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New Mexico Governor's Newsletter January 2021

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Heather C. Brislen, MD, FACP, ACP Governor

Heather C. Brislen, MD, FACP, ACP Governor

 


Governor's Message

Dear friends and colleagues –

I have not had a chance yet to write a newsletter that isn't completely consumed by COVID-related updates and news. Given the remarkable efficacy of the new vaccines though, I'm starting to hope that this trend won't last forever! Perhaps by next quarter, we will be talking about recovery, lessons learned, and a path back to normal processes, and before you know it, we'll be getting together in person once again. I will hold that thought in my mind while we battle through the terrible surge that we find ourselves in at this moment.

I recently decided to seek out volunteer work closer to the front lines, to help to relieve some of the pressure on my colleagues and community – and to get a better personal understanding of what this disease looks like. So, I have spent most of this past week covering team of hospitalized patients with COVID at the VA hospital. Not many people are aware of the VA's “4th mission,” which is to improve the Nation's preparedness for emergencies and disasters and to support national, state, and local emergency management, public health, safety and homeland security efforts. There are already a number of non-veteran patients receiving care at our VA, and having worked at the VA before, I'm glad to have found an opportunity for service that is full of familiar faces. Her work is hard, but manageable. I am feeling great full every day to have the opportunity to do this work. It's probably not for everyone, but a few have been tempted to seek out some extra opportunities to serve, I would strongly encourage you to consider it.

If you watch David Scrase's weekly updates (sign up HERE ) and listen to the Governor's press conferences and updates, you've no doubt heard about there are many opportunities to get involved – and a desperate need for both frontline patient care but also for physicians behind the scenes working on administrative and systems issues. If you are interested in volunteering, here's how: The first step is to sign up with the DOH's Medical Reserve Corps . (All volunteers are regarded as public employees, and liability coverage is provided by the state.) If you are eager to start, or have a particular kind of service that you are interested in, you may contact the program director, Bobbie MacKenzie at 505-476-8302 or by email at system@ecemail.samaritan.com to outline your availability.

Other helpful links – Anyone, physician or patient can register for a vaccine at https://cvvaccine.nmhealth.org

The state's new free, in-home saliva tests are available here (it requires a photo ID for verification of your identity and ability to sign on to zoom. The tests are sent out immediately and return postage for the test is paid.)

However, you find yourself spending time right now, we all have a role to play. Nothing like this has come to pass in any of our lifetimes, and I hope that you are finding time to reflect, rest, and mark the year going by. The following quote was in my first ever-newsletter back in the spring, but I liked it so much that I think it bears repeating:

Some of us are chosen to suffer, some to console; some to isolate, others to plunge into the fray; some to give, some to receive; some to be broken, others to be healers. We are still at the beginning of this terrible teaching. We need to respect it and give it the fullness of time. – David Von Drehle, Washington Post 3/27/20 “What the gift of this unpleasant infection has helped me understand”

Even though the world remains an uncertain and bizarre place, I hope that NMACP can be a steadying and reassuring force for all of you. Please reach out to me if there is something the chapter can do to help you in your practice or improve your connection to ACP. I'm available to you at Brislen@gmail.com Be well! Thank you for reading –

Heather Brislen, MD, FACP

Governor

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From the Diversity Equity and Inclusion (DEI) Committee, Krystal Chan, MD, chair – and Mandy Collar:

Our NMACP DEI book group has gotten national attention! See this article - Book Clubs Compliment Medical Education: Connect with Colleagues and Develop Better Patient Empathy – by Mandy Collar. We're lucky to have Dr. Chan leading these events – a happy and COVID-compatible new venture for us. By the time this newsletter goes out, we will have had our second even – On How Women Rise, by on How Women Rise, by Marshall Goldsmith and Sally Helgesen and coordinated by past NMACP governor, Barbara McGuire.

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Update from the Health Policy and Advocacy Chair, Mandy Collar, MD-PhD Candidate

NMACP has co-sponsored a Council of Student Member's Spring 2021 Resolution calling for increased research into Period Poverty within the United States and in support of repealing the “tampon tax”. Unlike other necessary items, like groceries and certain medical purchases, menstrual hygiene products (like tampons, pads, and menstrual cups) are subject to taxation in the majority of states. This is despite the majority of women in the United States believing that access to menstrual hygiene products is a right. Along with this taxation, significant barriers exist to menstrual hygiene product access and education. These barriers negatively impact women who are low-income, experiencing homelessness, migrants or refugees, or incarcerated. Yet, period poverty has been largely overlooked in the United States. This resolution calls for increased research into the barriers to accessing menstrual hygiene products and education in the US and the implications of period poverty on vulnerable populations, while supporting advocacy at all levels to repeal the tampon tax and other policies that implement unnecessary barriers, in order to promote health equity. This resolution is particularly timely, as Scotland becomes the first country to make menstrual hygiene products free to all women.

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From the Wellness Committee – Liz Lawrence, MD, FACP, Chair

I cared for patients hospitalized with CoVid-19 at UNM Hospital in early December. On my third day on service, I had to give a generally healthy woman the unexpected diagnosis of a stage IV cancer. I spoke with a palliative care physician to ask her about best communication practices given the barriers of PPE, the absence of family members, and the loud, constant background noise of the retrofitted airflow system. I followed my colleague's advice, opted to conduct the interview in person, and asked the patient how she preferred to receive serious news. She said she wanted the news delivered directly and with at least one family member listening. I invited the daughter to join us over speaker phone. I then delivered the bad news, practicing every communication skill I have learned over the years. And still, I believe I failed to make a therapeutic connection with the patient.

During this pandemic, many of us have been or will be asked to deliver care that feels substandard. I know that I cared about the patient I described and that I wanted to deliver the bad news as empathically as possible, and yet I feel I did a substandard job. Other examples may include feeling like you are giving each patient 80% of yourself instead of 100% because you are stretched too thin, rushing patients out of the hospital to make room for sicker ones awaiting admission, or ignoring chronic problems to focus on the most pressing needs at hand.

Enacting “crisis standards of care” recognizes that we can only do so much for our patients with the resources, clinicians, staff, and supplies we have in the face of this overwhelming pandemic. Accepting that we are doing our best given the times, however, still does not ease the hurt or the “moral injury” we may feel as a result of our experiences.

There are no easy solutions to heal our wounds, but here are some ideas that might help:

  • Consider starting or joining a group of peers regularly over lunch to share your experiences. This type of gathering works best if someone provides a prompt for the group such as “talk about what you are doing for self-care” or “share a moment that inspired you this week.”
  • Take advantage of the many resources offered to front line physicians and health care workers at this time. You can call our New Mexico hotline 24/7 to debrief or use any of these other resources for those on the front lines of the pandemic.
  • Practice self-compassion. Dr. Kristin Neff, a leader in the field of self-compassion shares several free practices and resources here.
  • Write to heal. UNM is offering a Wednesday writing and medicine workshop for free from 2 to 3 for the month of December – you can register here. Stanford offers an every-other-week workshop where healthcare workers can come together with other healthcare workers to write - https://www.laurelbraitman.com/writingmedicine.
  • Advocate for a meaningful change in your practice. You can try Getting Rid of Stupid Stuff, introducing a protocol to standardize CoVid care or designing an intervention unique to your organization. Knowing you have made a difference for your colleagues and patients can help relief moral injury.

I am curious to hear your stories and your strategies for staying well.

Best,

Liz Lawrence, MD, FACP

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The NMACP 2020 Meeting still lives!

AVAILABLE FOR AT-YOUR-CONVENIENCE VIEWING, NEW REGISTRATION, AND DON’T FORGET TO CLAIM YOUR CME/MOC!

Eva Angeli, MD FACP, led the conference planning committee in putting together a stellar lineup of topics for the year's all-streaming meeting – and in October, our first ever, all-virtual annual meeting went off without a hitch!

And, because of the magic of our newly digitized lives, all of that content – and CME and MOC – is still available, including 5 hours of required Pain-related CME that meets the NMMB requirement. I highly recommend ALL of the meeting content – there are so many good presentations available that you can watch at your leisure. The content is top-notch! You can still register for the meeting HERE.

If you already registered, the content and CME/MOC can be accessed via the Meeting Hub.

Congratulations to the Winners of the ACP New Mexico 2020 Competitions

Quality Improvement Poster:  Promise Brood
Research Poster: Zachary Pek
Clinical Vignette Poster: Britte Lowther
Medical Student Clinical Vignette Poster: Michelle Thomas
Oral Vignette Presentation: Ishan Shah

 

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COVID 19 RESOURCES:

NM Medical Society & NM Primary Care Assoc. COVID-19 Response Provider Webinar- every Tuesday, hosted by David Scrase (https://register.gotowebinar.com/rt/8609188545715912971)

Project ECHO COVID-19 programming (https://echo.unm.edu/covid-19/institute-nm)

ACP's COVID-19 Resource Hub

This Week in Virology Podcast (https://www.microbe.tv/twiv/ ) (This is my favorite! -HB)

All of the following resources are from Alex Castillo-Smith at NM HSD:

  • Visit NM Dept. of Health COVID-19 website. Screening and test site information can be found here, patient test result portal.
  • If you suspect COVID-19 in a patient, immediately notify infection control personnel at your facility and contact the NM Dept. of Health at 1-855-600-3453.
  • All Together NM: COVID-Safe Practices for Individuals and Employers (resource developed by the NM Economic Recovery Council)
  • Visit the Medical Advisory Team website, where you can find recommendations, resources, and information related to such topics as COVID-19 clinical, and healthcare reopening.
  • Check out the NM DOH reopening gating criteria website, where weekly updates are posted.
  • CDC and CMS have a wealth of guidance for health professionals regarding PPE usage, practice guidance, and clinical care.
  • NM Medicaid COVID-19 provider portal has variety of information related to policy flexibilities, special Medicaid guidance, and telehealth codes and resources.
  • Potential PPE/medical supplies/distributors, or people looking to make PPE/medical supply donations are encouraged to so at NM COVID-19 Emergency Supply Sourcing & Manufacturing
  • If you'd like to learn more about volunteer opportunities please sign-up at the DOH Medical Reserve Corps. Healthcare and non-healthcare professionals needed.
  • The NM Finance Authority Essential Services Working Capital Program: is still offering emergency loans for certain primary care and behavioral healthcare providers who need additional operating capital resulting from the pandemic. Interested applicants should email business@nmfa.net
  • Providers may submit requests for PPE to their local Emergency Manager by emailing an ICS 213RR Form. forms/ics form 213rr, resource request message (v3).pdf This Form is created by the US Federal Emergency Management Agency; and, providers only need to complete sections 1-8. An updated contact list of Emergency Managers is attached. Providers whose offices are located in Albuquerque and Santa Fe: Please email the ICS 213RR Form forms/ics form 213rr, resource request message (v3).pdf to your respective City Emergency Manager. Submitting requests to Bernalillo County or Santa Fe County managers will result in delayed/unprocessed requests.
  • The NMConnect app, available for Apple and Android, includes a “one touch” connection to a mental health professional on NM's 24-hour crisis and access hotline. For non-crisis support, including help finding a therapist or support group, or to just to engage with someone, the “Text Warmline” option connects people to a certified peer support specialist for non-emergency support (available from 6 p.m. to 11 p.m.) and a “Call Warmline” option is available for peer to peer phone conversations with someone in recovery from their own mental health diagnosis, (available from 3:30 p.m. to 11:30 p.m.).
  • NM Healthcare worker and first responder support line: 855-507-5509

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Advancing to ACP Fellowship Webinar Playback Available

Matthew B. Carroll, MD, FACP, FACR, Chair of ACP's Credentials Committee, presents the meaning and requirements for ACP Fellowship—a mark of honor and distinction within the internal medicine community. Each year, ACP Fellows are celebrated and inducted at ACP's annual Internal Medicine Meeting during the Convocation Ceremony.

For more information about ACP Fellowship and to access application materials in advance of the webinar, visit this page.

The ACP Leadership Academy will present several free member webinars during spring 2021. We encourage you to participate and to inform your members about these learning opportunities. More information and registration for one or more of these webinars.

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MKSAP Live Online Study Hall-What's That!?

Join us on Tuesday nights at 7:00!

You are invited to a weekly webinar series hosted by local ACP chapters from around the country. Each week our national hosts reveal a new “episode” of MKSAP 18, preparing you for boards over the next few months. This is an opportunity to prepare for recertification in a weekly casual, collegial, online setting.

It's free for ACP members, but you must own MKSAP 18.

More information and registration HERE.

We have been holding sessions for the last year but hope the New Mexico members join us now and in the future!

Join MKSAP Online Study Hall every Tuesday for:

Pulm/Critical Care January-March 2021

Endocrinology March-May 2021

General Internal Medicine June-August 2021

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