very different from goals of #socialjustice pro-equity clinicians

(or just clinicians being human)

Use & goals of #SciComm differ

Institutions need to be listening to right ppl

https://t.co/HJKQZUy9pi

By right voices I mean these ones that are frequently marginalized

or literally, not at the table

We *must* remove cultural chauvinism, ethnocentrism, sexism, racism, homophobia and every other -ism & phobia from #medicine and #healthcare #MedTwitter

https://t.co/kYOTXP2SkB

How about we don’t force women, particularly Black women, to stand quietly in line & wait to be called upon

or tick off every box of perfection to be invited to the table

What if women pushed PAST boundaries defined by others?
@techreview
#MedTwitter

https://t.co/ETMD5lrzJi

Does it make you uncomfortable? Does this push your boundaries of acceptability?
Good

Boundaries are what people create inside their own heads to maintain psychological equilibrium

Boundaries are NOT what you force upon others people to control them

https://t.co/o1YRhyHB0j

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