UMass FMCH Tuesday Talk - September 12, 2023/EDUCATION

Welcome to the FMCH Tuesday Talk. Please continue to send us your announcements, celebrations, and accomplishments to [email protected]

Table of Contents

Upcoming Events

Focus of the Week – Education

Ethics Corner

Announcements

Department Member Recognition

Presentations and Publications

Frankly Speaking Podcast

Clinical Services Spotlight

Upcoming Events


FMCH Grand Rounds

Tuesday, September 12th, 12:00 - 1:00pmFrank J. Domino, MD, presents "Journal Club".

Meeting ID: 191 986 273 Passcode: FMCH

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

Focus of the Week - Education

Mary Lindholm, MD and Frank Domino, MD,

interim leaders


UME: Convocation week started on September 8th as we welcome the new medical school class of 2027! The white coat ceremony kicked off the events and an LGBT Convocation welcome celebration occurred on Monday, September 11th.

GME: Dr. Beth Mazyk will be stepping down as residency director at Fitchburg Family practice after many years in the role. We are so grateful for her dedication and steady guidance to the residents! She will continue to serve as medical director in Fitchburg and will use the extra time to focus on some of her clinical interests. A search committee has been formed and will start interviewing applicants for a new program director. Please forward the attached job description to anyone you feel would be a great candidate!


CME: Don’t forget to create and account on CloudCME which is the UMass Chan Medical School – Office of Continuing Medical Education (OCME) new home for housing all CME activities. Activity attendance will also be recorded within the system. Please follow the instructions below:

  • To receive credit for attending an activity, it is VERY important that you create an account (profile) in CloudCME, as well as download the App to report/claim credit. If you do not create an account, you will NOT be receiving credit for attending activities.
  • As of September 1st, 2023, RSS attendance will no longer be housed within the clinical system’s Echo system and the use of sign-in sheets will no longer be needed nor supported with this new CloudCME platform.
  • It is very important that you know which email address is linked to your CloudCME account and profile. You should have received an email indicating this, but if not, I would recommend trying the UMass email you use most.
  • You can create your CloudCME profile at: https://umassmedcme.cloud-cme.com


TOT will be starting a new session this November. If you have never attended and would like to improve your teaching skills and network with other clinician educators, please register and join us! Register at https://umassmed.co1.qualtrics.com/jfe/form/SV_0GUbJ2w3HifJC8S.

Ethics Corner


Topic: Non-therapeutic Circumcision


Question 1: Is it ethical to circumcise a child who will receive no direct benefit from the procedure?

Answer 1: While there are hypothetical therapeutic benefits from circumcision, such as reduced risk of UTI, penile cancer, phimosis, and HIV infection, these benefits are only potential, and the occurrence of these diseases requires context and patient-specific risk stratification (1). Non-therapeutic circumcision is not considered preventive medicine.

Question 2: So, is it ethical?

Answer 2: It depends. Abstractly speaking, it is not ethical to perform procedures on non-consenting patients which produce no therapeutic benefit. This aligns with a statement from the Brussels Collaboration on Bodily Integrity (2) whose authors argue against “cutting any person’s genitals without their informed consent…unless the cutting is medically necessary.” On the other hand, in a systematic review, the American Academy of Pediatrics released a position statement concluding that the benefits outweigh the risks (3). This position has proven controversial (4).


Question 3: So, is it ethical?!

Answer 3: Non-therapeutic circumcision can be argued to violate the four principles of medical ethics (4) and to contradict the clinical imperative of only performing therapeutic, evidence-based procedures. However, the practice often aligns with the cultural values of parents, so careful counseling of the risks of the procedure is recommended as most parents request circumcision because they believe the procedure has medical benefits, is recommended, or is culturally “normal.”


Summary: Non-therapeutic circumcision is a controversial topic and counseling patients to ascertain the source of their request is an important part of ethical practice. However, given the lack of clear benefit to the patient, it is ethical to conscientiously object to performing the procedure even if requested by parents.


References: 1) Earp BD, Mishori R, Rotta AT. Newborn Circumcision Techniques and Medical Ethics. Am Fam Physician. 2021;103(2):69-70. 2) Brussels Collaboration on Bodily Integrity. Medically unnecessary genital cutting and the rights of the child: moving toward consensus. Am J Bioeth. 2019;19(10):17-28. 3) American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. 2012;130(3):e756-e785. doi:10.1542/peds.2012-1990 4) Svoboda JS. Nontherapeutic circumcision of minors as an ethically problematic form of iatrogenic injury. AMA J Ethics. 2017;19(8):815-824. doi: 10.1001/journalofethics.2017.19.8.msoc2-1708

Announcements


Past editions of the Tuesday Talk Newsletter are available

at https://www.umassmed.edu/fmch/ under Resources.

Pilot Project Award - Call for Applications

The UMass Chan Ambulatory Research Consortium (ARC, UMass ARC website) is a collaboration of the Departments of Family Medicine and Community Health, Medicine and Population and Quantitative Health Sciences, and the UMass Center for Clinical and Translational Science (CCTS). The goal of the PBRN is to accelerate health services research and improvement science and to serve as a learning laboratory for discovery that improves the delivery and outcomes of ambulatory care.

Letters of Intent (LOI) are due on September 22nd.

We welcome submissions for pilot project awards (up to $25,000 for 1 year).


Faculty Resource Fair

The Office of Faculty Affairs is holding a Faculty Resource Fair on September 28th from 11:30am-1:30pm in the school lobby, please see details [here].


The Worcester Healthy Baby Collaborative is thrilled to host its 10th annual Infant Mortality Summit on Tuesday October 3rd, 2023 from 8:30am-12noon, VIRTUALLY.

We are once again highlighting the connection between breastfeeding and infant mortality and presenting this summit in conjunction with the Massachusetts Breastfeeding Coalition’s annual conference. Our theme is Latch On! Supporting Latino and Black Families with Lactation: Examples of Community Programs featuring speakers from 4 different programs and a community panel of their clients. This year we are so excited to be able to offer AAFP CME for the conference. Please see attached flyer and REGISTER today through the link on the flyer.

(There is NO same-day registration and the only access to this is thru the MBC conference portal, so please register).

Department Member Recognition

Congratulations to Dr. Lisa Gussak. Her photo (included here) is being featured as the Cover Image of Family Medicine in the September 2023, Volume 55, No. 8 Issue.


She writes, "Every so often I am fortunate to find myself with my camera, in the right place at the right time. This image reminds me of the power of a small sliver of light—".

Lisa Gussak, MD, University of Massachusetts

Hugh Silk, MD, MPH, FAAFP, and a team of co-authors, were the recipient of the Shils Entrepreneurial Fund award for the Primary Care Collaborative Report –Innovations in Oral Health and Primary Care Integration

Kristina Gracey, MD, MPH, served as the ALSO (Advanced Life Support in Obstetrics) Faculty for the Brown ALSO Provider Course and joined Brown faculty including MaryBeth Sutter and UMass alum Ben Adler in teaching Brown FM residents on August 25, 2023 in Pawtucket, RI. 

Presentations and Publications


Hugh Silk, MD, MPH, FAAFP, had a narrative piece published in this month's Family Medicine. You can read the piece entitled "Letter to Your Grave" here: 

https://journals.stfm.org/familymedicine/2023/september/silk-0451/


Lucy Candib,MD, recently published a book, co-edited with Will Miller, PhD, titled "Family Doctors Say Goodbye: Shifting Grounds and Relationships".

https://link.springer.com/book/10.1007/978-3-031-33654-6

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: In this episode, we discuss the findings of a recent Lancet publication on a novel neurokinin 3 (NK3) receptor antagonist for treating hot flashes. Tune in as we talk about how this nonhormonal treatment addresses menopausal hot flashes, the prescribing precautions issued by the FDA, and the implications for patients seeking your help with alleviating symptoms. Guest: Robert A. Baldor, MD, FAAFP, presents: "A Cool New Treatment for Hot Flashes?" - Frankly Speaking Ep 345.

Clinical Services Spotlight:

Josephine Fowler, MD, MBA, Vice Chair of Clinical Services

Workday is coming in January 2024

UMass Memorial Health will launch Workday systemwide 

January 1st, 2024. As a reminder, Workday is a cloud-based system that will become our home for caregiver personal and job-related information, expense reporting, financial management, as well as purchasing and inventory activities.

Mandatory Masking During Patient Encounters

We have continued to see a dramatic increase in the number of COVID-19 positive employees leading to exposures to both fellow caregivers as well as patients. In response to this, as a protective measure for our staff and patients we will implement mandatory caregiver masking for all patient encounters in all licensed clinical areas effective immediately. Masks will not be required for common areas such as the cafeteria or lobbies, however they remain very strongly encouraged given the increase in COVID-19 we are seeing. Mask use continues to be encouraged for patients and visitors. We will continue to monitor this situation closely but expect to re-evaluate this mandate in four weeks. Visiting hours have not changed and remain

10:00am-8:00pm. 

 

COVID-US


COVID-MA

  • There were 2,278 confirmed new cases of COVID as of 9/28/23 over 7 days. 
  • The 7-day average of percent positivity, 12.07%. 
  • There were 18 new confirmed deaths during the past 7 days ending 9/7/23. 


COVID-UMMMC

  • The 7-day weighted moving average 13.3%. This is up from 9.6% last week.
  • The 7-day average of confirmed positive in-house patients, 19.
  • Of the 19, 68% are fully vaccinated. 

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