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Arghavan Salles, MD, PhD

8 Mar, 13 tweets, 10 min read

@Medscape

On this #IWD21, let’s talk about the data on quality of care by physician gender. I wrote about it for @Medscape (thanks, @eugeniayun!). Please read the piece if you think they should have a recurring gender equity column!

Let’s dig right in. A 🧵.

medscape.com/viewarticle/94…

@NEJM

The first major study examining this was in @NEJM in 1993. Researchers looked at visits for almost 100,000 women patients with over 1200 physicians and assessed how often pap smears and screening mammograms were done.

2/

nejm.org/doi/full/10.10…

They found that women physicians were more likely than men physicians to order both.

3/

medscape.com/viewarticle/94…

Taken all together, over the last two decades researchers have described quite a number of ways in which the care women provide may be more patient-centered, participatory, and positive.

jamanetwork.com/journals/jama/…

4/

For example, women are more likely than men to assess the opinions and needs of their patients, to build partnerships, to follow guidelines and refer to a specialist, and to counsel patients regarding alcohol, tobacco, and unsafe sexual behaviors.

5/

pubmed.ncbi.nlm.nih.gov/26765146/

Women also spend more time with patients, and patients of women physicians are less likely to go to the emergency department or get admitted to the hospital.

6/

medscape.com/viewarticle/94…

Three major studies in recent years have looked beyond how doctors’ care is perceived or how they spend their time. They have examined the outcomes of their patients.

7/

medscape.com/viewarticle/94…

@PNASNews

With results published in JAMA IM, @PNASNews, and @bmj_latest, they have all found that patients treated by women fared better than those treated by men.

8/

pubmed.ncbi.nlm.nih.gov/27992617/

NB: Unfortunately all the data treat gender as binary, and none of the studies I’ve seen have looked at race or other aspects of identity. For too long, intersecting identities such as gender and race have been ignored, and that needs to change.

9/

medscape.com/viewarticle/94…

The data show that women bring particular strengths to the job of caring, especially when it comes to treating the patient as a whole rather than focusing on a specific diagnosis; there seem to be some advantages to this approach.

10/

medscape.com/viewarticle/94…

So should you pick a woman or a man to be your doctor? That’s up to you. This (woman) doctor recommends, as always, following the evidence.

(there are more links to evidence in the article itself than I could fit in this thread)

medscape.com/viewarticle/94…

11/

Here's hoping this #IWD is not a day of admiring women superficially but rather a day of committing to giving us the respect, support, and compensation we deserve. If you'd like to see more columns like this, please read and share widely! Cheers!

medscape.com/viewarticle/94…

12/12

@drjessigold

cc @drjessigold @FutureDocs @HelenBurstin @ShikhaJainMD @JulieSilverMD @DrJenGunter @DrHowardLiu @VirusesImmunity @DoctorYasmin @cindygallop @DrCindyMDuke @DrLoladeAdeyemi @DrAyanaJordan @RoxanaDaneshjou @amydiehl @AmyOxentenkoMD @pedsmd2b @AmmahStarr @RheaBoydMD @RFentonMD

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More from @arghavan_salles

Arghavan Salles, MD, PhD

@arghavan_salles

10 Mar

@thoracicrad

Earlier this week I spoke at @thoracicrad about how biases affect our evaluations of performance. Here's the gist on how we measure "intelligence" and perceive others.

(I also talked about stereotypes but will save that for another day.)

1/

First of all, let's start with what intelligence is. There is a ton of variability, but this, from Howard Gardner, resonates with me.
2/

How do we measure intelligence? There are many many many tests. What I learned about human cognitive abilities in my PhD, though, was there's no one measurable "intelligence." There are instead measures, such as the ones on this slide, of specific skillsets.

3/

Read 13 tweets

Arghavan Salles, MD, PhD

@arghavan_salles

18 Feb

@fumikochino

Preparing for this “Master Class,” I reviewed a 2018 Pew study @fumikochino had recently tweeted. They surveyed people on words used to describe men and women and whether they are positive or negative. 🧵

https://twitter.com/arghavan_salles/status/1361004839048597507

People perceived society to use different words for men than they do for women. For example, “powerful” was mostly seen as a good thing for men and a bad thing for women. Similarly, “strength” was good for men, bad for women. Same for “leadership” and “ambition.”

I mean, do women even stand a chance in the workplace if we’re not supposed to lead or be ambitious??

Moving on...

Read 7 tweets

Arghavan Salles, MD, PhD

@arghavan_salles

18 Jan

Quick thread about vaccine distribution—personal story

Mom is in a high-risk category and is eligible to receive a vaccine. I’ve been busy in the ICU and honestly assumed she was signing up to get vaccinated because she’s a responsible, conscientious person.

1/

After days of meaning to call, I finally remembered at a time of day when we're both awake and asked, just to confirm because of course she’s on it, right?

Nope. She’s not signed up.

2/

I’m in Arizona right now, she’s home in California. I haven’t kept close tabs on what’s going on with vaccines there (I've been busy), so I ask her why not. She says she doesn’t know what she’s supposed to do.

3/

Read 28 tweets

Arghavan Salles, MD, PhD

@arghavan_salles

2 Jan

Can we all stop playing the suffering Olympics? You know this game. It’s the one where everyone fights with their friends to prove they have it worse than everyone else.

In a world full of suffering, no one wins this competition.

Empathy, on the other hand, may help us heal.

It goes like this:

Person A: I can’t believe I lost my job. I don’t know how I’m going to pay my rent.

Person B: Well, at least you’re still healthy. With my arthritis I can’t even work.

Often Person B goes on to explain how their suffering is more extreme/sad/awful.

This leaves Person A feeling invalidated when what Person A actually needed was some emotional support.

Person B is also struggling and in need of support. Rather than competing about who has it worse, maybe it’s “yes, and”?

YES, you are suffering. AND so am I.

Read 7 tweets

Arghavan Salles, MD, PhD

@arghavan_salles

9 Dec 20

The other day, as I was walking into the hospital, I saw that when someone shared one of my tweets as evidence of how real COVID is, another person said mine was a parody account. What, exactly, I was supposedly parodying, I don’t know.

THREAD

Here’s what happened that day. We evaluated a new patient early in the morning. He’s in his 80s, and he’s breathing between 40 and 50 times a minute. Try doing that—it’s barely more than a second per breath for both the inhalation AND exhalation.

2/

He says he feels fine and has no problems with his breathing. But looking at him huff and puff, trying to get oxygen into his lungs and carbon dioxide out of them, we know he’s not fine. And at his age, he can’t exert that much effort for long.

3/

Read 15 tweets

Arghavan Salles, MD, PhD

@arghavan_salles

23 Nov 20

This thread is based on conversations with doctors at 3 large metropolitan hospitals, all in the position to know what’s happening with their ICUs. Here are some important points that endanger the public’s health NOW in these and many other hospitals across the country.

1/

Even if hospitals are relatively empty prior to a #COVID19 surge, it is very challenging to manage the surge because of how sick the patients can be, how quickly they come in, and the high volume of deaths.

2/

If hospitals are already full prior to a COVID surge, it is not hyperbolic to say that more people will die. And in all 3 of these hospitals, that is the exact problem.

3/

Read 12 tweets

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