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Doctors protest immigration ban, deprescribing drugs, and more

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February 2, 2017

In order to bring you more of the news you want to read, Right Care Weekly presents articles related to moving our healthcare system toward the right care for all patients.

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In response to President Trump’s executive order temporarily banning immigrants and refugees from seven Muslim-majority countries from entering the US, physicians joined protesters across the U.S. Seven physicians in Boston, including Right Care Boston member Aaron Stupple, MD, donned their white coats in solidarity with their Muslim patients and fellow doctors. “We took an oath to take care of vulnerable people and support their health and well-being,” said Stupple, quoted in The Boston Globe. “This policy and this ban is an affront to that oath.” Separately, Ahmad Masri, MD, points out in an NEJM editorial that the executive order is already wreaking havoc on the Graduate Medical Education system and will exacerbate physician shortages in parts of the U.S.

In her piece in The Washington Post, Ranit Mishori, MD, vows to write fewer prescriptions and wean patients off drugs that are not needed. She complains that doctors are not taught how to deprescribe drugs, a skill that requires extreme caution and planning. Some 20 percent of adult patients are routinely on five or more drugs, many no longer needed, causing harm. Research is needed for developing discontinuation protocols, and payers must create incentives for physicians to better monitor patients, she asserts.

St. Louis University School of Medicine resident Stephanie Cull, MD realized that the guidelines for bed alarm placement were causing many of her patients to be unnecessarily trapped in their beds. One patient who didn’t need an alarm but had one told Cull that she “felt like she was in jail” because she was confined to her bed. Cull decided to raise awareness of this problem by submitting a vignette to the 2016 Right Care Vignette Competition. She won, and her vignette was subsequently published in the JAMA Teachable Moments series. Read our blog on Cull here.  And learn how you can submit your vignette to our 2017 competition here.

Scarce research on the long-term outcomes for egg donors worries Wendy Chavkin, MD, of Columbia’s School of Public Health, writes Emily Woodruff in STAT. Chavkin and others argue that donors cannot make informed decisions about the procedure they’re undergoing because there are no studies on the long-term consequences. “You’re supposed to have proof of efficacy, ethicality, proof of no other route,” says Chavkin. “Maybe donating is great…and consequences are minimal. But we don’t know.”

Americans are constantly encouraged to strive for success in the face of adversity, but emerging research suggests that the stress of “pulling yourself up by your bootstraps” may negatively impact your health, The New York Times reports. In several studies, people who reported using “high-effort coping” when facing challenges were at greater risk for cardiovascular, metabolic, and autoimmune conditions, compared to non-strivers. Environmental effects on DNA patterns and elevated exposure to stress hormones are possible causes of this phenomenon, researchers say.

 

Announcements

Join us for the 5th Annual Lown Institute Conference, May 5-7 in Boston, MA. Hear inspiring keynotes from health leaders, researchers, and activists; and participate in workshops created by RCA members. Early bird registration closes February 10, so Register Now.

If you have a teammate or colleague in the Right Care Alliance who has demonstrated extraordinary passion and dedication to right care, nominate them for a Right Care Alliance Award. The award recipients will be recognized at the Lown Institute Conference.

For the Lown Institute’s second annual Right Care Vignette Competition, we are seeking clinical vignettes written by trainees describing harm or near-harm from medical overuse. Winners will have the opportunity to submit their vignettes to the JAMA Teachable Moment series for review and potential publication, as well as a scholarship to the Lown Institute Conference. The deadline to submit a vignette is February 28, 2017. Submit your vignette here.

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