Lynne Stevens Memorial Program

About Us

Lynne Stevens was the Director of the Responding to Violence Against Women Program, and an Assistant Professor at the Boston University School of Medicine, Department of Family Medicine. Lynne was a clinical social worker who was a tireless advocate as well as clinician and researcher in the field of improving health care’s response to women experiencing violence. She specialized in evaluation of the quality of care offered in medical settings to women impacted by partner and sexual violence  and died in 2009 at the age of 63. Working with such groups as the International Planned Parenthood Federation/Western Hemisphere and the United Nations Population Fund (UNFPA), she developed and implemented programs in many countries, including Nepal, Venezuela, Sri Lanka, Vietnam and Armenia. Educational materials that she developed for program developers and staff have been widely distributed by UNFPA, the CDC, and state anti-violence programs, and been translated into a variety of languages.

On moving to Boston University in 2005, she championed the integration into medical settings of programs responsive to victims of violence. She led initiatives evaluating and strengthening services for victims of violence in a variety of settings, including the Family Medicine Department’s Ambulatory Care Clinic and other Department practices, Manet Community Health Center, and Boston University’s student health services, and dental clinics. Lynne maintained active and substantial community commitments, supporting programs offering free yoga for women with issues of poverty, homeless, domestic violence or  substance abuse histories. She also served as a member of the boards of directors of several domestic violence organizations in New York State and in Boston  where she became Vice-President of the Board of Casa Myrna Vasquez.

To keep Lynne’s voice and work alive for us, the Family Medicine Dept started a dedicated annual Grand Rounds, inviting a speaker to remind, instruct and inspire us to improve the care we provide to the women who were her life work.. Thanks to a generous donation in Lynne’s memory, our ambitions expanded to include providing the kind of lovely lunch that she always offered her friends and inviting some of the wider community of service providers and coalitions that Lynne participated in across the campus and city.

An additional exciting development was the establishment of a grant program for a research or practice improvement project. Funded in 2011 for to provide annual $5000 grants for 5 years or the life of the fund,  the focus is on evaluating, studying and improving care for women who experience partner and sexual violence receiving care in any of the hospitals, student health services and community health centers affiliated with Boston Medical Center or Boston University. This is a University-wide program, so that all faculty, staff, trainees and students of the University and affiliated services are eligible to apply if they receive endorsement by clinicians regarding clinical relevance.  Like Lynne, we want to make sure that what we do makes a difference.

CitiMatCH 2016 Abstract

The Health Perspectives of African American Adolescents and Young Men

Leanne Yinusa-Nyahkoon, OTR/L, ScD; Fatima Adigun; Timothy Bickmore, PhD;  Karla Damus, PhD, MSPH, MN, RN, FAAN; Kenneth Harris; Clevanne Julce; Justin Kramer; Jessica Martin, MPH; Steve Martin, MD, EdM; Stefan Olafsson; Michelle St. Fleur, MD, Brian Jack, MD

Click hereto read the full abstract.

Fertility Awareness Methods Are Not Modern Contraceptives: Defining Contraception to Reflect Our Priorities

Kirsten AustadKirsten Austad, Anita Chary, Alejandra Colom, Rodrigo Barillas,dDanessa Luna, Cecilia Menjı´var, Brent Metz, Amy Petrocy, Anne Ruch, Peter Rohloffa

A recent article in GHSP calls for classifying fertility awareness methods as ‘‘modern contraceptives’’ despite their inferiority. We believe in a rights-based approach, which considers the real-world conditions that many women face, including constrained sexual agency and low baseline reproductive health literacy. We must demonstrate true commitment to increasing access to the most effective and reliable contraceptive methods.

 

Unintended pregnancy is both a global public health challenge and an important human rights issue.1 Worldwide 40% of pregnancies are unintended.2 These unintended pregnancies pose significant health risks to women because of the obstetrical risks of multiple births, short interpregnancy intervals, and unsafe abortions, as well as because they worsen povertyrelated inequalities. Addressing this unmet need for family planning mandates a coordinated response of dedicated human resources, economic investment, and application of the best-available scientific evidence. Highly efficacious and safe methods of contraception including injectable and oral contraceptives, sterilization, and long-acting reversible contraceptives (LARCs), comprising implants and intrauterine devices (IUDs), are key to this effort.

Click here to read the full article Global Health: science and Practice

The end of residency means difficult goodbyes

Anne Toledoby Anne Toledo, MD

“It is easy to see the beginnings of things, and harder to see the ends. I can remember now, with a clarity that makes the nerves in the back of my neck constrict, when New York began for me, but I cannot lay my finger upon the moment it ended.”
– Joan Didion, Goodbye To All That

So it feels at the end of residency. Of course, there is a graduation date. However, the emotional jolt of starting intern year contrasts with a nebulous crawling sensation at the end. Residency seems to taper in repetitive, small appreciations that each teaching moment may be the last.

First came the final shift on inpatient medicine. I stood at the threshold of 6 West hospital floor and marveled that the sense of foreboding three years ago had given way to familiarity and, though hospitals can be quite dangerous, safety. Goodbye, 6 West.

Then my last ER shift passed. The other senior and I traded laughs over mutual flight anxiety between seeing patients, and suddenly it was over. Goodbye ER.

Click here to read the full story on KevinMD.com.

Congratulations to Michelle Dalencour, Karla Damus and Brian Jack for publication of their manuscript!

Congratulations to Michelle Dalencour, Karla Damus and Brian Jack for publication of their manuscript entitled "The future of preconception care in the United States: multigenerational impact on reproductive outcomes" that describes possible epigenetic mechanisms for  disproportionate health disparities in premature and low birth weight births among Black women.

Click here to read the full article.

Brookline Resident Runs for Addiction Treatment

Brookline Resident Runs for Addiction Treatment

Dr. Katherine Gergen Barnett, a physician at Boston Medical Center, completed the Boston Triathlon this past weekend for Team BMC. Brookline Patch

 

 

 

 

 

 

 

 

 

BROOKLINE, MA – A Brookline doctor completed the Boston Triathlon over the weekend to raise money for substance abuse treatment in teens and young adults.

Katherine Gergen Barnett, a family medicine physician at Boston Medical Center, placed fourth in her division for Team BMC. The event raised approximately $15,000 for BMC's Catalyst Clinic, a primary care clinic for teens and young adults with or at risk of substance abuse disorders.

Gergen Barnett has been a primary care physician, researcher and educator at BMC for 11 years. She now serves as the vice chair of primary care innovation and transformation in the Department of Family Medicine.

Click here to read the full story.

 

Dealing with Stress: How to Prevent Burnout

“Caring for myself is not self-indulgence, it is self-preservation….”

Audre Lorde

Stress affects all of us at different times and in different ways. A small or moderate amount of stress from time to time can be a good thing—it can motivate us to stay focused and push through a new or difficult challenge. But when you experience a high amount of stress over a long period of time, you may end up dealing with burnout.

Burnout is a physical or mental collapse caused by stress, and creates a combination of mental, physical, and emotional exhaustion. This can happen when things at work, school, or in your personal life are out of balance and very stressful. The effects of burnout vary from person to person, but some include:

  • loss of motivation,
  • feelings of self-doubt, frustration, or exhaustion, and
  • a lack of enthusiasm for things you typically enjoy.

There are strategies you can use to prevent burnout, however, and one of them is called self-care. Self-care, or intentionally taking actions to maintain for your physical, emotional, and mental health, is an effective way to keep yourself healthy through tough times.

Practicing Self-Care

There is no one right way to practice self-care. Self-care may mean fitting in early morning exercise for one person or curling up with a mug of tea and a favorite book for another.  To figure out what your self-care practice might be, try writing a list of things that you do (or would like to do) that make you feel better, help relieve tension, or less stressed. If you’re stumped on what to write, consider these popular types of self-care:

  • Eating healthy foods every day, or making a fun home-cooked meal each week
  • Exercising daily, even if it’s for a short walk during lunchtime
  • Getting more or better quality sleep
  • Writing in a journal
  • Practicing meditation, yoga, or prayer
  • Spending quality time with friends and loved ones
  • Setting aside time for a favorite hobby or activity
  • Decreasing screen time on phones, computers, tablets, etc.

Once you have your list, break it down in to things that can be done in small blocks of time – like 15-30 minutes, an hour, a few hours, or a whole day. Keep this list somewhere where you’ll see it every day, and pick an activity that works for you that day.

Things to Keep In Mind

We are often so focused on taking care of those around us, and managing all of our responsibilities, that taking the time to practice self-care can feel strange at first. It can feel selfish or like you’re not being productive, especially since we’re taught from an early age to put the world in front of ourselves, and to always be working towards something.  This can make it hard to turn off the little voice that keeps telling you to push forward and take on more – especially for women who often feel pressure to put others’ needs ahead of their own.

The beauty of self-care is that it shifts your mindset so that taking care of you becomes as much of a priority as taking care of others. When you are healthy and whole mentally, physically, and emotionally, you are in a better position to tackle problems or help others. You might need some time to get used to practicing self-care, and that’s okay! When you are in touch with your own needs, living with them in mind can help you feel happier, more open to others, and more creative.

Want to read more about this topic? Take an in-depth look at self-care and learn how it can help you here. Don't forget to leave a comment or story below!

 

Photograph courtesy of: http://thebodyisnotanapology.com/

Integrative Health Group Visits As Core Delivery Strategies

by John Weeks, Publisher/Editor of The Integrator Blog News and Reports

Katherine Gergen-Barnett, MDIntegrative health group visits was the topic of an April 28, 2016 grand-rounds webinar with the Academic Consortium for Integrative Medicine and Health, the organization of 68 academic medical centers promoting the integrative model. The two speakers were Katherine Gergen-Barnett, MD (pictured right) with Boston Medical Center (BMC), and Ilana Seidel, MD (pictured below) from George Washington University Medical School.

The growing exploration of “integrative health group visits” as core delivery strategies has developed from a need to consider strategies for cost savings as well as a number of other reasons including the following:

  • A focus on education and empowerment in integrative health and medicine.
  • Evidence that adults learn best when they are not merely being passive recipients
  • The whole person philosophy that success in creating health is ultimately in the hands of the individual seeking care rather than the practitioner who provides it

Ilana Seidel, MDGergen-Barnett opened the recent webinar by speaking to the power of the approach: “The idea of group visits is that we as human beings are built for community – and when we get sick we are often alone […] Group visit theory is that patients working together as a group can manage conditions better [and] not about the provider being in the room.”

Gergen-Barnett continued by explaining the group visit experience from the provider perspective: “This has been one of the most satisfying parts of my practice. Group visits take the onus off of me [as the practitioner]. In group visits, everyone is a learner and a teacher.” She went on to add that the value of these visits is more time with the patients. The sessions typically last between 2.5 and 3 hours. She also indicated that most patients have proven to be receptive to the experience. “There is a lot of evidence that even patients who are reticent about the group model come to like it.”

The webinar presentation explored two forms of group visit delivery. The first is the “closed model” that has been used at BMC and is currently the subject of a $1.8-million Patient Centered Outcomes Research Institute (PCORI) study. In this format, patients sign up for a a series of 2-3 hour visits over a period of weeks. Each billable session includes a mix of one-to-one time with an integrative professional, as well as group interactive and didactic time. The BMC model is based heavily on the Mindfulness-Based Stress Reduction format.

The other is an open model, pioneered by Jeffrey Geller, MD at the Greater Lawrence Family Health Center. In this model, patients are provided with certain times of the week that the doctor will be available and the session is shared by those who show up to participate. The model can function well with patients who face a wide variety of medical issues given the common roles of one’s relationship to stress, sleep, nutrition, mindfulness, and movement resolving or aggravating conditions.

During the webinar, Gergen-Barnett indicated that she expects even greater value and application of these methods as medical industry’s shift away from the production of services toward a “value-based” approach. Seidel echoed the opinions of Gergen-Barnett, indicating that her own experiences in practice have demonstrated that “group visits are not only good for battling loneliness but also for empowerment.”

Comment: Gergen-Barnett in particular has been championing the outcomes and the potential of the model. Her 2015 blog in the influential Health Affairs was entitled: “The Call to a New Kind of Care: Integrative Medicine Group Visits Offer Promise in the Treatment of Chronic Pain and Depression.” She spoke on the topic at the Integrative Medicine for the Underserved (IM4US.org) conference. (IM4US maintains an open source group visit resource here.) At Global Advances in Health and Medicine, Gergen-Barnett’s title was simply: “Group Visits – The Future of Healthcare.”

This is terrific work in an area in which the integrative health community should, by philosophy, be pushing the envelope. An additional resource is this posting from integrative center consultant Glenn Sabin: “4 Reasons to Consider Integrative Medicine Group Clinic Visits.”

Save the Date: Elaine Alpert MD MPH 7th Annual Lynne Stevens Speaker

speaker Intimate Partner Violence 
 Speaker: Elaine Alpert MD, MPH
 Tuesday May 24, 2016
 12:00 - 1:00 PM
 Boston University School of Medicine
 72 East Concord Street
 Room L110 first floor
 Attendees are cordially invited for lunch at 11:45 and
 Q & A discussion from 1-2 following the lecture

 Elaine Alpert MD, MPH, trained in internal medicine and public health,  is an  internationally-respected scholar and  consultant in family violence, sexual  assault, and human trafficking with expertise and experience in  trauma-informed care, interprofessional and innovative educational methods, and strengthening the health sector’s role in the coordinated community response to violence and abuse across the lifespan. The Founding Chair of the Massachusetts Medical Society Committee on Violence Intervention and Prevention, Dr Alpert is the lead author of  Intimate Partner Violence: the Clinician’s Guide to Identification, Assessment, Intervention and Prevention (6 th edition, 2015), as well as Human Trafficking: A Guidebook on Identification, Assessment, and Response in the Health Care Setting (2014). She has authored numerous additional important articles, guidebooks, curricula, and book chapters about family violence, sexual assault and human trafficking  for physicians and other health care providers, and developed online continuing medical education about domestic and sexual violence for the Massachusetts Medical Society. She also served on the U.S. Institute of Medicine Committee on the Training Needs of Health Professionals to Respond to Family Violence

            Dr. Alpert's  25-year academic career at Boston University Medical Center as a general internist, medical educator, public health faculty member, and Assistant Dean for Student Affairs, was followed in 2009 by  a Fulbright Fellowship to develop and teach interprofessional courses in violence prevention and in intervention planning for improving public health at the University of British Columbia (UBC) where she served as the Director of the Interpersonal Violence Prevention Program, and created the UBC Violence Intervention and Prevention (VIP) Connector. She also continues as a consultant to the Division of Global Health and Human Rights at Massachusetts General Hospital (MGH) in Boston regarding their research and publications regarding human trafficking ,and has engaged in on-site teaching, research and/or consulting in Asia , Pacific Islands and Central America.  Dr. Alpert has received honors and awards from the American Medical Association, the Massachusetts Medical Society, Futures Without Violence

2016 Stevens Lecture for distribution

The One Minute Learner: Evaluation of a New Tool to Promote Discussion of Medical Student Goals and Expectations in Clinical Learning Environments

Miriam Hoffman, MD; Molly Cohen-Osher, MD

BACKGROUND AND OBJECTIVES: The transition from pre-clerkship to clerkship curriculum in medical school presents many challenges to students. Student roles and supervising physicians’ expectations vary widely. Efforts to ease this transition have included third-year orientations, skills sessions, field-specific training, and peer-to-peer communication/support. We developed a new tool, called The One Minute Learner (OML), to promote and structure discussion of student goals and expectations and empower student ownership of learning. The OML can be used quickly and easily by students and faculty to facilitate integration of medical students into the clinical setting. This paper describes the OML and reports evaluation of its effectiveness through student evaluations.

METHODS: We compared student responses to two end-of-clerkship questions for the academic year before the OML was implemented to the first year of implementation. Students rated their orientation to their roles and responsibility and rated the communication of what was expected of them.

RESULTS: The percentage of students rating these highly increased dramatically: for “I was oriented to my responsibilities and role,” the percentage rating it highly (4–5 on a 5-point Likert scale) increased from 47% to 82%. For “Expectations of my role were communicated to me clearly” the percentage rating it highly increased from 66% to 89%.

CONCLUSIONS: The OML is a new tool that can promote and structure a proactive discussion between student and teacher about goals and expectations, leading to better integration of students into the variety of clinical setting in which they rotate.

(Fam Med 2016;48(3):222-5.)

The transition to the clinical setting from the traditionally classroom-focused pre-clerkship curriculum can be difficult for medical students.1-4 Students rotate through many clinical settings; they must quickly adjust, learning their roles and what is expected of them. This can be challenging for many students3 and can cause cognitive overload, which can negatively impact their ability to focus on clinical learning.5 Prior efforts to address this include clinical-immersion courses, third-year and clerkship-specific orientations,5-7 as well as clinical skills and field-specific training.6,7 Students also use peer-to-peer communication, telling their peers about expectations, roles, the clinical environment, communication, feedback, and strategies for success.4,8,9

This paper evaluates the effectiveness of a new tool, the One Minute Learner (OML),10 that can facilitate the transition of learners into the clinical setting by promoting and structuring a proactive discussion between students and teachers about goals and expectations. It can be used in any clinical setting or specialty and with any level of learner. In contrast to prior efforts to help students integrate into the clinical setting, the OML is a discipline-neutral tool that empowers students to proactively promote these discussions with their supervisors in any clinical setting.

To continue reading click here.