President’s Message

Posted on Jul 1, 2021 in President's Message | 0 comments

There is a phenomenon well described in the social science literature called the “U-curve.” It illustrates the nadir of job satisfaction that occurs in one’s mid career, say in one’s 40s-50’s. To the layman, it is the proverbial mid-life crisis. Previously, it was though that one’s happiness and wellbeing was generally on a downward slope as age progresses, all things being equal. However, that appears not to be the case. Data sets of approximately 500,000 individuals in the U.S. and Europe clearly identify a low point in self and job satisfaction in one’s 40’s, with a constant and steady rise thereafter.

Coincidentally, I find myself in just such an age bracket at the midpoint of my career. My early years as a physician were filled with fears of ineptitude, fears of making mistakes, but curiously tinged with the optimism that anything was possible.  As I aged, my skills and knowledge progressed, but they were countered by accumulated disappointments and regret. As such, I found myself in the inevitable burnout. I’ll admit that on the physician satisfaction surveys over the past few years, I have responded affirmatively to the burnout questions. How much of this was due to the actual work though, or was it part of a greater social experience?

As it turns out, I am not alone. This experience has been replicated across all income levels and career types in over 50 developed countries (notable differences exist in developing countries, though the exact reasons are not entirely clear). Just by being “successful” does not ward off this particular phenomenon. Whether you’re the CEO or you’re housekeeping, you are susceptible.

So what can we do about it? The first is to acknowledge and normalize it. The second is to focus on the things that we have control over, namely the personal relationships we have around us. The third is to express gratitude – to yourself and others, every day. Lastly, stop comparing yourself to others. Fear of missing out is a powerful fear, but it tends to highlight differences and magnify discontent.

As physicians and allied health professionals, we have taken a long road to get where we are. It is not an easy journey, and to get to this point requires an unusual combination of perseverance, intellect, and character. This is not to say that we are better than those in other professions, but just that we should recognize all the hard work and accomplishment that has gotten us this far. Pat yourself on the back. And it’s ok to feel burned out or dissatisfied. It will get better.

https://hbr.org/2015/04/why-so-many-of-us-experience-a-midlife-crisis

https://www.theatlantic.com/magazine/archive/2014/12/the-real-roots-of-midlife-crisis/382235/

https://www.inc.com/jeff-haden/scientists-just-discovered-mid-life-crisis-peaks-at-age-47-heres-how-to-minimize-effect-of-happiness-curve.html

Jeff Chen MD, MPH, FACEP
Chief of Staff, ABSMC Summit Campus
chenje@sutterhealth.org
jchen@bayem.org

WiserCare: An Online Advance Healthcare Directive Platform

Posted on Jul 1, 2021 in Announcements | 0 comments

Alta Bates Summit Cardiac Program Earns Highest Possible Rating for Mitral Valve Surgery from Society of Thoracic Surgeons

Posted on Jul 1, 2021 in Announcements | 0 comments

Key Result Spotlight: ABSMC Helps Remove Medication Cost Barriers for Patients Most in Need

Posted on Jul 1, 2021 in Announcements | 0 comments

https://newsplus.sutterhealth.org/blog/2021/06/23/key-result-spotlight-alta-bates-summit-helps-remove-medication-cost-barriers-for-patients-most-in-need/?doing_wp_cron=1625082779.4921801090240478515625

Insulin Correctional Scale

Posted on Jul 1, 2021 in Announcements | 0 comments

Glycemic control is important to prevent complications of diabetes, a common chronic condition. Uncontrolled diabetes can lead to fluctuations in blood glucose levels, which can result in unfavorable complications. Insulin correctional scales, which are insulin adjustments based on a set of criteria for insulin sensitive, average, or resistant patients, are strategies to target glycemic control in the setting of fluctuating blood glucose levels. Insulin correctional scales help ensure patients will receive an adequate dose of insulin based on their blood glucose levels. There is an increased risk of hypoglycemia with aggressive insulin strategies. Insulin correctional scales, in combination with long-acting/short-acting insulin, aim to provide adequate insulin coverage and minimize the risk of hypoglycemia.

At ABSMC, insulin correctional scales can be ordered through established ordersets in the EHR. Insulin correctional scale categories include insulin sensitive, average, and resistant scales.

  • Insulin Sensitive Patient (1 unit of Lispro will decrease blood glucose by ~50 mg/dL in ~3-4 hours)
    • Suggested starting point for patients with: BMI < 25, Patients >70 years of age, T1DM, Renal failure patients (CrCL < 30 mL/min), or those requiring <40 units of insulin/day
  • Insulin Average Patient (1 unit of Lispro will decrease blood glucose by ~25-30 mg/dL in ~3-4 hours)
    • Suggested starting point for patients with: BMI > 25, Daily dose of 40-100 units insulin/day
  • Insulin Resistant Patient (1 unit of Lispro will decrease blood glucose by ~16 mg/dL in ~3-4 hours)
    • Suggested starting point for patients with: BMI > 30, Sepsis diagnosis on anti-infective, Systemic steroids, Daily dose > 100 units of insulin/day

Joan Yim, PharmD, BCPS
Pharmacy Manager & Clinical Coordinator
Alta Bates Summit Medical Center – Alta Bates Campus
2450 Ashby Avenue, Berkeley, CA 94705
Office: (510) 204-1503

Sutter Community Connect

Posted on Jul 1, 2021 in Announcements | 0 comments

New Physician Memo

Posted on Jul 1, 2021 in New Physicians | 0 comments

Patient Thanks Dr. Rita Kwan-Feinberg for Her Thoroughness That May Have Saved Her Life

Posted on Jun 17, 2021 in Uncategorized | 0 comments

“I am an ABSMC patient writing to tell you a story about an amazing doctor who quite possibly saved my life – she for sure left me with an inspiring breast cancer story to tell, rather than a harrowing one.

Rita Kwan-Feinberg, M.D.

I was first referred to Dr. Rita Kwan-Feinberg by my general practitioner, Dr. Mary Miller when I inquired about an umbilical hernia I had been dealing with since my twins were born eight-years-ago. Upon exam, Dr. Kwan-Feinberg figured out that I also had an inguinal hernia, laying out my options ranging from laparoscopic surgery to no action. Hernia diagnosis aside, she noticed the prevalence of late onset breast cancer in my family – both my mom and my maternal aunt got breast cancer at around age 60.

In response to a question from the doctor about my cancer risk, I must have said – maybe somewhat flippantly – that for me, it was less about whether I’d get breast cancer and more about when. Once we were done talking about a possible hernia surgery, she re-visited my breast cancer risk and asked if I’d be willing to make a separate (virtual) appointment to do an assessment of my breast cancer risk. It turned out, weighing my entire health history, that my chance of getting breast cancer was about 34 percent.

From there, Dr. Kwan-Feinberg went over things I could do to reduce that chance, but she also recommended I start doing a breast MRI once a year, along with a mammogram once a year too. The two diagnostics were to be spread out every six months.

I went ahead and underwent the hernia surgery. Two weeks later I was due for the breast MRI. In my mind, I was just kicking off a new, more intense detection regimen. It turned out to be the kick-off of a breast cancer diagnosis!

They found a lump in my right breast and a biopsy confirmed it was Stage 1, Grade 1 Lobular Breast Cancer, something that didn’t show up on the mammogram I had six months prior.

I really am one of the luckiest woman around and all thanks to Dr. Kwan-Feinberg and her amazing intellect, intuition, bedside manner, knowledge, thoroughness and passion for a holistic, preventive based approach to medicine. That sneaky lump would have never shown up in a mammogram and it would have likely grown for years before I knew it was there – were it not for Dr. Kwan-Feinberg and that MRI…and she was just my hernia surgeon (initially anyway)!

I can’t say enough about what a superwoman she is – an incredible doctor and person. In addition to helping to relay the message of early diagnostic testing for those women with a higher risk of breast cancer, I also feel compelled to relay my kudos to one of the finest medical professionals I’ve ever met!”

President’s Message

Posted on Jun 1, 2021 in President's Message | 0 comments

Last month was AAPI heritage month, and I had the opportunity to participate on a systemwide forum, sponsored by the Sutter Multicultural inclusion and Diversity Group, as a panelist to discuss the experience of Asians in today’s troubling climate of rising hate crimes and violence. It was widely well received, and a similar forum was replicated locally, sponsored by the ABSMC Diversity and Inclusion Council. I appreciate all who were able to attend. Some tough questions were asked and not easily answered, but a dialogue was started, and there is intrinsic value to that. I will try to keep you updated on future forums regarding diversity and inclusion.

Here is the link to the recorded event, but it does need to be opened within the Sutter network due to privacy concerns.

https://bcove.video/3uuki71

On the COVID front, things are feeling eerily more normal. We are testing less thanks to less symptomatic patients, and given the vaccination rate, we have been able to avoid unnecessary screening tests on admission or pre-operatively. We even have hit a new low of cases in the hospital since the beginning of the pandemic! Thanks to Dr. Boynton for her regular updates.

I have been thankful to be able ride my bike outdoors and not wear a mask! I anticipate however that we will be wearing masks in the hospital for the foreseeable future.

We soon may be able to have indoor meetings, but we are waiting on SHEMS guidance based on local health department and CDC guidelines.

In Alameda County, nearly 64% of eligible residents have received at least one dose of vaccine!

This is taken from the CA COVID 19 page.

More information is available from:

https://covid19.ca.gov/vaccination-progress-data/

You can look up vaccination rates by zip code on this website as well.

California is projected to open up on June 15, with restrictions lifted on most indoor gatherings aside from mega-events.

If you’re vaccinated, you will be eligible for the Vaccine Lottery – 10 winners of $1.5 million, 30 winners of $50,000!

Vaccine hesitancy however is still real within certain communities and people of color. Please take the time to ask your patients if they have been vaccinated, and if not, what barriers exist to their receiving the vaccine.

Lastly, please update your Sutter Profile.

As a member of the medical staff, you should have a Sutter online MD profile. Some of you might not. Some of yours might be out of date. In 2020, physician profiles on sutterhealth.org were viewed > 17 million times. Please take a moment to review and update your profile with a current photo and campus information to make sure any info being posted is accurate. Thanks.

Step 1: Review your profile =  https://www.sutterhealth.org/find-doctor

Step 2: Update your profile = https://feedback.sutterhealth.org/f/141134/2f80/. Complete sections. Scroll to the bottom and hit “submit”

Once you submit this form, they will update it within 1-2 weeks. If you have any questions or need assistance with your online profile, please email physicianprofile@sutterhealth.org.

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

Chhavi Bajaj, M.D. Receives Caring for People Award

Posted on Jun 1, 2021 in Uncategorized | 0 comments

Chhavi Bajaj, M.D. Receives Caring for People Award
Dr. Chhavi Bajaj has been recognized for her invaluable contributions to our patients, specifically her guidance and assistance with our Case Management team. Dr. Bajaj spent a significant amount of time speaking with a patient and family members to review all options for a safe discharge plan. The family was very appreciative of Dr. Bajaj’s assistance and we truly appreciate Dr. Bajaj’s efforts to ensure the patient was safely discharged.