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Sadeq Rahimi's Personal Meeting Room - Shared screen with speaker view
Tony V Pham
01:10:19
HI!!!
Tony V Pham
01:11:01
1234
Maria de lourdes beldi de alcantara
01:11:09
Hi everybody
Maria de lourdes beldi de alcantara
01:21:48
I will put my video off, because I can not stop to cough
Maria de lourdes beldi de alcantara
01:22:04
Is it ok?
Sadeq Rahimi
01:22:15
of course, Lou
Maggie Sullivan, Boston Health Care for the Homeless
01:22:35
There are a number of staff from Boston Health Care for the Homeless here this morning who are on the addictions team
Seth Donal Hannah
01:23:35
If I watched MSNBC I would be more worried
Seth Donal Hannah
01:58:06
Long history of racial tensions in Canarsie. Wonder if that forms a backdrop of the nurses attitudes toward the patients.
Tony V Pham
02:02:20
great job!!
Ms Annikki Herranen-Tabibi
02:04:03
thank you so much for this powerful presentation, Kim! i have to jump on another call but can’t wait to welcome you to the spring semester seminar.
Catherine Panter-Brick
02:06:03
I host a seminar in a few, so regretfully, must leave now. Thank you for this fascinating talk, Kimberly!
christophe Millien
02:08:11
How do you deal with the root causes of the structurel racism every day?
Justeen Hyde
02:08:27
Policy changes are a necessary but insufficient step towards change. What are your thoughts about how to change the culture of care - particularly the cultural perceptions of substance use - and the provision of patient centered care for all people (regardless of their substance use)
Courtney Bell
02:12:10
I love the presentation
Courtney Bell
02:12:21
I can't talk at the moment
Courtney Bell
02:12:24
thank you
Sophie Lazar SE
02:12:39
I’m from BHCHP & have a question!
christophe Millien
02:12:52
its about policies, economy, social exclusion
christophe Millien
02:13:13
social suffering
christophe Millien
02:13:45
great presentation
yvbauer1
02:15:52
As someone who moved from CA to MA, I was struck by the attitudes here of "this is how we've always done this; why change it?". I wonder if this is as much of a problem in other parts of the country. Also, whether or not medicine and its Type A personalities make it more difficult to shift gears and think outside the box?
Maria de lourdes beldi de alcantara
02:17:33
Strategies to run from prejudices
Salmaan Keshavjee
02:20:11
I wanted to comment on the former Soviet Union example: we were able to provide TB care in the community of people with SUD using mobile medical units (accompaniment with nurses). Interestingly people felt very linked to the clinic through that.
giwilson
02:22:30
I'm wondering about our use of compliance v.s. adherance. Do the words we use to discribe medication management affect our treatment?
Arlene Katz
02:24:47
salmaan, the key is the ethos of accompaniment and connectedness; walking with people to determine what matters and addressing it.
Maggie Sullivan, Boston Health Care for the Homeless
02:28:06
To Gia's point - choice of words/language is an important reflection of our medical culture. https://www.nada.org.au/wp-content/uploads/2018/03/language_matters_-_online_-_final.pdf
christophe Millien
02:28:53
I like the idea of a political project of innovation
Michael Nathan (he/him/his)
02:29:07
@giwilson: This is a great point. Still I feel like, in medical settings, both terms carry a very similar valence now.
christophe Millien
02:29:08
against structural racism
Michael Nathan (he/him/his)
02:29:52
@Christophe: Agreed!!
Maria de lourdes beldi de alcantara
02:30:38
Agree, wonderful
Maria de lourdes beldi de alcantara
02:31:39
Need to think who the paciente/subjects can received that one way to be attend
Michael Nathan (he/him/his)
02:31:45
@ Arlene and giwilson: I think "medication taking behavior" comes closest, and in the clinic promotes real inquiry into med use (for instance), but it always feels clunky to me.
Maria de lourdes beldi de alcantara
02:31:55
Vice-versa
Michael Nathan (he/him/his)
02:33:36
@Lesley Sharp: THanks so much for your important insight and suggestions for approaches!
Joe Wright
02:34:16
people are in clinic who i need to work with now, i’m so sorry to bomb in and out but Kim grateful for you and your work and looking forward to seeing what you do w your observations
christophe Millien
02:36:28
we need to assess the structural racism in both sides patients and health care providers
Emma Seevak
02:36:42
Related to Dr. Bullon’s comment, I think the label “frequent flier” and the attitudes associated with it can be a form of violence in the medical system.
Emma Seevak
02:37:17
(Which relates to the earlier conversation about terminology)
christophe Millien
02:38:50
policies , economic decisions , social inclusion(food , housing, school for kids etc..) should be seen in both sides
Seth Donal Hannah
02:40:50
It would be interesting to hear the extent to which these negative attitudes toward patients with substance abuse disorder vary distinctively with the ethnicity/race of the patient. Or if the behavioral category (addict, etc) and the valence it carries applies widely across all patients.
Lissie Wahl-
02:41:17
Many of the accounts and observations around the culture of care that have been brought up I see as applying significantly toward marginal language speakers as well .
Maria de lourdes beldi de alcantara
02:41:20
Yes seth
Michael Nathan (he/him/his)
02:42:58
@Emma Seevak; I was just thinking about Grove's article on "The Hateful Patient" (mid 1960s I think). Terms like frequent flyer or the now archaic "crock" definitely lead to a form of dismissive abuse. Grove's points out the counter-transferential underpinnings (mostly a sense of nihilism in the providers) and recommends solutions for improving empathy. We need that kind of approach (as well as political and social change processes) to shift that kind of discourse without simply creating punitive politically correct behavior change.
christophe Millien
02:43:50
good leadership is also an important factor to address structural racism
Maria de lourdes beldi de alcantara
02:48:13
I think we need to think economic neo-liberalismo , who blaime the pacients
Maggie Sullivan, Boston Health Care for the Homeless
02:48:42
Unfortunately, NPs and PAs are required to complete significantly more waiver training hours than MDs
Michael Nathan (he/him/his)
02:50:37
@ Lou: Abolutely!!
Kendyl Salcito
02:53:50
Coming from a place of extreme ignorance, my understanding is that nurses also get drug-tested and that leads them to use opioids for pain rather than other treatments (even if they get injured on the job)... is there an opportunity to build better anti-stigma networks through/with/around nurses who end up with addiction?
Lissie Wahl-
02:54:50
^
Maria de lourdes beldi de alcantara
03:04:17
The paciente is subjects to choose what they want
Michael Nathan (he/him/his)
03:06:17
Perhaps because I'm a clinician, but I'm finding today's presentation and discussion incredibly interesting and germane. Thank you all!
Iman Roushdy
03:07:39
Medicare and Medicaid make 2.5 reduction in reimbursement for hospitals who's patients' evaluations show that their pain is not well managed, and nurses do not respond to calls for paon medication promptly... As a result, you "stay on top of pain" by giving it on schedule, even if patient doesn't ask for it, in anticipation!!!!
Iman Roushdy
03:07:53
2.5%
Iman Roushdy
03:08:55
Also, so avoid a situation where patient asks for pain med when nurses are busy with other tasks.....
Michael Nathan (he/him/his)
03:10:28
@Iman: I don't argue that standing pain meds may be a convenience for staff, but there is also good research data that supports scheduled over as needed pain med administration especially in hospital, depending on the nature of the pain.
Seth Donal Hannah
03:10:51
Great to have so much time for discussion
Michael Nathan (he/him/his)
03:10:54
It actually reduces overall pain med use.
Iman Roushdy
03:11:52
Agreed! I do it often to my patients. But it gets MISUSED AND EXPLOITED BY MANY NURSES!
Kendyl Salcito
03:12:01
Thank you SO MUCH, Kim, and everyone. I wish I could stay longer.
Lesley Sharp
03:12:24
Great Seminar!
Emery Eaves
03:12:58
Thank you so much for the talk! It was really helpful for thinking through some of these issues.
Sophie Lazar SE
03:13:07
this was really amazing, thank you so much
christophe Millien
03:13:59
wonderful talk
Angela Leocata
03:16:52
Thank you very much for this presentation, Dr. Sue! I have a meeting, but your presentation to Prof. Good’s undergraduate seminar was formative in my decision to pursue a phd in Med. Anthropology, and it is very inspiring to hear you speak again!
Maria de lourdes beldi de alcantara
03:16:52
Thank you….
Ralph Blondel Charles
03:17:07
Thank You for such a wonderful lecture!
Tony V Pham
03:17:09
thanks so much! i have to head to lunch soon. appreciate it again
christophe Millien
03:17:15
thank you so much Sue
Seth Donal Hannah
03:19:06
Bye everyone!
Michael M. J. Fischer
03:26:12
Thanks so much, Sue! Fabulous conversation.
Maria de lourdes beldi de alcantara
03:26:56
yes