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Umbereen S. Nehal, MD, MPH Profile picture
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20 Dec, 14 tweets, 12 min read
If you are NOT a clinician with DIRECT patient contact or other frontline service worker (janitor, delivery person, receptionist checking in patients F2F) and offered a vaccine, do the RIGHT thing and step back in line. #HealthcareHeroes needs to be more than a hashtag.
This is NOT okay.

#HealthcareHeroes my foot.

Actions > words

Trainees doing intubation daily should not have to protest to be heard that their LIVES are at risk as compared to administrators or non F2F care doctors.
I posted on #LinkedIn because, frankly, no administrator really follows #MedTwitter apart from “gotcha” policing to discipline or fire a whistleblower clinician.

This is unacceptable.

Admin before F2F care trainee?

Momma grizzly mode activated.

linkedin.com/posts/usnehal_…
Bear cubs (trainees) are not disposable cogs in the machine of the healthcare industry

I am grateful I felt protected & valued in residency under the leadership of Dr. Ralph Feigin. It is the only reason I made it through residency pre-work hour restrictions & perpetually sick.
Residency, being a nurse, cleaning COVID covered rooms as a janitor ..all are hard.

This is a defining moment for the industry, yes, industry, not profession, not field, industry.

“The algorithm made me do it!l”

Ain’t passing the sniff test for me.

Do better.
I do know: an excessive belief in #data #Analytics #healthcareanalytics

I have seen such 🤯😱😫 bad illogical harm-inducing decision-making cuz some operations person or consultant did some Excel solver “solution”

it is *plausible* this was an error

Hence vet/verify
If you buy (or internally) develop bad #healthcare #technology you do NOT get to shift blame as a #leader.

Literally JUST submitted a chapter to on “promise and perils” of #AI in #medicine.

In fact #EHR vendors shift THEIR liability TO doctors medicaleconomics.com/view/your-ehr-…
The #EHR issues have been discussed and published on extensively

Ignorance is not excusable for how technology can fail us, give wrong answers, add to waste, increase risk for patients, clinicians, systems

We had MONTHS to prepare for vaccine roll out

ncbi.nlm.nih.gov/pmc/articles/P…
My other #LinkedIn share is @sacjai’s perspective in @JAMA_current on need for trust in #healthcare #leadership.

How ironic, right?

I probably sound like a Luddite or Chicken Little at @MIT but in fact I want #technology to DELIVER results, value

linkedin.com/posts/usnehal_…
I led the organizing team of this #hackathon because we desperately need to humanize #AI and create ethical #AI

There is SO much good #technology can do IF we start with correct frameworks, adhere to ethics, & #humancentereddesign for ALL humanity

mitsloan.mit.edu/press/mit-sloa…
This is also happening right now at @Google with @timnitGebru where those who are BIPOC, Black, URM in #technology are going into the belly of the beast to work on #ethics & #diversity to #design #AI for all.

We can’t even get vaccine roll out right? 🤦🏽‍♀️

cnbc.com/2020/12/17/goo…
There is basic common sense that MUST be invoked. If someone offers you a vaccine on day one or early in vaccine roll out (let’s even say we accept the story at face value of “algorithm error”) if you are NOT at risk like this dad, step BACK in line

In conclusion, to summarize this thread

don’t be a selfish a-hole

(I think I just insulted the much maligned anus, frankly.)
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More from @usnehal

Umbereen S. Nehal, MD, MPH Profile picture
19 Dec
@ayesha_mian1 @WEIconnect @UN_Women @ELAMProgram @AfafMeleis @_saadshafqat @WGHPakistan @DrvanTilburg @arghavan_salles @JulieSilverMD I would go further. A woman who has actually earned a degree is told her actual role in the world is defined by “wife.” A publication with mostly male editors, read mostly by men, in the finance sector publishes a poorly written piece ridiculing her & rewarded with “clicks”
@ayesha_mian1 @WEIconnect @UN_Women @ELAMProgram @AfafMeleis @_saadshafqat @WGHPakistan @DrvanTilburg @arghavan_salles @JulieSilverMD She is told she is unqualified or cannot use her earned credentials by a man who lacks credentials. Then he takes a swipe at Black women. Almost all responses recognize the sexism but do not comment on anti-blackness. Western feminism has often been willing to leave some behind
@ayesha_mian1 @WEIconnect @UN_Women @ELAMProgram @AfafMeleis @_saadshafqat @WGHPakistan @DrvanTilburg @arghavan_salles @JulieSilverMD This is the glass cliff. You can do the work, get the title or c-suite role, and your accomplishments will not only be invisible, but result in anger and derision. What we saw in WSJ represents constant gossip that happens and sabotages the woman leader. hbr.org/amp/2011/01/ho…
Read 19 tweets
Umbereen S. Nehal, MD, MPH Profile picture
17 Dec
Peeps. My painting is nothing close to what it was supposed to look like. This was the goal. Image
This is how I started out, promising Image
I even got brown paper to cover my desk from newly delivered groceries Image
Read 9 tweets
Umbereen S. Nehal, MD, MPH Profile picture
23 Nov
Agree. The system has failed frontliners. Healthcare relies on shaming to control, diminish, shut down. Let’s NOT pass that on to others.

Back in spring when not enuf PPE for clinicians, and CDC & Fauci saying not to mask, I saw clinicians shaming public who WERE wearing masks.
We lose credibility this way. Scientists already are not believed or respected. In fact, are ridiculed by many. Spoke with @ETSshow on how the “snark” culture is a self harming one for communicating in public. #MedTwitter antics reduce credibility.

explorethespaceshow.com/podcasting/umb…
Much of how scientists act would get you laughed out of a room in business, ignored, lose your seat at the table, not invited back

Blocking, deleting, snarking, shaming

is not how it works among ppl who make high powered deals

Nor does it engage public blogs.scientificamerican.com/observations/d…
Read 23 tweets
Umbereen S. Nehal, MD, MPH Profile picture
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 27 tweets
Umbereen S. Nehal, MD, MPH Profile picture
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
Umbereen S. Nehal, MD, MPH Profile picture
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

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