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.

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/

 

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.

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.

The Deadly 17 Minute Cesarean Section: In Memory of Kira Johnson

The public should be wary of certain physicians, and the late Kira Johnson’s physician is one of them.

According to Case No. 800-2016-021723, the California Board of Medicine received six complaints of medical negligence against Dr. Arjang Naim, who is a board-certified obstetrician-gynecologist who practices in Los Angeles and Beverly Hills, California.

On April 12, 2016, Johnson entered Cesar Sinai Hospital for an elective C-Section accompanied by her family but left the hospital without her.

I attended medical school and did my internship with men like Arlang Naim and know them well. Cowboys is what we called them back in the day. They took pride in whizzing through operative surgeries like they were in a race against time. Safety rules did not apply to them. They breached standards of medical care, and no one held them accountable.

In cases of emergency C-sections, the expected length of time is thirty minutes. Kira Johnson had no emergency conditions, and her C-section was an elective procedure. Naim had two medical practices in Hollywood and Beverly Hills and was probably multi-tasking.

Johnson’s procedure began at 2:31 p.m. and ended at 2:48 p.m., 17 minutes, including her delivery. Unfortunately, in Naim’s haste, he failed to close the bladder flap. Shortly after that, he left the hospital, leaving Johnson’s care to the resident physicians who were in training.

At 4:40 p.m., Johnson developed abnormal bleeding in the bag that collects urine (known as the Foley catheter). Then, at 5:45 p.m., a massive blood clot could be felt through her skin incision. Her pulse then increased dramatically, and is a classic sign of impending shock.

Johnson received multiple blood transfusions and exhibited signs of a dangerous condition called DIC (disseminated intravascular clotting) which meant her blood was not clotting properly. Naim did not arrive at Johnson’s bedside until 8:47 p.m. Despite Johnson’s unstable condition, he wrote orders, including a CT scan and then LEFT THE HOSPITAL.

Johnson’s condition deteriorated further, and the resident physicians called Naim again. He arrived at the hospital at 11:45 p.m. but only wanted to continue to merely observe. However, the resident physicians convinced him to return to the operating room to determine the site of her bleeding.

At 12:25 a.m., Johnson was taken back to the operating room, and at 1:15 a.m., the resident physicians scrambled to find a general surgeon to assist Naim with the procedure. Unfortunately, Kira Johnson’s heart stopped beating.

Further evidence from the California Board of Medicine reported that Johnson was not the only patient who experienced medical neglect.

  1. On August 21, 2015, a patient had a ruptured tubal pregnancy. Naim performed her surgery but failed to achieve any follow-up hospital care for three days despite her requiring a blood transfusion
  2. On March 14, 2016, a patient had a ruptured uterus after experiencing a 16-week pregnancy loss. The uterus was repaired, the patient required a blood transfusion, and Naim did not see the patient during her entire hospital stay.
  3. On May 31, 2016 (approximately one month after Kira Johnson expired), Naim performed a C-section on his patient with a placenta previa (placenta covering the baby). Unfortunately, the placenta could not be removed, and the patient required a hysterectomy performed by Naim and a GYN oncologist. Although it was Naim’s patient, he failed to see her daily during her hospital course.

The California Board of Medicine placed Naim on probation in 2018 for two years, but he is practicing medicine again, including delivering

Would you want him to be your physician?

Soulmates Left Behind on Mothers’ Day

Charles Spurgeon Johnson, Anthony Wallace, Juwan Lopez, and Bruce McIntyre III.

On this Mother’s Day, I honor the soulmates of mothers who left before their time on earth based on clinical incompetence, arrogance, and, yes, that dreaded word no one wants to discuss but is ever apparent racism.

Here are some examples of why Sha-Asia Washington, Amber Rose Isaac, Kira Johnson, and Dr. Chaniece Wallace are no longer with us:

Dr. Dmitry A. Shelchkov, a foreign medical school graduate, failed to provide adequate oxygen or monitor three previous patients before finally killing Sha-Asia Washington. He did not give her oxygen when she became short of breath and placed her epidural catheter incorrectly. His mistakes had been known for years, but it took the death of a 26-year-old first-time mother before the New York Medical Board suspended his medical license.

The obstetrician who performed a 17-minute elective C-Section led to a postpartum hemorrhage and the preventable death probably of Kira Johnson. Unfortunately, he probably still has privileges at the infamous Cedar Sinai Hospital.

The ob-gyn residents and their attending physicians at Montefiore Hospital who missed Amber Rose Isaac’s dropping platelets are probably still practicing without any accountability except providing a pathetic apology that will not bring her back to life.

And then there’s the case that keeps me up at night involving my fellow physician colleague and sorority sister, Dr. Chaniece Wallace. The horrific two-hour delay of starting an intravenous line in the setting of her hypertensive crisis is chilling. Yet, St. Vincent’s Hospital in Indiana purports to have given her the best care.

Yet, amid this madness, four remarkable men have turned their pain into action on behalf of their departed soulmates. Their comments and posts on social media platforms demonstrate a palpable love. They speak about their beloved in the present tense. They not only continue to love these women but remain IN love with them despite their physical absence of 6 years for Charles Spurgeon Johnson IV and two years for Anthony Wallace, Juwan Lopez, and Bruce McIntyre III.

These brothers teach us that love continues to win, even in death, and has created beautiful children that represent their legacy.

Today, I salute the soulmates of Kira, Sha-Asia, Amber, and Chaniece, who continue to teach all of us that death has no real power over love, just as it had no power over Jesus, the Christ.

May my sisters continue to rest in Power, and may their memory continue to be a blessing.

 

My Mother Would Die if She Gave Birth to Me Today

Used with permission of E Bere Illustrate

If my mother gave birth to me today instead of over 60 years ago, she would probably be dead based on her risk factors. She was Black, had gestational diabetes, and gave birth to a 9-pound 4-ounce baby girl via C-section. She would have been discharged from the hospital on post-op day four rather than post-op day seven. But, thank God, my mother, unlike her mother, lived. I never knew my grandmother because she died from postpartum cardiomyopathy at age 39, a few months after delivering my youngest aunt in 1939.

When my mother had me, there were no managed care organizations that booted women out of the hospital 48 hours after birth or 96 hours after having a C-section. Had the federal government not stepped in with the Newborn and Mother’s Health Protection Act of 1996, mothers and babies would have been sent home after 24 hours, a phenomenon sarcastically referred to as “drive-through deliveries.”

In the discussion of reasons for the ignominious U.S. maternal mortality rates, the topic of managed care organizations and private equity investors is never discussed but should be.

According to Medical Economics, the Medical Management Group Association (MMGA) reported $60 billion in “deals” involving medical practices in 2019 by private equity firms. They are one of the reasons why nurses are leaving hospitals, physicians are jumping off hospital roofs, and yes, women are dying within a week of having a baby, and the stillbirth rate has increased.

The business model is not taught in nursing, midwifery, or medical schools. As a result, we do not know how to compromise quality care and satisfy your shareholders simultaneously. Perhaps if hospital CEOs and private equity shareholders are named co-defendants in future medical malpractice cases, the maternal mortality rate will move in the opposite direction.

You profess not to know why more pregnant women are dying? Try taking a closer look at your priorities and business practices. As long as profit and revenue take precedence over human life, there is little hope for change.