UMass FMCH Tuesday Talk - April 11, 2023/EDUCATION

Welcome to the FMCH Tuesday Talk. Please continue to send us your announcements, celebrations, and accomplishments to FMCHtuesdaytalk@umassmed.edu. 

Table of Contents

Message From the Chair

Upcoming Events

Focus of the Week – Education

Announcements

Presentations/Publications

Department Member Recognition

Frankly Speaking Podcast

Clinical Services Spotlight

Message from the Chair

The Department’s Annual Retreat will be Thursday, May 11th at UMass Chan South Street Campus in Shrewsbury. More detail is below. Lunch and registration will open at 12:00 noon with the formal program commencing at 1:00pm. The retreat will conclude with a networking reception with hors d'oeuvres, cash bar and musical entertainment from 5:00 – 6:30pm. Please Register Here. I hope to see you there!

Many of you are aware that Dr. Warren Ferguson, our former Senior Vice Chair of Community Health, is officially retiring. We are hosting a reception in his honor on June 20^th at 5:30pm at the Ecotarium in Worcester. We are looking to track down names of students and residents who were mentored by Dr. Ferguson. If you are aware of their email address, please share with Linda.Cragin@umassmed.edu. More details to come!

Upcoming Events

FMCH Grand Rounds

Tuesday, April 11th, 12:00 - 1:00pm, "HIV in Primary Care", presented by 

Laurel Banach, MD.

Meeting ID: 191 986 273 Passcode: FMCH

https://us02web.zoom.us/j/191986273?pwd=NEtlZmNkdWlSUGwyeTJQU3dCeUs1QT09

FMCH Grand Rounds

Tuesday, April 18th, 12:00 - 1:00pm, "Obesity Treatment: Tips and Examples", presented by Beth Mazyck, MD, FAAFP, Jeannette Ryan Alkasab, MD, and Kastoori Iyengar, MD.

Meeting ID: 191 986 273 Passcode: FMCH

https://us02web.zoom.us/j/191986273?pwd=NEtlZmNkdWlSUGwyeTJQU3dCeUs1QT09

FMCH Grand Rounds

Tuesday, April 25th, 12:00 - 1:00pm, "Working Exactly the Way It Was Designed: Why the U.S. Healthcare "System" Works the Way It Does:", presented by Robert Zavoski, MD, MPH, FAAFP.

Meeting ID: 191 986 273 Passcode: FMCH

https://us02web.zoom.us/j/191986273?pwd=NEtlZmNkdWlSUGwyeTJQU3dCeUs1QT09

Undergraduate Medical Education

DRIVE in Vista and across LiNC with Student Sentiments

This semester the DRIVE initiative is piloting a commendation letter program that will acknowledge faculty in the TH Chan School of Medicine for their work in advancing diversity, equity and inclusion in the learning environment. The commendation letters are based on student responses to the DRIVE-designed question about bias that appears in all IREA block and course evaluations. Comments from these evaluations will be used to identify individuals who will receive an official “Letter of Commendation” from the Dean and the Vice Chancellor of Diversity and Inclusion. This letter celebrates individual successes, and copies department Chairs to expand the impact. Letters will be emailed out annually in April and August and provide examples from the learners’ comments. We hope this recognition reinforces the good work being done and encourages all to continue to work for Diversity, Representation and Inclusion for Value in Education (DRIVE) at UMass Chan. Though the program is being piloted in the TH Chan SOM, we are in discussion to expand to other Schools. 

Faculty Development

Annual faculty performance review season is upon us. A great time to reflect on all of your wonderful work throughout the year and consider your goals and resource needs for the coming year. Please make sure to schedule a meeting with your supervisor by early June. If you have any questions or concerns about with whom you are assigned to meet, don't hesitate to contact Stacy Potts at stacy.potts@umassmemorial.org. The Office of Faculty Affairs has additional outstanding resources at https://www.umassmed.edu/ofa/academic/faculty-reviews/apr/.  

Consider the following questions as you complete your AFR:

Question 1: What is human subjects research?

Response 1: “Human subjects research” (HSR) is a tightly defined and regulated term produced by the Department of Health and Human Services to ensure ethical protection of human subjects participating in research. The definition and its components are very important to understand because various manners of protections and duties flow from them.

Question 2: What does “human subject” mean in a research context?

Response 2: In this context, HHS defines a human subject as a

“Living individual about whom an investigator conducting research a) obtains information or biospecimens through intervention or interaction with the individual, and uses, studies, or analyzes the information or biospecimens; or b) obtains, uses, studies, analyzes, or generates identifiable private information or identifiable biospecimens." In terms of medical research, the above refers to a human and/or data generated by or about them.

Question 3: What does “research” mean in this context?

Response 3: This is where it gets a bit tricky. However, HHS defines research as “a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge.” The elements of this definition are crucial: “systematic” generally means organized according to a standardized method replicated over time; “investigation” generally means activities based on proving or disproving a hypothesis; “generalizable” generally means that the outcomes or findings are not site/clinic specific and would apply in similar systematic investigations.

Why is this important? The elements of the definition of HSR serve as both a test and catalyst for ethical review boards (such as IRBs) when reviewing activities that potentially constitute research. I will address both PHI and a variety of activities that could be considered research in separate Ethics Corners. Please email me if you have any questions about these terms: philip.day@umassmed.edu.

Further Reading:

1) “Federal Policy for the Protection of Human Subjects”: https://www.hhs.gov/ohrp/regulations-and-policy/regulations/common-rule/index.html

2) “Research”: https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/understanding/special/research/research.pdf

3) "Research – Ethical Participation by Family Physicians": aafp.org/about/policies/all/research-ethical.html

We need your help. UMass FMCH Department's Epic Mastery Task Force wants to improve how providers use Epic and reduce EHR burnout. Please fill out this 5-10 minute survey!

Survey link: https://forms.gle/gfLrGsSMKrNPySfw7.

From your Epic Mastery Task Force (Henry Del Rosario, MD, Megan Brochu, PA-C, Veronica Farrell, NP, Nicholas Hajj, MD, and Jeannette Ryan-Alkasab, MD)

The 21^st Annual Primary Care Day will be held Wednesday, April 12th, 2023 at the DoubleTree Hotel, 5400 Computer Drive, Westborough, MA 01581, 8:00am-3:00pm. 

You can Register now . This program will provide updates on a wide range of rapidly changing primary care topics and will feature concurrent presentations from which attendees can select their own learning track and is sponsored by the UMass Chan Office of Continuing Medical Education. See flyer for additional information.

The UMass Chan Interprofessional Center for Experiential Learning and Simulation (iCELS) is pleased to announce the 1st Point of Care Ultrasound (POCUS) Basics for Primary Care Hands-on Skills Session, Thursday, April 13th, 2022, 8:00am-12:00pm. The session will cover basic ultrasound skills and several applications geared towards primary care providers.

You can Register now. See flyer for additional information.

Undergraduate Medical Education

Vista Town Hall: Please join us in person or online at the Vista Town Hall. The purpose of our time together is to share new information and collaborate with our community on topics related to Exploration and Horizons planning and development. From time to time, we will share Discovery phase milestones. 

• Wednesday, April 12th, 12:00-1:00pm (online, physical location TBD)
• Wednesday, May 10th, 12:00-1:00pm (hybrid), Amp 3

Join from PC, Mac, Linux, iOS or Android: https://umassmed.zoom.us/j/91713231333?pwd=SGkvUENlN2diTGZaajlDZlY2eGZnZz09&from=addon Password: 890756

Call for Nominations: Standing Committees

It is time for us to initiate the process of determining membership for the Standing Committees for the upcoming Academic Year. If you are interested in self-nominating for any of the committees described below, please submit your name, the committee of interest and the responses to the questions below to Faculty.Affairs@umassmed.edu The deadline for self-nomination is April 14th, 2023.

• Committee on Equal Opportunity & Diversity
• Faculty Grievance Committee (elected by faculty-at-large)
• Information Technology Committee
• Intellectual Property Committee 
• Library and Learning Resources Committee
• Personnel Action Committee (elected by faculty-at-large)
• Women’s Faculty Committee

With your self-nomination, please include your responses to the questions below.

1. Briefly describe your position & role at UMass Chan
2. Why are you interested in serving this committee?
3. What specific skills or strengths can you bring to this committee?

If you are interested in serving on a departmentally elected committee, as listed below, please contact your department chair:

• Faculty Council
• Committee on Scientific and Research Affairs
• Tenure Committee (if applicable to your department)

School committees are a great opportunity for career development and networking. More information on each of the committees and nomination process can be found here (umassmed.edu access required). Please consider sharing your passion and expertise with the institution.

Announcing the 19th Annual Gerald F. Berlin Prize for Creating Writing

Be sure to tell students and residents you know who like to write about the 19th Annual Gerald F. Berlin Prize for Creative writing. The Gerald F. Berlin Prize is awarded for creative writing, prose or poetry, authored by medical students, nursing students, graduate students, residents, and fellows based at UMass Chan Medical school, Berkshire Medical center, Worcester Medical Center/St. Vincent's or Baystate Medical Center. Submission deadline: April 15th, 2023. Click flyer for details. For guidelines visit Library's website at https://library.umassmed.edu/news-events/lsl-now/berlin-award-2023.

MCSTAP Guideline Update: A Series on Applying the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain. The latest CDC Guidelines for Prescribing Opioids for Pain include very important information for prescribers. To support you, MCSTAP is offering a three-part series on applying the Guidelines to managing care for patients with chronic pain. Register for the last session now!  MCSTAP

Dates/Topics:

• Wednesday, April 19th, 12:00 - 1:00pm, "Assessing Risk of Opioid Therapy: Applying the 2022 DCD Guidelines".

Save the date: Huppert award winning students are preparing presentations for the April 21st Research in Progress noon seminar. Presenters include: 

• Michael Urbanowski, PhD (SOM), working with mentor Daria L. Szkwarko, DO, MPH on a retrospective program evaluation of latent tuberculosis infection screening and treatment in an urban FQHC and 
• Samantha Creamer (GSN) and Annie Thornton (SOM), with mentors Linda Cragin, MS, and Janet Hale, RN, PhD, on Operation Conversation: Bridging the Gap between the Veteran Community and Future Health Care Providers. 

Senior Scholars Day is Wednesday, April 26th

Twenty-five of our 4^th year medical students participated in this year’s Senior Scholars Program – some of whom worked with faculty in our department. Senior Scholars Day is Wednesday, April 26th from 2:00-6:00pm in the medical school lobby (where students will formally present their work) and the faculty conference room (guest speaker this year: David Ayers, MD / Department of Orthopedics and Physical Medicine). Additional faculty are needed to help judge the student projects between 3 and 4 pm. If you’d be willing to have a student present their work to you and provide feedback/evaluation, we’re still looking for an additional 2-3 faculty (as well as Chief Residents) to help with judging the student’s work. If you’re interested in working with a Senior Scholars student for AY24, please let Judy Savageau know (judith.savageau@umassmed.edu).

The Massachusetts Psychiatric Society is offering Psychiatry for the Primary Care Physician, a virtual program, on Saturday, April 29th from 8:15am-3:45pm. Massachusetts Primary Care Physicians are often the de facto providers of psychiatric care. Compared to the past, PCPs today are often responsible for diagnosing and treating patients with more serious, complicated, and chronic psychiatric disorders. This course was designed to provide PCPs and other clinicians with lectures on salient topics of psychiatric diagnosis and treatment in Primary Care. The course provides 6.5 AMA PRA Category 1 Credits; 1 credit meets MA BORM for Risk Management and 1 credit for Risk Management/Opioid Education and Pain Management. The course is $150 for MMS members, $15 for fellows and free for students. Register here: https://maps.memberclicks.net/primarycare23

Click flyer for additional information.

Mindfulness and Compassion During Tumultuous Times - Essential Tools to Remain Steady and Whole, presented by Paula Gardiner, MD, MPH, CMMT and Gail Gazelle, MD, MCC, CMMT.

Friday, May 5th, 2023, 9:00 am - 3:30 pm (ET)

At this in-person program, you will acquire practical strategies to quiet your mind and gain mastery over worries and self-doubt. You’ll learn about the neuroscience behind mindfulness and meditation, and practice with a variety of readily accessible tools that will help you attain calm, clarity, and the balance you need to build resilience and avoid physician burnout. Event Info (massmed.org).

FMCH Vision 2030 – Next Steps: Belonging and Engagement

Dear Faculty, Residents/Fellows, and Staff, please join us for the FMCH Annual Retreat on Thursday, May 11th at UMass Chan South Street Campus, 333 South Street, Shrewsbury.

As a participant you will have the opportunity to:

• Revisit FMCH Vision 2030
• Promote Advocacy Efforts for Primary Care
• Provide Faculty Development
• Build a Culture of Mentorship

In follow up of our strategic planning last year, we have identified two areas to expand upon this year.  As we develop our role as leaders in Family Medicine across the state, we will explore legislative advocacy activities. Additionally, we will launch our new department mentorship program. Breakout sessions in the afternoon will include areas of continuing medical education as listed below:

• Belonging –Restorative Justice
• MCH – Shoulder Dystocia
• Epic Mastery Workshop (Laptops required)
• Educational Scholarship
• Medical Humanities
• Advocacy, Legislative Action

Lunch and Registration will open at 12:00 noon with the formal program commencing at 1:00pm. Lunch topics will be available to gather to discuss areas of interest. The retreat will conclude with an hors d'oeuvre, networking reception and cash bar with musical entertainment from 5:00 – 6:30pm.Here is the agenda. Please Register Here. We hope to see you there!

Presentations/Publications

Sunita Puri, MD, our palliative medicine fellowship director, recently published an excellent essay titled "As a Doctor, I know Being Ready to Die Is an Illusion" in the New York Times. Following is the link:

https://www.nytimes.com/2023/03/29/opinion/how-to-accept-death.html

Hugh Silk, MD, MPH, FAAFP, gave a presentation on April 4^th on the topic of Silver Diamine Fluoride: A Cost-Effective Tool for Medical Providers to Thwart Caries and Promote Health Equity with an interprofessional panel as a national webinar through the Harvard School of Dental Medicine Initiative Integrating Oral Health and Medicine.

Amber Cahill, PsyD, Jordan Howard-Young, MD, MA, and Lauren Eidt-Pearson, MSW, LICSW delivered a 6-hour in-person training titled, Team-Based, Integrated Primary Care: Navigating Challenges, Facilitators, and Complexity to East Bay Community Action Program in Newport, RI, an FQHC working to improve behavioral health integration across their primary care practices. These faculty are now in the process of delivering 6 sessions of a Project ECHO focused on addressing complex cases in integrated primary care settings. 

Department Member Recognition

Drs. Sara Shields and Mukti Kulkarni were quoted in an article that ran on the front page of the Worcester T&G on April 7^th about Worcester’s high infant mortality rate and the work of the Worcester Healthy Baby Collaborative. They shared that while there is progress, there are stark racial and ethnic disparities. Dr. Shields shared several strategies to address the concern.

https://www.telegram.com/story/news/healthcare/2023/04/07/infant-mortality-a-concern-in-worcester-racial-disparities-a-factor/70082466007/

Frankly Speaking Podcast

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

Listen on Apple Podcasts: https://podcasts.apple.com/us/podcast/frankly-speaking-about-family-medicine/id1194659367.

Please join us for an overview: This episode will explore a common syndrome that is often misdiagnosed and underdiagnosed. Listen in as we discuss the cardinal symptoms and diagnostic criteria for postural orthostatic tachycardia syndrome (POTS) and learn about different management options, including the benefits of salt. Guest: Mariyan L. Montaque, DNP, FNP-BC, presents: "Chalk It Up to Stress and Anxiety or Is There More to It?". - Frankly Speaking Ep 323.

CLINICAL UPDATES

COVID-19 US

• President Biden has signed the bill to end the COVID-19 public health emergency. 
• XBB.1.16 has a new name, "Arcturus".
• Symptoms associated with the new variant include fever, sore throat, body aches, and abdominal discomfort. 
• Most commonly seen in the elderly, those with underlying conditions, and persons with respiratory conditions. 
• The US has pledged $5 Billion to develop COVID vaccines. 

COVID-19 MA

• The Public Health Emergency will end in Massachusetts on May 11th. 
• There were 1,842 new cases in the past 7 days (34 new confirmed deaths).
• The 7-day average percent positivity was 3.70%.
• On April 4th, there were 90 patients primarily hospitalized for a COVID illness. 

COVID-UMMMC

• As of April 10th, the 7-day average percent positivity is 7.8%.
• COVID positive inpatient = 20 (80% are fully vaccinated). 
• Of the 3 patients in the ICU, all are fully vaccinated. 

Marburg Virus

• The CDC has alerted the US to Marburg Virus. 
• It is similar to Ebola. 
• Currently, there is no treatment. 
• Marburg is not an air-born virus; it is spread person to person via contact.
• Signs and symptoms include: fever, muscle aches, pain, diarrhea, weakness, vomiting, stomach ache, and unexplained bleeding or bruises. 
• Key history: travel to Equatorial Guinea or Tanzania.

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.

Yoga Classes with Dr. Liz Erban

New members always welcome. 

Please join for early morning gentle yoga, Wednesday mornings 6:30am via Zoom.

Much appreciation to Dr. Liz Erban for hosting these outstanding classes. 

Join Zoom Meeting ID: 923 9393 3653 Passcode: 764113

https://umassmemorial-org.zoom.us/j/92393933653?pwd=RW9TL3FhZGtLUVZBa09oMWhIQzZDUT09