The Top 5 HealthCity Stories of 2022: A Story of Equity and Innovation in Healthcare
As 2022 comes to a close, it's time to reflect on what we learned in the past year to advance our efforts into the coming year. Throughout the year, HealthCity explored many pressing issues in healthcare today: provider representation without unconsented disclosure of identities, training of new medical residents, gaps in healthcare, and innovation for medical interventions, among so much more. Looking back at 2022, we've identified our most popular stories that are worth another look as we move into a new year.
1. "Is Healthy Sleep for Medical Residents Possible?"
Our first-ever audio series centered on sleep health, specifically for those with notoriously poor sleep schedules: medical residents. In the first episode of the series, residents from across Boston Medical Center departments kept sleep diaries from their real lives on the job and shared tips and tricks for getting a good night's sleep amid a constantly changing schedule, a stressful job, and the buzz of a hospital environment. Sleep experts discuss what BMC is doing to help its residents, how to achieve better sleep health, and the history of how we got here with medical residencies.
Jeffrey Schneider, MD, Associate Chief Medical Officer at Boston Medical Center
"When I was a resident it was almost a badge of honor to say, I've been up for the last 24 or 36 or even more hours than that, but I think we're past that now. I think we are now acknowledging that fatigue — whether that be emotional fatigue, mental, or physical fatigue and burnout — is real.... The fact that we're having conversations like this…we've come a long way, and we certainly have a long way to go."
2. First-of-Its-Kind Study Determines Best Treatment for Severe Peripheral Artery Disease
More than 200 million people have peripheral artery disease, but the best path of treatment for the most severe cases hasn't been studied until now. A new study led by investigators from Boston Medical Center, Brigham and Women's Hospital, and Massachusetts General Hospital has answered the longstanding question about whether surgical bypass or endovascular therapy is the best course of action for patients with chronic limb threatening ischemia — and the answer isn't one-size-fits-all.
Alik Farber, MD, MBA, chief of Vascular and Endovascular Surgery at Boston Medical Center
"Our study provides high-quality clinical evidence to inform the conversations clinicians will have with their CLTI patients about how to best provide treatment to them. Our findings support complementary roles for these two treatment strategies and emphasize the need for pre-procedural planning to assess patients and inform what treatment is selected."
3. Advocating for Patients Everywhere, Even in Flight
When BMC surgeon Andrea Merrill was on a flight to Portugal, a medical emergency arose. Merrill jumped into action with the use of an in-flight medical emergency kit. Though the situation ended up being relatively minor, Merrill noted that the in-flight emergency kit was very outdated, and her tweet about the situation went viral. Her op-ed for HealthCity expands on her viral tweet after the incident and highlights the critical need for an update to these in-flight emergency kits — and how this update is essential to keeping passengers safe.
Andrea Merrill, MD, surgical oncologist, Boston Medical Center
"While the passenger thankfully ended up fine with minimal intervention, I was pretty shocked at how ill-equipped I would have been to take care of a more serious situation like a stroke, cardiac arrest, or overdose. There was no Narcan, Epipen, glucometer or pulse oximeter, and the disposable stethoscope was disassembled and wrapped in plastic."
4. The "Colorado Option" Raises Concerns of LGBTQ Provider Privacy in Path to Health Equity
A first-in-the-nation health coverage plan launching in Colorado, known as the "Colorado Option" is designed to advance health equity. One way it aims to do that is by requiring insurance plans to cover a network of providers that is culturally responsive, mirroring its enrollees in race/ethnicity, gender identity, and sexual orientation. However, some providers have pushed back about self-reporting their own identities — citing privacy concerns and making providers vulnerable to targeting by hate groups. HealthCity spoke with Carl Streed, MD, MPH, FACP, the research lead for the Center for Transgender Medicine & Surgery at Boston Medical Center about this innovative health coverage plan and the concerns that have arisen.
Carl Streed, MD, MPH, PACP, research lead, the Center for Transgender Medicine & Surgery
"Particularly for LGBTQ folks, if you're meeting with a gay doctor or trans doctor, you're likely not going to face discrimination based on your sexual identity or your gender identity. And that's really important, because that's a major barrier for LGBTQ folks, and trouble with accessing care is the experience of discrimination in healthcare. The same can be said around race and ethnicity. Having somebody who shares your racial or ethnic background reduces the concern for and potential experience of discrimination in healthcare… While I support patients having access to more information that helps them make choices about their care, I see the double-edged sword…At the end of the day, I don’t think that sharing this information should be mandatory. Providers should have control over their personal information."
5. Cultural Humility vs. Cultural Competence — and Why Providers Need Both
Boston Medical Center clinical psychologist Shamilia Khan, PhD, is the training director of the Center for Multicultural Training in Psychology at the Boston University Chobanian & Avedisian School of Medicine. In her work and training, she has developed a keen understanding of how healthcare providers can use cultural competence with their patients— but that's far from enough to make a safe, welcoming space for people of all identities and circumstances. We must also entwine cultural humility, a more dynamic process that involves self-reflection among providers and staff.
Shamaila Khan, PhD, clinical psychologist, Boston Medical Center
"A provider operating with cultural humility must listen with interest and curiosity, have an awareness of their own possible biases and attempt a non-judgmental stance about what they hear, and recognize their inherent status of privilege as a provider and be willing to be taught by their patients.
Utilizing one of these frameworks without the other misses the mark, and effective interventions would uphold both. However, intertwining cultural humility and competence into healthcare, ideally, would go beyond individual providers and their patients."