UMass FMCH Tuesday Talk - September 21, 2021/COMMUNITY
Welcome to the FMCH Tuesday Talk. Please continue to send us your announcements, celebrations, and accomplishments to [email protected].
Table of Contents
Message from the Chair
Upcoming Events
Focus of the Week - Community
Announcements
Frankly Speaking Podcast
Department Member Recognition
Clinical Services Spotlight
Message from the Chair
 
Congratulations to Olga Valdman and Gurutze Barluenga who are in Liberia this week to celebrate the graduation of four Family Medicine residents! These residents join three other graduates of this new residency now prepared to serve the residents of Liberia. The Vice President of Liberia, representatives from WHO, USAID, UNICEF and many other dignitaries and representatives from international and national organizations will be joining the celebration. Beshoy Sidhom, Duy Nguyen (Global Health Fellow), Raul Colon-Mulero (Global Health Fellow) have been in Liberia working with the residents and doing clinical teaching and Liz Dykhouse has supported the residents with online lectures and tutoring on Behavioral Health.
Upcoming Events

FMCH Grand Rounds/Steven L. Putterman, MD Memorial Lecture
Tuesday, September 21st, 12-1pm; J. Nwando Olayiwola, MD, MPH, FAAFP presents "Moving Towards Health Equity: Why Anti-Racism Must be a Core Value in Medicine".
Meeting ID: 191 986 273 Password: FMCH

Department of Family Medicine and Community Health Septemberfest!
Hopkinton State Park, Saturday, September 25th,11:00 – 3:00pm.
Catering by Café Reyes, activities for the kids, canoe, sailboat and kayak rentals
Don't miss out on the fun at Septemberfest.
Carpooling is recommended as the parking lot fills up fast on weekends.

The WFMR is happy to announce a Fall Resident Retreat date
10/5/21 8am to 5pm at Camp Selah, Orange, MA
We appreciate faculty who will be doing additional service to allow the residents this important wellness and team building time. Also, residency faculty who are interested and able to be free are invited to join. Please mark your calendars and contact Hilda Alers for further details.

American Board of Family Medicine Maintenance of Certification
KSA (SAM) Workshop: “Care of Children”
Thursday, November 18, 2021, 8:00 – 10:00 AM
WEBINAR (no need to leave your desk) Link will be sent prior to 11/18/2021
We will complete the latest (just released) 60 question Care of Children KSA via a virtual CME event. You will record your answers while we work through the KSA, then after completion, log into your ABFM account and enter the results and claim your CME credits through the ABFM. Successful Completion of the Knowledge Self-Assessment (KSA) Module is eligible for up to 10 ABFM Credit Hours.
See the attached invitation for a WEBINAR to complete the ABFM KSA: Caring for Children. To register, please complete and follow the directions on the attached registration form.
Focus of the Week - Community

Doing our part to eliminate the purple flags
On August 31st, I visited the UMMHC/UMMS memorial for the individuals in Massachusetts who lost their lives in the last year to overdose. For most of us, it is personal with patients lost and families known whose lives have forever changed. The number of flags is a stark reminder.
NIH last week released a report detailing research on the 38% increase in overdose deaths for African Americans between 2018 and 2019 while other racial and ethnic groups witnessed no increase or improvement. And, in the pandemic era, overdose death rates have risen in every state.

Our department conducts innovative care, education, and research to mitigate the impact and downstream outcomes of opioid use disorder (OUD).

  • Clinical care: All our teaching health centers and practices have robust treatment programs for OUD, with all second- and third-year residents trained to provide agonist medication treatment. Our faculty provide innovative treatment access. Jeff Baxter, MD, Chief Medical Officer of Spectrum, has created bridge clinics for treatment provision, and Spectrum provides treatment in the Commonwealth’s prisons and some jails, joined by Pam Tsinteris, MD. Jay Broadhurst, MD has practiced part time at Spectrum for years. Jennifer Bradford, MD, MPH serves as medical director of all substance use disorder services at Community Health Link. With Emergency Medicine and Dr. Kavita Babu, Drs. Erik Garcia and Hugh Silk staff a treatment van supported by a SAMHSA grant. and Mohammad Alhabbal, MD is medical director at AdCare Treatment Centers. Residency graduate Heidi Ginter, MD serves as Chief Medical Officer for Recovery Centers of America. 
  • Education: Thanks in large part to the pioneering efforts of Jeff Baxter, MD, medical students all receive clinical education on treatment of OUD and training starts early for students assigned to a family medicine LPP due to our robust treatment programs. Steve Martin, MD and Amber Cahill, PsyD lead a Project ECHO program focused on expanding access to MOUD. In partnership with a former behavioral health fellow, James Anderson, PhD, they published the results of the work (Anderson, 2021). Daniel Mullin, PsyD MPH completed a 3 year SAMHSA project that focused on the development of the “Care of Patients with Opioid Use Disorder” course. This course has been deployed at UMass, Tufts, and Boston University.
  • Research: Robin Clark, PhD’s current work focuses on implementation of treatment for individuals with addiction in real world settings and the impact of Medicaid policies on treatment. Paula Gardiner, MD, MPH conducts research on complimentary and alternative treatment of chronic pain via medical group visits. Ekaterina Pivovarova, PhD conducts research on drug courts and their effectiveness as an alternative to incarceration and she and Warren Ferguson, MD are co-investigators on the MA-Justice Community Opioid Innovation Network with principal iInvestigators Peter Friedmann, MD, UMass-Baystate and Elizabeth Evans, PhD, UMass-Amherst School of Public Health. As noted, Dan Mullin, PsyD, MPH, director of the Center for Integrated Primary Care, is conducting research on the effectiveness of Project ECHO on access to treatment for OUD.
  • Health Policy: As Governor Charlie Baker made the opioid epidemic one of his most important issues, UMMS was a pivotal ally. Dennis Dimitri, MD in his role as President of the Massachusetts Medical Society was a critical leader in supporting this work. Currently, Jennifer Bradford, MD, MPH serves as a consultant to the Office of Medicaid on substance use disorders.
Announcements

The WFMR Structural Oppression and Anti-Racism (SOAR) Committee is planning a number of upcoming didactic sessions as part of the SOAR framework for residents. We are looking for faculty and residents interested in co-facilitating the following sessions:
  • Intersectional Feminism and Reproductive Justice on 11/16/21 (specifically looking for faculty co-facilitator)
  • Anti-AAPI Racism (AY21)
  • Oppression Against Indigenous Peoples (AY21)
  • Anti-Latinx Discrimination (AY21)
  • Disability, Ableism, and Holding Medicine Accountable (AY22)
  • Immigration and Colonialism (AY22)
  • Medicine and the LGBTQ+ Community (AY22)
If you are interested or have questions, please contact Jordan Howard-Young, MD at

Please consider for in person learning Pri-Med East  
Thursday−Saturday, December 9−11, 2021 at the Boston Exhibition and Convention Center. Many of our colleagues will be presenting for 19 AAFP CME hours. This year’s keynote speaker is Pulitzer Prize-winning author Siddhartha Mukherjee, MD on: “Themes From the Future of Medicine”. I hope to see you there.

Family Medicine Moments
The new academic year brings the re-start of the Thursday Morning Memo – under a new name, Family Medicine Moments. It is important to highlight as often as we can Family Medicine and the relationships we build. Editor Hugh Silk welcomes your poems, haikus, 55-word stories, or photos – please send to [email protected].  If you are not on the listserv or would like to ensure that a group of learners, faculty or staff are on the listserv, please contact [email protected].

Tend Health COVID-19 Recovery Course Faculty Development Opportunity
You matter! The Department wants to support you through your COVID recovery efforts. We have hired Tend Health to provide recovery courses for our faculty.  A series of four sessions over two months will guide you through recovery and build resilience. 
Objectives:
Learn new concepts, build resiliency, and find community through live courses.
The team of expert and diverse instructors bring together a community of like-minded health professionals to learn new skills and expand our insights.
Faculty will need to choose one cohort and stick with it for all the sessions. 
Here are the dates:
Cohort 1: Mondays 8-9:15am 10/18, 11/1, 11/15, 11/29
Cohort 2: Fridays 4-5:15pm 10/29, 11/5, 11/19, 12/3
RSVP as soon as possible to Jennifer Masoud to reserve your spot in your chosen cohort, Jennifer.masoud@umassmemorial.org.

Hepatitis C and General Hepatology
Project ECHO (Extension for Community Healthcare Outcomes)
You are invited to join an exciting virtual collaborative learning opportunity!
What? Hepatitis C ECHO, a virtual case-based tele-mentoring educational model
Who? Primary care interdisciplinary team members (providers, nurses, social workers, community health workers, patient navigators, etc.)
Why? Tele-mentoring model that links specialists to primary care providers (PCPs) via video conferencing from any computer; Case based, iterative learning facilitated by specialists and related experts; through guided practice, PCPs become proficient in specialty care
When? A new cohort begins Friday, September 10th, 2021, 12:30 - 1:30pm ~ with 10 sessions held bi-monthly.
Curriculum content includes:
  • HCV screening
  • Acute HCV
  • Chronic HCV: Workup
  • Treatment of non-cirrhotic patients
  • Treatment of cirrhotic patients
  • Monitoring during treatment
  • Monitoring post treatment
  • "Topic by request"
  • Other hepatitides in the context of HCV/Hepatitis A&B
  • Treatment of special populations

UMass Family Medicine & Community Health Apparel Orders 2021
The pandemic has limited what we are able to order for Department gear, and thus the order form is changing significantly. Below is a Google Link, for which people can order Department gear from. Pricing will depend on quantity ordered. Please reach out to [email protected] with any questions. Submission Deadline: Tuesday, September 21st. https://forms.gle/GT1YrtDfBST1R8cb9.

STEP UP
Program Dates: September 1st, 2021 to October 31st, 2021.
Using your smart phone and/or smart watch track the number of steps each week and enter it into the data base link that will be sent out at the end of each week by your designated team leader. You can choose your own team, designate a name for your team and a leader who can keep track of data by each team member using a smart link. Your team leader will complete the first sign up survey after which we will create a “team link” for you where each member of your team can enter their own numbers/data. It will take less than a minute for the whole week’s activity tracking. Incentive: Improve team bonding, improved physical activity, friendships among co-workers, recognition in the Tuesday Talk and system wide recognition at the end of the program.

Massachusetts Latent Tuberculosis Infection (LTBI) ECHO. Come join us!
What? Massachusetts Latent TB Infection ECHO, a virtual case-based telementoring educational model.
Who? Primary care interdisciplinary team members (providers, nurses, social workers, community health workers, patient navigators, etc.).
Why? The USPSTF guidelines urge primary care teams to test high risk populations for TB & treat latent TB infection within primary care.
When? Thursday 12:15 - 1:15pm for 11 monthly sessions; 10/14/21, 11/18/21, 12/16/21, 1/13/22, 2/17/22, 3/17/22, 4/21, 5/26/22, 6/16/22, 7/21/22, 9/15/22.
This course is designed for beginners and more advanced practitioners. Those who are new to LTBI management will receive introductory material from our previous LTBI ECHO courses. We welcome previous course participants to join for new curriculum content and more advanced considerations in LTBI management.
Curriculum content includes:
  • Latent TB infection testing and treatment recap
  • Short course regimen considerations
  • Ruling out TB disease - advanced considerations
  • LTBI advanced testing and treatment considerations in special populations (i.e., pediatrics, pregnant people, liver disease)
  •  CME available

Teaching of Tomorrow (TOT)
January 7-8 and March 25-26, 2022
Registration is Open! 
For over 25 years, UMass faculty from the departments of Family Medicine and Community Health, Internal Medicine and Pediatrics have trained over 1,500 clinical faculty and preceptors from across the Northeast and beyond. TOT focuses on building and refining foundational skills for effective clinical teaching in both the inpatient and ambulatory settings. Preceptors from any specialty and discipline will enhance their clinical teaching skills through discourse and practice. TOT also provides valuable opportunities to network with other clinician educators. Our award-winning faculty utilize the principles of adult learning, drawing on participants’ experience and building knowledge through dialogue. The conference provides frequent opportunities to practice and assess new skills in a safe and fun environment.
 Audience:
  • Clinical educators – MDs, DOs, NPs, PAs, RNs, Behavioral Health, Pharmacists
  • Primary Care and Specialty providers
  • Teachers of students, residents, and advanced learners
  • Teachers in both In-patient and Ambulatory settings

Medical School Applicant Interviews
The School of Medicine is seeking raters for the Multiple Mini Interviews (MMI) to choose the next class of medical students. It is a great opportunity to meet enthusiastic MD applicants. Please forward any questions to Stacy Potts at [email protected] or Brenda Fusaro at [email protected]. Here is the doodle link for the training sessions:
Frankly Speaking Podcast

A weekly Podcast series covering newsworthy topics in primary care medicine.

Join us to discuss Gluten exposure is known to cause a number of problems in both those with celiac disease and those with non-celiac gluten sensitivity. One aspect that has not received much attention from the research community is the neurocognitive impairment that can occur following gluten exposure in these individuals. Join us for this podcast to dive into a recent article that describes these effects. Guest: Alan Ehrlich, MD, FAAFP presents: Cutting Through the Fog: Recognizing Gluten-induced Neurocognitive Impairment - Frankly Speaking Ep 242.
Department Member Recognition

Hugh Silk,, MD, MPH, FAAFP is an award winner in the 2021 FMEC “This We Believe” award competition for the FMEC conference for his essay “I Believe in Mentorship”.
Clinical Services Spotlight:
COVID-19 UPDATES

COVID-19 MA
  • Confirmed cases 738,303; 7-day average of percent positivity is slightly down at 2.26%.
  • 704 patients are hospitalized for COVID with 176 in the ICU and 98 are intubated.
  • Confirmed MA deaths 18,062.
  • Worcester Stop-the-Spread positivity is 8.9% (up from 7.5%).

COVID-19 UMMC
  • As of 9/20, 40 COVID- positive inpatients at the medical center (11 in ICU).
  • In-house test positivity for symptomatic patients is 12.8% (down slightly for past 2 weeks); asymptomatic test positivity is 1.8%.
  • 32 employees tested positive for COVID over the last 7 days (91 in September to date, already more than all of August).

West Nile
  • West Nile is the most common mosquito-borne disease in the United States.
  • Massachusetts has its 7th case as of 9/16/21.
  • Twenty-seven communities in Essex, Middlesex, Norfolk, and Suffolk counties are at high risk. Eleven additional communities are now considered at moderate risk for West Nile Virus: Fall River and Seekonk in Bristol County; North Andover in Essex County; Bridgewater, East Bridgewater, Halifax, and Plympton in Plymouth County; and Blackstone, Hopedale, Milford, and Millville in Worcester County.
  • Evaluation: testing of serum or cerebrospinal fluid (CSF) to detect WNV-specific IgM antibodies.
  • The incubation period can range from 2 to 14 days but the typical period is 2 to 6 days.
  • Consequence: The spectrum of illness can range from asymptomatic to having a fatal neurological disease.
  • The West Nile rash consists of pink spots on the arms, legs, and trunk. It looks similar to roseola or measles. Symptoms include fever, headache, and fatigue.
  • Prevention: avoid mosquitos, wearing DEET mosquito repellant, wear protective clothing, and use screens on windows and doors when appropriate.
  • Clinical management is supportive.

Newborn Screening Awareness Month - September
New England offers early screening to diagnose and prevent treatable newborn disorders. A newborn screen is required in Massachusetts. The newborn screen checks for 30 disorders. The Department of Health may have some tests that are in a pilot program and parents may be offered the opportunity for their baby to be tested. 
  • If you have questions concerning results from a newborn screening, please contact the New England Newborn Screening Program at 774 455 4600.
  • Promote newborn screens with your parents who are pregnant. Don't forget to discuss this with your patients during the prenatal period and at the hospital postpartum visit. 
Wellness Resources

The Caring for the Caregiver Program provides resources such as the Caregiver Support Line (508-334-HELP) and The Employee Assistance Program (EAP) which offers a variety of services and supports (including virtual peer support and wellness tips. EAP can be accessed at 866-263-3525, or www.LiveandWorkWell.com, [company code UmassMemorial]. More information is available on the Caring for the Caregiver page.
Working on Wellness
Yoga Classes with Dr. Liz Erban
Please join department members for early morning gentle yoga, Wednesday mornings 6:30am via Zoom.

Much appreciation to Dr. Erban for hosting these outstanding classes. Join Zoom Meeting
Zumba with Dr. Anna Zheng

Please join department members Monday mornings at 6:00am over ZOOM, Thursday evenings at 6:15pm**(30 Anna Street, NEW tall, spacious indoor location), some Saturday mornings at 9:15am and get moving with Zumba. Please note details and any changes via webpage: http://annazheng.zumba.com/. ZOOM still possible for all classes.

Much appreciation to Dr. Anna Zheng for hosting these outstanding classes. Join Zoom meeting: https://kennedychc.zoom.us/j/5578995952 pwd=bzVnY0xXdFNTQkpQQ1hmZkw3Snh6Zz09.