Tagged With "Community Physicians"
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Adverse Childhood Experiences (ACEs) and Community Physicians: What We've Learned [thepermanentejournal.org]
By Brian R. Stork, Nicholas John Akselberg, Yongmei Qin, and David C. Miller, The Permanente Journal, January 24, 2020 ABSTRACT Introduction : The prevalence of childhood trauma, as measured by the Adverse Childhood Experiences (ACE) Study questionnaire, has been studied in a wide variety of community settings. However, little is known about physicians’ familiarity with and use of the ACE questionnaire or the prevalence of childhood trauma in the physician community. Objective: To survey a...
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August Meeting Minutes
Hello everyone, I've attached the meeting agenda from this month's call. Due to some technical difficulties, some of our meeting documentation was lost. However, we started some very important discussions on collaboration, successes in trauma informed care implementation, and obstacles we faced. I encourage everyone to continue having those conversations!
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California Statewide Screening for Child Trauma in Primary Care [ChronicleofSocialChange.org]
California is leading the nation in our response to trauma. Newsom approved a budget in June that will help California move toward universal ACEs screening, a goal that Nadine Burke Harris has long supported. The state is setting aside about $45 million next year to reimburse Medicaid providers in the state for trauma screenings of adults and children, and another $50 million to train 88,000 primary care providers on how to administer these screenings and to respond with trauma-informed...
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Center for Healthcare Strategies: Great Practice-based Resource
I am increasingly finding myself sharing pdfs, infographics from this wonderful organization's site, I am sure most of you have seen it but just in case: https://www.traumainformedcare.chcs.org/screening-for-adverse-childhood-experiences-and-trauma/
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Georgia Health Students Plan Trauma Informed Care Training Day, Oct. 19, 2019
Home to the Center for Disease Control, Atlanta is a city full of great minds focused on all issues related to public health. Despite this, a group of students and faculty at neighboring health professional schools including Emory School of Medicine, Emory’s Nell Hodgson Woodruff School of Nursing, Georgia State University, Morehouse School of Medicine, Mercer University School of Medicine, and the Medical College of Georgia at August University, found that education and awareness around one...
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How trauma-informed care promotes healing: Patient Narrative
So pleased that KevinMD published this patient narrative. I was encouraged to share it here as well! https://www.kevinmd.com/blog/2...romotes-healing.html By MEGAN R. GERBER, MD | CONDITIONS | JULY 26, 2019 As physicians, we face the formidable task of working with patients who appear angry, never content with care or “made better” by anything we do. They may be known as “difficult,” unpleasant, or demanding. These patients are the most challenging and often the least rewarding to care for.
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January TIHCER Zoom meeting
Our next TIHCER monthly meeting will be on Monday, Jan 27 th (3-4p) CT. Binny Chokshi and Daniel Chen will be presenting on their recent publication, Becoming Trauma Informed: Validating a Tool to Assess Health Professional’s Knowledge, Attitude , and Practice (see attached). In addition, Binny will give us her practical wisdom on considering an adaptive leadership approach for ACEs screening. See articles attached. Martina Jelley is inviting you to a scheduled Zoom meeting. Join Zoom...
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Links from Oct. 24 webinar
For all who attended — and who watch today's webinar — thank you for taking the time to do so. Below are some links you requested. Please don't hesitate to contact me if you have other questions. ACEs science and opioid addiction: Addiction doc says: It’s not the drugs. It’s the ACEs…adverse childhood experiences. Bad news-good news: Each additional ACE increases opioid relapse rate by 17%; each ACE-informed treatment visit reduces it by 2% Dr. Sumrok cofounded Integrative Health Centers...
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Medical students' ACE scores mirror general population, study finds
A national survey published in 2014 revealed a disturbing finding. Compared to college graduates pursuing other professions, medical students, residents and early career physicians experienced a higher degree of burnout. Citing that article, a group of researchers at University of California at Davis School of Medicine wondered whether medical students’ childhood adversity and resilience played a role in their burnout, said Dr. Andres Sciolla, an associate professor of psychiatry and...
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Meeting Minutes for September 23rd
Hello everyone! I've attached the meeting minutes to this post. I want to thank Pat Rush and Audrey Stillerman for an incredible presentation on their work at the THEN Center. Just a note- our meeting was recorded and will be posted on this site. I've outlined specific time marks on the document that correlate with topics at the meeting.
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New Analysis Presents Puzzle About Physician Suicide [medpagetoday.com]
By Elizabeth Hlavinka, MedPage Today, February 4, 2020 Female physicians were more likely to die by suicide than women in the general population in recent decades, but the same trend was not observed among male doctors, according to a meta-analysis of nine British and U.S. studies. Compared with the general population, female physicians had a significantly higher suicide mortality ratio (SMR) from the 1980s to date (1.46, 95% CI 1.02-1.91), reported Dante Duarte, MD, PhD, of Harvard Medical...
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RCT of simulation-based communication training improves patient-centeredness & health risk communication
https://www.sciencedirect.com/science/article/pii/S0738399110000340 This article is one of the few (only) RCTs looking at simulation-based communication training relevant to ACEs, which included a 2-year follow-up of observed skills in medical visits.
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The State of the Science on Trauma Inquiry
Beautifully written and well done colleagues! Lewis-O'Connor A, Warren A, Lee JV, Levy-Carrick N, Grossman S, Chadwick M, Stoklosa H, Rittenberg E. Womens Health (Lond) . 2019 https://www.ncbi.nlm.nih.gov/pubmed/31456510
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Tomorrow’s Doctors will Diagnose the Mental Toll of Climate Change [ozy.com]
By Carly Stern, Ozy, July 22, 2019. First-year medical student Anna Goshua was interviewing an emergency room physician in March to learn more about the job when she heard about a patient who had come all the way from Puerto Rico to that ER in Massachusetts for health care. Hurricane Maria had wiped out all prospects of the patient seeking care at home. A surprised Goshua pored over her Stanford University curriculum to learn more about climate migrants. She realized the school offered no...
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Trauma-Informed Care May Ease Patient Fear, Clinician Burnout [jamanetwork.com]
By Bridget M. Kuehn, JAMA Network, January 29, 2020 For many sexual assault survivors whom Anita Ravi, MD, MPH, sees as a New York City–based family physician, the prospect of even basic medical care can be frightening. Some have put off Papanicolaou tests and mammograms for years or even decades. To help them, Ravi has adopted a trauma-informed approach that works to restore patients’ trust and give them a greater sense of control over their visit. This may include asking permission before...
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Trauma Informed Care: Understanding and Responding to the Effects of Adverse Experiences Throughout the Lifespan (Webinar)
Please join the Project Co-Directors (TICHER Members) for an overview of 42 innovative and original (free to the pubic) virtual cases. These cases highlight a patient centered approach to the care of patients who have survived traumatic life experiences. Experiences that include, for example, sexual assault, interpersonal and community violence, military sexual trauma, and child abuse. The virtual cases comprise a comprehensive online training curriculum created for physicians and other...
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Trauma-informed primary care for residents
Andrea Garroway recently joined TIHCER. She published the following article describing a brief interdisciplinary intervention to train medical residents in trauma-informed primary care at a Veterans Affairs hospital. See attached article. "We generated a trauma- informed care curriculum involving five 1- hour didactic sessions, 10- minute group reflection regarding patient interactions prior to each didactic session, and optional patient care observation and feedback."
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UPDATED CALL-IN DETAILS: Trauma Informed Care: Understanding and Responding to the Effects of Adverse Experiences Throughout the Lifespan (Webinar)
Please join the Project Co-Directors (TICHER Members) for an overview of 42 innovative and original (free to the pubic) virtual cases. These cases highlight a patient centered approach to the care of patients who have survived traumatic life experiences. Experiences that include, for example, sexual assault, interpersonal and community violence, military sexual trauma, and child abuse. The virtual cases comprise a comprehensive online training curriculum created for physicians and other...
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Re: Center for Healthcare Strategies: Great Practice-based Resource
Thank you for sharing your experience in using the ACE findings clinically. Attached is an article describing our doing this in a 135,000 adult patient sample where the ACE Questions were integrated into a lengthy medical history questionnaire filled out at home as Step 1 of comprehensive medical evaluation. The benefits were major. Unexpectedly, colleague (but not patient) resistance was also significant. Our getting this information initially by an inert mechanism rather than face-to-face...
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Inside Boston Hospitals, A Reckoning With Racism (WBUR)
By Martha Bebinger, June 19, 2020, WBUR As calls for racial justice continue on Boston streets, conversations have shifted to what’s next. That’s true inside hospitals as well, where the life-long effects of racism play out every day. “You could almost take any chronic disease in America, diabetes, hyper-tension, and there will be higher rates and worse outcomes in Black Americans,” says Dr. Rose Olson, a resident physician at Brigham and Women’s Hospital. “That’s not due to biology or...
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Re: TIHCER June Zoom 2020
This is a very interesting presentation, and I look forward to reading Dr. Strait's article in The Permanente Journal. The subject has great relevance for the military because there is highly suggestive evidence that ACE Scores and their generally not-understood sequelae may be more common in a volunteer military that in a draft military. Attached as Item 3 is an article describing how routine ACE screening was carried out on a very large scale in one Kaiser Department, and its effects and...
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Re: TIHCER June Zoom 2020
Thank you Dr. Felitti for your kind words and helpful attachments. Your paper is so important, especially in light of the military families I work with. Your words are inspiring and transformative: "We realized that asking , initially via an inert mechanism with later followup in the exam room, coupled with listening and implicitly accepting the person who had just shared his or her dark secrets, is a powerful form of doing ."
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Re: Trauma-Informed Telehealth in the COVID-19 Era and Beyond
Thank you for posting @Ellen Goldstein and for your enduring kind support! The pdf is now available and attached.....
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Trauma-Informed Telehealth in the COVID-19 Era and Beyond
https://www.mdedge.com/fedprac/article/225184/coronavirus-updates/trauma-informed-telehealth-covid-19-era-and-beyond Background: The Veterans Health Administration (VHA) entered the COVID-19 pandemic crisis with an existing and robust telehealth program, but it still faces a fundamental paradigm shift as most routine outpatient in-person care was converted to telehealth visits. Veterans are a highly trauma-exposed population, and VHA has long offered effective telemental health services.
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Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context
Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context Given that key perspectives and practices are cemented during medical education, the authors advocate teaching trauma-informed care in UME, including curricular content, clinical skills, and self-care techniques. Taylor Brown, Sarah Berman, Katherine McDaniel, MSc, Caitlin Radford, Pooja Mehta, MD, Jennifer Potter, MD, and David A. Hirsh, MD
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Emergency departments look inward to deepen practices that support traumatized patients
An interdisciplinary team of clinicians from Brigham and Women’s Hospital had a bold idea in 2017. They would completely change the way things worked in their hospital’s emergency department so that the care provided to their patients was infused with a trauma-informed approach. That means recognizing how widespread trauma is and using a myriad of techniques to mitigate its harmful effects among patients, providers and staff. The realization of just how widespread trauma is came to light in...
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Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter (JAMA)
By Donna M. Zulman, MD, MS 1,2 ; Marie C. Haverfield, PhD 2,3 ; Jonathan G. Shaw, MD, MS 1 ; et al January 7, 2020, JAMA. JAMA. 2020;323(1):70-81. doi:10.1001/jama.2019.19003 MOST READ NON-COVID ARTICLES, 2020 Question What are the most promising practices to foster physician presence and connection with patients? Findings This mixed-methods study identified 5 practices that may enhance physician presence and meaningful connection with patients in the clinical encounter: (1) prepare with...
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A Better Normal Community Discussion - Reimagining Health Care
In a conversational style, join physician Drew Factor who will speak with Dr. Tracy Gaudet, Liza Guroff and An é Watts in a discussion entitled "Reimagining Health Care". Dr. Gaudet will speak about her experience engaging in transformational change at the Veterans Administration and how this has shaped the development of her own Functional Medicine Institute , while Ms. Guroff and Ms. Watts will speak about their knowledge of a Trauma-Informed Approach both at a systems (National Council...
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A New Hippocratic Oath Asks Doctors To Fight Racial Injustice And Misinformation [NPR]
First-year medical student Sean Sweat "didn't want to tiptoe around" issues of race when she sat down with 11 of her classmates to write a new version of the medical profession's venerable Hippocratic oath. "We start our medical journey amidst the COVID-19 pandemic, and a national civil rights movement reinvigorated by the killings of Breonna Taylor, George Floyd and Ahmaud Arbery," begins the alternate version of the oath, rewritten for the class of 2024 at the University of Pittsburgh...
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Register now for "Building the Movement with Coalitions", presented by the Campaign for Trauma-informed Policy and Practice, PACEs Connection, and the National Prevention Science Coalition to Improve Lives
Please register now at this link to reserve your spot. You’re invited to participate in Building the Movement with Coalitions, the first of eight remarkable workshops featured in the series, “ Building a National Movement to Prevent Trauma and Foster Resilience ”. The first half-day workshop will occur virtually on January 7th from 1-5pm ET/10am-2pm PT. It focuses on the history and future of the movement and building community-owned, trauma-informed, prevention-focused, and healing-centered...
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Register now! Dr. Bruce Perry to discuss historical trauma and help launch new "Connecting Communities One Book at a Time" book study with his best-seller, "What Happened to You?"
Please join us on June 28 from 1:30-3:00 p.m. ET for a virtual conversation with best-selling author Bruce Perry. Ingrid Cockhren , CEO of PACEs Connection; Mathew Portell , PACEs Connections’ director of communities, and Perry, a psychiatrist and neuroscientist, will engage in a conversation concerning historical trauma and Perry’s best-selling book " What Happened to You? Conversations on Trauma, Resilience and Healing, " which he co-authored with Oprah Winfrey. Please share this blog...