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
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.
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-…
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-…
Do I identify waste, harm, and those making a career out of former two?
Yup.
It’s what my job was in #Medicaid: identify #fraud, #waste, #abuse.
Identifying abuse and #bullying of most vulnerable is what pediatricians do as well. Mandated to do so in fact.
Yup.
It’s what my job was in #Medicaid: identify #fraud, #waste, #abuse.
Identifying abuse and #bullying of most vulnerable is what pediatricians do as well. Mandated to do so in fact.
#Bullying and exploiting your value creators - clinicians - is the lazy route of bad #leadership prevalent in #healthcare.
This was published in 2019 and only got worse in the #pandemic.
It harms patients.
It harms clinicians.
It harms all.
nytimes.com/2019/06/08/opi…
This was published in 2019 and only got worse in the #pandemic.
It harms patients.
It harms clinicians.
It harms all.
nytimes.com/2019/06/08/opi…
@EricTopol wrote that physicians were betrayed. I would include janitors, delivery people, receptionists, doctors, nurses, families, patients.
There are people with direct exposure, doing direct care, giving direct service, putting own lives at risk. Others peer behind screen.
There are people with direct exposure, doing direct care, giving direct service, putting own lives at risk. Others peer behind screen.
https://twitter.com/usnehal/status/1330630066850631691
I have worked in numerous #healthcare settings.
Yes, there are amazing #operations folks.
Too often, the operations (non-clinical) types spy via #EHR.
The rare compassionate exec, manager, bureaucrat gets outcompeted by the #bullying one.
And everyone stays afraid, silent.
Yes, there are amazing #operations folks.
Too often, the operations (non-clinical) types spy via #EHR.
The rare compassionate exec, manager, bureaucrat gets outcompeted by the #bullying one.
And everyone stays afraid, silent.
#bullying in healthcare traditionally was the male surgeon throwing the scalpel across the room
even though we also have surgeons like Atul Gawande or Lucian Leape
too often the narrative of “advocate” labels the male and/or doctor as “bully” to control
ihi.org/Engage/Initiat…
even though we also have surgeons like Atul Gawande or Lucian Leape
too often the narrative of “advocate” labels the male and/or doctor as “bully” to control
ihi.org/Engage/Initiat…
Medicine’s traditions, resistance to change is why frustrated administrators & advocates turned to non-clinician “disrupters” in the first place.
Except now you have the equivalent to these Texas vines that suck SO much out of the system & out of clinicians, it strangles/breaks.
Except now you have the equivalent to these Texas vines that suck SO much out of the system & out of clinicians, it strangles/breaks.
#Healthcare: an industry
driven by Porter’s Five Forces
If follow data points of my CV, writing, etc can see I’m the (naive) do gooder who chose increasingly less lucrative paths (peds, HSR, #publichealth) going to margins (#FQHC, Medicaid, refugees)
Yet operations take 💰💰💰
driven by Porter’s Five Forces
If follow data points of my CV, writing, etc can see I’m the (naive) do gooder who chose increasingly less lucrative paths (peds, HSR, #publichealth) going to margins (#FQHC, Medicaid, refugees)
Yet operations take 💰💰💰
Those mergers in #healthcare now threaten the most vulnerable in America - ones dying of #COVID19 - to reach into spaces #community-oriented clinicians go to serve, away from the ego-driven politics of #academicmedicine away from lack of safety for WOC.
healthleadersmedia.com/strategy/how-h…
healthleadersmedia.com/strategy/how-h…
Example. One of oldest inner city hospitals in U.S. treating low income patients was:
-bought by an investor
-shuttered
-real estate holdings sold off
-trainees left in lurch
in a #pandemic, #business exec refused to help except for 💰💰💰
#MedTwitter
nytimes.com/2020/03/27/us/…
-bought by an investor
-shuttered
-real estate holdings sold off
-trainees left in lurch
in a #pandemic, #business exec refused to help except for 💰💰💰
#MedTwitter
nytimes.com/2020/03/27/us/…
The @AmerMedicalAssn now is stepping up, after that, to protect residents
because in bankruptcy proceedings the investor/owner tried to sell off the #Medicare funded residency spots as a commodity.
ama-assn.org/residents-stud…
@Health_Affairs on that: healthaffairs.org/doi/10.1377/hl…
because in bankruptcy proceedings the investor/owner tried to sell off the #Medicare funded residency spots as a commodity.
ama-assn.org/residents-stud…
@Health_Affairs on that: healthaffairs.org/doi/10.1377/hl…
They say “follow the money”
but I would say:
“follow the vulnerability”
to find the value-extracting (not value-creating) predators
Who is attacking the poor, elderly, & vulnerable?
Which is the predatory vine strangling young trees?
Who sucks 💰without accountability?
but I would say:
“follow the vulnerability”
to find the value-extracting (not value-creating) predators
Who is attacking the poor, elderly, & vulnerable?
Which is the predatory vine strangling young trees?
Who sucks 💰without accountability?
Harm showing in the young, old, infirm, or trainees affects YOUR patient’s care, #quality, #safety, as well as your (clinician) #burnout
#pediatrics is so passionate about #advocacy, we broke off from the rest of medicine 100 years ago
Now, no escape
Industry is consumes all
#pediatrics is so passionate about #advocacy, we broke off from the rest of medicine 100 years ago
Now, no escape
Industry is consumes all
https://twitter.com/usnehal/status/1256528254703489024
The most esteemed institutions are affected by quality compromises like this. Few clinicians were willing to be quoted in this piece on political deference > safety (not enforcing mask policy)
True, I am willing to be the Cassandra & speak first on harm
We need clinician unity
True, I am willing to be the Cassandra & speak first on harm
We need clinician unity
https://twitter.com/marketwatch/status/1255906577246294018
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