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New Mexico Governor's Newsletter September 2020

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Heather C. Brislen, MD, FACP, ACP Governor

Heather C. Brislen, MD, FACP, ACP Governor

 


GOVERNORS MESSAGE

Dear Friends and Colleagues,

We've just wrapped up our third quarter council meeting and are barreling ahead on plans for our all-virtual annual chapter meeting – October 15-17, kicking off hand-in-hand with UNM Grand Rounds that Thursday afternoon. Registration is now open here. 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. We have a lot of material to share with you in this newsletter, so I keep my comments short. 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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NMACP Supports VotER – Resources for Patient Voter Registration

You may have seen the announcement last month about this new, health care based voter registration resource called VotER. Please take a moment to consider if this is a fit for your work or clinic! VotER was started by a group of physicians and voter registration organizer as a response to what frontline providers see each and every day as they care for patients – the healthcare inequities that result from a system in which 51 million citizens aren't registered to vote.

VotER has rolled out free badge-backers, lanyards, and posters as part of their Healthy Democracy Kit to more than 15,000 interested healthcare workers.

Here is the link to get your free kit: vot-er.org/healthy-democracy-kit/.

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From the Health Policy and Advocacy Committee

One of the most important elections of our lifetimes is coming up this November. The representatives that we elect into office will help determine how we move forward through the pandemic, rebuild our nation in the aftermath, and better prepare for future pandemics and natural disasters. For this reason, and so many more, it is imperative that we all making voting a priority this November. We must also stay cognizant that the Presidential election is not the only important election occurring. There are so many positions of power on the ballot throughout the state, from State Senator and Representative to judicial positions to Country Sheriffs.

One issue that is likely to come up during this legislative session in New Mexico is access to broadband Internet for telemedicine. Many physicians are all too familiar with the lack of infrastructure for broadband across New Mexico. Additionally, the need for broadband is unlikely to disappear when COVID-19 does. Instead, telemedicine may continue to be a preferred and useful avenue for certain patients to access healthcare, including for those with chronic illness, patients living in rural areas, and perhaps even those with opioid use disorder. The Annals of Internal Medicine published an article last year describing the limitations and insufficient access to broadband to support telemedicine in rural America. We can help to elect candidates that support this and other important issues that affect the health of New Mexicans this November.

I encourage you to take a moment to register to vote or change your voter registration information before the deadline of October 6th, which you can do here. Visit NMVote.org to request an absentee ballot, find an early voting location, and more. Deadline to request an absentee mail-in ballot for New Mexico is October 20 (must be received by that date.) Completed ballots should be mailed NO LATER THAN OCTOBER 27 in order to ensure they are received by 7pm on the night of the election, November 3.

Thank you,

Mandy Collar
Health Policy and Advocacy Committee Chair

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Notes on the Diversity Equity and Inclusion (DEI) Committee

Krystal Chan, MD, Chair

Thank you to everyone who participated in and supported our first DEI book group! We read and discussed How to be an Antiracist, by Ibram X Kendi. The chapter distributed 20 copies of the book to members, and several additional attendees obtained their own copies. It was a heartening moment of NMACP community building and collegiality. As Amanda Collar wrote in a forthcoming IMpact article, “Book clubs help instill empathy and compassion among participants. The setting provides a rich environment that allows for learning in a non-judgmental and safe space, which is particularly important for sensitive topics.”

The committee's next book group will be on How Women Rise, by Marshall Goldsmith and Sally Helgesen. The chapter received a development grant from ACP that will cover several copies of the book – free to interested members. Keep an eye out for an emailed announcement soon!

Lastly, let's not lose sight of little things that we can do in service to our most vulnerable community members. This pandemic has been particularly devastating to minority communities, we are all facing economic recession, while racism remains a powerful enemy reminding us that we should all work proactively for equity. Please support our small and local and women and minority-owned businesses. Here is a list of black-owned businesses in and around Albuquerque to get you started:

Taste of the Caribbean
Nexus
Flower Loop
Frank's Famous Chicken and Waffles
Rude Boy Cookies
Mr. Powdrel's BBQ
Bobbi's Homestyle Catering
Creative Duke Media
K’Lynn's Southern Cajun Fusion
Manimalkingdom
Leela's Body Cocktails
Q Cakes
Biscuit Boy
The Rain Tunnel Car Spa
Beet's Juice Bar and Café
Talking Drums African Caribbean Grill
Focus Advertising Specialties
Trendz Beauty Supply
The Doorman
Cultivating Coders
Crispy Clean Mobile Car Wash
ABQ Affordable Residential Cleaning

Native Women-owned businesses can also be found at NativeWomenLead.org.

(Thank you to Krystal Chan and the Diversity, Equity, and Inclusion Committee for this list!)

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From the Wellness Committee: Physician Wellbeing in Pandemic Times

I believe deeply that we are called to our profession. I understand the need and the desire to make personal sacrifices for the privilege of answering our call to heal. I have the deepest respect for the physicians, residents, and other clinicians who have been on the frontlines caring for patients with COVID-19, often without adequate PPE and in overcrowded and understaffed hospitals.

Yet how do we take care of ourselves and avoid burnout while making necessary sacrifices to care for patients, even in normal times? And how are we to find such balance in a pandemic?

Dr. Lorna Breen, an emergency room doctor and the director at New York–Presbyterian Hospital, literally worked herself to death during New York City's CoVid-19 surge. She suicided on April 26, 2020 while visiting her family in Virginia. More than half of healthcare workers globally who have died of CoVid-19 are physicians. And almost half of front line and second line providers in Italy endorsed symptoms of post-traumatic stress syndrome in a cross-sectional study, similar to the high rates of anxiety, depression, and insomnia reported in front line nurses and doctors working in Wuhan, China.

What do we owe ourselves and our loved ones compared to what we give to our patients? Physicians are not good at self-care. We are not good at asking for help. We like to be the ones with the answers, the ones in control, the ones ministering to the needs of others. We put the needs of our patients before the needs of ourselves.

Our society was already facing an epidemic of physician burnout before the CoVid-19 pandemic. All of the evidence from research in physician well-being in recent years says that burned out clinicians provide lower quality, more costly, and less effective care than clinicians who are well. We have evidence-based interventions that can be used at the individual, systemic, and national levels to reduce physician burnout.

The President of the National Academy of Medicine, Dr. Victor Dzau, warned in the August 6, 2020 issue of The New England Journal of Medicine about a “parallel pandemic“ of physical and emotional harm to our front line providers due to their COVID-19 pandemic work and called for immediate action at the institutional and national levels to protect the health of the nation's clinical workforce.

We need to look beyond the individual physician to the systems and cultures in which we work and to our federal government for a national strategy to support physicians and other healthcare providers from the harm that comes from doing the work we love. As we advocate for these important changes, we also need to take care of ourselves and peers. Here are some tools to help us promote changes at all levels and help us care for ourselves:

  1. Dr. Dzau's article mentioned above and found here lists five essential strategies at the institutional and federal levels to safeguard our physician workforce.
  2. An influential article from Stanford published early in the pandemic identifies eight clinician needs that must be addressed for clinicians to feel safe.
  3. The Institute for Health Care Improvement has created a “caring for caregivers” section on its website with toolkits, videos, and articles to support healthcare workers before, during, and after the pandemic. I highly recommend its free virtual learning series on “caring for caregivers.” Although the series is almost over, past videos are available here.
  4. ACP offers webinars with important information on advocacy and self-care.
  5. UNM's own ECHO on first responder resiliency during COVID-19 offers a weekly opportunity to learn tips for managing stress and to share stories with others on the frontline,

Resources are useful, however, only if physicians are able and willing to use them. The healthcare systems in which we work need to support a culture of help-seeking and give us time to take advantage of these opportunities.

Society has applauded physicians for answering our calling during COVID-19. We now need to call on society to support us in our healing work.

Liz Lawrence, MD, FACP
Chief Wellness Officer & Assistant Dean for Professional Wellbeing, UNM SOM

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Physician Wellness, Part 2: What is Physician Coaching?

Lida Fatemi, DO, MPH

As Physicians, we are aware of the significant rates of burnout, moral injury and suicide in our medical profession. This is even more prevalent now with the COVID-19 pandemic. For many years we've been looking for solutions. One of the most effective solutions has been studied and utilized in business for years. In the business world, they value their executives as their highest assets. They invest in their executives and provide them with executive coaches.

Doctors are executives. When was the last time you had a confidential coach talk to you about your purpose? When was the last time your coach met with you to help fine-tune your mindset to serve you? When was the last time a coach asked you about your character strengths?

Empowering our Physicians through coaching will lead them to realize their full potential. We've worked way too hard to become doctors and not enjoy our jobs and our lives. We deserve to live enjoyable and fulfilling lives!

Physician coaching provides a confidential space for individuals to recognize and overcome their current obstacles in reaching the next step in their growth. Some Physicians are completely burnt out and ready to quit medicine, some are figuring out how to take the next steps for career promotion, some need to find a way to connect with themselves, some need tools to connect with their families.

Coaching focuses on the individual's needs and customizes the sessions for the Physician's goals. These sessions are not mentorship or therapy. They are specifically catered to create a path for the individual to discover their unlimited potential.

Every session is full of new realizations and revelations.

If you want more information, you can check out ConsciousPhysician.org or email me at LidaFatemi@ConsciousPhysician.org

References:

  • Dyrbye LN, Shanafelt TD, Gill PR, et al. “Effect of a professional coaching intervention on the well-being and distress of Physicians: a pilot randomized clinical trial.” JAMA Intern Med. 2019;179:1406–1414.
  • Smith, Jeffrey M. MD, FACS, CPC. “Surgeon Coaching: Why and How.” Journal of Pediatric Orthopaedics: July 2020
  • W. Joseph Askin, MD, “Coaching for Physicians, Building more Resilient Doctors” October, published Can Fam Physician. 2008 NCBI.
  • McGonagle, A. K., Schwab, L., Yahanda, N., Duskey, H., Gertz, N., Prior, L., Roy, M., & Kriegel, G. “Coaching for primary care Physician well-being: A randomized trial and follow-up analysis.” Journal of Occupational Health Psychology.Advance online publication. 2020
  • Murray Erlich, MD, FRCPC, ACC “Life coaching for doctors” April 25, 2020 DOI: https://doi.org/10.1016/j.jcjo.2020.04.016

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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 

Project ECHO COVID-19 programming 

ACP's COVID-19 Resource Hub

This Week in Virology Podcast (This is my favorite! -HB)

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Register Now For NMACP 2020 – October 15-17

Eva Angeli, MD, FACP, is our intrepid meeting chair, and she has led the conference planning committee in putting together a stellar lineup of topics for this fall's meeting. We are offering 5 hours of pain CME credits designed to satisfy the state medical board requirement, as well as broad clinical updates, trauma-informed care, COVID-19 perspectives, and in-depth health policy. We will miss seeing you in person! Rest assured though, the content will be up to our usual high standards and CME and MOC will be available. Registration is available here and through our NM ACP chapter website. Further meeting details will be posted and announced by email – stay tuned!

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Chapter Elections and Candidate Announcement

The following members have been nominated for election to the NMACP council for two-year terms that would begin following the annual business meeting. Elections will take place during the annual business meeting, Friday, October 16th at 12:30 p.m. (during the annual scientific meeting).

Sepehr Khashaei, MD, FACP
Alisha Parada, MD, FACP
Eva Angeli, MD, FACP
Amanda Collar, MS
April Volk, MD, FACP

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