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Healing garden under threat, nixing nukes, and discrimination against trainees

November 3, 2016

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our healthcare system toward the right care for all patients.

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“If we’re going to promote healing, we need healing spaces!” This was the rallying cry of protesters who gathered in late October to save Prouty Garden. A beautiful green space within the Boston Children’s Hospital, Prouty Garden has been a refuge for sick children and their families for over half a century. However, the garden is slated for destruction in order to make way for the expansion of BCH. While access to health care for children is paramount, a further look at the expansion plan reveals it has more to do with increasing the hospital’s market share than providing needed services. Vikas Saini, MD, president of the Lown Institute, was invited to make a statement at the rally connecting the BCH expansion to larger systemic problems in the health care system. “We need to ask ourselves, how and why do these decisions get made? Too often, it’s the bottom line,” Saini said. “This goes to the heart of how the system works.” Unfortunately, the Massachusetts Public Health Council voted later that day to approve the BCH expansion that would destroy the garden. But this does not mean the fight is over; supporters of the garden will appeal the decision in court. The Right Care Alliance will continue to stand with Friends of the Prouty Garden to help save this unique healing space.

The presidential election next week compels us to write about nuclear war because the winner will have the power to order a nuclear strike. At a time when conflicts across the globe are too many to count, the president will have his or her finger on hair-trigger alerts—the ability to decide to attack in minutes, most likely based on preliminary information. The superpowers (the US and Russia) as well as seven other nations have arsenals of nukes, and there have been many near-misses and near launches. In an opinion piece on CommonHealth, Matt Bivens, MD, of the Greater Boston Physicians for Social Responsibility, calls on the next U.S. president to de-alert nuclear weapons, that is, to take them off hair trigger status even if we believe we are under attack. At the very least, Bivens wants a mandatory waiting period of 24-hours before the president orders a strike, and he recommends other nations also wait. But the ultimate goal, in the view of Bivens and others, is banning nuclear weapons. Next month the United Nations General Assembly will vote on a legally binding treaty to do just that, making them illegal under international law. Yet the White House wants to spend $1 trillion in the next decades to upgrade our existing nuke arsenal. Lown Institute’s Bernard Lown, MD, a founder of Physicians for Social Responsibility (1961) and International Physicians for the Prevention of Nuclear War (1980), writes in his book, Prescription for Survival, about the human devastation of such a war. There would be “no functioning medical organization remaining, even to render primitive care.” Let’s hope the next president truly understands this.

What would you do if you were a first-year medical resident and your patient refused treatment from you because of your race, ethnicity, gender, or religion? While patients not wanting to be treated by medical trainees is nothing new, there are few institutional policies in place to address this type of discrimination. This week, researchers at the Stanford University School of Medicine released a report in Academic Medicine offering strategies for dealing with discrimination from patients. They brought together 13 Stanford faculty members, presented them with scenarios in which patients mistreat trainees because of discrimination, and asked participants what they would do. While it may be easier to stay silent when discrimination occurs, participants recommended that faculty speak up for the benefit of both the patient and the trainee. If the medical need is not urgent, faculty can engage the patient in an honest discussion about why they are worried about working with a certain trainee. At the same time, faculty should help maintain a safe learning environment by declaring their trust in their trainees. As uncomfortable as it may be, addressing discrimination is an essential step toward right care. The Stanford researchers agree, concluding, “As medical professionals, our duty is to prepare our trainees and ourselves to appropriately navigate these situations.”

Announcements

Reminder: For the Lown Institute 5th Annual Conference, May 5-7, 2017, in Boston, we continue calling for abstracts for our special academic research symposium on Friday, May 5. We’ll highlight research that enhances our understanding of right care. On Saturday, May 6, we will be holding skills-building workshops. We welcome and encourage your proposals for workshops that will engage all health professionals, patients, patient advocates, and community leaders. Deadline for both submissions is December 18. Learn more about abstracts here. Learn more about workshops here.

Lots of amazing things happen at Lown Institute conferences–like falling in love. Congratulations to Kendra Lawrence, RN, BSN, and Eric Coon, MD, recipients of this year’s best abstract awards at April’s annual conference in Chicago. They met for the first time during Research Day, fell in love, and are now engaged to be married. Lawrence, a registered nurse in palliative care and a graduate student at the University of British Columbia, received the Best Student/Trainee Abstract Award; Coon, a pediatric hospitalist at the University of Utah, received the Best Abstract Award. Both had been encouraged by their mentors (a.k.a, the “cupids”) to attend the conference. Lawrence writes “since the day we met, we have spoken to each other nearly every night. Eric proposed at the end of September, but I knew I’d be a fool not to marry him only a short time after we’d met.”

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RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation.

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