on Mentoring: We Rise By Lifting Others

June 2, 2022 // Randy Glick

---- by Dr. Mohammed Afraz Pasha

“My sixth grade teacher was my first mentor” recalled a mentoring session panelist at a national meeting that I recently attended, adding that he continues to practice the daily routine instilled at a young age by his mentor. His description of this relationship was longitudinal, where his mentor was deeply invested in his intellectual growth for over five years. “A mentor is an individual within or outside your professional circle, who guides you towards growth”, added another panelist contributing to the discussion on effective mentorship. The narratives of their journeys towards matching with the right mentor and of the mentor’s role in their success were inspirational. I was particularly astonished to learn about the culture of “paying it forward”. “The fulfillment experienced when my mentee achieved the desired goals was more than my personal achievement”, said a panelist traversing his journey from the role of a mentee to a mentor.

Relatively new to the concept of mentoring relationships, I was introduced to a mentorship program by my institution when I started my residency. With no past formal mentoring experience, I was paired with my mentor based on my interest and career goal. “How can I help?” were the introductory words from my mentor most often, laying the platform for me to seek assistance without hesitation. It went a long way in instilling comfort while seeking help. I discussed career goals, identified weaknesses, created ideas, formulated working strategies, and worked on constructive feedback with the assistance of my mentor’s wisdom. The key was to have honest discussions to gain insights and benefit from them. In instances where I felt the need for guidance with scholastic activity, I sought the guidance of my mentor.  He not only assisted me but helped me grow. With my mentor investing in my holistic professional growth by acting as a teacher, senior author, and guide, I immensely benefitted and continue to do so from this relationship.

As I have advanced in my career, my junior colleagues have often come to me seeking assistance. The writing skills I developed were useful when my junior colleagues sought help with regard to their scholarly activities. Without realizing it, I had stepped into the shoes of a peer mentor.  The fulfillment I experienced when I saw them excel and achieve was exhilarating. Through medical societies like the SMA, I have seized the opportunity to be a peer mentor to trainees even outside my institution. This experience has confirmed my belief that we rise by lifting others. Physicians will always be presented with opportunities to contribute to others’ growth, eventually helping develop and strengthen our skillset. At the end of the day, these opportunities are a medium of change and betterment.

I call upon physicians-in-training who have been mentees, to grow and transition as effective mentors who foster meaningful mentoring relationships. While we learn from the invaluable insights of our mentors, that wisdom ought to be shared and passed on. This culture of transition is well promoted by societies such as the SMA, where residents are encouraged to sign up both as mentors and mentees. We continue to grow as mentors while simultaneously benefitting from our own mentor’s feedback. Our development as effective mentors involves continued learning and commitment, but it begins with an intention to “pay it forward”.

 

**Bio for Dr. Pasha -

Mohammed Afraz Pasha is a 2nd-year Internal Medicine resident at North Alabama Medical Center and the incoming 3rd-year Chief Resident. He is also a member of the SMA's Physicians-in-Training Committee, serving as a leader for the group's Outreach Subgroup.

on Mentoring: Mentoring in the time of COVID

June 2, 2022 // Randy Glick

---- Thomas J. Nuckton, MD, MS
---Tom is a pulmonary/critical care physician practicing in the San Francisco Bay Area. A California native, he completed med/peds residency training at Tulane, in New Orleans, LA, and returned to California for fellowship training at UCSF, in San Francisco, CA.---

 

To be honest, I almost sent the request to be a mentor into my email trash box. As a practicing intensivist, I was working in an ICU during the COVID pandemic. The last thing I needed was a new project. But driving into work the next morning, I started to reconsider. I had benefited greatly from mentorship throughout my career. Maybe it was time to return the favor, or at least try. In short order, the SMA assigned me not one, but two mentees.

Did I do a good job as a mentor? I’d like to think so, but I don’t really know. In retrospect, the year, with COVID’s impact, often seems blurry. But I do have a few reflections on mentoring.

I enjoyed being a mentor far more thant I thought I would. I genuinely looked forward to Zoom sessions with a mentee in the evening – me often with a bowl of soup at the end of a long day. Although I don’t consider myself to be overly considerate, I have to admit that I found myself thinking about my mentees quite a bit. What insights from my past could I give to their current situations? What might help their applications to residency or fellowship? How best to navigate the complexities at their level of training? Both mentees worked in regions with high levels of COVID; I offered support when I could, but both were already showing amazing character and resilience.

I felt immense pride when one mentee, a 4 th year medical student, matched into a fantastic internal medicine residency. And frustration when the other, a resident in a rigorous county program, didn’t match in cardiology – frustration not with the mentee but with a system that often seems capricious.

(Undaunted, the mentee has already started to re-apply). Regardless of their career goals, both mentees have fantastic personalities, ideals, and dedication. Getting to know them was a privilege.

Final thoughts: If you’re considering becoming a mentor – give it a try. Grab a bowl of soup and login to Zoom. Listen. Do your best. And be prepared to be surprised. You might find the experience to be far more rewarding than you imagine.

Posted in: Physicians-in-Training

Benefits of Telemedicine

May 20, 2022 // Randy Glick

The Benefits of Telemedicine

by JBrigham

Telemedicine has a long and illustrious history. With each innovation in communication technology, medical care has expanded its outreach and lowered costs. Healthcare writer Josh Heurung reports that the first known use of telemedicine was done via telegram in the 1840s. Union army physicians used telegrams to assist in the care of soldiers in the American Civil War.

As time went on, telemedicine evolved with the technological advancements of the time. By the 1910s, it was being conducted via telephone. Then hospitals began using televisions to transmit images to each other in the late 1940s. The advent of the Internet finally brought us the telemedicine we know today.

Modern telemedicine essentially shares the same purpose as it did nearly 200 years ago: to bring healthcare to those who need it the most. With all the advancements we’ve achieved in the medical field, this means that telemedicine is exceedingly useful for our society’s senior citizens. So with that in mind, here are a few benefits they can reap from telemedicine today.

Accessibility

This is arguably one of the most prevalent issues currently in healthcare. Telemedicine provider Wheel explains that barriers to accessibility in healthcare are more commonly experienced by seniors. Many are uninsured, have mobility impairments, or live in rural areas, which can affect their ability to visit medical facilities in-person. Others may not be able to afford healthcare services. The fact that wait times to book doctor appointments can be quite long further complicates these issues.

Telemedicine can help seniors overcome all of these barriers. Appointments can also be set at the convenience of both the healthcare worker and their patient, helping seniors forego wait times entirely. Since they’re remote, there may be no need for seniors with mobility impairments or who live far from urban centers to leave their homes. Telemedicine can be cost-effective as well – it eliminates the need for transportation and may be cheaper than a traditional doctor’s appointment. Finally, it’s available even to those without medical insurance.

Affordability

For the average American, healthcare is already expensive. Over 55% of Americans have medical debt because of things like emergency room (ER) visits, COVID-19 treatments, and mental health treatments. Seniors in particular can be more vulnerable to falls and severe cases of COVID-19, which in turn may bring about the need for such trips to the ER and COVID-19 treatments.

Because telemedicine can be cheaper and more convenient than in-person appointments, seniors can make appointments more proactively — and avoid costs associated with these incidents — by addressing medical issues before they become more serious over time. Many telemedicine platforms also integrate features that physicians can use to consult specialists and even to order lab tests and prescriptions. This streamlining of medical care can allow seniors to pay less for these services.

 Continuous Quality Care

Finally, the accessibility and affordability of telemedicine services makes it easier for seniors to get these services over a longer period of time. Via teleconference, healthcare providers can easily prescribe and monitor the entirety of any treatment plans they prescribe to elderly patients. Seniors will also find added value in the fact that telemedicine can be used in line with the Internet of Things, which is essentially a network of Internet-enabled devices. This allows healthcare providers to practice medicine beyond remote video conference calls.

Wearable devices — like smart watches that monitor user vital signs — can record patient information and transmit them directly to healthcare professionals so seniors can receive the majority of treatments from their homes. We’ve mentioned that additional safety precautions need to be taken for patients with conditions like Alzheimer’s — and here more specialized instruments like senior safety alert devices can help. Much like a home security system, these devices immediately alert emergency personnel in case of incidents like a fall.

Telemedicine offers seniors three key benefits: accessibility, affordability, and continuous quality of care. Although that may sound like very few, these benefits are enough for telemedicine to begin improving the collective health of America's senior population. 

Content solely for the use of sma.org

Content by: JBrigham

SMJ: May 2022 Vol. 115, No. 5

May 3, 2022 // Randy Glick

The Southern Medical Journal(SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists, including medicine; surgery; women’s and children’s health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices.

The Role of Anticipation in Patient Adherence

Peter M. Nguyen, MS, Patrick O. Perche, BS, Steven R. Feldman, MD, PhD

A Narrative Review of Medical Interpretation Services and their Effect on the Quality of Health Care

Stacie A. Schlange, BS, Angela L. Palmer-Wackerly, PhD, Virginia Chaidez, PhD, RD

Sex Education and Sexual Risk Behavior among Adolescents and Youth in the Deep South: Implications for Youth HIV Prevention

Paul A. Burns, PhD, MS, Fei Teng, MPH, PhD Candidate, Angela A. Omondi, PhD, E. Thomaseo Burton, PhD, MPH, Lori Ward PhD, MS

Facilitating the Advance Care Planning Conversation with Patients: An Interactive Virtual 1.5-Hour Session

Suzanne Minor, MD, Marquita Samuels, MBA, Sanaz Kashan, MD, Marcos Milanez, MD, Jorge Camilo Mora, MD

Webinars and Continuing Medical Education: Pros, Cons, and Controversies

Rodrigo Martín Torres, MD, Víctor Reviglio, MD, Iván Basanta, MD, Divya Srikumaran, MD

Multidrug-Resistant Bloodstream Infections in Internal Medicine: Results from a Single-Center Study

Edoardo Pace, MD, Christian Bracco, MD, Corrado Magnino, MD, Marco Badinella Martini, MD, Cristina Serraino, MD, Chiara Brignone, MD, Elisa Testa, MD, Luigi Maria Fenoglio, Massimo Porta

Annual FEV1 Loss in Patients with Noncystic Fibrosis Bronchiectasis and Affecting Factors

Sermin Borekci, MD, Sule Gundogdu, MD, Deniz Ongel Harbiyeli, MD, Benan Musellim

Vessel Sealant Devices in Thyroidectomies: An ACS-NSQIP Study

Zoltan H. Nemeth, MD, PhD, Karen Kong, BS, Richard Hwang, MD, Sara S. Soliman, BS, Rolando H. Rolandelli, MD

The Doctors in the House: Examining Physician Legislators in the US Congress from 2011 to 2020

Bharat Kumar, MD, MME, Manish Suneja, MD, Melissa L. Swee, MD, MME

Developing Awareness and Allies: Simulating Difficult Conversations about Microaggressions for Faculty and Students

Allison Kumnick, BA, Khushali Shah, MD, MPH, Carly Muller, MD, MPH, Kasha Bornstein, MD, MPH, Hanna Perone, MD, MPH, Alexandra Herweck, MD, MPH, Samantha Syms, MS, CHSE, Saily M. Gutierrez, BS, Paul Mendez, MD, Sarah Bland, MD, Gauri Agarwal, MD, Monica Broome, MD, Julia Belkowitz, MD, MPH

Vaccination of Children in the United States against COVID-19: An Ounce of Prevention

Sarah K. Wood, MD, Dennis G. Maki, MD, Charles H. Hennekens, MD

Relationship between Sociodemographic Factors, Perceived COVID-19 Risk, and Engagement with Health Protective Behaviors

Jennifer A. Andersen, PhD, Brett Rowland, MA, Shawn M. Ratcliff, PhD, Holly C. Felix, PhD, Pearl A. McElfish, PhD

Posted in: SMJ

Gas Station Drugs

April 25, 2022 // Randy Glick

They are in nearly every gas station, all claiming to improve or enhance your life. But what is actually in them? Why does nearly every gas station seem to carry them? This webinar gives insight from Investigator Dustin Gray of the Montevallo Police Department/Alabama State Drug Task Force pulls back the curtain on some of these highly addictive, yet readily available and legal, drugs.

*Courtesy of Safe and Healthy Homewood Coalition

Prom Safety

April 21, 2022 // Randy Glick

Courtesy of Carissa Anthony, MS

Prevention and Development Coordinator, Safe & Healthy Homewood Coalition

Spring is here, and there is a mix of angst and excitement in the air that can only mean one thing…Prom! We all want prom to be a memorable and positive experience for our children, but post-dance celebrations can be a time for risky behaviors and unhealthy choices. With careful planning, open communication, and appropriate monitoring, parents can ensure teens have fun and stay safe while making lasting memories with friends.

Tips for a Safe and Healthy Prom

  • Tell your teen you love them and your main concern is their health and safety.
  • Make sure they know you expect them to celebrate without alcohol or other drugs.
  • Make sure they know you do not want them to ride with anyone that has been drinking or using other drugs.
  • Discuss plans for post-dance celebrations. Call the host parents and ask questions about supervision. Make sure alcohol and other drugs will not be allowed.
  • If you are hosting a post-dance celebration, call in reinforcements. Ask other parents to help chaperone. Set a clear policy of no alcohol or other drugs.
  • Discuss risky situations that may arise and positive ways to handle them. Ask your teen to think of suggestions too. Together you can develop a plan, such as this X-Plan, that allows for a comfortable exit strategy in difficult or dangerous situations.
  • Sign a contract with your teen that clearly states your expectations and your commitment to support them. Download a sample contract here.
  • If you are using a limousine service, speak directly to the driver and discuss your expectations for a drug and alcohol free ride. Tell the driver you do not want any stops made on the way to and from the dance.
  • Meet your teen when they return home.
    • Talk to your teen about their evening. Compliment them on good choices they made.
    • If they are impaired, do not let them go back out and assess to determine if medical assistance is needed.

Bio
Carissa Anthony is the Prevention and Development Coordinator for Homewood City Schools and serves as the Coordinator of the Safe & Healthy Homewood Coalition. She has over 20 years of experience in prevention.

Carissa grew up on a family farm in south Alabama. She received her Bachelors from Auburn University and Masters from Georgia State University in Professional Counseling. She began her career as a community educator with the University of Tennessee and then with the University of Florida. In 2002 she and her husband moved to Birmingham and Carissa became the Prevention Coordinator for Hoover City Schools and coordinated the Hoover Coalition, a youth drug prevention coalition. In 2004, while serving as the Coordinator of the Hoover Coalition, Carissa received an award from the Office of National Drug Control Policy, for the Coalition’s successful efforts in reducing youth substance use. In 2007 she was a special guest at a Presidential Press Conference held by President George W. Bush recognizing outstanding drug free community coalitions.  Working at the local level, helping communities come together to support healthy youth development is Carissa’s life work and passion.

Carissa is married to John Anthony who is a Traffic Engineer with the City of Hoover. She has two lovely daughters and a very energetic golden retriever.

Posted in: Patient Education

Autism Acceptance Month

April 11, 2022 // Randy Glick

Autism Acceptance Month, previously named Autism Awareness Month, is being held this month, with the aim of celebrating and promoting acceptance for the condition.

Autism is a complex developmental condition with a wide range of subtypes which affects a person's ability to interact with others and progress along physical and mental milestones at a typical pace. The annual initiative first took place in 1972, promoted by the Autism Society. It calls for greater public awareness and acceptance, encouraging all of us to be more inclusive toward people with autism.

Around the world this month, events are underway to encourage people to promote autism acceptance. The Office of Autism Research Coordination, at the National Institute of Mental Health, stated that they "recognize the need for supporting, understanding, accepting, including, and empowering of people on the autism spectrum".

The UN Secretary General, Antonio Guterres, made a statement on World Autism Awareness Day, April 2. He affirmed the UN’s support of the rights of people on the autism spectrum to fully participate in society, in line with the Convention on the Rights of Persons with Disabilities and the 2030 Agenda for Sustainable Development.

Secretary Guterres said, "Many persons with autism still live in isolation, discriminated against and disconnected from their communities, in institutions or even in their own homes. The Covid-19 pandemic has exacerbated many of these inequalities through the loss or reduction of services at school, in homes and in the community."

He continued, "We need to ensure that the rights, perspectives and well-being of persons with disabilities, including those with autism, are an integral part of building forward better from the pandemic."

The solution, he believes, lies in more community-based support systems for people with autism, as well as inclusive education systems, training programs, and suitable technology solutions - all developed in active consultation with persons with disabilities and their representative organizations.

Autism is thought to be associated with a combination of genetic and environmental factors, with much of the research focusing on possible genetic causes. Many people with autism also have additional physical health conditions such as epilepsy or mental health conditions such as anxiety or depression.

The genetic basis of autism remains poorly defined and this complex disorder may have a number of distinct causes that may co-occur. Recent genetic and genomic studies have implicated a large number of genes in autism, and some of the latest work has looked at genes that control synaptic proteins in brain cells, suggesting that synaptic dysfunction may have a critical role in autism.

A study by Dr. Steven Clapcote and colleagues at Leeds University, UK, investigated whether a reduction in the action of a gene called NRXN2 would cause autism in animal studies. They used mice with the same alteration in NRXN2 as seen in some people with autism. This did indeed lead to behavioral features similar to autism symptoms. "In other respects, these mice were functioning normally," said Dr. Clapcote. "This is exciting because we now have an animal model to investigate new treatments for autism."

These findings appeared in the journal Translational Psychiatry. The researchers add that the genetically altered mice replicated some of the core symptoms of autism such as reduced sociability and heightened anxiety under stress, while showing no impairment in intellectual ability. The team concludes, "Recent genetic and genomic studies have implicated a large number of genes in autism, many of which encode synaptic proteins, indicating that synaptic dysfunction may have a critical role in the genesis of autism-related behaviors." These mice "may thus provide a useful experimental system for the exploration of disease mechanisms and novel treatments in autism", they believe.

Certain antipsychotic drugs used for the treatment of autism, as well as schizophrenia, are being investigated due to their effect on this group of genes. "We don't fully understand how the drugs used to treat schizophrenia and some symptoms of autism work," explains Dr. Clapcote. "If we can show they can affect mice with this particular genetic mutation, then it gives us a clue to better understand the illnesses and opens up the possibility of more targeted treatments with fewer side effects."

"However, these illnesses are complex," he adds, "involving not only inheritance, but other factors such as environment and experience. It's possible the genetic mutation might create a predisposition, making people more likely to develop autism or schizophrenia."

A recent study has looked at links between a genetic predisposition for autism and adverse outcomes, such as self-harm and suicidal thoughts. This represents "complex gene-environment interactions", and highlights "potential mediators of this shared biology", say researchers led by Dr. Varun Warrier at the Autism Research Center at Cambridge University, UK. They point out in Molecular Psychiatry that there is an urgent need to understand and address these links, but that “only a handful of studies have investigated variables that contribute to and mediate this association”.

Their study analyzed genetic information on 105,222 individuals from the UK Biobank, and identified significant correlations between the genetic predisposition for autism and self-reports of childhood maltreatment, thoughts of self-harm, and actual self-harm. “A better understanding of these issues is critical to improving wellbeing in autistic people”, said the lead researcher, Dr. Warrier. "While we have found an association between a genetic likelihood for autism and adverse life events, we cannot conclude the former causes the latter.”

“We suspect this association reflects that genes partly influence how many autistic traits you have and some autistic traits such as difficulties in social understanding may lead to a person to be vulnerable to maltreatment.

“This research highlights the risks of such adverse outcomes for those with a high number of autistic traits, if adequate safe-guarding and support aren't provided."

Could an intervention early in life positively impact autism symptom severity and improve developmental outcomes? This possibility has been explored by researchers from Australia and the UK.

Dr. Andrew Whitehouse of the University of Western Australia and his team suggest that an early parent-led intervention may benefit infants with autism spectrum disorder-related behaviors. The researchers examined an approach that could begin well before clinical diagnosis is possible.

Writing in JAMA Pediatrics, they explain, "Intervention for individuals with autism spectrum disorder typically commences after diagnosis. No trial of an intervention administered to infants before diagnosis has shown an effect on diagnostic outcomes to date."

They conducted a randomized trial including 103 infants aged 9 to 14 months with early behavioral signs of autism. One group of children was given the therapy which used video feedback to help parents understand their baby's abilities, so they can use them as a foundation for future development in areas such as social engagement, sensory behaviors and repetitiveness.

Among those given the intervention, 7% met the diagnostic criteria for autism at three years, compared with 21% for those who received usual care. This represents "a statistically significant reduction in the severity of autism behaviors across early childhood", they report.

Professor Jonathan Green of the University of Manchester, UK, said, “These findings are the first evidence that a pre-emptive intervention during infancy could lead to such a significant improvement in children’s social development such that those receiving the intervention then fell below the threshold for a clinical diagnosis of autism." He added that the intervention "works with each child’s unique differences and creates a social environment around the child that helps them learn in a way that is best for them".

It remains unclear what gives rise to the diversity within the autism spectrum or why some people with autism have better outcomes than others. Work continues around the world to understand the biomedical causes of autism, to evaluate promising interventions, and to improve the health and wellbeing of people with autism.

The understanding of autism has improved a lot since research into the condition began. But there is still much more we need to know to improve the quality of life and outlook for people with autism and their families.

 

References

Dachtler, J. et al. Deletion of a-neurexin II results in autism-related behaviors in mice is published in Translational Biology. Translational Psychiatry, 26 November 2014 doi: 10.1038/TP.2014.123
www.nature.com/tp/journal/v4/n11/full/tp2014123a.html

Warrier, V. et al. Childhood trauma, life-time self-harm, and suicidal behaviour and ideation are associated with polygenic scores for autism. Molecular Psychiatry, 29 October 2019 doi: 10.1038/s41380-019-0550-x
http://dx.doi.org/10.1038/s41380-019-0550-x

Whitehouse, A. J. O. et al. Effect of pre-emptive intervention on developmental outcomes for infants showing early signs of autism: A randomized clinical trial of outcomes to diagnosis. JAMA Pediatrics, 20 September 2021 doi:10.1001/jamapediatrics.2021.3298
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2784066

Posted in: Medicine & Medical SpecialtiesWomen’s & Children’s Health

Simple Ways to Teach Your Child About Self-Care

April 7, 2022 // Randy Glick

By Janice Russell

Kids were dealing with isolation, cyberbullying, and other issues before the pandemic. But the restrictions and fear of a global health crisis made such issues even more prevalent among kids of all ages. Among other factors, limited in-person interactions, mask-wearing, and an increased reliance on virtual environments have contributed to more suicide attempts among children since early 2020. 

In other words, self-care has never been more important — for adults and kids alike. If you want to learn how to introduce your child to healthy self-care routines, your first step is to start with yourself. Once you commit to being your kid's self-care role model, there are countless activities to try that can help them foster their health and well-being. SMA has listed a few tips to get you started!

Modeling Self-Care      

It likely comes as no surprise that the most effective way to teach your child healthy self-care routines is to model them yourself. This means that you should try your best to foster your own physical, mental, and emotional health because your child will notice the steps you are taking. Along with abiding by a nutritious diet, try to find an exercise routine that fits your lifestyle and needs, and make sure you are getting adequate sleep each night.

Your child will also be able to tell if you are stressed out, which will influence their health and well-being. If work has you overwhelmed, look for ways to alleviate the stress (or at least reduce it). 

If you work from home, you probably have more freedom to make changes to your work schedules than if you had a traditional desk job. Mixing up your routine can go a long way in making your day-to-day more interesting and reducing stress. For example, if you work from 9 a.m. to 5 p.m., consider working 8 a.m. until 4 p.m. a couple of days a week. 

Creative Activities

Whether or not your child is naturally creative, they can benefit from activities and movements that provide an outlet for expressing their thoughts and emotions. For instance, try a few drawing, painting, coloring, or musical activities, and see if it doesn’t help their mood!

Fortunately, there are plenty of online resources for ideas and plans. Another activity to consider is dancing; whether you dance to a workout video together or hold an impromptu dance-off, something about moving and letting go does wonders for the soul.

Screen Breaks

Adults and children spend a lot of time staring at electronic screens. And if you have a teenager, it might seem like they are on their device than they are not. Encourage your child to spend time away from their phone, tablet, computer, or video games. Fill the space with holistic activities like cooking a meal, listening to music, patining, practicing yoga, or doing any other activity that can reduce stress and promote wellness.

Acts of Kindness      

Despite how it sounds, self-care is not always all about the self. Doing things for other people allows us to take our minds off ourselves for a moment and make a difference in their lives. Consider signing your child up to volunteer at a local charity, or make a gift or offer a helpful service to their teacher, friend, or other important figures in their life.

Compassion Breaks

The next time your adolescent experiences a stressful event, show them how to acknowledge the challenging moment and explain how stress and struggles are common in life. This will show them that they are not alone while also allowing them to embrace the circumstances. Then, teach them to ask themself how they can be kinder to themself, whether it means reciting a self-affirmation or engaging in a fun and relaxing activity.

 

There is no getting around that mental health issues are on the rise since the beginning of the pandemic. If your child doesn’t know how to implement self-care in their life, now could be the ideal time to teach them. Consider the tips above for showing your kid how to foster their health and well-being. And keep looking for other ways to equip them with the mindset and habits to keep them thriving through the challenges ahead.

 

About the Author: 

Janice Russell believes the only way to survive parenthood is to find the humor in it. She created Parenting Disasters so that parents would have a go-to resource whenever they needed a laugh, but also to show parents they aren’t alone. She wants every frazzled parent out there to remember that for every kid stuck in a toilet, there’s another one out there somewhere who’s just graced their parents’ walls with some Sharpie artwork!

Would you like to read more helpful content or learn about our medical organization? Visit SMA.org today!

Posted in: Mental HealthPhysicians-in-TrainingWomen’s & Children’s Health

Abstracts from the 2nd Annual Physicians-in-Training Leadership Conference are now available!

April 6, 2022 // Randy Glick

Session 7A - Emergency & Disaster Medicine; Surgery & Surgical Specialties; Quality Health Care, Patient Safety & Best Practices

A Comatose Patient: A Systematic Approach To Diagnosis And Management In An Emergency Room Setting, Niyati Patel, BS

Addressing Disruptions In Care: A Study Of Chronic Disease Exacerbations In An Underserved Community Following Hurricane Ida, Yichi Zhang, BS

Nutritional Management for Obese ESRD Patients Planning to Undergo Bariatric Surgery Prior to Kidney Transplantation, Valeria Noguera, BS, MS

A Systematic Review Evaluating the Risks and Benefits of Different Methods for Pain Management Following ACL Reconstruction, Aditya Vinjamuri, MS

Alcoholic Neuropathy: An Unusual Polyneuropathy Seen in a Rural ED, Katie Falkner, MD

A rare case of adult ileo-ileal intussusception secondary to small bowel squamous cell carcinoma treated by exploratory laparotomy and small bowel resection, Emana Sheikh

Difference in nosocomial infection rates of inpatients since the adoption of a “hospital laundered scrubs” only policy at a rural regional health center, Gunnar Orcutt, BS and Christian Mitchell

Session 7B - Medicine & Medical Specialties; Mental Health

Non-Hodgkin's lymphoma presenting as an ischemic stroke in a elderly male, Kavitha Juvvala, MD

Irreversible monocular vision loss in times of pandemic, Harsh Sharma, MBBS, MD

Large Dermoid Cyst Masquerading as a Thyroglossal Duct Cyst, Zaydi Javeed, MD, BS

A Rare Case of Tricuspid Valve Endocarditis caused by Serratia Marcescens, Masi Javeed, MD, BS

Pre and Post-Treatment MRI Brain Imaging Findings in Non-Alcoholic Wernicke’s Encephalopathy, Zaydi Javeed, MD, BS

A Case of Systemic Paradoxical Embolization through Patent Foramen Ovale Causing Acute Right Renal Infarction, Masi Javeed, MD, BS

Resilience to Mental Fatigue in Sports Performance, Caitlin Drakeley, BA

Left sixth cranial (abducens nerve) and right seventh nerve (facial nerve) palsy in the setting of an extracranial mass and vascular disease, Francis Demiraj

Session 9A - Surgery & Surgical Specialties; Medicine & Medical Specialties

A Diagnostic dilemma- Bradycardia with Premature Ventricular Contraction, Richi Kashyap, MD

A challenging case of Metastatic Mucosal Melanoma, Sangeetha Isaac, MD

A Fast Pass for Motor Vehicle Accident Patients: Expediting Time to Surgery Reduces Their Mortality, Magnus Chun

Techniques for Preserving Endothelial Glycocalyx when Using Electron Microscopy, Jacob Packer, BSE and Aaron Cotton-Betteridge, BS

Morphology of the Groove of the Inferior Petrosal Sinus: Application to Better Understanding Variations and Surgery of the Skull Base, Uduak-Obong Ekanem, BA, MS

Cocaine associated Cardiomyopathy, Richi Kashyap, MD

Session 9B - Medicine & Medical Specialties

A Rare Case of Polymicrobial Infection with Pseudomonas stutzeri Urinary Tract Infection in a Patient on Sarilumab, Jordan Torres, MD, BS

You Are What You Eat – A Case of Benign Skin Jaundice, Mary Ileso, DO 

Covid vaccine causing life threatening Right ventricle thrombus from breakthrough covid infection, Kaur Sukhmanjot, MBBS/MD

Mechanical Thrombectomy with INARI Flowtriever Device for Massive Pulmonary embolism with GI bleed, Kavitha Juvvala, MBBS, MD

BLASTOMYCOSIS: A GREAT MIMICKER, Abhinav Vyas, MD

A Rare case of Immune Thrombocytopenic Purpura Secondary to Clopidogrel, Haroutiun Hamzoian, MD and Lakshmi Tatineni MD

The Mass that Engulfed Four Organs: IgG4 Related Disease Presenting as a Large Abdominal Tumor in a Young Hispanic Female, Christine Loftis, MD, BS and Sonya Montes, MD

A Rare Case of Diabetic Myonecrosis, Khin Win, DO

Breaking Barriers: A Case of Leptomeningeal Disease, Ariadna Fernandez, MD

The Effects of Osteopathic Manipulative Therapy and Topical Diclofenac Sodium on Osteoarthritis, Veenah Francis, BS and Adam Hurwitz, BS

Session 12A - Women's & Children's Health; Medicine & Medical Specialties

Ultrasound Findings of Pre-Dissection Axillary Lymph Nodes in Breast Cancer Patients, Ruby Arora, BA and Lauren Mueller, BA

Enterotoxigenic Escherichia coli enterotoxins modulate IL-1 signaling and alter mucosal immunity, Natalya Motyka

Breakthrough Case of COVID-19 in a Fully Vaccinated Patient, Junaid Alam, DO

Cefepime Neurotoxicity a commonly delayed diagnosis, Melissa Hidalgo, Doctor of Medicine

Clinical Conundrum: A Rare Case of Osteomyelitis Posing as Metastatic Disease, Natalie Weiss, BA, BS

An Unfortunate Trio: Esophageal Kaposi Sarcoma, Immune Thrombocytopenia, And Uremia-Induced Platelet Dysfunction, Yichi Zhang

Plasmapheresis in Conjunction with Extracorporeal Membrane Oxygenation in a Patient with COVID-19 Pneumonia, Nathaniel Kim, MD

Gynecomastia with Dasatinib Use in Chronic Myeloid Leukemia, Natalie Torrente, MS, DO

Session 12B - Bioethics & Medical Education; Medicine and Medical Specialties

Resident Duty Hour Shift Length and It’s Association on Resident and Patient-Based Outcomes: A Systematic Review and Meta-Analysis of Randomized Control Trials, Andrew Sephien, MD

Design and Implementation of a Leadership Assessment Instrument to Evaluate Medical Student Leadership in Team-Based Simulations, Mary Mahaffey, BSBE

An Electronic Medical Record Pocket Guide for Incoming Internal Medicine Interns: Perceptions and Impact on Patient Information Gathering, Andrew Sephien, MD

Educating Our Future Academic Physicians: A Look at the Current Education of Medical Student Research, Magnus Chun, BS

Unveiling Hidden Patterns: Analysis of Recommendation Letters in General Surgery Residency Match, Magnus Chun, BS

Concomitant Primary and Secondary Adrenal Insufficiency due to Immune Checkpoint Inhibitor Therapy, Eileen Montalvan, MD

The Effects of E-cigarette Use on Cardiovascular Health:  A Systematic Review & Meta-analysis, Rishan Jeyakumar, MD and Saloni Shirke, MD

Session 13A - Public Health & Environmental Medicine; Mental Health; Medicine & Medical Specialties

Ambient Ultraviolet Exposure Decreases Thyroid Cancer Risk in Black Populations: A Multiethnic Study, Tessa Lavorgna, BS

Increasing Mississippi’s HPV Vaccination Rate: A Proposal Based on Providers’ Insights, Madison Thornton, BA

THE IMPACT OF GUT MICROBIOTA ON COGNITIVE DEVELOPMENT, Tara May, Masters of Science

MYRIAD OF PRESENTATIONS AND OUTCOMES OF POST-GUNSHOT INJURY INFECTIONS: A FOCUSED CASE SERIES, Yichi Zhang, BS

Spontaneous LAD in a 62 Year-Old Lad: A Case Report, Adele Soutar, MD

High Ferritin And High TIBC: A Case Of Anemia With A Uniquely Paradoxical Iron Study, Yichi Zhang, BS

REFINING PAIN MANAGEMENT IN CRYPTOCOCCAL IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME, Yichi Zhang, BS

ACUTE AND CHRONIC INFECTIOUS COMPLICATIONS FOLLOWING GUNSHOT INJURIES: A CASE COMPARISON, Yichi Zhang, BS

Proteoglycan Dysregulation in Chondrodysplasia Disorders: A Narrative Review, Tessa Lavorgna, BS

Session 13B - Medicine & Medical Specialties

There’s more to ICU than COVID-19: Simulation based training for core trainees, Matilda John Ravindran, MMBS, DA, MMed, MRCA

Anchoring on Ketoacidosis in the presence of the Unforeseen Thyroid Storm, Vanessa Nwaiwu, BS

Calcific Uremic Arteriolopathy After 22 Years on Hemodialysis Leading to a Fatal End, Aksiniya Stevasarova, MD

EVALI, diagnosis of exclusion in the age of COVID, Victor Camba, DO, MEd, MS and Daga Olsen, MD

Extensive Venous Thromboembolism and Massive Pulmonary Embolism in a Middle-Aged Male with Polymyositis Flare Up, Aksiniya Stevasarova, MD

A 6-Year Retrospective Study of Intraocular Len Exchange, Veshesh Patel, BS

Complicated Choledocholithiasis with Acute Cholangitis and Gallstone Pancreatitis with Lipase of 40,000, Aksiniya Stevasarova, MD

An Autoimmune Concoction: The Difficult Diagnosis of a Cavitary Lung Lesion, Bray Aron

Anticonvulsant Hypersensitivity Syndrome in a Patient with Phenytoin Toxicity, Sucheta Kundu, MD

Pheochromocytoma: A Rare Etiology of Hypertension in the Pediatric Population, Omar Cardona, BS

Posted in: Physicians-in-Training

On Mentoring: Sangeetha Isaac

April 4, 2022 // Randy Glick

By Sangeetha Isaac, MD

Sangeetha is a second year Internal Medicine Resident at North Alabama Medical Center, Florence, Alabama.


My First Mentor

July 2011, India.

I went to the Department of Medical Oncology looking for my professor. Through the door I could see him, seated at his desk, reading something on his desktop. I hesitated a moment, thinking. I do not have an appointment to meet him. He is the Chief. Should I still go in? After telling myself it was alright to meet without a prior appointment, I said, “Excuse me, Sir, may I come in?” He turned around, looked at me, and smiled. “Yes Sangeetha, please come in!”

I went in, made myself comfortable, and started speaking while he was still looking at me, not knowing why I was there. “Sir, I have thought about this a lot. I am interested in Oncology and would like to pursue a career in Oncology,”’ I said. He was still looking at me, nodding his head without interrupting. I continued after a brief pause. “I came to seek your advice on how to proceed.” There it was! I had just identified the need for a mentor and spotted the right one.

I had rehearsed a few conversations in my mind. I thought he would say something like, “You have to study hard, be an outstanding physician,” etc. But, instead, he said, “You have to make your work do the talking.” I was perplexed. How do I do that? How do I make my work do the talking? I left his office that day with these thoughts.

The next day, I went to work and made sure my work spoke of my interest in oncology for the next 15 months that I spent in the department. I signed to be the research officer in medical oncology, taking the responsibility of co-investigator on five different multicentre clinical trials, while I was actively involved in oncology-related clinical work and preparing for the post-graduate examination.

Fast forward to March 2013. I received an offer to relocate to Singapore to work for the Ministry of Health Holding, Singapore. This was one of the most difficult decisions I had to make. Leaving the comfort of the known and venturing into a world of the unknown. I met my mentor again to ask if this was the right decision. He looked up and smiled. “This is your life, and you get to live it once,” he said. I instantly knew what I should do.

March 2022, USA.

After a 7-year stint in Singapore, now a resident physician in the United States, I am more familiar with the culture of mentorship. I know the importance of identifying the right mentor and know that mentorship is crucial for professional development and success. I have had several mentors from then till now, who have advised me, guided me, supported me, and placed me on the trajectory to success in professional life. But the words of my first mentor still resonate in my mind every single day and have become my mantra: “Make your work do the talking!”

A friend is someone who tells you what you want to know
A mentor is someone who tells you what you need to know!

Posted in: Physicians-in-Training

Depression in the Global Spotlight

March 30, 2022 // Randy Glick

By Jane Collingwood

Jane Collingwood is a medical journalist with 17 years experience reporting on all areas of medical research for online and print publications. Jane has also worked on a range of medical studies funded by the UK National Health Service within the University of Bristol in the South West of England. Jane has an academic background in psychology and has authored books on stress management and respiratory infections. Currently she is combining journalism with a national coordinating role on the UK's largest surgical research trial.


A new report is calling for greater action to be taken on depression around the world. Professor Helen Herrman of the University of Melbourne, Australia, and international colleagues published the report recently in
The Lancet.

It is the latest report from the Commission on Depression, set up in 2018 by a global collaboration of researchers including experts from economics, epidemiology, neuroscience, primary care, psychiatry, psychology, and public health. They joined with the World Psychiatric Association to focus on depression, and specifically, why it remains a neglected global health crisis, "despite abundant evidence that much can be done to prevent and aid recovery of people suffering from it even in resource-limited settings".

 Twenty-five experts from 11 countries contributed to the new report, titled 'Time for united action on depression'. It explains that depression is a leading cause of avoidable suffering globally, affecting 1 in 20 adults each year. "Yet, too few people in communities, governments, and the health sector understand or acknowledge depression as distinct from the other troubles that people face," it states. 

 Professor Herrman and colleagues believe that, "Not enough is done to avoid and alleviate the suffering and disadvantages linked with depression, and few governments acknowledge the effect of depression on social and economic development."

The report outlines the scale of the disease and makes recommendations to tackle the current inequities, including underdiagnosis, treatment, and prevention, and the need for collaborative care in all settings. It includes an analysis of evidence from many diverse contexts and consultations with individuals with lived experience, to "generate action-oriented recommendations". The aim is to "promote united action to reduce the burden of depression and ensure that greater attention is paid to the millions of people who live with it across the globe".

The authors write, "This Commission provides a message of hope, not only in the form of robust evidence on what can be done to prevent and treat depression, but also on how such interventions can be integrated with wider health and social systems and implemented even in the least resourced contexts." They explain that depression is a common but poorly recognized and understood health condition that can cause profound distress, impair social functioning and economic productivity, and lead to premature mortality.

Depression has a range of clinical presentations, severity levels, and courses, commonly overlapping with other conditions. There is also considerable variability in depressive symptoms and signs among cultures. The authors believe that both social and economic actions are needed to mitigate the effects of adversities and inequities early in life and across the life course. Interventions are also needed at the individual level, focusing on current life habits and risk factors.

There is now an opportunity for united action to transform mental health care systems globally, with a "whole of society" approach to the prevention of depression. Specifically, the Commissioners point out that the approach by which people with symptoms of depression are classified into just two groups, either clinical depression or not, is overly simplistic. 

Instead, they support a personalized, staged approach, recognizing changes over time and the intensity of symptoms. Interventions should be individually tailored and could cover self-help and lifestyle changes, as well as thorough psychological therapies and antidepressants, and up to more intensive treatments such as electroconvulsive therapy if necessary.

Many myths continue to surround depression, the report states, which "perpetuate inaction". For example, some believe that depression is simply sadness, or is a sign of weakness, or only occurs in certain cultural groups, whereas in reality it can affect anyone, although there is variability in types and rates of symptoms between cultures.

The Commission would like to see a cohesive approach to preventing depression similar to the global efforts to reduce heart disease and cancer. Professor Herrman says, “Depression is a global health crisis that demands responses at multiple levels. This Commission offers an important opportunity for united action to transform approaches to mental health care and prevention globally.

"Investing in reducing the burden of depression will give millions of people the chance to become healthier, happier and more productive members of society, help to strengthen national economies, and advance the United Nations’ Sustainable Development Goals for 2030.” Commenting on the report, a Lancet Editorial asks, "Why are there such insufficient and inequitable health resources for depression, and what can be done about it?" 

This Commission calls for "concerted action to reduce the burden of depression among four groups: scientists and researchers, policy makers, health-care workers, and civil society." It gives several reasons why depression "does not receive sufficient resources and global attention". Firstly, depression has historically been stigmatized and the legacy of stigma continues to this day. Secondly, managing depression is not always straightforward and can be challenging, especially in the absence of mental health insurance schemes or universal health coverage. In addition, depression requires a “multidimensional approach” of policies and investment across many sectors including health, education, employment, and social services. 

The editorial highlights certain groups that already face obstacles before a diagnosis of depression, such as persecuted ethnic groups, and adolescents whose struggles are compounded by the impact of COVID-19 pandemic, and people affected by civil strife and violence, such as refugees. But "there is cause for hope," it states, "the great majority of individuals with depression recover from an episode if they can obtain adequate support and treatment."

"The Commission lays out a stark choice," it concludes, "to improve equitable and stigma-free access to interventions for people with depression or to continue to condone indifference to the wellbeing of the one billion people with mental health needs. Together, the global community must decide to prioritize the emotional wellness of our species."

To mark the global launch of this Commission, a webinar was held featuring the Lancet's Editor-in-Chief, Professor Richard Horton and a number of international experts. Professor Horton said that the journey to where we are today "has been long and hard". In 2007 the Lancet launched its first series on global mental health, because mental health was completely excluded from the Millennium Development Goals, "with catastrophic consequences".

As far back as 2005, Commission Co-chair Professor Vikram Patel of Harvard Medical School, highlighted the fact that the Millennium Development Goals relating to health "almost entirely ignore mental disorders, yet there is compelling evidence that in developing countries mental disorders are amongst the most important causes of sickness, disability, and, in certain age groups, premature mortality".

"Apart from causing suffering, mental illness is closely associated with social determinants, notably poverty and gender disadvantage, and with poor physical health, including having HIV/AIDS and poor maternal and child health," he wrote in PLoS Medicine. "But mental health remains a largely ignored issue in global health, and its complete absence from the Millennium Development Goals reinforces the position that mental health has little role to play in major development-related health agendas."

His 2005 article questioned that assumption. Using evidence on mental health in developing countries, he argued that addressing mental health problems is an integral part of health system interventions aimed at achieving some of the key Millennium Development Goals. He linked mental health with three of the Goals: eradicating poverty, reducing child mortality, and improving maternal health. "However," he adds, "the relevance of mental health is not limited to these goals alone. For example, there are several areas of confluence between HIV/AIDS and mental health - people with HIV/AIDS are much more likely to suffer mental health problems, and these problems in turn can affect their overall health outcomes."

Recently, at the launch of the new report, Professor Patel said, “The Commission’s findings offer a clear message of hope, both for decision makers struggling with addressing the rising tide of depression in their populations, and for individuals who are experiencing the profoundly disabling symptoms of depression. There is much we can do to care for individuals with depression.

“No two individuals share the exact life story and constitution, which ultimately leads to a unique experience of depression and different needs for help, support, and treatment.” Professor Patel pointed out that the Covid-19 pandemic has been linked to around 53 million additional cases of major depressive disorder worldwide in 2020 alone. “The pandemic presents a historic opportunity to enhance investments and promote concerted actions across sectors to implement these interventions,” he said.

Professor Horton of the Lancet agrees, stating during February's webinar that, "We need to strengthen mental health systems, promote mental wellbeing, and expand the availability of interventions to treat those with mental disorders.

"The Commission is a call for united action on depression," he adds "it couldn't be better timed. Its recommendations couldn't be more urgent. The pandemic held up a mirror to society to show us who we really were, and what we saw of ourselves has been disquieting and distressing. Absolutely no sense of global solidarity. This Commission gives us an opportunity to write a different story. We will work our hardest to seize that opportunity."

This 2022 global spotlight on depression is not only appropropriate, but it is also long overdue.

 

References

Herrman, H. et al. Time for united action on depression: a Lancet World Psychiatric Association Commission. The Lancet, 15 February 2022 doi: 10.1016/S0140-6736(21)02141-3. www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02141-3/fulltext

Editorial. Ensuring care for people with depression. The Lancet, 15 February 2022 doi: 10.1016/S0140-6736(21)01149-1. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01149-1/fulltext

Miranda, J. J. and Patel, V. Achieving the Millennium Development Goals: Does Mental Health Play a Role? PLoS Medicine 13 September 2005 doi: 10.1371/journal.pmed.0020291. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020291

Posted in: Mental HealthPatient Education

Monthly Webinar: Musculoskeletal Manifestations/Complications of Diabetes

March 10, 2022 // Randy Glick

Presented by: Dr. Chris Morris
April 12 at 6:00 PM CST

It has been estimated that over 38 million Americans have diabetes mellitus. The cardiovascular, neurologic, and renal effects of diabetes are well-recognized; however, surprisingly little information on the musculoskeletal manifestations of this disease has been disseminated.

This webinar, presented by Dr. Christopher Morris, will focus on the effects that this disease has on the musculoskeletal system, and how it can affect the everyday activities of the diabetic patient.

Register today

Learn More About Dr. Chris Morris

Christopher R. Morris, MD, a board certified rheumatologist with more than 25 years’ experience, is in private practice in Kingsport, Tennessee at Arthritis Associates. Additionally, he has served as a clinical educator for internal medicine residents at East Tennessee State University in Johnson City, Norton Community Hospital in Norton, Virginia, and Johnston Memorial Hospital, in Abingdon, Virginia.

A native of Springfield, Illinois, Dr. Morris received his undergraduate degree from Tulane University in New Orleans, Louisiana, and received his medical degree from the Universidad Autonoma de Guadalajara, Guadalajara, Jalisco, Mexico. He completed his Internship and Residency at the University of Tennessee Medical Center in Knoxville, and he performed rheumatology fellowships at the Bowman Gray School of Medicine, Winston-Salem, NC, and at the Medical College of Georgia in Augusta.

Dr. Morris is an active member of the Southern Medical Association (SMA) and he previously served as an SMA Councilor for the state of Tennessee, as well as a member of several of the Association's Education Design Groups. Additionally, Dr. Morris has served on 5 Committees for the American College of Rheumatology, currently serving on the Insurance Subcommittee of the ACR, which advocates for the specialty of Rheumatology, as well as-for the patients with arthritic diseases.

Dr. Morris is married to Jane and together they have 2 children, Christopher Jr, and Amanda.

On Mentoring: Natalie Weiss

March 3, 2022 // Randy Glick

By Natalie Weiss, BA, BS

Natalie is a fourth-year MD/MBA student at Tulane University School of Medicine in New Orleans, LA. She is Chair and Founder of the Southern Medical Association’s Physicians-in-Training Committee. The following excerpt describes some of her experiences surrounding mentorship in medicine.

I believe that, among other things, a capacity for teaching and learning sets humans apart from other species. Our human nature drives us toward developing mentoring relationships with those in our “pack.” This has been true for me, at least. When I feel uncertain, I seek advice from others; when I feel certain, others seek advice from me.

There are many times when I have felt uncertain and needed a mentor for guidance. While growing up, I often imagined that other children would look to their siblings for answers to important questions. How do I make friends in school? How do I apply for college? How do I pick a job? How do I make the world a better place? As an only child, I expanded my “pack” beyond my family. A pediatric emergency physician in New Mexico (and a family friend) became one of my first mentors in medicine. She showed me that it is possible to both love your job and make a meaningful impact doing it. When I left home to study music in college, I often looked back fondly on my time with this physician. Good mentors can change your life, and she certainly changed mine. Her guidance helped me make the decision to change career paths completely. In the years since, I have been lucky enough to find many more great mentors among my colleagues and faculty in medical school.

Knowing the profound effect of mentoring on my path, I have always jumped at the opportunity to pay it forward as a mentor when I feel certain about my position. (do we always need to be certain? Is there value in letting our mentees know we aren’t certain?) Getting involved in organizational leadership has made these opportunities to expand my pack abundant. I have found mentoring to be rewarding on several levels. First, it is a positive experience to see a mentee succeed. Second, I am able to learn more about myself and what drives me through mentoring. And, finally, I have gained a lot of perspective through mentees.

In sum, it is human instinct to develop mentoring relationships with those around us. For success in medicine, we must give support to and receive support from others. I look forward to future relationships with mentors, in times when I need guidance, and mentees, in times when I have guidance to offer.

Posted in: Physicians-in-Training

SMJ: March 2022 Vol. 115, No. 3

March 3, 2022 // Randy Glick

The Southern Medical Journal(SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists, including medicine; surgery; women’s and children’s health; mental health; emergency and disaster medicine; public health and environmental medicine; bioethics and medical education; and quality health care, patient safety, and best practices.

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Characterization of Clinical Skills Remediation: A National Survey of Medical Schools

Andrew S. Parsons MD, MPH, Karen M. Warburton, MD, James R. Martindale, PhD, Ilene L. Rosenberg, MD

Propensity Score Matching to Determine the Impact of Metformin on All-Cause Mortality in Older Veterans with Diabetes Mellitus

Juliana Ferri-Guerra, MD, Raquel Aparicio-Ugarriza, PhD, Y. Nadeem Mohammed, MD, Otoniel Ysea, MD, Hermes Florez, MD, Jorge G. Ruiz, MD

Using an Implementation Research Framework to Identify Facilitators and Barriers to Physical Activity and Weight Loss in Appalachia

Tyra Turner, MS, Treah Haggerty, MD, MS, Patricia Dekeseredy, MScN, RN, Julie Hare, MD, Cara L. Sedney, MD, MA

Evaluation of an Electronic Health Record Alert to Improve Screening and Management of Cardiovascular Disease and Stroke Factors in a High-Risk Population

Warren L. Felton, MD, Susan G. Kornstein, MD, Tamala Gondwe, PhD, MPH, Christine Huynh, MD, Jordyn T. Wallenborn, PhD, MPH, Jeneane Henry, RN, BSN

Neurocognitive Rehabilitation in COVID-19 Patients: A Clinical Review

Ryan Mathern, MD, Pooja Senthil, BSc, Nguyen Vu, MD, Thanigaiarsu Thiyagarajan, MD

Ultrasound-Measured Urethral Length Does Not Change following Minimally Invasive Sacrocolpopexy for Pelvic Organ Prolapse

Maeve A. Serino, BA, Sarah A. Collins, MD, Kimberly Kenton, MD, MS, Julia Geynisman-Tan, MD

Analysis of Airway Management for Cesarean Delivery: Use of Risk and Proportion Differences

Andrew King, MD, Justin Morello, MD, Allison Clark, MD, Adrienne Ray, MD, Colleen Martel, MD, Roneisha McLendon, MD, Anne McConville, MD, Melissa Russo, MD, Liane Germond, MD, Bobby Nossaman, MD

Implementation of a Postpartum Note Reminder and Factors Associated with Postpartum Glucose Tolerance Screening

Anna Domingo, DO, Joshua Fogel, PhD, Ryan Raffel, MD, Timothy Gesner, DO, Petr Itzhak, DO

Comparison between Rural and Urban Appalachian Children in Hospice Care

Mary Lou Clark Fornehed, PhD, RN, Radion Svynarenko, PhD, Jessica Keim-Malpass, PhD, RN, Melanie J. Cozad, PhD, Kerri A. Qualls, BSN, RN, Whitney L. Stone, BSN, RN, Lisa C. Lindley, PhD, RN

Posted in: SMJ

Regions Next Step Webinar: Smart Money Habits

March 2, 2022 // Randy Glick

When Your Money Goes Far, SO DO YOU.

Regions strives to provide you with easy-to-understand guidance and tools to help you accomplish your unique financial goals.

Being financially responsible involves planning and having a strategy in place to reach your financial goals. Learn how to establish reachable goals and develop new spending and saving habits. Get tips on organization, record-keeping, and controlling your money to create stability in your financial future.

In this webinar you'll learn how to:

  • Set financial goals.
  • Track your daily spending habits.
  • Increase your income and decrease your spending.
  • Get more out of your paycheck.
  • Get out of debt.

One Webinar, Same Topic, Multiple Dates to Attend

Tuesday, March 29,2022 at 6 PM CST

Sign Up Here

Thursday, March 31,2022 at 12 PM CST

Sign Up Here

Sign up for this FREE webinar today and start learning about financial independence!

Posted in: Business

Understanding Medicare: Tips for Seniors on How to Choose the Right Coverage

March 2, 2022 // Randy Glick

Understanding Medicare and everything that goes with it can be one big puzzle, and for many seniors, figuring out what type of coverage is best for their needs can be overwhelming. Even if you currently have Medicare coverage, you likely still have questions about how it works or what you’ll need in order to make changes in the future. Because there are several stipulations that come with this type of insurance, it’s important that you’re aware of deadlines and the rules surrounding what exactly will be covered when you need to use it.

The good news is there are some easy ways to understand Medicare no matter what stage you’re in. Having coverage is essential after a certain age, and once you figure out the best choice, you’ll have peace of mind for a long time to come. SMA.org recommends that you think about what your needs are right now, as well as what they might be down the road, then keep these things in mind:

Learn About the Different Parts of Medicare

Medicare has many different parts, including A, B, C, and D, and it’s important that you understand what they all do. Most people automatically receive part A — hospital coverage — at the age of 65 if they have paid taxes for a certain number of years, and it typically comes without a premium. Part B is medical insurance and it does come with a premium, but if you aren’t yet 65 and are living with a disability, you may qualify for special coverage. Part B covers a broad spectrum of services from doctor visits to ambulance transport. It also pays for some durable medical equipment and mental health treatment. Part D is prescription drug coverage and comes in handy when you take a lot of medications. There are different plans, and they do not all cover the same drugs. Do a little research online to find out what is available to you according to your age and the state you live in.

Consider a Part C Plan

Part C (also called Medicare Advantage or Medicare Plus) plans can be extremely helpful for seniors who either have a need for a specialist or for dental or prescription coverage, which isn’t covered by Medicare Parts A or B. There are certain enrollment periods for these plans and they may differ depending on where you live, so it’s a good idea to find out how you can get the process started as soon as possible.

It’s important to note, however, that Part C plans typically have a very limited preferred provider panel. Be sure to speak with your physician specifically about a Medicare Advantage plan if you’re interested in this coverage, and verify with your own research that you’ll be able to continue visiting your preferred healthcare professionals under Part C.

Talk to Your Doctor

 If your coverage changes at any time, or if you sign up for a new plan under Medicare, you’ll want to talk to your doctor to make sure he still accepts your insurance. While most healthcare providers are fine with Medicare, some services may not be covered, and you don’t want to be saddled with a surprise medical bill you weren’t expecting. Find out for sure whether your needs will be taken care of before you make any big changes.

Plan for the Future

Medicare is so complex that many seniors can be left worrying and wondering whether their long-term care is covered. Luckily, from private insurance to government benefits, there are ways you can make sure you have a way to pay for nursing facilities that are not specifically covered by Medicare.

Even if your health is in good shape now, that could change down the road, so it’s crucial that you think about what your needs may be as you grow older. Planning for the future can be difficult, but it’s absolutely necessary for seniors who may require long-term care at some point. Medicare may help pay for some coverage, but often won’t take care of hospital stays after a certain number of days. It will pay for rehabilitation following a hospital stay if it’s clinically required, but only for about a month, and perhaps for even less time if the therapists don’t indicate significant improvements are being made. Many times, this care is provided in a nursing home rather than the hospital. 

In addition, nursing home stays are typically out-of-pocket expenses, which means you’ll need to find a facility that’s both affordable and trusted. Think about the amounts you may be responsible for and how to start saving for that possibility.

Understanding Medicare and all its parts can be extremely complicated and frustrating if you don’t use the resources available to you. Look online for tips, talk to your doctor, and contact a Medicare representative to answer any questions you still have. Planning a bit now will give you peace of mind and will allow you to figure out your future while you have time to prepare.

About the Author: 

Janice Russell believes the only way to survive parenthood is to find the humor in it. She created Parenting Disasters so that parents would have a go-to resource whenever they needed a laugh, but also to show parents they aren’t alone. She wants every frazzled parent out there to remember that for every kid stuck in a toilet, there’s another one out there somewhere who’s just graced their parents’ walls with some Sharpie artwork!

Posted in: Patient Education

How I Made It Through: Navigating Residency & Childrearing

February 24, 2022 // Randy Glick

Presented by Safiya K. Lyn-Lassiter, MD

The goal for this lecture is for the audience to understand the current parental leave policy and how it impacts medical residents. Raise awareness of the physical and emotional effects that women physicians endure by having children at a later age. Offer medical residents effective strategies for navigating difficult conversations surrounding family-planning, pregnancy, parental leave, post-partum & return to work. Suggest feasible interventions designed to reduce discrimination against childbearing physicians.

Learn more about Dr. Safiya K. Lyn-Lassiter:

Dr. Safiya K. Lyn-Lassiter is an Assistant Medical Director at a prominent Free Standing Emergency Department (FSED) in South Florida with over eight years of experience in Emergency Medicine. Dr. Lyn-Lassiter has worked at several hospitals in the South Florida community serving a variety of populations.  She is also serves as Assistant Professor at Nova Southeastern University College of Osteopathic Medicine.

As Assistant Medical Director, Dr. Lyn-Lassiter's day-to-day responsibilities include overseeing a 16 bed acute care emergency room, managing general operations, caring for critically ill patients, responding to all patient concerns, and implementing new policies on sepsis, stroke, STEMI and critical care.

To keep abreast of the latest developments in the medical field, Dr. Lyn-Lassiter maintains affiliations with The American College of Emergency Physicians (ACEP), American Medical Association (AMA) and National Medical Association (NMA).  As a testament to her success, Dr. Lyn-Lassiter was honored as the Physician of the Month at Memorial Hospital in February 2016.  She works closely with the community to inform and educate people on evolving medical practices through engaging lectures and community-centered outreach programs.  Dr. Lyn-Lassiter was honored in 2017 by the American Health Council for “Best in Medicine” award.

Dr. Lyn-Lassiter became involved in the field of Emergency Medicine after discovering how unpredictable and rewarding each patient interaction can be. Her specialties include FSED Administration, Graduate Medical Education and patient satisfaction. When she reflects on her medical training, her rotations in Nashville’s underserved community not only exposed her to the reality of health care inequity, but also this experience prepared her to engage a cross-section of patients with care and compassion. 

In 2017, Dr. Lyn-Lassiter launched Ask Doctor Lyn focusing on the effectiveness of medicinal marijuana (MMJ) use among Florida, California and Georgia residents. As an advocate of MMJ, she created a user-friendly website to identify, evaluate, and recommend MMJ for qualifying patients.

Dr. Lyn-Lassiter graduated with honors from Trinity University (DC) with a Bachelor of Science in Physical Science. She completed her medical training at Meharry Medical College in 2010 where she earned her medical degree (M.D.).  She received her postgraduate emergency medicine training at Morristown Medical Center in Morristown, NJ, a Level I trauma center.  Dr. Lyn-Lassiter has proudly served the South Florida community since 2013.

Dr. Lyn-Lassiter is a proud parent to Myla, her twelve-year-old daughter. Considering the future, Dr. Lyn-Lassiter is committed to further excelling in her emergency medicine career, exploring medical journalism and advocating for MMJ patients nationwide.

Stay up to date with Dr. Lyn!

Website: www.askdoctorlyn.com
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Posted in: Physicians-in-Training

Scholarship for the Busy Physician

February 24, 2022 // Randy Glick

Dr. Christopher Jackson will provide guidance about finding research projects that are doable during training, examples of such projects, and the formula for starting and finishing projects.

By the end of this session, attendees should be able to:

  • Identify various opportunities for research/scholarship from your daily work;
  • Implement the five step formula that can help you turn any project into a scholarship;
  • Address common pitfalls that come up with research projects during training.
  • and How being a woman has made this harder and easier to achieve-the reality.

Learn more about Dr. Jackson (in his own words):

I am a board-certified academic general internist in Memphis, TN. Additionally, I am an associate program director for curriculum for the UTHSC Internal Medicine Residency Program. My connection with SMA started in 2016. I presented an oral abstract presentation on statin-induced necrotizing autoimmune myopathy. This moment changed my academic trajectory in multiple ways. I realized how much I enjoyed attending conferences and presenting my findings from research. Moreover, I connected with a welcoming organization that continues to provide professional development opportunities that have enhanced my academic general internal medicine career. As a clinician-educator, I enjoy the opportunity to provide high-quality care to patients and train the next generation of internal medicine physicians. For my efforts, I’ve been fortunate to win our Educator of the Year award at UTHSC after my first year on faculty. This award would not be possible without the seed planted at my first SMA conference in October 2016. At present, I serve as an assistant editor for the SMJ, and I work alongside outstanding colleagues on the SMA Education Committee. Over the past five years, the SMA continues to expand its educational offerings to be at the forefront of cutting-edge digital education.

Defying the Odds: How to Succeed in Medicine

February 24, 2022 // Randy Glick

Dr. Mary Killackey will review key turning points and decisions in her personal journey to leadership as well as basic leadership tenets, including:

  • The Beginning - Understanding why and motivation;
  • The Middle - Overcoming Fear, Taking Risks, and Managing Ambiguity;
  • The “Now” - Recognizing Opportunity for Impact, and Commitment to Something Greater than Oneself;
  • and How being a woman has made this harder and easier to achieve-the reality.

Learn more about Dr. Mary Killackey:

Mary Killackey, MD is the Robert & Viola Lobrano Professor and Chair of Surgery and Adjunct Professor of Pediatrics at Tulane University School of Medicine. She was appointed Chair of Surgery in May 2016 and since that time has exponentially grown the department in all missions. Dr. Killackey received her undergraduate and medical degrees from Columbia University. She completed her General Surgery residency at the University of Rochester, Strong Memorial. From there, she went on to complete the Abdominal Organ Transplant Fellowship at the Mount Sinai Hospital in New York City. She was recruited to New Orleans in 2006 to join the team of abdominal transplant surgeons and by 2009 was named the Director of the Pediatric and Adult Kidney Transplant program. She also assumed the Directorship of Pediatric Kidney Transplant at the Children’s Hospital of New Orleans. In recognition of her leadership, she was accepted into the Executive Leadership in Academic Medicine fellowship in 2017. Later that year, she was inducted into AOA Medical Honors Society and in 2019, elected into the Leonard Tow Gold Humanism Society. Dr. Killackey’s passion is promoting a thriving work environment which prioritizes professionalism and allows her the opportunity to facilitate the careers of her faculty, trainees and students. She and the department are leading the effort to promote professionalism at the medical school. She is quite active outside of her own institution, most visibly within UNOS (United Network for Organ Sharing) and the Society of Surgical Chairs. She is deeply committed to fostering the careers and leadership skill building of women leaders and is grateful for the opportunity to bring these efforts to the national stage through the Women’s Subcommittee of the Society of Surgical Chairs.

Invited Speakers from the 2022 Physicians-in-Training Leadership Conference

February 24, 2022 // Randy Glick

Did you miss the 2nd Annual Physicians-in-Training Leadership Conference in New Orleans, LA?

Check out the invited guest speakers from the conference! Abstract presentations are coming soon!

Defying the Odds: How to Succeed in Medicine

Presented by Dr. Mary Killackey

Dr. Killackey will review key turning points and decisions in her personal journey to leadership as well as basic leadership tenets, including:

  • The Beginning - Understanding why and motivation;
  • The Middle - Overcoming Fear, Taking Risks, and Managing Ambiguity;
  • The “Now” - Recognizing Opportunity for Impact, and Commitment to Something Greater than Oneself;
  • and How being a woman has made this harder and easier to achieve-the reality.

Scholarship for the Busy Physician

Presented by Christopher Jackson, MD

Dr. Christopher Jackson will provide guidance about finding research projects that are doable during training, examples of such projects, and the formula for starting and finishing projects.

By the end of this session, attendees should be able to:

  • Identify various opportunities for research/scholarship from your daily work;
  • Implement the five step formula that can help you turn any project into a scholarship;
  • Address common pitfalls that come up with research projects during training.
  • and How being a woman has made this harder and easier to achieve-the reality.

How I Made It Through: Navigating Residency & Childrearing

Presented by Safiya K. Lyn-Lassiter, MD

The goal for this lecture is for the audience to understand the current parental leave policy and how it impacts medical residents. Raise awareness of the physical and emotional effects that women physicians endure by having children at a later age. Offer medical residents effective strategies for navigating difficult conversations surrounding family-planning, pregnancy, parental leave, post-partum & return to work. Suggest feasible interventions designed to reduce discrimination against childbearing physicians.

Accelerating Change in Medical Education

Presented by Gerald Harmon, MD, AMA President

This message, which will impact all members of the healthcare community, will address advocacy, education, and important public health issues, as well as why association membership is so important.
Posted in: Physicians-in-Training
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