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.

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.

Tina Turner’s Death Puts Hypertension in the Spotlight

On May 24, 2023, Tina Turner’s death was announced at the age of 83. The iconic singer’s death has spotlighted hypertension and kidney disease. Hypertension (also known as high blood pressure) is a condition that affects millions of people worldwide. In most cases, it is treatable with lifestyle changes and medications. Tina Turner’s words about high blood pressure (hypertension) haunted me. The picture of her on dialysis haunted me. Essentially, she said, if she knew better, she would have done better.

Many pregnant women who have preeclampsia or hypertensive disorders of pregnancy continue to have blood pressure problems after having a baby.

According to the Centers for Disease Control and Prevention (CDC), one out of every three deaths in America is caused by heart disease or stroke—two conditions that are often associated with high blood pressure. It is especially dangerous for African Americans. We can never receive enough information about combatting this deadly disease.

 

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/

 

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

You Saved My Baby’s Life

As Preeclampsia Awareness Month comes to a close, I want to share a blog post I wrote on 2/28/2011 that provides a better description of my former patient’s birth that resulted in her amazing son. If nothing else, please pay attention to what her blood pressures were and how the resident physicians had a false sense of security that almost led to her baby’s death. 

I was greeted by those words during a patient’s recent postpartum exam and was both gratified and humbled.  A potential disaster was avoided and her pregnancy had a happy ending.

Katina* (name changed) had registered for prenatal care early so when her blood pressure was a little “different” at 32 weeks, the change was duly noted. She wasn’t complaining of a headache, her feet weren’t swollen but this was her first pregnancy which placed her at an increased risk of developing pre-eclampsia.  A blood pressure of 120/82 would seem normal to most people but in Katina’s case it wasn’t. She was sent to the hospital and then discharged home with instructions to monitor her blood pressure daily and I asked her to return in one week for closer scrutiny.

Upon Katina’s return, her blood pressure was 140/90 so off she went to the hospital’s labor and delivery triage department for further evaluation. Upon her arrival, her blood pressure appeared to have improved. The resident physicians on duty made snide remarks, insinuating that she was referred inappropriately.  As she was about to be discharged, the baby’s heartbeat dropped precipitously. Before Katina could blink, a team of physicians and nurses descended upon her with full force. They shoved papers in her face requesting a signature for an emergency c/section and informed her that it was possible she could die as well as her baby. Her blood pressure had escalated through the roof and her heart raced dramatically. She was quickly put to sleep, a “stat” c. section was done,  and her baby was born alive. For the next four days, the hospital staff had difficulty controlling her blood pressure and her heart continued to pound at rates above 150 beats per minute. It was one of the most harrowing experiences of her life however, in the end, both mother and baby were discharged home and are now fine. Katina experienced what we in medicine call a “diagnostic save.” A life was saved because the proper diagnosis was made in a timely manner. How often does that happen? Not often enough. If you can “see it” then you can treat it. Pregnant moms must be empowered to help their healthcare providers “see” the problem before it spins out of control.

 

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.