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Umbereen S. Nehal, MD, MPH Profile picture
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26 Dec, 5 tweets, 5 min read
Just because I am perpetually wading into controversy...as a BIPOC but not a Black woman... here I go again.

#BlackExcellence in #healthcare is VERY needed. Thanks for tweeting this @mdawriter

That includes #blackexcellence as physicians AND every other type of #HCW
This is super complicated. Traditionally, #healthcare has been physician-led "therefore" the ills of healthcare also fell squarely on the heads/shoulders (malpractice insurance) of physicians. That said, now most physicians are employed. Then the "therefore" of #accountability?
Workforce and representation very much are important for the 1:1 care. We know this to be true, for instance:

hbr.org/2018/08/resear…

But it is a long pipeline to get a practicing, licensed physician and requires a lot of debt/resources
But can clinicians who make up single digit percentages of the workforce really address system level issues? What resources are available to docs once in practice? Who defines "performance" and "value-based care" metrics? Follow the 💰💰💰#medtwitter

ineteconomics.org/perspectives/b…
This is not limited to dermatology practices or #biotech or #healthtech btw, private investors are even buying up historic #safetynet hospitals. My own experience in the #FQHC was shocking much more "Wall Street" than #communityhealth. @sciam #medtwitter

blogs.scientificamerican.com/observations/t…

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More from @usnehal

Umbereen S. Nehal, MD, MPH Profile picture
28 Dec
We need more doctors who speak up.

Yes, I know we have worked hard to get where we are and are regulated/monitored in so many ways it is scary to deviate and take a risk of censure or discipline. It feels like we are vulnerable, not strong.

Speak up anyhow.
We can’t let our reputations or achievements become reasons why we stay silent.

Opposite, what is it all for anyhow?
What does your title mean?

They say you can’t take it with you in regards to money. But you aren’t going to take your CV with you either. Image
We can’t be telling the most vulnerable to speak up, like those early in career.

While I have yet to understand the details of what went on here, what is reported is deeply concerning.

Even with a good lawyer, this can derail an entire career right at its start.
Read 25 tweets
Umbereen S. Nehal, MD, MPH Profile picture
28 Dec
It is not about being "woke" per se as some people claim. It is about caring about measurable results & caring about human life. If you don't care about such things and are in #healthcare, if #equity is merely a hashtag or for "reputation management", you are part of the problem
I understand some people feel those at the margins can be written off or just are not part of their consciousness, irrelevant. That position of privilege goes away in a pandemic. Those people you may disregard most of the time become highly relevant to everyone's wellbeing.
It is very attractive to break problems into little, manageable parts and to isolate yourself to a silo. Too much of science operates this way. Too many of those rewarded within #STEM go narrow and deep. Then the messiness of the real world is not addressed in solutions.
Read 14 tweets
Umbereen S. Nehal, MD, MPH Profile picture
28 Dec
"Died at the scene"?

This was a suicide bombing & terrorism where someone filled an RV with explosives, parked it in front of key infrastructure, while he was inside. They were not initially sure if the "tissue" found was human or not to ID him.

Why not call it what it is?
I am feeling SO exhausted this morning.

Add the media coverage of Dr. Moore describes her as "complaining" as opposed to "reporting" or "identifying." Then the hospital's response is to describe her as "intimidating" to nurses as "knowledgeable"

The words we use matter. How much caution do we use, with whom, when? What tropes or associations are invoked? How does that populate the "data" in our brains that fill certain "buckets"? Who "complains" or "intimidates" vs "we don't know all the facts"

brookings.edu/blog/the-avenu…
Read 10 tweets
Umbereen S. Nehal, MD, MPH Profile picture
27 Dec
Nothing captures structural racism better than this as has been put out by many including @QaaliHussein1

Knowledge + Black (+ woman) = scary?! (“intimidating”)

This is the type of implicit bias to racism spectrum communication I had identified this summer as well. #MedTwitter
These dynamics is partly why I have been wary of any subsequent executive roles I have been offered.

I made it past the glass ceiling. In many institutions this is exactly what you will find.

Why many BIPOC go off a #glasscliff

Your job: Be token.

hbr.org/2011/01/how-wo…
To be clear, I have the privilege of choosing to be so called “model minority” or to be anti-racist.

Black women and men never get that choice.

Executive incentives and rewards often are to generate revenue for an institution per the existing system, NOT to be a change agent.
Read 4 tweets
Umbereen S. Nehal, MD, MPH Profile picture
27 Dec
This is very important. I had been preferably using Black gifs for representation.

The nature of #communication is that how you intend it and how others may receive it will pass through many other filters as well as sources of trauma.

When in doubt err on side of caution.
While I have not received any feedback that my gif use is inappropriate one should not wait to be told. Going to be sure to apply an additional lens and filter.

Caution: Some who call themselves #communication “experts” may be about promotion rather than reliable #DEI or results
In particular, when you look at who to trust or emulate on #SciComm or #MedTwitter, take note of who is effective at communicating their point, does not need to delete, can post on important topics with least misinterpretation, while maintaining the broadest audience.
Read 10 tweets
Umbereen S. Nehal, MD, MPH Profile picture
27 Dec
The world (specifically healthcare) is not giving me good feels right now.

And:

I miss my cat

I miss NYC

I want bubble tea
Well, bubble tea has been ordered.

Puritan territory New England does not have the flavors I want at 10:27 p.m. but I realize that at least I do have bubble tea access in the first place.

As much as I now call Boston a village... it isn’t really.
It’s here!!! Image
Read 8 tweets

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