Currently attending the plenary PLN3: Realizing True Health Equity- An Equal Opportunity To Be Healthy For All. #SGIM21 Right now @daynamatthew3 is discussing the historical + constitutional foundation of racism and inequality in the U.S., and its impact on health outcomes today.
.@daynamatthew3 "If you want to translate values into action as a physician, I implore you to consider your role in using law as one of your weapons of choice." Cites 1963 Simkins v. Cone federal lawsuit to desegregate hospitals.
.@daynamatthew3: Disparate rates of COVID-19 among communities of color is not due to vaccine hesitancy or lack of trust. Uses example of plane crash survivors who were seated at the front vs. wings of the planes--"where you sit on the plane determines your life chances."
.@daynamatthew3 COVID-19: "An illness that manifests in a marginalized population hurts us all. Structural inequality hurts us all. And we ignore it to our peril."
.@daynamatthew3 Racism is a system. An institutionalized system. It structures value, and opportunity--unfairly. Structural racism ascribes an unfair hierarchical ordering of value to people according to their race, and this ordering determines who has access to resources.
.@daynamatthew3 describing the implicit bias test and its effect on physician-patient relationship: implicit racial bias affects communication, clinical encounter, physician-patient relationship--but implicit bias is malleable.
@daynamatthew3 draws powerful parallels between the structural racism of past and present using the South Bronx, where she grew up, to illustrate "the enduring effect of racial segregation, of structural racism". Describes environmental, educational, food security disparities.
.@daynamatthew3 concludes her presentation with a call to action: How can you help? Do the individual de-biasing, the organizational de-biasing; consider using law as a tool to address social determinants and change policy- "SGIM physicians can lead the second 'Quiet Revolution'"

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More from @thecurbsiders

22 Apr
Currently watching the pre-recorded Update in Primary Care which reviews the 10 most impactful articles published in @AnnalsofIM, @NEJM, @TheLancet, ACP Journal Club, @JAMA_current, and @JAMAInternalMed from the past 2 years, as selected by a panel of SGIM physicians. #SGIM21
Study 1: 'Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction" by J.J. V. McMurray, et al. @NEJM pub. date Nov 21, 2019; nejm.org/doi/full/10.10… DAPA-HF trial bottom line: in pts with HFrEF, regardless of diabetes, dapagliflozin reduced HF and CV death.
Study 2: 'Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer' by Giancarlo Angelli, et al. @NEJM pub date March 29 2020 nejm.org/doi/full/10.10… Bottom line: in pts w/ cancer-associated VTE, apixaban is not inferior to dalteparin for preventing recurrence.
Read 12 tweets
22 Apr
Currently attending the discussion held by the @CPSolvers Anti-Racism in Medicine team on moving moving towards anti-racism in medical education. Right now @UREssien is describing the ways in which racism is ingrained in medical education and medicine as a whole. #SGIM21
Examples: over-emphasis on biological constructions of race/biological predictors of health disparities.
.@rohankhaz noted the importance of med learners engaging, honoring and becoming educated on a community's history with respect to racism, segregation, and patients' lived experiences.
Read 8 tweets

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