UMass FMCH Tuesday Talk - March 14, 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

Upcoming Events

Focus of the Week – Education

Announcements

Frankly Speaking Podcast

Clinical Services Spotlight

Upcoming Events

FMCH Grand Rounds

Tuesday, March 14th, 12:00 - 1:00pm, "Updates in Higher Risk Obstetrics Care in Family Medicine", presented by Kristina Gracey, MD, MPH, Tracy Kedian, MD, Claudeleedy Pierre, MD and Sara Shields, MD.

Meeting ID: 191 986 273 Passcode: FMCH

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

Psychiatry Grand Rounds

Thursday, March 16th, 12:00 - 1:00pm, "Unmet Needs in the Pharmacotherapy of Depression: Is Help Really on the Way?", presented by Michael Thase, MD.

Meeting ID: 818 349 233 Passcode: PsychGR1

https://umassmed.zoom.us/j/818349233?pwd=VVRDNUxZZmF4K3NqNXppTHJiVmNSUT09

Special Seminar

Wednesday, March 22nd, 12:00 - 1:00pm, "Improving Cancer Health Equity in Rural Settings through Participatory Implementation Science", presented by Melinda M. Davis, Ph.D., M.C.R. Dr. Davis is an Associate Professor at Oregon Health & Sciences University, Interim Director of the Oregon Rural Practice-based Research Network and co-Director of the OCTRI Community and Collaboration Core. Dr. Davis conducts participatory implementation science research with patient, community, and health system partners to improve health and enhance health equity in rural settings. Please register in advance for this webinar.

https://umassmed.zoom.us/webinar/register/WN_hrdGUagDQuqwEHBBniA_cQ

See flyer for additional information.

Career Development Workshop: UMass Cancer Screening Research

Thursday, March 23rd, 12:00 - 1:00pm, Presented by Melinda M. Davis, Ph.D., M.C.R., for early-career researchers and faculty, however, all are welcome.

https://umassmed.zoom.us/meeting/register/tJwufumvpzIjGdf54vKqf8zMuvLfMB6uK4GQ

Black Maternal Health 6th Annual Conference (BMHC)

Friday, April 7th; "Centering the Role of Nurses and Midwives in Addressing the Black Maternal Health Crisis", this conference is hybrid, with virtual spots remaining, and is free.

You can register here: 

https://www.accelevents.com/e/bmhc2023?utm_medium=email&utm_source=govdelivery

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

Annual Department Retreat

Thursday, May 11th, 12:00-5:00pm, with reception to follow. Please save the date. Registration materials and agenda will be sent by email in the coming week.

Annual Faculty Review 

The AFR Process is beginning soon. Instructions will be delivered to faculty in boxes, we hope to complete these by the end of June. Please be prepared to update your CV and reflect on your goals from last year. Arrange a meeting with your supervisor in May or June to discuss. A great time to celebrate all the incredible faculty work done year-round.

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.

Presentation Opportunities:

AAFP National Conference of Family Medicine Residents and Medical Students

Student and Resident poster competition upcoming with proposals due April 1st. Consider student and resident projects that might benefit from presentation.  Explore at https://www.aafp.org/events/national-conference/education/posters.html.

Ethics Corner with Philip Day, PhD 

Topic: Assessing Decision-Making Capacity in Practice 

Question 1: What is “capacity” in healthcare contexts?

Response 1: “Capacity” refers to the ability of patients to make decisions about healthcare interventions and treatments. It is related to though separate from “competence,” which is a legal term referring to overall decision-making and is not exclusive to healthcare contexts. 

Question 2: How do I assess capacity?

Response 2: Capacity consists of four components: understanding, appreciation, reasoning, and communication. These components are readily and intuitively assessed by a provider through general conversations with a patient. If a component is in doubt, then capacity should be formally assessed. 

Question 3: What are specific examples of patient behavior that shows lack of capacity?

Response 3: These can vary patient to patient, but in general be attentive to abrupt change of mental status, patients who hastily agree to risky procedures, or those who may have a known risk factor for diminished capacity (e.g., chronic psychiatric condition). 

Question 4: How should I assess capacity if I’m in doubt?

Response 4: If patient capacity is in doubt, then take a stepwise approach to evaluation: 1) ensure there are no communication barriers, including the use of medical jargon; 2) evaluate for reversible causes of incapacity such as infection or adverse effects of medications; 3) consider the patient’s cultural and personal values; 4) formally assess capacity through a clinical interview that can establish if any of the four components of capacity are missing or impaired. 

Summary: Assessing capacity is an important component of clinical practice and should be assessed before questioning or restricting patient autonomy. If the stepwise approach is insufficient, then consider using a formal tool such as the Aid to Capacity Evaluation or Understanding Treatment Disclosure.  

Further Reading: 1) Barstow C, Shahan B, Roberts M. Evaluating Medical Decision-Making Capacity in Practice. Am Fam Physician. 2018;98(1):40-46. 2) Chaet DH. AMA Code of Medical Ethics’ Opinions on Patient Decision-Making Capacity and Competence and Surrogate Decision-Making. AMA J Ethics. 2017;19(7):675-677. doi: 10.1001/journalofethics.2017.19.7.coet1-1707. 

MassAHEC Rural Health Scholars is pleased to share that Zach Strecker SOM Class of 24, has received the 2023 Student Leadership Award sponsored by the National Rural Health Association and John Snow, Inc. He was nominated by Andy Lowe, former director of the Cape and Islands AHEC and now the New England Rural Health Association. The award includes a scholarship. Zack will receive the award in May at the national conference in San Diego. 

Commission on the Health of the Public and Science (CHPS) - please provide your post-Dobbs (and soon to be post-Alliance for Hippcratic Medicine) stories (see link below)!

Background: last week, AAFP President Tochi Iroku-Malize, participated in an event hosted by Vice President Kamala Harris, on the topic of reproductive health. The Vice President's team was interested in learning more about how groups are preparing for a potential decision in the case Alliance for Hippocratic Medicine v. FDA – which seeks to overturn the 2000 approve of Mifepristone. Dr. Iroku-Malize was joined by the President of ACOG and several other reproductive and legal organizations. The administration is preparing for a decision that could come as soon as today. In a discussion about realities Post-Dobbs – the Vice President was interested in learning more from clinicians about any impact stories we have received from our members. Last year, a link was created where members could offer stories. AAFP is not looking for names or locations beyond the state to protect confidentiality. If you have a story to share, we encourage you to submit it through this survey: Action Center (votervoice.net)

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 all dates now!  MCSTAP

Dates/Topics:

• Wednesday, March 15th, 12:00 - 1:00pm, "Continuing Opioids: Applying the 2022 CDC Guidelines
• Wednesday, April 19th, 12:00 - 1:00pm, " Assessing Risk of Opioid Therapy: Applying the 2022 DCD Guidelines



MassAFP 2023 Annual Meeting & Spring Refresher

Manju Mahajan is co-chair of the MassAFP Education Committee. 

Click here for the full conference schedule.

For more details go to: massafp.org. 

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.

Psychiatry for the Primary Care Physician Learning Opportunity

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).

Primary Care Bootcamp for NPs and PAs

Jillian Joseph, MPAS, PA-C, Kristin Wickstrom, PA-C, Megan Brochu, PA-C, and former Barre APPs Mariyan Montaque, NP, Andrea Julian, NP, and several other APPs from UMass and GSN collaborated with Pri-Med to create Primary Care Bootcamp for NPs and PAs. The Bootcamp is a digital, on-demand curriculum designed to help early career APPs build confidence and hone skills in primary care. The platform is now live at bootcamp.pri-med.com and open for registration! There are over 20 hours of CME available through the Bootcamp and the courses are organized into two distinct tracks that cover a range of topics, including chronic disease and concern-based sessions, professional development topics, as well as practice management concepts. Any questions can be sent to Jillian.Joseph@umassmemorial.org.

Click flyer for additional information.

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 children, bacterial infections are a common cause of infectious conjunctivitis. But, like many clinicians, you may be uncertain about the efficacy of using antibiotic drops in these pediatric patients. Join us to get an evidence-based answer to the important question, "Are antibiotic drops needed in children with acute infectious conjunctivitis?". Guest: Alan M. Ehrlich, MD, FAAFP, presents: "Antibiotics for Infectious Conjunctivitis: Efficacy Is in the Eye of the Beholder". - Frankly Speaking Ep 319.

CLINICAL UPDATES

COVID-19 MA

• There have been 2,703 new COVID cases in the last 7 days.
• The 7-day average of percent positivity is 4.85%.
• The total confirmed deaths are 22,365.

COVID-19 UMMMC

• In House patients with COVID-19 as of March 13 was 35. Of the 35, 63 are fully vaccinated. 
• The 7-day average of percent positivity is 3.8%.

Documenting Depression Screening

Depression Screening is one of the key metrics monitored in our ambulatory practices. The enclosed information will assist us in making sure our efforts are captured in Epic. 

• The PHQ-2 is a first step approach in screening for depression. 
• The PHQ-2 is the first two questions of the PHQ-9. If positive, proceed using PHQ-9.
• PHQ-9 is preferred when screening for depression.
• PHQ-9 may be better at screening for school related stress. 
• For patients 12 years of age or older, these tools are appropriate in screening for depression. The highest rates of depression are between ages 12-25. 
• Please see the attached updated Depression Screen guidance and key content.

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

Yoga classes are canceled on March 15th and 22nd. 

Classes will resume on Wednesday, March 29th.