To clarify, yes, aware there is a legislative battle going on. When at work, need to be effective in a team - be careful on escalating “us v them” narrative. Outcomes are driven by systems & culture. Neither newer entrants nor old guard have full answer to access or quality.
No matter what I tweet, also, am sure some term or phrasing will offend. Am in b-school right now so using b-school terms. Medicine and nursing are both old and noble professions but also fraught with scandal and controversy, sexism and racism. No one has moral superiority here.
Access has a lot to unpack, as does quality. Does patients (us all) a disservice when these bandied about for escalating emotional reactions as trigger words as opposed to being thoughtful on policy, frameworks, systems
Sadly politicians respond to the so-called “Karen” approach
We have a fragmented system without coordination or whole person care. We all are burnt out. So much of healthcare is about 💴 power, turf, ego, false narratives. The main divisions I see on access and quality are by race, disability, LGBTQ, insurance status, undocumented, etc.
As a former CMO of 14 center, $100m FQHC, was a daily struggle to staff for safe care & access. I had grandiose ideas of building community programs, addressing burnout & morale, writing grants. Instead, daily fire drill of just keeping centers open and not canceling appts.
I was coming from Boston, @harvardmed @HarvardChanSPH and also @The_BMC and @EBNHC but was massively unprepared for the difference between FQHCs in #Boston vs #NYC and different culture of healthcare. At EBNHC was still working with former colleagues from @BostonChildrens
It changed my ideas on what is needed for staffing. If you are NOT living the daily fire drill, literal at times (manhole explodes in Harlem & smokes out adjacent buildings, including a clinic), if you are not doing the work, stop talking down to the WOC clinicians doing the work
It is easy to sit in your ivory tower or private practice & issue “commandments” or proclamations or create an army of online warriors or play mind games with “optics” as to who is a victim. Just get in the trenches. Get your hands dirty. Get bloodied. Accept liability. Be real.
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