President’s Message

Posted on Jul 7, 2020 in President's Message | 0 comments

The death of George Floyd was shocking and horrifying. As the nation has reeled with massive social unrest for weeks, it is clear that there is a need for dramatic change in how black people are treated in this country. While it would be easy to assign some bad actors to systemic racism within law enforcement, we all have a duty to understand our part in the injustice.

It is imperative as health care providers that we examine and challenge our own implicit biases. This is not to say that all bias is intrinsically wrong, some of it may be informative and predictive. But bias influences how we make decisions for our patients, how we perceive their underlying medical problems, and most importantly, their outcomes.

Studies, including one within Sutter’s own population of patients, have shown that significant health disparities in both exposure and outcomes, as well as access to care, are disproportionate in communities of color. Please see link below for more information.

https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00598

Oakland is among the most ethnically diverse cities in the country; we have a duty to be both culturally sensitive and aware of the structural inequalities that have shaped the experiences of our patients.

On June 8, physicians and nurses took a knee for George Floyd to show solidarity with peaceful protests (see below).

I implore each of you to examine your own implicit biases and to do as much as you can to help balance the scales.

Jeff Chen, MD, MPH
Chief of Staff ABSMC Summit Campus

Alta Bates Summit Comprehensive Cancer Center Now Providing Superficial Radiotherapy for Skin Cancer Patients

Posted on Jul 7, 2020 in Announcements | 0 comments

EHR Education for Providers

Posted on Jul 7, 2020 in EHR Updates | 0 comments

Dr. Ronn Berrol | KTVU Fox 2: Blood Shortage and Impacts

Posted on Jul 7, 2020 in Announcements | 0 comments

Headline: Summit ED Director Talks About Blood Shortage on KTVU News

Dr. Ronn Berrol was interviewed on KCBS and KTVU news about the shortage of blood and the impact on patient care. Click here to watch the segment.

Why Sutter Community Connect?

Posted on Jul 7, 2020 in Announcements | 0 comments

Creating Safe Environments for our Patients and Colleagues during COVID-19

Posted on Jul 7, 2020 in Announcements | 0 comments

This is the Wellbeing column. Why talk about Race? Because our wellbeing is necessarily tied to the wellbeing of our community.

Posted on Jul 7, 2020 in Uncategorized | 0 comments

Systematic Racism and Healthcare Disparities:

Lessons from the Black Lives Matter Movement as We Reckon with Healthcare Disparities.

In the wake of the recent widespread protests over police killings, San Francisco is discussing creating a new service of community responders who would be unarmed and properly trained to deal with issues the police should not be involved with, like homelessness, addiction and other non-violence problems.  People are demanding that we defund an expensive institution that is ill-suited to do much of what it does. We are now beginning to see some civic leadership proposing different solutions that reflect the demands of the people.

Many people across the nation are learning that being “not a racist” is not enough; we need to be actively “anti-racist” if we are to end racism that is weaved to into the fabric of our society.   For health care workers that means not just protesting and voting but taking a hard look in our own backyard.  I for one have become numb at times to the way we operate in a dysfunctional healthcare system that has albeit weak but important analogies to the criminal justice system. 

While distinct from criminal justice issues, health disparities are an important manifestation of and continued driver of systemic racism.  We all know how pervasive health inequities are and we see the end result of them daily as increased morbidity – in the African American community in particular. At ABSMC, probably a quarter of what we do should have never reached our doors and sadly, our solutions don’t get to the root of the problem. I treat an opioid dependent person and discharge them back to their tent and needles.  I offer no real program for our patients with COPD who still smoke. My diabetes patients are discharged back to shop at the dollar store for food since they are impoverished. Much of the follow-up care for those in the “safety net”, though provided by smart, dedicated people is shamefully underfunded. When I acknowledge that I have become complicit with this dysfunctional status quo- while receiving societal respect and a good salary – I am at moments ashamed. 

At the same time, I am truly proud of the work we do at ABSMC.  Beyond the excellent, compassionate care we provide, we now have an in-house diabetic education program, case managers funded by us in the ED and our FCHCs.  There is an asthma initiative in the ED and nascent inpatient addiction service now, too. We are working on a vegan diet our kidney patients who are disproportionally underserved. To target high users, we have the STAR program.  Wow, bold and inspiring work; thanks to Steve Lockhart, Meggie Woods, Michelle Tang, Manj Gunawardane, John Mouratoff, Sutter Enterprise, local physician and executive leadership and the many others of us involved in spearheading these efforts.

Yet, we have so much more work to do. Seeing the police officer kneeling on George Floyd’s neck caused anguish for many reasons: loss of life, cruelty, seeing the results of societal racism and dysfunction. To grieve publicly as a number of us did at our kneel-in acknowledged the pain and was moving but also inspiring.  Those of us there have a renewed clarity of our values as a medical center and sense of purpose. We must admit that the expensive and failed healthcare system is both a symptom and a source of societal problems.

 I have been around long enough to remember the slogan of the HIV movement: Silence=Death.  The same holds true today. True, we are all working so hard and the answers often lay beyond our skills set, but inaction is not a moral option.  What do we do? First, we need to acknowledge that inaction makes us complicit. Next, get educated about our own implicit biases.  Admitting them doesn’t make us a bad people.  It simply acknowledges we are human.  Then, we need to loudly advocate (and likely pay more taxes) for programs that lead to primary prevention for the problems we make a living off of. How to do that?  We all have to figure that out.  I have communicated with the president of my specialty organization, Society of Hospital Medicine, and asked them to advocate for programs that put dollars into primary prevention perhaps at the expense of hospital care. I have similarly messaged the CMA. I have written to Steve Lockhart, Sutter’s point person on health disparities asking how we can help him in his work.  As an institution, we need to be aware of how we are tracking the med center’s activities that are tied health disparities and follow the trends so we can better advocate for services.  Services here at the med center, in the broader medical safety net and more generally as anti-poverty programs for our community. I would suggest a quarterly report to the MEC about our institutional efforts that is then sent out to all medical staff.

And I am now asking our med center and my hospitalist leadership and YOU to think about ideas – maybe using a different toolkit – to address our community’s most vexing social and health problems.

Living with purpose and being anti-racist means acknowledging racism imbedded in our society and healthcare’s role in it.  It also means working toward solutions. So, what should happen? And what should we be doing?  Let’s talk! 

Well-Being Events to Connect with Each Other during COVID-19

Posted on Jul 7, 2020 in Announcements | 0 comments

New Physicians Memo

Posted on Jul 7, 2020 in New Physicians | 0 comments

President’s Message

Posted on Jun 1, 2020 in President's Message | 0 comments

We’ve made it to June.

Unfortunately, the sense of relief that the pandemic has not surged through our hospital has been replaced by the increasing anxiety of how we successfully open up our services safely. As we’ve discovered, opening up has been a greater challenge than the lockdown posed.

I have the greatest confidence in our leadership and our staff that we can meet this challenge and safely deliver high quality care to our patients. Volumes are creeping up, though not to pre-COVID levels, our OR and procedural areas have been ramping up caseload, and we have testing capabilities in place to ensure that patients are adequately screened for the coronavirus. Things are not perfect, however, and we should not expect a return to how things used to be, as the new normal will undoubtedly be with us for at least the next year as we see a regular stream of COVID cases, and not until a vaccine/herd immunity takes effect. We should also anticipate that our work to be ever more challenging, with workflows that have become more complicated and time consuming, even for patients that would have been previously straightforward and simple.

Through it all, we must look after ourselves. The nature of our work is incredibly draining: physically, mentally, and emotionally. Every day that our batteries drain, we need to recharge them to be effective clinicians, in order to provide the empathic care that our patients expect. Whether that’s going for a hike, a bike ride, meditating, or cooking a delicious meal, we must treat ourselves to these moments of joy to stay whole. I ask you to connect with your fellow clinicians, see how they’re doing; oftentimes a kind word and sharing a laugh is enough for us to feel that what we’re doing is worth it.

Our Wellness medical director, Jill Kacher Cobb, has compiled these useful resources for you (listed below). Please avail yourself of these opportunities and don’t be shy!

In addition, Lenny Husen has started a small book lending library called the Resilience Shelf Project: books are available in the Doctor’s lounge, peruse and take one home, donate if you have something to contribute.

Leif Hass, our Wellness committee chair, has these thoughts:

Amazingly, disasters can lead to true emotional highs as we find ourselves being our best selves and working together.  Eventually, what goes up must come down and we can come down really hard when we are physically and emotionally exhausted.  Expect to have real low moments. I know I hit lows most every day in the last week or so.  I comfort myself by saying this is part of being a normal healthy human being.

What can really help is support – or as I often say a little love.  Be Your authentic self, if you are tired and a little down, let others at work know.  We are all caregivers.  I am sure any colleague you talk to will be there with some support and reassurance.

For those of us on the giving end remember, picking up a colleague builds culture and makes you feel good in the moment.

Be on the lookout for a survey about wellbeing from the Sutter research team.

Next week you will get an email about a quick survey. The results will help people from big Sutter down to our campus best help you all out!


Mental Health Resources including MANY free counseling sessions:

1. EAP-provided for free to all physicians on the ABSMC Medical Staff including a 24/7 crisis hotline and three free counseling sessions: 1-800-477-2258
2. Free counseling sessions provided by local Bay Area Therapists who are volunteering their time to help us out during the crisis. Click here for easy sign up for sessions: https://sites.google.com/view/cpbc-proj/home

3. Peer Support at ABSMC. Free one-on-one support from an ABSMC peer. Email us at peeroutreachABSMC@gmail.com

4. Dr. Pamela Wibble has been a nationwide resource for physicians at risk for suicide. https://www.idealmedicalcare.org/contact/?inf_contact_key=d914553d5079fa4f2638ad2b21296b60680f8914173f9191b1c0223e68310bb1

5. Another source for free counseling: https://www.7cups.com/

6. Resilience Consultations 1-650-756-7787 (Northern California). This is CMA’s 24 hour Physicians’ and Dentists’ 24 hour assistance line providing completely confidential doctor-to-doctor assistance. This service is free.

7. National Crisis Lines: 1-800-273-TALK or 1-800-SUICIDE

Fun things to do:

1. The Open Culture website is a gem. They scour the web for free courses, free audiobooks, and free language lessons, along with free movies, text books, business courses, educational videos, K-12 resources, art & images, music, writing tips, etc. Scroll down to find Choir! Choir! Choir! for weekly sing alongs and a link for Dolly Parton to read you a bedtime story. Not kidding! http://www.openculture.com/

2. The California Academy of Sciences with the museum at home with live streams and science labs/STEM-friendly activities: https://calacademy.org/academy-home

3. Free opera with the NY Metropolitan Opera: https://www.metopera.org/user-information/nightly-met-opera-streams/

4. Free Cirque du Soleil shows every Friday evening: https://www.cirquedusoleil.com/cirqueconnect.

5. Free virtual museum tours at many famous museums including the British Museum in London, The Uffizi in Florence, Musée d’Orsay in Paris: https://www.travelandleisure.com/attractions/museums-galleries/museums-with-virtual-tours

Stress Reduction/Meditation:

1. Headspace is free for health care professionals: provide your NPI number: https://www.theverge.com/2020/3/16/21181773/headspace-free-health-care-provider-public-health

2. Online yoga classes at Tahoe Yoga: http://www.tahoeyoga.com/

3. Mindfulness for Anxiety and Sleep-was free, may now need to pay: https://www.udemy.com/course/heal-anxiety-sleep-easily-tara-brach/

4. 21 Best Meditation Podcasts for busy people: https://www.verywellmind.com/best-meditation-podcasts-4771686#for-busy-people

5. 12 Mindfulness Hacks: https://medium.com/the-mission/12-mindfulness-hacks-you-can-use-in-24-hours-558fe00d7dd2

6. Mindfulness hacks for those who cannot sit still: https://siyli.org/resources/mindfulness-hyperactive-hack

7. Greater Good Science in Action: practice gratitude, empathy, connection and forgiveness; find the wonder and beauty in life; many free activities: science based practices for a meaningful life: https://ggia.berkeley.edu/

Self Care/Exercise:

1. Care tips for emergency responders from the CDC: https://emergency.cdc.gov/coping/responders.asp 

2. Peloton exercise app: offers many exercises and a virtual exercise community: https://www.onepeloton.com/app

3. A list of free online exercise offerings: https://www.fastcompany.com/90481514/these-free-online-exercise-offers-will-help-keep-you-fit-and-sane-during-the-coronavirus-pandemic

4. Nike is offering free exercise courses online: https://news.nike.com/news/nike-digital-health-activity-resources

Education:

1. Take one of 450 free online Ivy League courses: my high schooler is doing this and is having a blast! https://www.freecodecamp.org/news/ivy-league-free-online-courses-a0d7ae675869/

Kids:

1. Scholastic learn at home website for K-12 students: https://classroommagazines.scholastic.com/support/learnathome.htm

2. Kids Activities blog: a compilation of fun things to do at home with kids: https://kidsactivitiesblog.com/

3. Podcasts for kids: https://www.wired.com/story/best-podcasts-for-kids/

4. Mindfulness hacks to calm an anxious child: https://lemonlimeadventures.com/7-simple-mindfulness-hacks-calm-anxious-child/

5. List of educational online resources for kids and parents: https://smartsocial.com/online-activities/

A guide for difficult conversations with patients and families:

1. Vital Talk: a COVID-19 physician communication playbook for difficult conversations: https://www.vitaltalk.org/guides/covid-19-communication-skills/

Jeff Chen, MD, MPH
Chief of Staff ABSMC Summit Campus