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.
Insularity & Impenetrability: What Happens to Health Funding and Policy When Voters Can’t Reach Lawmakers
In the United States, Congress wields enormous power over health care policy and funding. With health care committees and floor votes on budgets controlling national health spending of nearly three trillion dollars annually (Department of Health and Human Services 2015), and the U.S. estimated to spend 50% more on health care per capita than any other nation (Commonwealth Fund 2015), the impact of members of Congress on our health policy is impossible to overstate. In late 2014 and 2015, the first two authors of this column conducted an outreach experiment to gauge the accessibility and approachability of all 535 members of Congress and their staff representatives, in relation to an important public health issue. We contacted the offices of all Senators and Representatives to advise them of a recent article (by the first and third authors) on the long-term health effects of war on civilians in affected areas -- namely, interactions between malnutrition and infectious disease that result from sanctions, embargoes, and other intentional tactics. We offered to send a full version of the published article, and then tracked responses. Not one member of Congress requested a copy, and the only direct response we received was a request not to be contacted again (for a full description, see the resulting Anthropology Newscolumn).
What this brief summary belies, however, is how difficult it actually was to attempt to share such public health information with elected officials. To even identify email addresses to which to address our messages proved extremely challenging, taking countless hours of digging through official legislative websites, calls to district and D.C. offices to verify ‘official’ email address formulas that resulted many times only in bounce-back messages, and ultimately, in two of us systematically writing to each member of Congress through online contact forms on their websites (which preclude uploading attachments), over several months. Still, this did not yield actual communication with those who ostensibly represent average Americans, and who we expect to advocate for our health needs.
The challenges we encountered in contacting elected officials for a simple public health information mission have serious and troubling implications for voters who need to contact their members of Congress about more urgent and personal health issues like difficulty getting V.A. benefits, help with processing Social Security disability claims, appealing Medicaid or Medicare coverage denials, or efforts by those who wish to lobby for state block grants for homecare funding -- to name just a few reasons voters might wish to contact their elected representatives at the federal level.
Congress members’ local district and D.C. offices may ostensibly be reached by phone, but in many cases people could have scanned versions of benefits denial documents they need to submit as part of a request for advocacy, or other documents they hope to show their Congressperson -- in our outreach experiment, simply sending a PDF of an article proved impossible. Applied medical anthropologists, or those to whom we return our findings, may find it equally difficult to engage elected officials in policy change efforts related to health coverage or funding efforts, if simply reaching a Senator or Representative is so difficult in routine matters.
With the damaging effects of neoliberalism on democracy (Collins et al. 2008) and increasing corporatization of the political process in the U.S., signified by the more than $2.5 billion spent on corporate lobbying (Drutman 2015), Congress has evolved into an insular institution in which, rather than lawmakers being protected from well-funded special interests like the paid lobbyists of multibillion dollar corporations, elected representatives are secluded from the citizenry and, hence, from accountability to voters who put them in power (Ostrach, Houston, & Singer 2015; Schoenbrod 2008). The result is unhealthy health-related laws that are harmful to the broad public interest (Castro & Singer 2004).
While the current presidential election campaign continues to feature politically motivated discussions of building a 1,954-mile wall across the southwest sealing the country off from a workforce it actually needs, a real wall has been built sealing off the elected from the electorate (Schoenbrod 2008), while opening the door to corporate and special interest lobbyists (Brodbeck, Harrigan & Smith 2013). So long as those making funding and policy decisions with our tax dollars and those of our participants can avoid communicating with and being responsive to those whose health is most affected by their decisions, this insularity and impenetrability at the highest levels of the U.S. government should be of grave concern to medical anthropologists.
References Cited
Josh Brodbeck, Matthew T. Harrigan, and Daniel A. Smith. 2013. "Citizen and Lobbyist Access to Members of Congress: Who gets and who gives?" Interest Groups and Advocacy 2:323-342.
Castro, Arachu and Merrill Singer. 2004. Unhealthy Health Policy: A Critical Anthropological Examination. Walnut Creek, CA: AltaMira Press.
Commonwealth Fund. 2015. "US Spends More on Health Care Than Other High-Income Nations But Has Lower Life Expectancy, Worse Health." Commonwealth Fund press release, October 8th, 2015.http://www.commonwealthfund.org/publications/press-releases/2015/oct/us-spends-more-on-health-care-than-other-nations
Collins, Jane, Micaela Di Leonardo, and Brett Williams, eds. 2008. New Landscapes of Inequality -- Neoliberalism and the Erosion of Democracy in America. Santa Fe: School for Advanced Research Press.
U.S. Department of Health and Human Services. 2015. "Health, United States, 2014." Report prepared jointly with the Centers for Disease Control and the Center for Health Statistics.http://www.cdc.gov/nchs/data/hus/hus14.pdf#102
Drutman, Lee. 2015. The Business of America is Lobbying: How Corporations Became Politicized and Politics Became More Corporate. Oxford: Oxford University Press.
Ostrach, Bayla with Ashley Houston & Merrill Singer. 2015. "Syndemics & Legislative Outreach: An Experiment in Educating Congress about the Health Effects of War." Anthropology News 56(6): e1-e12.
Schoenbrod, David. 2008. Power Without Responsibility: How Congress Abuses the People Through Delegation. New Haven: Yale University Press.
Syndemics and Legislative Outreach
An Experiment in Educating Congress about the Health Effects of War
Society for Medical Anthropology , Ostrach B., Houston A., Singer M.
In the United States, Congress wields enormous power over health care policy and funding. With health care committees and floor votes on budgets controlling national health spending of nearly three trillion dollars annually (Department of Health and Human Services 2015), and the U.S. estimated to spend 50% more on health care per capita than any other nation (Commonwealth Fund 2015), the impact of members of Congress on our health policy is impossible to overstate. In late 2014 and 2015, the first two authors of this column conducted an outreach experiment to gauge the accessibility and approachability of all 535 members of Congress and their staff representatives, in relation to an important public health issue. We contacted the offices of all Senators and Representatives to advise them of a recent article (by the first and third authors) on the long-term health effects of war on civilians in affected areas -- namely, interactions between malnutrition and infectious disease that result from sanctions, embargoes, and other intentional tactics. We offered to send a full version of the published article, and then tracked responses. Not one member of Congress requested a copy, and the only direct response we received was a request not to be contacted again (for a full description, see the resulting Anthropology Newscolumn).
What this brief summary belies, however, is how difficult it actually was to attempt to share such public health information with elected officials. To even identify email addresses to which to address our messages proved extremely challenging, taking countless hours of digging through official legislative websites, calls to district and D.C. offices to verify ‘official’ email address formulas that resulted many times only in bounce-back messages, and ultimately, in two of us systematically writing to each member of Congress through online contact forms on their websites (which preclude uploading attachments), over several months. Still, this did not yield actual communication with those who ostensibly represent average Americans, and who we expect to advocate for our health needs.
The challenges we encountered in contacting elected officials for a simple public health information mission have serious and troubling implications for voters who need to contact their members of Congress about more urgent and personal health issues like difficulty getting V.A. benefits, help with processing Social Security disability claims, appealing Medicaid or Medicare coverage denials, or efforts by those who wish to lobby for state block grants for homecare funding -- to name just a few reasons voters might wish to contact their elected representatives at the federal level.
To continue reading click here.
Listening to Their Words: A Qualitative Analysis of Integrative Medicine Group Visits in an Urban Underserved Medical Setting
Danielle Dresner MPH, Katherine Gergen Barnett MD, Kirsten Resnick BS, Lance Laird ThD, Paula Gardiner MD, MPH
Introduction
Chronic pain is a pervasive and costly health issue in the United States today, affecting up to 100 million individual Americans, and costing up to $635 billion in health care dollars [1]. Even with the billions of dollars being spent, current medical treatments for chronic pain in primary care settings are still often limited to pharmaceuticals such as narcotics and non-steroidal anti-inflammatory drugs [NSAIDS] [2]. Furthermore, primary care physicians who are concerned about chronic pain patients being narcotic seeking, having poor self-management skills, and potentially poor medical compliance, often undertreat chronic pain [3]. Current evidence suggests that chronic pain is consistently undertreated in patients of low socioeconomic and minority status [4].
Group medical visits (GMVs)—a model where patients get medical care together—are gaining national attention as an effective treatment for some patients with chronic illnesses, such as chronic pain [5]. The GMV helps address some of the barriers to effectively treating chronic pain in patients of low socioeconomic and minority status by improving quality of care, access to physicians, and thus, health outcomes [6–7]. Research on GMVs for the management of chronic disease suggests that this model improves health status indicators such as health-related quality of life, patient satisfaction, and coordination of care [8–10]. There are many theories as to why GMVs are successful including improved social support, enhanced self-efficacy, and increased perceived benefits to the participant—all of which increase the likelihood of initiating and sustaining behavior change [11–13].
Integrative medicine, an approach to care that emphasizes the mind-body connection and views the patient as a whole person, rather than a set of diagnoses, is another growing trend in chronic pain management [14–19]. Integrative medicine emphasizes the importance of a patient’s self-management skills and incorporates lifestyle changes, complementary and alternative medicine (CAM), and mind-body techniques to both prevent and treat chronic diseases [20]. Integrative medicine is well-aligned with the principles of the GMV, focusing on simple self-management skills including nutrition, physical activity, and stress management, as a way of maintaining or restoring health.
Finally, mindfulness-based stress reduction (MBSR) is another promising intervention that has been applied to patients suffering from a number of chronic illnesses, including pain [21–25]. The 8-week group curriculum draws on the principles of MBSR and includes didactic discussions and experiential practices such as sitting meditation, body scan, walking meditation, and yoga.
Integrative medicine group visits (IMGVs) combine a group medical visit, integrative medicine techniques, and MBSR (see Figure 1). The IMGV curriculum includes health education, stress management (through the principles of mindfulness-based stress reduction: yoga, meditation, and body scan), and health self-management in a “toolkit” of techniques including healthy eating, acupressure, and self-massage (see Table 1). We have previously published a peer-reviewed paper on the curriculum, recruitment methods, and quantitative improvements in pain and depression [26].
To continue reading click here.
A 10% fare hike T is too much
Anything above 5% is a social inequity
By Katherine Gergen Barnett
AS THE BITTER COLD has returned to the streets of Boston, I have been driven into the warmth of the T more than once on my bike commute home from the hospital. The scene there is familiar – workers weary at the end of the day, parents with children swaddled in snow pants, young adults making their way. The English language is wrapped into many other languages, many of which I now recognize from my 11 years working at Boston Medical Center, New England’s largest safety net hospital.
The MBTA, though rife with many concerns about functionality over the past year, has long served as a window into the population of Boston. As such, it is a great equalizer. According to estimates, the typical weekday ridership of the T is 1.3 million. On weekends and holidays it is around 500,000. These numbers make the Boston T the fifth-busiest transit agency in the nation. My patients are among these riders, using the rail lines carved through the city as their way of getting to one of many jobs, numerous appointments, and children’s schools.
This means of commuting may soon become financially untenable to some of Boston’s T riders. On January 4 this year, the governor’s Fiscal and Management Control Board released two possible scenarios for fare increases to go into effect in July 2016. One raises fares by nearly 7 percent; the other is more radical, increasing fares by 10 percent. This will not be the first time the MBTA has increased its fares recently. In fact, since 2000 the MBTA has increased fares five times: in 2000, 2004, 2007, 2012 and 2014. Fares have increased 6.1 percent per year on average between 2000 and 2014, which is significantly more than inflation.
The proposal for fare increases comes from a seemingly justifiable position: the MBTA is looking to address an estimated $242 million deficit in the next year. However, critics of the fare hikes, such as the Conservation Law Foundation, have correctly pointed out that a system-wide average fare increase of over 5 percent is not needed to balance the MBTA’s FY2017 operating budget. This deficit has already been closed with additional state assistance (held constant from last year at $187 million) coupled with cost reductions identified by the MBTA (such as the elimination of non-essential spending increases and reductions in unnecessary materials, services, and supplies), which will add at least another $55 million.
As a resident of Boston, I deeply want the T to become solvent and a dependable source of timely transport. However, as a physician who cares for individuals whose incomes are often 200 percent below the poverty line, I am extremely concerned what this hike in fares will do to the lives and well-being of many residents of Boston. Just recently, a patient of mine – a young woman who is already a mother of four and a grandmother – was late to her appointment. Knowing her medical and psychological issues were complex and urgent, I folded her into my schedule and she began the visit crying, stating that one of the reasons she was late is that she could not find the fare to travel across the city. The proposed increases may mean that she will become one of many who no longer are able to easily access needed appointments, subjecting her to potential poorer health outcomes and increased social isolation.
I am thus joining others in imploring the governor to look for different means than a passenger fare increase of up to 10 percent to bridge any gap in the MBTA’s funding. Asking for a greater than 5 percent fare hike every other year (a predictable and modest increase that people can budget for) from riders is a social inequity. What is more, we need to start thinking about transportation more holistically: the well-being of our T system can be fed, in part, by revenue sources such as higher taxes on individual drivers. State and federal gas taxes are at an all-time low and our bridge and tunnel tolls are the lowest compared to other large metropolitan areas. Bringing our T system back to health by means outside of radical fare hikes also means that, as a city, we can recommit to bringing people to appointments, schools, and groceries safely and with a sense of true equity.
Meet the Author
Katherine Gergen Barnett
Boston University Medical Center
Bio » Latest Stories » Dr. Katherine Gergen Barnett is the vice chair of primary care innovation and transformation at the Boston University Medical Center’s Department of Family Medicine.
“Tell Me Tuesday: All About the Black Toenail” by Maureen Dempsey
Doug Comeau and the Ryan Center is features in the article “Tell Me Tuesday: All About the Black Toenail” by Maureen Dempsey
Click here to read the full story.
Highlights of 2015: BMC Program for Integrative Medicine & Health Disparities
Dear Brian,
At BMC we believe all of our patients, regardless of their social or economic status, should have access to every available treatment. Gifts from our benefactors and other forms of much needed support from friends and colleagues helped create access to integrative care for the whole person, from hands-on therapies such as massage and acupuncture to the personal empowerment facilitated through learning self-care practices such as yoga and mindfulness meditation.
It's our pleasure to share highlights of 2015 with you, featuring exciting new clinical partnerships, innovative research projects, and a novel program that supports the education of integrative healthcare providers.
We would love to have your support for low-income patients who would not otherwise have access to these innovative forms of healthcare. Please consider an end of year gift to our Program.
With appreciation,
Rob, Paula, Katherine and Maria
New Clinical Partnerships
PEDIATRIC PAIN CLINIC
Our longstanding partnership with the New England School of Acupuncture formed the basis for a new partnership with the Department of Pediatrics to establish a Pediatric Pain Clinic. The clinic incorporates best practice in complex chronic pain management with integrative medicine. This partnership involves multiple members of our team in weekly case conferences with the pain clinic core team. In the ten months since the clinic launched, we have successfully obtained funding from the Marino Health Foundation to expand the clinic to include pediatric massage, yoga classes, Reiki and aromatherapy. Our collaboration with Pediatrics is featured in the December special issue on pediatrics in Medical Acupuncture.
ACUPUNCTURE FOR PATIENTS WITH HIV/AIDS
Through an innovative partnership with Infectious Disease, our Program now provides free acupuncture to patients with HIV/AIDS. Services include a mix of individual and group acupuncture, delivered both at BMC and at Victory Programs' Boston Living Center, a nonprofit community resource agency that fosters the wellness of all HIV positive people through education, treatment information and support services.
The monies garnered for this program allowed us to add Elizabeth Sommers, PhD, MPH, LAc, a national figure in HIV acupuncture research, integrative public health and program evaluation to our
team.
Innovative Research
INTEGRATIVE MEDICINE GROUP VISITS
Paula Gardiner, MD, MPH's PCORI contract enables the inclusion of Codman Square and Dorchester House Health Centers on important research on the impact of Integrative Medicine Group Visits.
Paula and the teams in the health centers are doing breakthrough work on telehealth for the underserved. They have developed and piloted Our Whole Lives (OWL), an interactive web-based resource. OWL provides all integrative medicine group visit materials online including videos of clinician-led talks (stress reactivity, understanding pain, insomnia, obesity, depression, nutrition, and goal setting). Patients are also introduced to self-massage techniques, acupressure, and healthy cooking. They are also empowered to track their vitals, health goals, and participate in a monitored discussion group with peers. Patients can access OWL using a computer, tablet, or smartphone. Preliminary data indicate that this mHealth tool offers a feasible means of increasing access to non-pharmacologic options for treating chronic pain among low-income, medically underserved populations. A new award to Paula from the Aetna Foundation will build on her growing expertise in web-based delivery of self-care tools for meditation, yoga, and nutrition.
Our first integrative medicine fellow, Dr. Oscar Cornelio-Flores, is providing integrative medicine group visits in Spanish for our Latino patients at the East Boston Neighborhood Health Center.
MUSIC AND MASSAGE
Our study "Moving Music and Massage Therapy from Nice to Necessary," which examined the feasibility and effectiveness of conducting a randomized controlled trial comparing massage therapy and music therapy to usual care on the BMC family medicine 6 West inpatient unit. We successfully recruited all 90 participants in less than six months. We were particularly proud of being able to offer the study in both English and Spanish. Preliminary quantitative and qualitative analyses suggest strong feasibility for the intervention, high satisfaction among patients, and strong engagement with the nursing staff.
YOGA FOR CHRONIC LOW BACK PAIN
Back to Health contributes to the growing evidence base for non-pharmacological approaches to treat chronic pain in low income minorities. We are currently completing a manuscript of our results to be submitted to a high impact journal. Among 320 patients recruited from BMC and our health centers, yoga was as effective as physical therapy but less expensive for reducing the impact of back pain. These findings have the potential to justify integration of yoga into mainstream health care settings for pain management.
We recently launched a new study, Veterans Back to Health, which compares yoga to education for 120 Veterans with back pain recruited from the Bedford VA. The strength of these studies led to our Program being awarded a large contract from PCORI for a pragmatic trial in five cities (Boston, Pittsburgh, Charleston, Salt Lake City, Baltimore) to test the effectiveness of targeted physical therapy interventions for prevent high risk patients with acute low back pain from progressing to chronic back pain.
BRAVENET
We continue to extend our research on integrative medicine for the underserved. We initiated data collection for PREMIER this fall, a Practice Based Research Network launched by Bravenet, beginning with surveying patients in Family Medicine, but eventually including data collection also in Oncology and Infectious Disease. As one of only two safety net hospitals in Bravenet, our participation is key to ensuring the database will represent underserved patients.
Our Patients' Experience: In Their Own Words
I was depressed most of the time. When I started with the group, I met these people who had the similar situation I had with pain. For me it helped me learn how I could relax. And since I was in the group, I'm calm, I'm relaxed. I'm not depressed anymore. - Integrative Medicine Group Visit Patient
The group really helped me changed my mindset around the pain ... like now when I'm feeling the pain, I can sit and meditate and be like, okay - let me focus on my breathing, calm down and kinda say like, this isn't the first time I've been in pain, it's not going to be the last time I'm in pain, it is what it is and it doesn't overwhelm me. - Integrative Medicine Group Visit Patient
During the time that I was working with the music therapist, I was so completely engaged in what the two of us were doing together.... Pain no longer was part of my focus. - Music Therapy Participant
The massage therapy sessions made me feel like I mattered in the hospital. - Massage Therapy Participant
This is what it means to work at BMC! I'm being paid to have a massage on the job! - BMC Nurse
It's going to have to be something that's part of my life. I'm going to do this for a long time. So I'm looking at it as a medical treatment-it's not just a yoga class. - Yoga for Back Pain Patient
I felt good because I was doing something, not sitting around waiting for a diagnosis, not taking another pill. I was involved in my treatment, that's how I felt. - Yoga for Back Pain Patient
Healthcare Provider Education
Our recently awarded HRSA funding will support an extension of our partnership with BMC Preventive Medicine and Internal Medicine on resident education and enhancing our program with inter-disciplinary case conferences. Rob Saper, MD, MPH and his team partnered with the Suzanne Hanser,
MMus,EdD of the Berklee School of Music to bring their first cohort of Master's Music Therapy students to BMC to experience our program and learn from its leaders. We will be funding a music therapist to enable an internship program at BMC. And, our exciting new partnership with the Human Resources team at BMC will support a pilot of mindfulness and resiliency training (Breathe, Move, Connect) for BMC staff that will serve as the chassis for a hospital-wide program.
STAFF TRANSITIONS
Our team evolved this year in wonderful ways, with new additions, significant promotions, and fond good-byes. Maria Broderick, EdD,LicAc joined the team as Director of Programs. Paula Gardiner, MD, MPH was promoted to Associate Professor.Katherine Gergen Barnett, MD continues her commitment to healthcare for the underserved through her new role as Vice Chair of Primary Care Innovation and Transformation for the Department of Family Medicine. Ellen Highfield, LicAc our Director of Acupuncture, moved her focus to private practice while retaining her research connections to BMC. Chelsey Lemaster, MPH, was promoted to Project Manager for research under Rob Saper, MD, MPH. We said fond farewells to long-term contributors to our clinical team, Lisa Spellman, LicAc, Paula Nesoff, LMT, MSW, and our clinical coordinator, Breighl Mobley, MPH.
MAKE A DONATION-- Be sure to designate "Integrative Medicine Program"
Congratulations to Katherine Gergen Barnett for being published in Global Advances in Health and Medicine!
"Group Medical Visits: The Future of Healthcare"
小组医学访视：医疗的未来?
Visitas médicas en grupo: ¿El futuro de la asistencia sanitaria?
By: Katherine Gergen Barnett
We are at an interesting crossroads in today’s medical healthcare system. The
Patient Protection and Affordable Care Act (ACA) passed in 2010 and, further supported in the King vs Burwell Supreme Court Decision earlier this summer, has the laudable intention of getting every citizen covered by health insurance. We have made enormous gains in this realm, and as of last month more than 90% of Americans are covered by medical insurance.1 A seemingly obvious consequence of these gains is that more people than ever are seeking primary care. As a primary care physician who believes strongly in prevention of disease and promotion of wellness, this of course strikes me as excellent news. The downside is that, for a variety of reasons, there are not enough individuals choosing primary care as a future profession,2 leaving very few
of us on the front lines to care for this swell of patients with an increasingly prevalent set of chronic illnesses such as diabetes, obesity, hypertension, and chronic pain. Additionally, while the ACA promised to move away from fee-for-service—where financial incentives are based on numbers of people seen and procedures performed—to pay-for-performance, which offers incentives for good health outcomes, the medical system has yet to traverse this transition in many places in the country. The unwitting outcome is that primary care providers are pushed to see more people in less time and reimbursed for numbers over quality, leading many healthcare professionals
and patients dissatisfied.
Click below to read the full story.
Images of Healing
Congratulations to Katherine Gergen Barnett, MD for being published in the "Global Advances in Health and Medicine".
Circles
You speak to me of Uganda
Recalling when you brought
A blade
To the neck of the king’s son
Your eyes widened
In surprise
By the memory
A memory
Scraped clean by
Your recent circles of
Frantic motion
Up all night, reading newspapers
Writing, pacing
An endless force
Pushing the cap off the bottle
And all your past
Bubbling up
Hitting and holding your wife
Running in the street in your underwear
These were boyhood days, you say
As you sit across from me
Large square glasses
Perched firmly on your nose
Your khakis ironed
Your new frantic circles
Tying back to the old
Brought together by the “side effect” of a medicine
But is this a side effect of anything?
Or is this moment meant to
Surface
As bubbles of carbon arise?
And I, I am new to this, to you
Our first encounter
Bearing witness
And trying safely to guide you
To the other shore
Out of the mad eddy
Endlessly connecting and circling
— Katherine Gergen Barnett, MD
Emergency Department Visits for Adverse Events Related to Dietary Supplements
Emergency Department Visits for Adverse Events Related to Dietary Supplements
In the NEJM ar
ticle on dietary supplement adverse events in the ED (below); among the 39 citations listed, four of them were first authored papers of Paula Gardiner in the DFM. It’s a powerful sign of the impact of her work. Congratulations Paula!
Click below:
Emergency Department Visits for Adverse Events Related to Dietary Supplements
DFM’s very own Sara Schlotterbeck is in the Boston Globe!
"Medical residents seek to access prescription data"
By: Felice J. Freyer
"The patient at Boston Medical Center needed painkillers, but Dr. Sara Schlotterbeck had concerns: The medical record suggested past misuse of opioids by the man.
She wanted to check the Prescription Monitoring Program, a state-run database of every prescription for controlled substances, to see whether the patient had obtained opioids from multiple providers. But Schlotterbeck, who is in her first year of residency training after completing medical school, can’t get into the database on her own.
Medical residents don’t have access — even though they’re allowed to prescribe controlled substances.
As the state grapples with a deadly and still-growing opioid abuse epidemic, this gap has drawn the attention of legislators and policymakers. State Representative Nick Collins, a South Boston Democrat, filed legislation that would require the state to enable medical residents to log in to the prescription database.
The Committee of Interns and Residents, a union representing doctors-in-training at Boston Medical Center and Cambridge Health Alliance, is collecting signatures on a letter asking Governor Charlie Baker to expand access. And the state Department of Public Health is working “to address this issue in a timely fashion,” spokesman Scott Zoback said.
In the case of her recent patient, Schlotterbeck managed to track down a fully licensed physician who had time to look up the patient’s record for her. She learned the patient had received more than 50 prescriptions from about 20 medical professionals in the past year."
To continue reading the full story click here.