Thread by @usnehal

This is a truth few want to admit. Rural health or inner city health depend on the full range of clinician types. When was a CMO of a 14-center FQHC with $100m budget, we already had massive staff turnover & burnout - ~50% loss in 2 years with hard to fill staff openings.

True, don’t have too much respect for those who simply want to fast track to “medical” cosmetic procedures to compete with plastic surgeons on Botox injections

vs extending needed care in primary care fields

but it is a free country

every healthcare loophole gets exploited

Please spare me, tho, attempts at superiority of who has more/less heart/ethics/intellect by training

Lots of fraud by in healthcare by

...humans

“fraudsters enlist unscrupulous health professionals ―doctors, physician assistants, nurse practitioners”

npr.org/sections/healt…

Frankly, have lost faith in the entire industry...

yes, industry

of delivery system (not care)

constant fighting for turf, power

💰 💰 💰

snarks vs tortured data to prove “superiority” of newer entrants

and weaponized “empathy”

withOUT commitment to anti-racism

Or quality

For the record, none of us get paid enough (vs tech fields). As an academic pediatrician & community health physician I learned I earned much less than median salary of nurses at the same institutions I worked per news coverage of a strike (on what was considered too low a wage)

This is not shaming but an observation not to make assumptions about salary or compensation.

Nurses do AMAZING work

I think everyone in direct service often is underpaid

compared to business side administrators who shift liability to others instead of showing leadership

I learned the latter the hard way - the lack of #leadership among people w/ titles in #healthcare

I got knocked down & bloodied

But like any a good #newyorktough story, got back up & punched back

that is what is respected here - in the U.S. & NYC

It is NOT “empathy” that is going to win any battle I wage in any c-suite position to address wage gap -

which, by the way, most affects Black women but is a fact often ignored by non-intersectional feminism or not addressed in #healthcare turf wars

fortune.com/2020/08/13/bla…

This year I am getting not just tougher or smarter but am getting more adaptive. ❤️❤️❤️ that I can learn from THE professor Heifetz who actually *gets* the core issues of #leadership and in the first few classes overtly addresses our nuanced & complex identities, including BIPOC

Had multiple conversations w/ @MITSloanFellows on what is needed for BIPOC & women to address #BlackintheIvory types of issues that extend in various forms to all not “standard.” There is commitment to improving. SO thrilled can crossregister in meantime. hks.harvard.edu/faculty/ronald…

This is ALL over, from the bias among doctors, to executive coaching not designed for minority women, to nurse education - those of us who rise to positions of any authority only get more embattled yet others assume we have power our titles imply. Every day feels like a battle

While some are focused on churning out one #Medbikini publication after another

some of us are battling simply to have accurate data recorded in charts

if speak up on behalf of errors & bullying towards BIPOC patients/trainees, labeled doctor bully

go.beckershospitalreview.com/scott-becker-i…

This is why we MUST get past these turf wars. #Safety & #quality in #healthcare are #system level issues

worsened when we divide into warring factions

Patients are harmed when we overpolice each other on petty issues

Black, immigrant, LGBTQ, BIPOC are most harmed.

Instead of fighting, can we start to think about what our country needs? We simply don’t have enough clinicians, regardless of degree or training type. That is added to lack of access by hospital closures in rural areas. 8% of Americans lack insurance.

bhw.hrsa.gov/health-workfor…

Then there are the myriad risks within hospitals and clinics. Personally have experienced or seen it all as a patient, friend, family member. Near miss potentially fatal med error when I was being put under. Aunt killed by medical error. Friends lost healthy baby to medical error

This @bmj_latest study by @MartyMakary is oft criticized but regardless of quibbles over data, evidence of harm within #healthcare unavoidable. Can we fight the right battles? We are losing lives & hemorrhaging money/resources yet #MedBikini & turf wars?!
bmj.com/content/353/bm…

Who would want to be in a system like that? Is it even possible to show up at work in healthcare and not be an agent of harm? If I cannot honor “first do no harm” then what is the point? I’ve lost faith, yes.

The infighting is simply not improving anything for patients.

I don’t exactly know what I am going to do at the end of this year.

I do intend to be able to honor “first do no harm” as well as work with super cool people I would actually enjoy working with, people I trust, and people I can create quality results with as a team.