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Umbereen S. Nehal, MD, MPH Profile picture
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5 Apr, 11 tweets, 11 min read
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…
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-…
Turf wars make all #healthcare more unsafe for patients

Many parts of the U.S. have clinician shortages in physical #health & #mentalhealth
No need to fight

Except fight is over 💰💰💰
Healthcare is 20% of GDP

#MedTwitter
#PsychTwitter

ihi.org/about/news/Doc…
As you can imagine, as I am outspoken on this, I have made a few dark web enemies.

I am not designing torture & calling self a “#safety officer”, then hiding, denying, “crafting narrative”

I am pro #safetyculture. A best practice of that is reporting.

Report, report, report
I am outspoken on many, see this thread on Dr. Birx

She:
1-took taxpayer money to harm and/or fail to protect/do her job
2-advanced own consulting by using that prior taxpayer funded position, now to sell banned tech
3-reputation repair tour timed with new lobbyist position
The art of manipulating words can be misused in this way - psychologists are often hired for marketing. As doctors often lack good communication skills, marketers hired for this:

(vs a positive example of manipulating language is #CBT to reframe from negative to positive)
At the same time, there are massive issues in medicine as evidenced by the denial of medical racism.

In addition to what @RheaBoydMD describes, this is who controls promotion, hiring, termination, discipline.

They also decide budget allocation, quality & performance metrics.
Hospital execs: Racism in #healthcare is actually bad for your #budget & #operations, as I describe here with @becker_sbecker in a 12 minute #podcast. Disrupted #teamwork harms patients, drives staff turnover, & leads to poor outcomes
#MedTwitter

go.beckershospitalreview.com/scott-becker-i…
I make physician peers upset when I am transparent on errors in #healthcare or I promote team-based care - yes, political narrative of “new entrants” to healthcare or those seeking to expand scope utilizes that to attack.

Doing the right thing by patients requires #transparency.
The misuse of #patient #data is real.

As we build #largedatabases & #bigdata for #BigDataAnalytics there are serious cautions:

Look at all the current, recent past & remote past abuses.
Look at COI issues of #healthcare #leadership.

All concerning.

healthcareitnews.com/news/group-war…

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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
When it comes to #AntiAsianHate crimes, we need to be able to call it a "hate crime" when the assailant is not black as well.

"Sex addiction" ...but only towards Asian women? That sounds like race-based behavior or racial assumptions.

time.com/5947626/atlant…
Stop, just stop this "but what about black crime" question

or "not to trigger but...." intrusive questions from the melanin & ovary deficient folks seeking to pit minority vs minority

or sudden concern towards #AAPI #aapihate from those who usually talk of "reverse racism"
There is a stiking difference, anecdotally

to when it is quickly identified as a hate crime
versus "but is it really a hate crime?"
that seems to be related to amount of melanin of the attacker

nytimes.com/2019/06/12/us/…
Read 7 tweets

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