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Umbereen S. Nehal, MD, MPH Profile picture
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7 Apr, 5 tweets, 3 min read
@adamcifu - the idea that doctors should not be political is why the entire field of #pediatrics walked out on the rest of #medicine. Children don't have the luxury of "every man for himself" mindset. Also, Muslim patients' or atheist patients' autonomy at #endoflife : political
All of us are trained, in residency, on "political" dollars from #Medicare and much of our #EBM is funded by tax dollars from #NIH and elsewhere. Tax dollars are public money, managed by elected officials, who are put in place and held accountable by the political process.
Then there are seemingly extreme examples, but are they so extreme given how often horrific things happen in history & even uptick of violence in the U.S.? Should doctors opt out of protecting vs this? These camps, if formed, may utilize doctors/nurses

time.com/4574680/muslim…
Having a well reasoned & ethical stance on things does not mean an inability to treat patients who disagree with you and/or even you find appalling on a human level. Per human rights we are obligated to treat child molesters, human traffickers, mass murderers with quality care..
If I testify in a trial, as a medical expert, against child abuse, does that make me unable to treat a teen who is physically or sexually abusing a younger sibling? If doctors lack ability to manage that level of complexity or manage our multiple responsibilities: pretty scary.

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More from @usnehal

Umbereen S. Nehal, MD, MPH Profile picture
7 Apr
When you want to know why
-women & minorities leave medicine
-why research lacks data to serve needs of anyone not white & male
and/or
-why different mortality rates in patients by gender, race, SES

this is why

This is #MedBikini “#professionalism” again

#MedTwitter
#MedEd
Is insidious
but highly effective
maintains
-segregation
-different access
-barriers

As women, LGBTQ, minorities, disabled enter or advance in medicine, this professor’s public stance will be cited to mislabel having #ethics as “lacking #professionalism”

bioethics.net/2020/07/medbik… ImageImageImage
#medbikini is not one article
=attitude of many physicians
=drives this

We saw this happen with @ayshakhoury and @uche_blackstock and so many others. It especially happens at midcareer to WOC, especially black. Also if Muslim, LGBTQ, disabled, #mentalhealth

#MedEd
#MedTwitter Image
Read 51 tweets
Umbereen S. Nehal, MD, MPH Profile picture
6 Apr
#MedTwitter showed me the dark side of this, of all times, during a #pandemic. Turns out some who are employed in supposed #SciComm actually stalk patients on behalf of doctors & administrators. Sadly, #bullying patients has gone from "just" in hospitals to dark web.
There is a type of doctor, not all, who believes self a "victim" of patients.. "I am a victim" is used to do mental gymnastics to "justify" #bullying patients who seek answers, report error or harm, initiate lawsuits.

Yes, there is too much litigation. But this is America.
#Tweetiatrician training is for #advocacy on #vaccines #VaccinesWork #VaccinesSaveLives

This has been our lane for well over a decade. As long as I've been a pediatrician we've been using every form of #communication and #SciComm, the sillier the better

pediatrics.aappublications.org/content/141/1_…
Read 9 tweets
Umbereen S. Nehal, MD, MPH Profile picture
6 Apr
Further, suboxone has required special training and certification, adding an administrative barrier and creating an added fear barrier among risk-averse clinicians whereas oxycodone can be prescribed easily with the DEA certificate we all have.
Because doctors/prescribers are definitely lacking in administrative burden and CME obligations, we're just twiddling our thumbs eager for someone to ask us to get MORE educated, taking time off from patient care to get this:

medpagetoday.com/psychiatry/add…
The law enforcement side sees doctors through this lens. So doctors seek to limit their risk and liability. I'm all for taking down those who harm patients. I've testified in cases like the ones below for the AG's office as a medical expert.

medscape.com/viewarticle/91…
Read 7 tweets
Umbereen S. Nehal, MD, MPH Profile picture
6 Apr
This happens not uncommonly. Sadly, it means being Muslim-American means that you never know who has been targeted, "converted", especially via #mentalhealth targeting

Need to fulfill metrics of "terrorists caught" to report to superiors... meanwhile, Jan 6th happened....
If you work in refugee health, are an activist, seek to empower the marginalized or targeted, this has either happened to you directly or happens to people you know

The person you are supposed to pick up from the airport arrives hours or days later with no info where they are
"Go back to your country then" does not work if you are
1-born in the U.S. thus are in "own country"
2-drones kill grandmothers in their own homes across the world too

#Safety for whom?
Look at #CapitolRiot, etc
How's that #security going, America?

pri.org/stories/2016-1…
Read 7 tweets
Umbereen S. Nehal, MD, MPH Profile picture
6 Apr
This is where a "culture of civility" enables abusers & predators. If you do not say something to inappropriate behavior in a professional context, maybe you feel it will draw negative attention to yourself oor associate you with the harm

you are complicit
you teach "this is ok"
What I find with "civility" culture

is it will punish action - like even smiling too much, identity (natural hair) or things of a non-European culture

while rewarding suppression, silencing, & inaction as "not making people uncomfortable" called #professionalism.
A prime example is how "comfortable" Dr. Birx made us on ongoing harm. Per her recent interviews, she knew was going to happen, she carefully documented (like the bureaucrat expecting later accountability and protects self) but did not speak

businessinsider.com/dr-deborah-bir…
Read 5 tweets
Umbereen S. Nehal, MD, MPH Profile picture
6 Apr
This is VERY important because we already have a mistaken belief that being "a good person" or "having empathy" can erase or mitigate racial bias or disparity when study after study proves opposite. Now we're encoding bias into #algorithms and #AI that will be called #DataDriven
This is the new frontier of #systems driven #bias. Look at the demographics of who is in #technology and #BigDataAnalytics and #AI. Look at the reputation of culture of these spaces. This puts everyone at risk even if you think you "benefit" from the bias. Inaccuracy is harm.
Just look at the #COVID19 #pandemic. Who correctly predicted AND took correct actions for good outcomes?

The risk of the most vulnerable became YOUR risk

if your #sytems and #bigdata and #BigDataAnalytics fail to capture reality

your real life results will be failure.
Read 4 tweets

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