Celebrating the Word Physician: A Language of Respect

Taking care of patients is not a business transaction.

Kudos to Bayhealth, a Delaware company that removed the word “provider” from their lexicon.

Language matters in our healthcare system; it shapes our perception and can empower or diminish the vital relationships between physicians and patients. That’s why the recent decision by physician leaders at Bayhealth in Delaware to stop using the term “provider” deserves our attention.

The term “provider” has long been associated with devaluing the physician’s role. It reduces their extensive education and training to a generic label, failing to acknowledge the depth of their qualifications. It’s no wonder many physicians view this term as negative and derogatory. It undermines their professional worth and purpose, contributing to the growing issue of physician burnout.

The decision by Bayhealth aligns with the views of reputable organizations such as the American Medical Association (AMA), the American College of Physicians, and the American Academy of Family Physicians. These organizations recognize the harmful implications of the term “provider” and encourage physicians to reclaim their professional identity. By emphasizing professionalism and respect, they aim to restore the focus on the patient-physician relationship, which lies at the heart of quality care.

Bayhealth’s bold step to remove the term “provider” from their medical staff bylaws and publications sends a clear message. They are committed to fostering a culture that values the work and role of physicians. By actively avoiding the use of the term, they reaffirm the importance of the patient-physician relationship and promote a sense of trust and partnership in healthcare.

Words have the power to shape our reality. The decision by Bayhealth to drop the term “provider” shines a light on the need for a language that respects and honors the expertise of physicians. By advocating for this shift, we empower physicians to provide the high-quality care they are trained for while reminding patients of the significance of the healthcare relationship.

Let’s applaud Bayhealth’s commitment to change and support endeavors that prioritize the humanity and expertise of our role as physicians.

The Death of Tori Bowie, Pregnancy and Social Determinants of Health

Let me put it right out there. I am the daughter of a schizophrenic, so I am well-versed in discussing mental health issues.

My beloved mother battled schizophrenia from adolescence until well into her adult life. Because of the graciousness of her sisters, who allowed me to live with them, I did not end up in the “system” (aka foster care) despite their limited resources.

Tori Bowie, like me, was not raised by her mother but by her grandmother. We do not know the circumstances, nor is it necessary. She was an Olympian in track and field, and as the mother of two cross-country state champions, I understand that journey well. The discipline. The perseverance. The pressure to be perfect in a very imperfect world.

Tori was found dead at the age of 32, pregnant and alone. It took a well-check visit by law enforcement to discover her death. How does a 32-year-old woman end up dying at home alone while giving birth?

Initially, people speculated that this tragedy resulted from a home birth gone wrong. However, the objective evidence does not support that if you dig deeper, and as a physician and MSW, I did.

The Orange County Coroner’s report states Tori weighed 96 pounds on a 5’9 frame. The calculation of her BMI (Basal Metabolic Index) results is 14.2, meaning she was significantly underweight during her pregnancy. Her weight is the type of weight you see in cancer patients.

Orange County Coroner also reported that Tori also had a medical history of Bipolar Disorder. This objective evidence is a glaring red flag that my poor sister had some deep issues. One of her friends commented that Tori’s world was becoming “more and more isolated.” “People had disappointed her.”

Her agent, Kimberly Holland, commented that Tori “did not trust hospitals.” That statement broke my heart because, as a Black woman, her reasons were valid. But back to her weight and her friend’s comments. Did the father of Tori’s baby abandon her? Was her weight loss reflective of depression? We will never know these answers. I’m not trying to pry into Tori’s personal life, but her case represents teachable lessons for the future. It demonstrates why addressing the social determinants of health of pregnant women, especially women of color, is so important.

Tori Bowie’s case highlights the importance of checking in on friends and family even when they don’t want us to. Even if it means getting on a plane, especially if they’re pregnant, it may mean you get your feelings hurt, and I have borne witness to that regarding a personal family issue that I will not discuss.

Yes, Tori died from complications of pregnancy that included eclampsia and respiratory failure, but I suspect my sister also died of a broken heart.

 

AN ACTION PLAN FOR PREGNANT PEOPLE EXPOSED TO SMOKE

 

Full transparency: This blog was originally written in 2021 in response to the California wildfires. I never imagined I would be writing to warn the citizens of my birth state about the very same issues.

Do these wildfires affect an unborn baby and its mother? The answer is a resounding yes, in the same manner as cigarette smoke. There are toxins in the air called PM2.5 that adversely affect our lungs and heart. Pregnant women exposed to PM2.5 and other toxins associated with wildfires are at risk for

  • Small babies
  • Growth-restricted babies
  • Preterm labor
  • Gestational Diabetes
  • Preeclampsia

 

Here are the action steps a pregnant woman should take if exposed to wildfires:

  • Request an ultrasound to document the proper size and weight of your unborn baby
  • Ask your OB provider about your fundal height to document appropriate growth
  • Be vigilant regarding monitoring the fetal movement per your OB provider’s recommendation, and do not hesitate to contact them if you are not comfortable with the level of activity or movement

Perhaps we need to bring Smokey the Bear out of retirement, but until then, please be safe and share this post to help pregnant mothers do the same.

HGTV Celebrity Couple Lost Cousin in Childbirth

Every time I write one of these posts, it breaks my heart, but these women’s deaths would go unnoticed without raising public awareness.

If you are interested in receiving information about the Black Ob-Gyn Directory that will drop in February 2023, please contact me at DoctorLindaOnline@gmail.com or https://www.thesmartmothersguide.com/contact/

 

“I’m on Maternity Leave Without a Baby”

A young, Black woman, pregnant with her second child, leaves the hospital empty-handed because no one would listen to her. It is a social refrain that bears no repeating. She had a previous delivery at 37 weeks because of preeclampsia. When she became pregnant again, her ob-gyn told her she was not a high-risk patient, but he was wrong. She didn’t receive baby aspirin during the second pregnancy, although she should have. Her provider told her he would prescribe it at 28 weeks, which was wrong because the optimum time to receive it is 16 weeks. She never saw a high-risk pregnancy specialist, although she should have. Instead, she developed the HELLP Syndrome at 25 weeks, and her baby expired.

One might say that the baby died from prematurity. However, evidence-based research reports a 67 to 76% survival rate for preterm babies born at 25 weeks.

She went to a social media group, seeking solace and comfort for her grief, and the disparities were glaring. Painful. Everyone in the group knew what a maternal fetal medicine specialist was except Laney, and no, they did not look like her.

I am weary of those sad stories. I am frustrated that things get worse instead of better regarding our healthcare system. However, I am committed to “Be the change I want to see.” So, I, along with other Black ob-gyn physicians, are rolling out a Black Obstetrician-Gynecologist Directory/Database so people like Laney can receive care from people who respect her culture and, most importantly, LISTEN to her.

Representation matters. Healthy Babies Matter. The dignity of this patient matters.

We, as humans, matter, and that means ALL of us.

Say No to 4 Prenatal Visits

The new policy being promoted to clinicians and patients places patients at risk. Please share your thoughts. Do you agree?

Happy Father’s Day: 10 Important Things an Expectant Dad Can Do to Help Have a Healthy Baby

This blog was originally written in 2011 but it still holds true today.

Some of the most endearing moments I have witnessed as an obstetrician involved observing men in the labor room. There was the Jewish dad from Brooklyn who brought his Anita Baker tape and played it while his wife was in labor. Because she was one of my favorite artists, I was constantly in their room under the guise of watching the fetal monitor, just so that I could listen to the music. Another memorable moment was the dad who cried tears of joy when his wife was returned back to her room after having a c. section. The love and admiration that beamed in his eyes almost tempted me to ask him if he had a friend (this was of course when I was single). The point is, that expectant dads can play a significant role in helping their wives or girlfriends have a healthy babies. Here’s how:

  1. Remind the baby’s mother to make certain she feels the baby move at least 4 or more times in one hour.
  2. Make sure she knows what her blood pressure is at each prenatal visit
  3. Make sure she keeps all of her prenatal appointments
  4. Make certain her hospital bag is packed and she has all her important papers in one specific location
  5. Ask permission to be in the labor room with her so that you can witness the birth of your child. It is a scene you will never forget and will bring you closer together as a couple.
  6. Please don’t cheat on her while she’s pregnant. You could give her an unwanted sexually transmitted infection
  7. Encourage her to push when it’s time
  8. Rub her back in between contractions
  9. Take notes when she’s in labor. If there’s a change of shift, make sure that the new shift knows what went on during the previous shift; particularly if she’s having complications such as high blood pressure or fetal distress on the monitor. One of the greatest risks of OB medical malpractice is miscommunication or a lack of communication during shift changes. The proverbial left-hand doesn’t always know what the right hand is doing.
  10. If the nurses become concerned about the baby’s fetal tracing, ask that the doctor or midwife come to the hospital immediately.

The active participation of an expectant father is priceless. In the words of an old R&B classic by the Winstons, “. . . color him father; color him love.” Happy Father’s Day.

My 25th ACOG Rejection While Black Maternal Death Continues to Rise

Dear Dr. Abbasi-Hoskins:

Thanks for your response regarding my 25th rejection to become a member of ACOG’s  Medically Underserved Women’s Committee. Please be advised that I will not be submitting any future applications.

Although I have paid my annual dues for the past 25 years, I cannot guarantee that I will continue to do so in the future.

Have you noticed the dwindling number of obstetricians-gynecologists who pay their dues, especially those who look like me?

Although I originally planned to write a lengthy letter, my former high school photographer teacher (may he rest in peace) once said, “A picture is worth 1,000 words.”

The picture of this Black woman’s unassisted homebirth speaks volumes and represents our dismal failure as effective clinicians in keeping pregnant women safe and unharmed. Some Black women would rather stay home and deliver their babies in a tub without assistance than come into a hospital where they are often disrespected, ignored, and clinically mismanaged. How do we change that narrative?

This week’s JAMA opinion hits home. Medicine is an art as well as a science. Since ACOG will not allow me a membership to the Medically Underserved Committee, let me offer this advice based on my 35 years of clinical and professional experience:

  1. Stop allowing ob-gyn residents to “cut and paste” history and physicals and feign them as their own. This practice represents cheating and does not enhance their clinical acumen. How are residents supposed to learn if they use someone else’s data?
  2. Initiate mandatory competency exams regarding the diagnosis and management of preeclampsia. Some residents do NOT know how to manage preeclampsia effectively, and I have reviewed those dismal malpractice cases to prove it: The case of the late Dr. Chaniece Wallace is a prime example. The state of Indiana could use some much-needed help.
  3. Adopt the California Maternal Quality Care  Collaborative’s clinical guidelines that have proven they can reduce maternal mortality. The present ACOG clinical guidelines for the management of preeclampsia are as clear as mud, especially as it relates to patients who demonstrate preeclampsia symptoms before 39-weeks. My late residency director, Dr. Sterling Williams, former V.P. of Education at ACOG, is greatly missed. We did not have confusing clinical guidelines when he was alive.

I wish you a successful year as the new ACOG president and hope you will consider some of my recommendations.

Respectfully,

Linda Burke (formerly Burke-Galloway), MD, MS, FACOG

Three Things You Should Know About the Infant Formula Crisis

On May 13, 2022, the U.S. D.A. (U.S. Department of Agriculture) issued Press Release No. 0106.22 regarding the U.S. infant formula crisis.  In plain English, here’s what parents need to know:

  1. If you are a WIC participant and participate in Food Packages I and II, you might not need a doctor’s note to get “noncontract infant brand formula.” Your state would have to request a waiver from the U.S.D.A
  2. If your state applied for a waiver, your maximum monthly allowance (MMA) could increase
  3. If you state applied for a waiver, you can exchange products purchased with WIC benefits

The USDA reports that to date, not all states have submitted waivers which might adversely impact families. If your state is not listed on this list. Then they did not apply for a waiver. If your state is not on the list, contact your local political representatives to find out why.

For further help and assistance, contact the U.S.D.A website.