Saroo Sharda MD MMEd FRCPC Profile picture
Jan 14, 2022 15 tweets 19 min read Read on X
How we implemented specific & tangible #PhysicianWellness recommendations into our national #anesthesia guidelines @CASupdate

🧵of highlights

link.springer.com/article/10.100…

At the end of 2019 the @CASUpdate wellness committee was formed. I had two broad goals for my term as Chair

1/
supported by an amazing committee (I didn’t know a 🌎 pandemic ws coming!)

1.Train anesthesiologists 2provide quality evidence based #PeerSupport 2one another,esp after critical events&encourage creation of institutional peer support programs

👀 4more on this another day

2/
2. To embed tangible & specific wellness recommendations into our National Guidelines (because healthy physicians are safer physicians and also…urmmm…basic humanity!)

- Appropriate breaks 🚽
- Enough rest 😴
- Skilled help esp after hrs 👩🏽‍⚕️
- Transparent&equitable policies

3/
- Transparent&equitable hiring & scheduling 🗓
- Zero tolerance of discrimination/harassment/bullying based on any identity (microaggressions def a form of bullying) 🛑
- Support during career transitions 🚊

The wonderful Standards committee,Chaired by Dr Dobson,reached out

4/
With the help of many smart folks on my committee - special shout out to @AnitaChakravar2 @MndpSingh7 @YesSrICanBougie @DrFadiTO
@annekwong and all the non-tweeps - we managed to embed all of the above, based on the wellness literature and our own experiences

5/
This is the *first* major rehaul of the wellness section of our standards

It is now entitled Physician Health and Wellness

Next few tweets are screenshots of the context for this new section and the recommendations 📸

6/
7/
8/
9/
We recognize that this is just a start and there’s much more to do.

The #Wellness and Standards committees will continue our collaboration and update and refine as we continue to listen & learn

10/
Our hope is that leaders in Canadian #anesthesia translate these recommendations into practice.

Tagging a few of those leaders here to please 📣 & implement these recommendations

@Dolores_McKeen @AlikaMD @ON_Anesthesia @UofTanesthesia @MacAnesthesia @OttAnesthesia

11/
Addendum
Many of the Wellness Committee members (including our two fantastic resident members) are not on Twitter. But their names are listed on the @CASUpdate website. So much gratitude to all of them for their extra work in the MIDST OF A PANDEMIC! Fin/
Ah the risks of forgetting to tag people who actually *are* on Twitter and were so central to the committee and the work (I’m blaming having to online school my kiddos for my short term amnesia!)
@cpaolag @brittp_27 @sukhibasran

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More from @SarooSharda_MD

Jul 29, 2022
I’m an anesthesiologist who did a Masters in interprofessional education and team dynamics

Here’s why bad takes like this from surgeons are not only disrespectful but also potentially

HARMFUL

1/
The surgical procedure may be short&sweet but the patient may be

very sick
have multiple co-morbidities
be anxious
have previous trauma

or

have a number of other reasons that require

a careful,gentle,quiet anesthetic

This takes planning, time, & an abundance of skill

2/
2. Basic lack of respect or understanding for the role of other key people in your team has been shown time and time again to impede the above mentioned planning/time/use of skill

This phenomenon of lack of respect is especially felt by minoritized physicians

3/
Read 16 tweets
Jul 27, 2022
Questioning of womens’ expertise doesn’t always come via men

I had to be “appropriately confident” (to quote the brill @DrJenGunter) recently when my professional expertise was questioned

A female colleague asked for a male colleague to get involved in something which was

1/
A) clearly within my domain of expertise
B) I had been working on w another woman of colour expert
C) I had been working on for some time as it was complex

During the meeting I clearly outlined mine and my colleagues expertise and our ability to appropriately advise&manage

2/
When said colleague and I debriefed afterwards she said she “couldn’t believe” I had done that.

That I had just said it

Plainly

No nonsense

Just like that

In front of everyone

But that she was happy I did

I’m at a stage&age where being “appropriately confident”

3/
Read 4 tweets
Aug 23, 2021
On vacation but still 🤔 about equity,justice,oppression

🤔about how BIPOC folks speak of

disappointment
frustration
fatigue

when #EDI initiatives that aim to disrupt are overturned @CMA_Docs

while others use the words

surprise
shock
“at least it’s a start”

1/
The stark contrast in words is because

those who live this

for whom lack of #EDI is deeply personal, lived&often traumatic

are exhausted

but we are most definitely

NOT

surprised

because

we know

that those who hold power do not wish to rebalance/redistribute

2/
we also know that healthcare is deeply racist and still (in 2021)

centres whiteness,
heteronormativity, maleness and able-bodies

and yet also believes that physicians are “neutral” and always “objective”

when we continue to centre this,how can we possibly shift&transform?

3/
Read 8 tweets
May 13, 2021
When I think about colleagues who’ve influenced me,rarely is it their academic work/publications I think of
Rather it’s their ➡️humility
➡️ability to hold space
➡️compassion
➡️advocacy
➡️integrity

So,the past few weeks when greeted w “Oh I’m so glad it’s you!” by a colleague 1/
who is a patient, or by a colleague with whom I’m working with that day on a complex case; or a patient in clinic asking “could YOU look after me in the OR?”; or a colleague who calls me cos’ their child is havin a *really* hard time as woman of colour in medicine; or a friend 2/
who says “I don’t think my specialist is listening to me& I’m scared - can you help?”; or an acquaintance who asks “can you talk to me about vaccine risks”; or a parent who says “can we chat about how hard this home schooling thing is?”; or a group of physicians doing 3/
Read 5 tweets
Jun 20, 2020
What I’ve learnt about advocacy work from my running app...
“It’s not about speed, it’s about endurance,”she reminds me as I find myself flagging half way through the run.A little voice in my ear,the steady&reliable lady on my app,reminding me,“One foot in front of the other”

1/
I keep going. This non-runner, trying time remember how far I’ve come from week 1 till now.

I think about how much work there is still left to do with regard to anti-oppression, anti-racism, the intersectionality of race and gender, and my head begins to swim.

2/
The little “to-do lists” are popping up in my mind. Pinging at me and stinging my conscious.
“You’re not doing enough, not working hard enough,”

And then my trusted running coach again, in my ear,
“Remember how hard you’ve worked, keep running. Slow down. Just don’t stop.”

3/
Read 9 tweets
Jun 17, 2020
So grateful that @javeedsukhera accepted my invitation to speak on #bias #implicitbias #oppression to @MacAnesthesia

Live tweeting some pearls!

Stigma has a negative impact on clinical outcomes
Shame is not an effective pedagogic strategy in calling out stigma. Shaming and calling out may actually make problem worse

Education may be helpful but it also isn’t enough alone
We often have conversations about #equity that are blaming (“us” vs. “them”)

Blame has an inverse relationship with accountability
Read 21 tweets

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