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Umbereen S. Nehal, MD, MPH Profile picture
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4 Apr, 12 tweets, 10 min read
The folks who are anti-diversity need to update their tired playbook.

Sharing space for win-wins is not the same as hating people in a space.

Violating professional ethics by trying to diagnose via Twitter only damages own professional reputation by displaying poor judgment.
The time to have diagnosed by Twitter was here - instead of holding leadership accountable, people scrambled to put guardrails and install people to be "adults" in the room to reassure the public.

Actually don't be reassured.
Do something.

theconversation.com/thousands-of-m…
This was time to raise alarm, not "reassure"

All of you who distribute pacifiers and those eager to be pacified killed Americans

Plus, there was utterly bad and WRONG advice from a #physician and #publichealth #leader that "no need" to think about DNRs.

Why does @Forbes know more than a seasoned #heatlhare leader that #COVID19
=rationing
=deciding who lived & who died? Dr. Birx clearly indicated whose deaths she was "reassured" by: >50 years, "pre-existing conditions. Later term implies "not my fault"

forbes.com/sites/joshuaco…
We needed conversations on DNR - based on what we saw in Italy that Dr. Birx referenced, not only for rationing (which Birx essentially stated: >50 years old were reassuring deaths) but #clinician #safety

"exposes healthcare personnel to the coronavirus"

cidrap.umn.edu/news-perspecti…
I am not pro-rationing care for life & death to be clear, AM saying: when the top #COVID response coordinator describes deaths of >50 years "reassuring" then SHE is stating HER comfort with rationing care for who lives and who dies & directing the national response accordingly.
Among clinicians who died at a higher rate? Minority clinicians depending how that is characterized in that particular country.

Besides these actual #COVID deaths, there was also an uptick of #pandemic bullying (by race) within #healthcare and #STEM

theguardian.com/world/2020/may…
There data on racial disparities in the U.S. context, mostly looking at frontline workers. Among frontline workers are clinicians as well as essential hospital and healthcare staff ranging from janitors to delivery personnel.

ncbi.nlm.nih.gov/pmc/articles/P…
Yet amid these deaths, folks who oppose diversity & mislabel healthcare quality as "hate" (it's not the first time quality, #safety, #equity, #standards, or #ethics were mislabled) claiming for self, victim status. It's fascinating.. if it were not so appallingly anti-humanity.
The reality is that anti-diversity folks claiming persecution or crying "cancel culture"

when their own words - unethical per #healthcare standards - that they put into the public sphere
are held to account

are NOT the ones, literally, dying this way:

#COVID19 #pandemic is creating a #mentalhealth pandemic that is causing people to spin out in whatever direction is their inherent weak point or simply their beliefs.

Fear of other is fear.
We know last POTUS incited xenophobia too.
=Worsens disparities

nature.com/articles/d4158…
#mentalhealth in #COVID19 had to adapt. Boundaries of time, space, countries were disrupted in a #global #pandemic - we now have #telehealth in #behavioralhealth. This, though, raises #privacy concerns and #access to care issues with #workforce shortages

thelancet.com/journals/lanps…

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More from @usnehal

Umbereen S. Nehal, MD, MPH Profile picture
6 Apr
This is good news!
Let’s hope this will re-employ the many women who left the workforce too.

brookings.edu/essay/why-has-…
A longer report

mckinsey.com/featured-insig…
Read 5 tweets
Umbereen S. Nehal, MD, MPH Profile picture
6 Apr
Hello 👋 new followers. Feel free to introduce yourself.

Me: A top strength of mine is “input” Others in pics.

I tweet A LOT. I tweet long threads with links to articles, with highlighted screenshots, links to others’ tweets. I hold onto info & reference past yet “futuristic” ImageImageImageImage
You have to know the past to understand patterns and see possibilities as well as navigate past barriers for the future.

If you like control or boundaries, run now as I promise you I will be 🤯 for you.

If you like creativity, expression, innovation, equity, ethics, welcome.
I am going to constantly run around the world finding interesting concepts & facts, be passionate & outspoken on justice/equity, re-use old tweets to explore new facet in new thread.

I’ll shape shift & if you try to pin me down or box me in, you will be frustrated.

All me: ImageImageImageImage
Read 28 tweets
Umbereen S. Nehal, MD, MPH Profile picture
6 Apr
The lack of empathy, or inability to feel pain the same when someone's skin is black/high malanin and you see them in pain, is literally documented in studies as well as a simply real life disparities.

Please stop with the "empathy" hogwash. We need to address systemic racism.
I *finally* figured out the whole "empathy" silliness and why I feel, increasingly this..

if somoene quotes brene brown at me on "vulnerability" - you think enslaved black women with babies were not vulnerable? Your WHOLE society/culture is designed to not see/feel black pain.
What I figured out is

by touting "empathy"
you can self-appoint yourself as "good"
with "but I am a good person"
or "but she was nice to so and so, therefore"
and deny racism and, more importantly

NOT CHANGE structures or policy
Do NOTHING and feel good about yourself
Read 21 tweets
Umbereen S. Nehal, MD, MPH Profile picture
5 Apr
This was me one night intern year, the night of 22 admissions as a solo intern, no cross cover, no team to divide admissions among, no night float, no work hour restrictions, call lasting up to 36 hours. (In those days before safety standards).

I almost left/quit.
#MedTwitter.
I remember my pager and spectralink going off over and over, it was past midnight. I wasn't going to be "weak" and ask for help from the single resident covering 5 floors or 200+ patients, if I didn't respond to the mom concerned about no poop in a baby for 24 hours...
...that Mom would feel ignored (& file a complaint) but there were also a few admits on Q2 (almost ICU) albuterol waiting in the ED. On acuity, might require earlier attention than the no poop x 24 hours already admitted patient. I remember turning to look at the elevator doors..
Read 6 tweets
Umbereen S. Nehal, MD, MPH Profile picture
5 Apr
Those who:
do not touch patients & never have
who maintain no clinical licenses
who feel free of any commitment to #ethics

are put in charge, by administrators, to control, often via fear & shame, clinicians.

This harms on many levels.
It is anti-#safetyculture.
#MedTwitter
We have lost >500,000 Americans to #COVID19 alone. Preventable deaths. These are mostly the marginalized, vulnerable.

Either document measurable work to save lives, or get out of the way and out of budgets that could be used to save lives.
I’ve seen SO much over the years, in the name of #compliance consulting to siphon off money to block &, ultimately, harm.

No this does not save money.
It harms families.
It monetizes coded racism.

There are a multitude of such vendors & consultants.

governing.com/topics/health-…
Read 16 tweets
Umbereen S. Nehal, MD, MPH Profile picture
5 Apr
The field of #psychology has MANY problems. SO many levels of wrong:

1-clinicians designing torture
2-a strategy to exploit the lack of ethics by APA leadership to gain scope of practice
3-monetizing harm
4-validating minority distrust of #mentalhealth

nytimes.com/2015/05/01/us/…
The details are damning. It was clearly about expanding turf/scope of practice with a “deal with the devil” to bypass civilian regulations & go after DoD💰💰💰

There was not any commitment to human rights but manipulating words to craft unethical policy

journalofethics.ama-assn.org/article/profes… ImageImageImageImage
There have been reputation repair attempts, to distance self from torture, however professional societies tend to fixate on gaining or protecting turf & scope of practice. They use patients for “stories” but in reality show little care about patients.

apa.org/news/press/op-…
Read 11 tweets

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