Indeed. And I silence myself for no one. Too many women - ones who seek personal success by aligning with the past or perpetuating current system - are the ones shushing other women, especially shushing activist WOC with authentic lived experience of system gaps or harms.
I’ve been in compliance myself. I still believe in the need for oversight of safety & quality. But petty policing that is common in those naturally drawn to compliance is itself waste & harm. “Professionalism”, used to silence “problem” WOC’s communication is harm. @COCoQC Image
Compliance cuts out waste & harm - overpolicing & gaining “market share” thru fear, not facts or outcomes, is an example

If your source of profit, revenue, or even job represents waste & harm, then yes, we might be coming for your job

Waste & harm:

psmag.com/news/research-…
I used to feel badly if people lost jobs

but if your work harms others

if your job is to block, deny, harass (demand more & more paperwork), stalk

if withOUT merit or factual, standards based rationale

then your job is soul-crushingly inhumane

If valid standards? 👍 carry on ImageImageImageImage
Some jobs DO need to go away to free funding for other things. Is a tough minded approach if we go beyond hashtags to reality and if we are committed to generating measurable outcomes

Reduced administrative burden = fewer admin jobs, yes

journals.sagepub.com/doi/10.1177/10…
Despair my peers feel at the front lines

(amplified if a medical director who takes personal responsibility for outcomes)

is NOT personal failure
is SYSTEM failure

misdirected resources
waste, harm paid for & incentivized by system

I recognize this

nytimes.com/2020/07/11/nyr…
This by @danielleofri was pre-pandemic. Has only gotten worse

I am livid, disgusted, and have just had enough when I see systems, now, in a pandemic, double down on this

It is why I turned down another CMO job in NYC for 10 centers as pandemic rose

nytimes.com/2019/06/08/opi…
Don’t hire a WOC if you want us to be silent or token

“Barbot's claim..DOH staffers ‘talents must be better leveraged’..criticize..city's decision to put the department in the backseat of its coronavirus response”

WOC are not a diversity checkbox

cnn.com/2020/08/04/us/…
So, I *was* taught this in my all girls school and in my family of outspoken women of the same culture that gave us Malala, Asma Jehangir, Benazir Bhutto, Iqbal Bano

You know who shuts up women? Other women, often, acting on behalf of patriarchal values

mashable.com/article/kamala…
This is my aunt in Pakistan speaking to a room of doctors, on #womenshealth, talking on birth control

something that as a doctor in U.S. an employer could ban me or fire me for speaking on

I have courage & confidence cuz my brain & spirit got freedom from U.S. “professionalism” ImageImageImageImage
Is your own biases/racism that assumes everyone who looks like me is eager to sell ethics, dignity, other humans to kowtow to power as a so-called “model minority”

Further some women perpetuate the idea of “saving” certain “oppressed” women or exploit sexist tropes for own gain
What we need is less control over words & clothing - let women choose how much or little

live & let live for others choosing differently from you

Is a form of deep insecurity if women need cliques of self validating “safe spaces”

Empower
Be risk tolerant
Tolerate mere words
Safe for whom? “Safe spaces” shut out/police out/shame BIPOC women as “too much” or making others “uncomfortable” despite posting memes on Kamala Harris. Why do you think it is a WOC & child of immigrants succeeded before a “daughter of the revolution”? We color outside the lines
It is textbook, predictable, & tiring that this repeats over & over, embedded in culture and coded into “professionalism”

Professionalism often: compliance/policing to control others’ self expression or block questioning institutional actions or ethics

npr.org/sections/codes…

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More from @usnehal

22 Nov
Normalize reporting that is non-punitive. There may be some reporting that leads to a dismissal but good systems do a fish one or RCA to identify system factors and processes or staffing levels before blaming anyone individual.
Now that the majority of physicians are employed, there is an imbalance of power between administrators eyeing hospital margins and their main revenue producers, docs. With expanded scope of practice then it is “providers” who bill. All are employed/controlled/kept in line.
In the past (there was a LOT wrong in the past albeit) there was a balance of power. Hospitals needed doctors to admit to them, refer to them, do procedures there, see their patients there. Docs needed hospital facilities for inpatient or surgeries. Now, that mostly is erased
Read 26 tweets
21 Nov
🧵, riffing off of this comment

The system teaches people they don’t matter, symbolized by name “does not matter”

To change “doesn’t matter”, change the system & culture in academia & medicine

When people respect individual humanity, people will become comfortable as salves
I hear “shocked” a lot and so this is not to single anyone out as it is common. If shocked, then need to dramatically educate self on #BlackintheIvory that affects Black & brown & immigrant. Also, when common to be called wrong name entirely, many of us finally just adapt/accept.
Personally, at the end of the year meeting w/ my division chief, when I have prepared my packet for academic promotion, if I find myself given the one other South Asian woman’s evaluation in a group of 7 that is my time wasted because you did not vet or verify individual identity
Read 20 tweets
21 Nov
If you are still saying "slavery happened a long time ago" whether you are a bedside provider communicating which are the "good" families to the rounding doc vs not
or a new immigrant...
please, just don't
Read the 13th amendment.
Educate yourself on preschool to prison pipeline.
Please don't tell me you have "read" or "know" U.S. history unless you are going to break down the exception clause in the 13th amendment for me. What is written in laws matter. You can be anti-government in views but does not change role of government in: muse.jhu.edu/book/39502
On the preschool to prison pipeline. Racism affects children in the spaces that should develop their minds and curiosity - instead criminalized and taught self concept of “bad”

tedxmilehigh.com/preschool-to-p…
Read 5 tweets
21 Nov
Why is my desk chair so complicated to assemble? I am exhausted just taking the parts out of the box.
This is not looking good.... Image
At least my vacuum was easy to assemble. Already used. Image
Read 4 tweets
20 Nov
Never, ever, ever, ever in my life have I had such a horrid view. In the past looked onto a park, or just even the inner courtyard..I somehow ended up with a window right in front of me and another not far away..with WFH..in each other's faces plus exhaust pipes of roof. Yuck
So...I am doing a thing...that is likely a waste of money and time...but since I have a ridiculously (waste of space) huge bathroom..am buying stuff from Overstock to make it into a Moroccan themed "spa" bathroom so I can look into my bathroom instead of out the window. LOL
Also..am thinking to get "art glass" film that lets in light and obscures outside view or WFH neighbors whose desks are at their windows. Thinking to do a strip to avoid losing too much light from my single piddly windows in each room. My old apt in same building had more windows
Read 5 tweets
19 Nov
This does not surprise BIPOC. We live it daily. The rest of you often deny our lived reality or assume it is exaggerated. Then you are shocked and ask “what happened to my country”

what happened: is you insisting on keeping your head in the sand & shutting down truth tellers
Most liberal/progressive types who get super excited by data... data that are incomplete, flawed, or based on people lying in polls due to social acceptability bias. But many liberal intellectuals are
Very little has changed since this was written by MLK. Very little has changed since my grandfather was training in England in Colonial times (there he was considered “black” and black/brown more similar as BAME) as a highly skilled surgeon (ophthalmologist) but sub-human.
Read 22 tweets

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