Diabetes physician/researcher & Mum. Values lived experience & diverse perspectives. Believes in compassion, inclusion & that language matters. She/her/hers.
Nov 4 • 11 tweets • 3 min read
We need to have a serious talk about the reality of being a young MD.
What we need to understand is the #healthcare #workforce crisis is linked to decades of preventable & compounded professional pain. The young MDs see it, and are done w/ it.
1/11 🧵
1. The burden of debt & life suspended is too much. Personal #MedEd debt in 🇨🇦 is ~$90K; $190K in 🇺🇸. Higher than ever.
Ppl are immersed in study during their 20-30s, placing family & relationships on hold. Pregnancy loss is higher among trainees; as is infertility. 2/
Oct 7 • 11 tweets • 2 min read
@globeandmail appreciate the editorial but it misses the mark, IMO.
Let me unpack why our (quantitative) data obsession is moving us further from a system designed for human wellbeing. 🧵 1/11 theglobeandmail.com/opinion/editor…1. Data is important but insufficient. As noted in the editorial, @CIHI is loaded with data from a variety of resources. We have ++ data but a system in crisis. Information = data + context. It's context we are sorely missing.
Stop conflating data w/ useful information. 2/
Sep 23 • 6 tweets • 2 min read
Lots to unpack in this article about the diversion of $1.5B 🇨🇦 tax $ to private nursing agencies, but I'd like to highlight three things that illustrate we do NOT plan for health in this country. 🧵 1/6 theglobeandmail.com/canada/article…
First, we have to stop thinking about health as a business that delivers a service in hospitals. Health care should always be about health promotion & disease prevention. Yet the crisis talk is focused solely on care delivery in hospitals. This is a sliver of "health care". 2/
Sep 21 • 9 tweets • 2 min read
🙏 @picardonhealth.
There is overwhelming evidence that women elevate the practice of #medicine but exploitation & oppression of ppl & trainees has been institutionalized. A few things that are needed to really make #equity possible 🧵1/9
1. Flexible strength-based eduction.
Equity & diversity are most valuable when ppl have space & support to bring something new to the field yet #meded is rigid & unforgiving. Changes are underway to make meded accommodating, but its lack of compassion has broken many. 2/
Sep 7 • 21 tweets • 4 min read
I realize this may be a career limiting 🧵, but hey, somethings are more important.
After a year of working as a Senior Med Director of a Strategic Clinical Network in AHS, I need tell you why shutting them down is a big problem. 1/ edmonton.ctvnews.ca/drowning-in-pa…
Background- Strategic Clinical Networks (SCNs) were introduced in AHS as method of building provinicial communities to help harmonize care throughout the province & ensuring all Albertans could have similar, excellent outcomes. 2/
Aug 27 • 20 tweets • 4 min read
As @GillianSteward states, AHS was a leader in Canada before the UCP demolition.
Lets take a minute to remember what was working & what wasn't.
The gutting of AHS was *absolutely* political but #healthcare crises are everywhere and crises have many determinants.
1/20🧵
AHS' strength was integration and coordination of services across a large, diverse, mobile province. This is, without question, a foundational element for a high functioning system. 2/
Nov 19, 2023 • 17 tweets • 3 min read
This is a must read article on why #healthcare is failing.
At the heart of all of this, is a failure to design/evolve a system that addresses/responds to clinical & social complexity.
Alberta, you really need hear this: 🧵 1/ pressreader.com/canada/toronto…1. Health is a result of a number of social/structural determinants.
Wealthy, housed, emotionally supported ppl are healthier than those that are not.
#COVID illustrated this powerfully. If you were racialized & poor, it was devastating. If wealthy, you were inconvenienced. 2/
Aug 21, 2023 • 5 tweets • 1 min read
The association b/w COVID-#diabetes- #heartdisease is real and worrisome.
I am a diabetes care MD & I am booking in MAY 2024 with no capacity for new referrals & booking 3x as many patients I am contracted to. Same for my colleagues. 1/5
3 years ago we could see this unfolding.
#Diabetes has + structural/systemic determinants. Communities w/ the highest #COVID rates were at the greatest risk for diabetes. They were also the most likely to lose employment & health benefits when sick. @NaheedD @CampbellLab_yyc 2/
Jul 9, 2022 • 9 tweets • 4 min read
Oh my, sit tight & let's unpack how this case illustrates how medicine is an incredibly unsafe training environment for ppl with intersectional vulnerability. 1/9 #metoo#equity#psychologicalsafety#cardiology#MedEd
1) The power gradient creates no ability for learners to speak up against a preceptor. Trainees in specialty programs want to get hired & can't risk pushing back, esp if you are equity deserving. 2/9
In #medicine, we need to re-think "leadership".
On this Jan 1, 2022 I find myself 3 yrs in to a 5 yr leadership position & reflecting on what I have learned about "leadership".
Some thoughts (🧵): 1/81. "Leadership" is a terrible brand & misunderstood. Often equated w/ lots of work & big decisions, "leadership" over-emphasizes the actions of the "leaders" & devalues the contributions of the team. That concept will get you the wrong leaders & terrible results. 2/8
Jan 1, 2022 • 8 tweets • 2 min read
In Alberta, we have had lots of experience w/ moving too fast too soon on lifting restricitons wrt to COVID.
On the 5-day iso recommendation:
The evidence says viral shedding peaks at 5-days, but ppl are still infectious until ~9 days. 1/8 thelancet.com/journals/lanmi…
I get that w/ high infectivity, workforce management is a nightmare. Decreasing iso time for folx w/ lower viral loads d/t vaccination may be a reasonable BUT saying that essential workers can work in those first 5 days is ++problematic. 2/8
Oct 18, 2021 • 11 tweets • 3 min read
CS:Suicide.
I have planned my death, twice. 1) CO poisoning while kids were away w/ their dad. 2) Insulin OD in secure med closet (I am alone in clinic after hrs all time, it would have been easy & effective).
I had explicit plans, even dates. 1/11 cmaj.ca/content/193/41…
I have a history of disordered eating, anxiety & depression, all very stable & well treated but work is a major trigger for my suidical ideation. I have used the @Albertadoctors PFSP program, but lets be clear- that is a BANDAID, not a solution. 2/11
Jan 31, 2021 • 6 tweets • 4 min read
TY @NightShiftMD for sharing this important conversation w? @jkwan_md & @NathanStall. As a fledgling advocate, I want to amplify & expand on some important points re: MD advocacy. Short thread 1/6
Advocacy as a professional competency is both required & ill-defined. The @Royal_College has an important role in empowering trainees to "flood the freeway". There needs to be more emphasis on healthy policy & how we can influence in #MedEd & beyond. @JillianHortonMD 2/6
Jan 3, 2019 • 11 tweets • 4 min read
Dear friends & colleagues- the support you have shown in a vulnerable moment has been overwhelming. I will try to highlight some of the advice and reflections I have received on #burnout that were helpful & thought provoking:
1) Celebrate your numerator. We focus to much on the denominator (those things not yet done), but the wins we have delivered get forgotten too quickly.
