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Caring for Patients and My Female Colleagues at CHEST 2018

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The American College of Physicians hosted around 6,000 physicians and researchers in pulmonology, critical care and sleep medicine earlier this week in San Antonio, TX for CHEST 2018 their 83rd annual conference. “Learn by Doing” was the key theme for this conference with more than 100 simulation and hands-on sessions, around 400 sessions on topics in debate from experts in the field, and multiple “bite-sized” session concise 10 minutes sessions to review topics of pivotal importance. This was my first CHEST conference, and as a resident attendee, I had a remarkable experience. For me there are two messages that I take away from these amazing 5 days.

Patient Care

Dr. Richard Irwin, MD, Master FCCP, the Editor-in-Chief of CHEST journal, gave the keynote speech about his journey into learning the importance of patient-focused care. Dr. Irwin defined patient-focused as care defined from a patient’s perspective. He revealed the 3Cs that embody patient-focused care are “Communication, Continuity of Care, Concordance of Expectation (finding the common ground).” All of these lead to a significant improvement in patient outcomes. He emphasized that the lesson “patients matter” should begin in medical school. And not just on the formal curriculum. Patient-focused care must be part of the hidden curriculum as well — the unspoken learning that happens when medical students see more experienced clinicians at work.

“For the clinicians and educators, remember trainees are watching you and learning your behaviors. That is the hidden curriculum when talking about Patient-Centered Care.” He spoke with heart, stating that clinicians should treat their patients as they would expect their family to be treated, do for others what you expect for your own. The three lessons Dr. Irwin wanted to take the attendees to take away three important lessons from his lifetime of experience.

1. Never lie to your patient!

  1. Learn from all your colleagues

  2. Never take yourself too seriously

Women and Pulmonology

“Women and Pulmonology” was one of the most inspiring themes at the CHEST 2018 annual conference. The American College of Chest Physicians held several sessions that were to highlight problems faced by women in the field of pulmonary, critical care and sleep medicine. Also, several sessions were dedicated to diseases unique to women, a session “ How to attend a rapid response call in the Obstetrics Unit” was of special highlight as it highlighted how very few intensivists knew the special precautions of CPR and resuscitation in case of cardiac arrest in a pregnant mother, or how to manage the extremes of blood pressure to ensure the safety of the mother and child. For the second year in a row, CHEST foundation continued its Women and Pulmonary Luncheon where Dr. Schneider MD, MSc, FCCP, the global patient affairs lead at Pfizer, spoke about myths facing women in medicine. She emphasized that women should be willing to negotiate, and should not underestimate what they are bringing to the table. She pointed out the visibility and value myth. People often say “the work speaks for itself,” but it doesn’t, she emphasized. One way to raise your visibility is networking “beyond your usual suspects,” she advised. Dr. Roozehra Khan, section editor at the CHEST journal, spoke how many women face an imposter syndrome. Imposter syndrome is a concept describing high-achieving individuals who are marked by an inability to internalize their accomplishments and a persistent fear of being exposed as a “fraud,” she said. It’s not gender-specific, but women tend to experience it more intensely and are more limited by it. Stephanie M. Levine, MD, FCCP, president-elect of CHEST, and program director of pulmonary and critical care fellowship at the University of Texas Health — San Antonio, dove into “breaking the glass ceiling.” Women are 13% less likely to get promoted to professor, they have less research funding and production, and their salary is 21% less than men. She mentioned a few possible reasons why women lag behind in gender specialty parity including lack of same-gendered mentors, and she mentioned that women may lack behind in advancement partially because they aren’t as good of negotiators. But women often have better collaborative skills, more compassion, and more empathy, she said. Dr. Levine wrapped up with a few take-home points for women.

“Get involved and stay engaged,” she said. “I’m not just talking about CHEST here — get involved in your division, in your community, in your workplace. Find a mentor or sponsor. Apply for appropriate committees at work or in your professional societies, self-nominate, seek nomination and help try to nominate others. Be a strong advocate for yourself.”

It was an amazing conference but the two moments that I would remember is when I was thinking about my own patients and how I may want to change my care about them when listening to stories from Dr. Irwin and now after this conference I have a new perspective, value and importance for my female colleagues in medicine.

Muhammad Sameed, MD is currently an Internal Medicine resident at University of Maryland Medical Center. Major areas of research interest include ARDS, Airway Management and Trauma induced lung injury. Outside the realm of medicine they advocate for #FOAMed (Free Online Access Medical Education), and like playing chess and tennis. They have no conflicts of interest.

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