President’s Message

President’s Message

Posted on Nov 3, 2020 in President's Message | 0 comments

This month I would like to try something different.

We are a big medical center with a lot of doctors, and some members of the medical staff I just don’t regularly encounter through my clinical practice as an emergency physician. I’m sure that some of you feel similarly in your daily practice, and as such, I am starting an interview series: “An evening with one of your Summit Medical Staff.”

I would like to start this series with a colleague that to this date I have only met through meetings, but who continually impresses me with the deftness of his comments and his appreciation of the intricacies of other specialties. Not to mention that he is the hippest dressed doctor at Summit!

Sebastian Sasu, MD, chair of Pathology.

Me: “Thanks for giving me some time this evening Sebastian. I know you have a busy schedule, so I appreciate you allowing me to intrude.

SS: Any time for you, Jeff.

Me: So I wanted to do this so that we can learn a little more about you. What made you choose to be a pathologist? We used to have a running joke in my med school that pathologists like dead people…

SS: So, this is going to sound really weird, but the reason I chose pathology is because I like to have the last say. (laughter ensues) We used to go to these multispecialty conferences, the internal medicine doctor would stand up and present the case, and they would tell us all about the patient and how he came in, and then they would say that they got all these radiology studies done, and then he would turn to the radiologist, who would stand up and say “oh, we did these studies and we found this really weird mass, and then we did a biopsy of it.” And then everybody would turn to the pathologist and ask, “what did this patient have?” There is definitely a satisfaction to figuring out what is going on.

Me: If you were not a doctor, what would you be?

SS: A journalist. I’ve always wanted to be a journalist. I’ve always wanted to travel to these fantastic places and cover amazing stories. That sense of get up and go and adventure has always been very enticing.

Me: I know you spent some time practicing in LA. Let’s get down to brass tax, are you an LA or NY guy, or has the Bay area stolen your heart?

SS: That’s a hard answer. I spent some time on the east coast, in Boston, and when I was there, I was a Boston guy, then when I moved to LA, I was still a Boston guy living in LA. But then I spent so much time in LA that I ended up being an LA guy. And then my wife pried me away from that, kicking and screaming, and moved us to the Bay Area. And you know, it was a process, people talk about the difference between Southern California and Northern California, and it’s there. The thing I liked about LA, and what I miss about it, is that there’s a lot more ritz, than there is in the Bay Area.

Me: What’s the rest of the pathology department like? Are they as cool as you? I envision you all sitting around drinking absinthe… or maybe that’s toxicology folks.

SS: Probably not, but about half of the department is as cool if not cooler than I am. You know I’ve been encouraging everybody to be more interactive and show their face more, but believe it or not, we have a lot of clinicians, different specialties come by the pathology department and interact with us. Medicine has changed a lot, in the last 5-10 years. It used to be that certain clinicians that we interact with quite a lot would be in our office everyday looking with us at slides, getting to understand the subtleties of when we make a diagnosis. Like what the gray zones are, what the comfort level was at making a diagnosis.

Me: Can anything gross you out, or are you immune to that sort of thing?

SS: Oh man, nothing can gross me out.

Me: What was your most recent ASMR (Autonomous Sensory Meridian Response – a sort of pleasant paresthesia that goes down the spine) moment?

SS: My what? I don’t know what that is. (explanation above ensues). Nope. (refuses to answer)

Me: Describe to me your perfect evening.

SS: Weekday or weekend? It’s different. Ok – weekday, come home, have a nice dinner with my family, have a nice glass of wine, read my book. Weekend – go out for a drink or dinner, catch a band, and have some good cocktails.

Me: What’s the last book you’ve read? Or what are you reading now?

SS: I am reading a fantasy book, believe it or not. It’s called the Black Song by Anthony Ryan, one of my favorite fantasy writers.

Me: You seem to enjoy the finer pleasures. Cosmopolitan, Martini, Manhattan, or none of the above?

SS: None of the above. I’m actually a custom cocktail kinda guy. I don’t do a lot of the traditional ones. The only traditional ones I do are margaritas and mai-tai’s. But I do a bunch of custom cocktails. My wife does gin and tonics, so I modify her gin and tonics quite a bit, an example would be a dark and stormy with muddled mint. It’s halfway between a dark and stormy and a mojito.

Me: How has the pandemic affected you? Not just at work, but personally?

SS: Both positive and negative. So positive, it’s brought me closer to my family. So we’re spending a lot more time together, and it’s been a lot of fun. Negatively, it’s been the lack of a routine exercise regimen.

Me: Second to you, who’s the coolest person in the medical center to sit down and have a drink with?

SS: There’s actually quite a few people that I would love to do that with. You’re trying to pin me down to one person. That’s a tough thing. Shlomo Leibowich.

Me: PC, Apple, or Linux?

SS: Apple anyday. Anyday and twice on Sunday.

Me: Thanks for giving me almost, gosh, 30 minutes of your time tonight. I hope this was fun for you. It was for me.

SS: And pretty honest answers that are not censored. For whatever that’s worth. I hope I’m not going to be in big trouble.

The above was edited for content and time.

A few reminders for this month.

The physician engagement survey is live and running for the next 3 weeks. A raffle for Apple Airpods goes to one winner from each campus each week. Please fill out the survey (was sent to your email last week) and give honest feedback to the medical center!

Open notes is now live, which means that notes and results for your patients are viewable by the patient in My Health Online in real time. Please be aware of how you are documenting!

The rest of the country is experiencing a significant surge in coronavirus cases but we are currently holding steady in ABSMC and the bay area. We are expecting a fall surge to be imminent. Please continue to practice appropriate social distancing, wear masks, and avoid large social gatherings, especially as the holidays approach.

Stay safe and be well!

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

President’s Message

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

The recent death of Supreme Court Justice Ruth Bader Ginsburg, “the notorious RBG” made me reflect and explore further the efforts that she made on behalf of gender equality.  She graduated at the top of her class at Columbia, but found it difficult to obtain clerkships and positions in law firms after graduation, largely due to pervasive gender discrimination in the 1950’s. When she finally secured a professorship at Rutgers, she realized that she was not working in a level playing field, and was, along with the rest of the female faculty, grossly underpaid compared to her male peers; through collective action she was able to subsequently achieve pay parity. She co-founded the Women’s Rights Project at the ACLU and argued many landmark cases before the Supreme Court, with the position of defending the gender rights of both men and women. As a Supreme Court Justice, she wrote the majority opinion in United States vs Virginia Military Institute in 1996, in which it was the decision of the court that a state supported university could not exclude women on the basis of sex.

So how is this relevant to us today and as a medical staff?

Medicine historically has been a male dominated profession, but the last twenty years have seen a rise in the number of female medical school graduates in the US, with 2017-2018 finally seeing more women than men become physicians.  At the Summit Campus, our current breakdown shows that 80% of our allied health professionals are women, but for physicians, only 32.4% of the medical staff are women.

We have been fortunate to have strong female leadership for the hospital and in our medical staff. Our two prior medical staff presidents and our current vice president are women. Our current Chief Medical Executive is a woman and our regional and organization CEOs are both women. Despite this, I have heard from physician colleagues and witnessed on my own, the bias that exists in treatment of female physicians. This has been supported by several studies[1][2][3] within training programs, and implicit gender bias has wide ranging effects in diminishing the morale of providers and impeding effective patient care.

What is implicit bias? It is subconscious and a product of our cultural norms that cause us to assign certain values and behaviors to certain people; a cognitive shortcut if you will. It is not sexism or racism, but it can lead to pervasive mistreatment of a group of people. Being aware of implicit biases and calling them out when you see them, or recognizing them internally, is a good start to treating others fairly and with compassion and empathy.

Our recent COVID 19 pulse survey showed that as a medical staff, more than 40% of female respondents reported feeling burned out, as opposed to roughly 20% of males. While we are still in the process of trying to discern the reasons for this, the clear difference in perceptions of burnout between the two is quite alarming and will need to be addressed.

 As medical staff president, I want you to know that I strongly support education on implicit bias and will work with administration to help change the climate that continues to favor men over women.

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



[1] Brucker K, Whitaker N, Morgan ZS, Pettit K, Thinnes E, Banta AM, Palmer MM. Exploring Gender Bias in Nursing Evaluations of Emergency Medicine Residents. Acad Emerg Med. 2019 Nov;26(11):1266-1272. doi: 10.1111/acem.13843. Epub 2019 Sep 23. PMID: 31373086.

[2] Galvin SL, Parlier AB, Martino E, Scott KR, Buys E. Gender Bias in Nurse Evaluations of Residents in Obstetrics and Gynecology. Obstet Gynecol. 2015 Oct;126 Suppl 4:7S-12S. doi: 10.1097/AOG.0000000000001044. PMID: 26375558.

[3] Klein R, Julian KA, Snyder ED, Koch J, Ufere NN, Volerman A, Vandenberg AE, Schaeffer S, Palamara K; From the Gender Equity in Medicine (GEM) workgroup. Gender Bias in Resident Assessment in Graduate Medical Education: Review of the Literature. J Gen Intern Med. 2019 May;34(5):712-719. doi: 10.1007/s11606-019-04884-0. PMID: 30993611; PMCID: PMC6502889.

President’s Message

Posted on Aug 5, 2020 in President's Message | 0 comments

It’s been roughly six months since we started planning for COVID-19. We had early hints that the storm was going to come, with an early surge of cases in March. Administration and medical staff leaders came together to devise a plan on how we would handle this new threat; establishing a command center, creating surge plans and capacity to care for those affected, securing PPE, bolstering our testing capabilities, and obtaining therapeutics that may have some benefit. We weathered that initial precipitation quite well, perhaps also lucky that a massive surge did not overwhelm us in the way that it did in other states and localities.

Nationwide, we have approximately 4.5 million cases. Over 150,000 Americans have died. California now leads the country with over 493,000 cases. We have suffered over 9000 deaths. ABSMC has identified and cared for over 468 cases since the start of the pandemic, of which 20 have died. Our current census of COVID patients as of July 30 is 44 cases shared amongst the two campuses. There has been a concerning rise in the overall burden of cases in the community, and as a result, hospitalizations, in the last 2 weeks.

Those numbers above become more personal when among them are our own staff. We recently lost two employees to COVID-19. Janine Paiste-Ponder was an RN on PCU 6 and Juan Salgado was a chef in our Summit café. Both were valued members of our Summit family, and they exemplified the qualities of selflessness and caring that make our medical center so great. They will be greatly missed. I am frightened by the prospect that we will undoubtedly lose more staff members to this deadly disease.

Please know that we are doing everything we can to make this medical center safe for patients and employees. It is absolutely critical that we are consistent with messaging to our fellow doctors and nurses in regards to appropriate PPE, both within and outside the hospital. Miscommunication will only further sow mistrust and fear. Studies have shown that wearing a simple surgical mask while the patient is masked can drastically cut down on transmission. We have an opportunity to model to the community in our personal lives as well, wearing a facemask and eye coverings at all times, even while exercising or being outdoors.  We should not attend large in person gatherings, and limit nonessential travel. Only through concerted efforts inside and outside the hospital can we limit the spread of disease.

A note of positivity:

ABSMC Summit was nationally ranked as a high performing program in bypass surgery, heart failure, and COPD by US News and world report!

https://health.usnews.com/best-hospitals/area/ca/alta-bates-summit-medical-center-6930031#common-care-ratings

Please take care of yourselves and be safe.

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

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

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

President’s Message

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

It looks like the curve has flattened in the Bay Area. Our worst fears that our emergency departments and ICU’s were going to be swamped, thankfully, did not come to pass.

So what now?

As we begin the process of trying to figure out how to open up again, as a state, as well as a hospital, we are left facing new challenges. It is clear that our hospital volumes have diminished substantially during the last few months, but it is equally unclear whether or how we can regain the volume loss. The effects of this pandemic and the associated economic toll are just beginning. Many of our outpatient based practices have seen a significant decline in visits, and only some larger practices have instituted telehealth capabilities. Some of us have had to make difficult decisions to furlough non-essential staff.

As much as we as healthcare providers have worried about how we can safely provide care to our patients, both COVID and non-COVID, our patients have felt that same concern.

This story in the SF chronicle, which features interviews from Dr. Junaid Khan and Dr. Ronn Berrol, summarizes the fears of our patients accessing our medical systems and hospitals.

https://www.sfchronicle.com/bayarea/article/A-shelter-in-place-side-effect-Bay-Area-people-15219842.php#photo-19328615

We are carefully planning how we can address the non-COVID health care needs of our patients, as established disease processes are agnostic to this new kid on the block. It is vital that we do this, not only to adequately safeguard our community, but to maintain financial viability of the hospital. For this, we are asking for your help. Please circulate the below information to your patients and to your staff.

How We’re Managing Non-COVID-19 Care

At Sutter, your health is our main priority. We understand you might have concerns about going to an emergency room or to see your doctor if you don’t have COVID-19 (coronavirus) symptoms. That’s why we want to let you know that if you need any type of care, we’re here for you.

If you have a medical problem, please contact your doctor.
We may be able to schedule a video visit, or you may need to come in to be seen by your provider. If you visit a care center, be reassured that we’re actively isolating anyone with COVID-19 symptoms. All patients are screened before entering the building. It’s important not to delay seeking treatment when you need it.

Our emergency and urgent care facilities are open and ready to provide care.
We’ve taken several steps to make sure you’re safe when you come to our doctors’ offices, emergency departments and urgent care facilities:

  1. Mandatory Masking – All patients and visitors must be masked while in any of our care sites, with specific exceptions.
  2. Isolation – Anyone with COVID-19 symptoms is isolated from waiting areas, patient rooms, entrances and any space that the general population uses.
  3. Cleaning – Our teams are performing extra cleaning and disinfecting in all spaces.
  4. Employee Screening – We’ve instituted mandatory employee temperature screenings before each shift.

You can find out more about the steps we’ve taken to prepare for COVID-19 and answers to frequently asked questions on our website.

If you or someone you know is experiencing an emergency such as a heart attack or stroke, it’s essential to seek care immediately by calling 911 or going to the nearest emergency room.

Thank you for trusting us with your care, and for the support and gratitude you’ve shared for our clinicians on the front lines. Together, we’re #SutterStrong.

SEND TO A FRIEND

I want to thank you all for your resilience. The medicine that we practice now is drastically different than three months ago, and it is incumbent upon us to determine how, as a medical staff, we can envision the shape and direction of healthcare going forward at ABSMC. I am continually impressed with the level of engagement and volunteerism that our medical staff has demonstrated during this crisis.

We rely on our hospital administrative partners: Ursi Boynton, CME, Denise Navelier, CNE, Patty Pilgrim, CFO, to channel that vision, and I want to thank them for the incredible work that they have done to get our hospital ready, to train staff, to procure critical PPE. We welcome David Clark, our new CEO, who has done an amazing job in the last year as our interim CEO, as he helps to lead ABSMC in the challenging times ahead.