Today is National Physician Suicide Awareness day. #NPSADay
A couple of issues drive problems with physician mental well-being:
- Job-associated burnout
- Stigma and harm associated with seeking help (having to report this condition on your license, and to your hospital)
What I find interesting are the responses you get from physicians when you ask about what actions can be taken to reduce burnout. Not shorter hours / more pay.
- Reducing low-value work & EHR clicks
- Eliminating insurance barriers like #PriorAuth
These factors don't just affect physicians. Nurses, RTs, MAs, CNAs & more are harmed.
We are in a work-force crisis. We should be looking to protect the people we have.
Forget the mindfulness exercises.
Reduce EHR burdens.
Reduce box-checking. #FixPriorAuth.
Concierge for @AnthemBCBS reached out, very friendly. Talked to MD reviewer (adult internist) who said, yeah, makes total sense, but I am a Level 1 reviewer and can't approve your request. 🤦♀️
Level 2 reviewer (peds GI) cannot be called directly. 1/x
Patient's peds GI stayed in the office until 11:00 pm last night finishing a multi-page letter of evidence & justification and attaching additional clinical documentation. Sent it off.
And ... now we wait?
Meanwhile this child is on high dose steroids with no endpoint. 2/x
My colleague says there is a national peds GI listserv replete with stories of patients just like ours, including stories of people dying while waiting for approval.
The longer we wait, the greater the risk that our patient will need a surgery to deal with her inflammation. 3/x
First: if Rs pick up two seats in the legislature, they'd have a supermajority.
A supermajority can place initiatives on the ballot to directly amend our Constitution and exclude abortion care from the right to privacy. They could even call a new constitutional convention.
Second: our Supreme Court affirmed in 1999 (Armstrong) that Montana's constitutional right to privacy includes abortion care.
PSC chair Jim Brown is running against current justice Ingrid Gustafson for the Supreme Court, and if elected would choose not to uphold that precedent.
Starting a list of Montana schools that have had to close or go virtual in the setting of increasing COVID infections in students and staff. Feel free to add. #mtnews 👇
On Tuesday @DPHHSMT wrote emergency orders citing "science" that masks don't work: a smattering of sources such as popular press, letters to the editor, articles they misread and - yes - tweets.
Might be time for a giant thread on the evidence behind masking? LET'S GOOOOO.
And by GIANT, I mean GIANT, because, well, there's a lot of evidence.
This is necessary context for when people throw out one-off colorful graphs of questionable provenance and saying, SEE?!? SEE?!?
I can't respond to all of that, if I had a zillion hours in the day.
Remember: Scientific consensus is built on more than a cut-and-paste list of articles. Trust experts who review ALL the evidence as it comes out, and tell you >>90% aligns. (Climate, anyone?)
Testimony today on HB 137, an effort to cancel ALL Montana communities' local ordinances on tobacco & vaping products. Setting the stage for our trend in youth vaping to continue. 30% of MT high schoolers currently vape.
I'm concerned about this. It seems to me like we should value our kids' health (and the long term health effects of tobacco use) over the health of this industry, and we're really not doing so in Montana.
A few facts on vaping. <5% of MT adults vape (versus 30% of kids). Many teens, per surveys, regard it as safe (it's not). Most cite the sweet flavors as a major factor in starting, and teens who vape are four times more likely to go on to smoke cigarettes too.
It's Sunday, you're on Twitter. I'm pretty sure you have 5 minutes. Can you use those 5 min to speak up for our #transgender Montanans, who are targeted by 2 harmful and discriminatory bills, being heard Wednesday?
HB 113 would fine health care providers up to $50k for providing gender affirming care (seriously, following our national guidelines on this would be ILLEGAL). Medical care for transgender youth is evidence-based & has been shown to reduce their very high risk of suicide by 70%.
HB 112 would prohibit trans athletes from playing sports according to their gender identity. NCAA & others have rules & criteria allowing this, but MT wants a blanket ban to keep kids off teams for good. Trans kids are kids too, and deserve the health benefits of sports.