Optimizing the health, functioning & well-being of children with disabilities through health services & outcomes research, clinical care, leadership & advocacy.
Millions of seniors and people with disabilities can’t get long-term care in their homes and communities – a life-or-death problem during COVID. I spoke to
@sandra_harris1
from
@AARPMA
and
@HoutrowMDPhDMPH
this past week about why it’s critical to expand access to these services.
We are currently in the phase of pandemic where the
@CDC
doesn't provide accurate data to assess personal risk of
#COVID19
and 'trusted experts' are now telling us assess our own risks and live our lives. What happened to public health?
Everyone, mask up. We are in a surge. The variant is so very very contagious. We all should have been masking indoors (but folks
@CDCDirector
told us to make our own decisions without good guidance). Do it for yourself, do it for others.
#CovidIsNotOver
The
@CDCDirector
opted to promote a, "you do you" approach for
#CovidIsNotOver
. This is not a public health strategy. Collectively our society (not everyone) has opted to behave as if ignoring the pandemic will make it go away. Please wear a well-fitting mask inside around others
@fuzzymittens
A friend of mine (a physician) was in labor in L&D, called for nurse & OB b/c she was ready to deliver. No one came -despite her husband also requesting by going to the nurses' station. Her husband (also a physician) delivered the baby. Bill included the OB's for the delivery.
@AlissaMitche11
Overhead call on plane: "Is there a doctor on board? If so please come to row 28." I go, and say, "I'm a doctor." Flight attendant, "Please get out of the way, we need a doctor." Me: "I'm a doctor, I can help." FA: "We need a doctor." Me: "Yes, I know. I am a doctor..."
Making each person responsible for their own health doesn't work. Imagine if we dismantled sanitation systems (a great public health measure) and said, "Everyone, just stay clean, watch out for waste." That's my analogy for our current public health response to
#CovidIsNotOver
@ToraTigress
@fuzzymittens
Both doctors worked at that hospital and called risk management and also requested an M&M. It was a major hassle to get their bill addressed. Everyone was okay.
@daytheon
I have been doc on board on numerous occasions; in a majority, I was not believed to be a doctor at first. In most of those situations, I have been apologized to and profusely thanked by the flight crew. One time I had to Jedi mind trick 2 surgeons from causing a big disaster.
@DrTiffJohnson
I have a punch card/sticker chart thing for myself that encourages me to say no. For every 10 times I say no, I get to get myself a present. I am about to award myself my 4th present. None of my emails declining an invitation are as thoughtful as yours!!
@RebeccaCokley
Totally preventable but insurers won't cover necessary equipment, supplies and services to prevent pressure wounds. This is despite the high cost of these wounds. Cost in terms of actual $ and more importantly to the lives of the people with the wounds.
@ChristleNwora
@Abigail_CaseMD
What if instead of demanding patients develop the health literacy of a health care professional to navigate the health care system, we make the system easier to use and explain things in clear language?
@POTUS
Perhaps you could promote the following: indoor in-public mask wearing, ventilation, air filtration, frequent testing when exposed to COVID or feeling under the weather, contact tracing, & not exposing others when ill & please make high-quality masks & ample testing free.
@PedsDrJeff
I thought the coin laundry was for money laundering (a term I also took literally). I had been told that money was very dirty. My mom wouldn't take me to coin laundry so I washed the coins from my allowance in the sink. You do what you have to do.
@DGlaucomflecken
Wheelchairs. I once had an insurance company deny just the wheels. "A wheelchair without wheels is just a really expensive chair and defeats the purpose of wheelchair," I explained on peer-to-peer.
@ECritty
I have had this happen but not in such a notable way. I discussed with customer service. They said I would not be able to return it because the receipt didn't match the item. I told her that it really benefits me, and she was all like 'glad I could provide good customer service'
@AmyGDalaMD
A: You'll improve flow if you don't let the residents see patients first & then present to you. They should watch.
Me: Come back to me when you understand core assumptions. This meeting is over.
A: Wait what?
Me: This was a waste of time & money. Let's not waste more of my time
@KatiePennick
OMG! Did they ask for permission to use your work? And it bothers me so so much that folks further stigmatize disability by refusing to say the word disability.
@PaulNWilliamz
I had to do a peer-to-peer because an insurance company denied the wheels for a wheel chair. I said (not so nicely) "you are authorizing a very expensive chair which doesn't serve the purpose of the prescription I wrote. A wheel chair needs wheels to be considered a wheel chair."
Congratulations to Amy Houtrow, MD, PhD, MPH, who was recently awarded three grants that will help advance health equity for people with disabilities.
@UPMC_PMR
@HoutrowMDPhDMPH
@_nomadic_soul
Perhaps this will help. Boomers can be the parents of Gen X, Millennials and Gen Z, Gen Xers can be the parents of Millennials, Gen Z and Gen Alpha (not shown here), Millennials can be the parents of Gen Z and Gen Alpha (not shown here)
@kathryniveyy
Guessing you are making assumptions based on your own opinions about QOL. Turns out you can be old w/ lots of comorbidities & still have a great QOL & want to live. Also, as a rehab doc, I have seen amazing recovery after prolonged critical illness. This reeks of
#ableism
#ageism
The National Academies of Sciences, Engineering, and Medicine appointed Dr. Amy Houtrow Chair of the Planning Committee for Supporting Children with Disabilities. Congratulations
@HoutrowMDPhDMPH
@UPMC_PMR
@AmyGDalaMD
I feel badly that I almost made an admin cry in a meeting after they had spent a lot of time/money with a consultant to tell us that the best way to improve patient flow was to stop letting the residents see patients first (in a teaching hospital). I said, "this meeting is over."
@womlliv
@daytheon
The surgeons were trying to out-status each other (to them I had no status at all). They were a mess taking a history/doing a quick exam and made the situation worse. The young man was high and anxious, so I claimed highest status as a pediatrician & dismissed the surgeons.
@DrKimSue
Also politics is everywhere. When people say, "let's keep politics out of it," I hear, "the status quo is fine by me." I know that isn't always true. I am now saying 'social and political determinants of health' instead of just 'social determinants of health.'
Favor to ask of
#DisabilityTwitter
, I am doing some disability equity presentations and would love to photographically represent people of all ages with a wide array of
#disabilities
(visible or not) living their best lives. Please post or DM which would indicate consent to use.
@oni_blackstock
Thank you for saying this. I just posted something similar in response to a retweet. And I tweet
@Bob_Wachter
about it to no avail. Hopefully he will rethink his stance and be more community-minded with his threads. I appreciate your voice so much. Thank you for your advocacy.
@RebeccaCokley
I feel this! Once I had to give an acceptance speech for an award focused on disability from a table top because there wasn't a podium I could use.
@Bob_Wachter
This whole line of reasoning is frankly ill-advised. When you have COVID & know it, you should do whatever you can to keep other people from getting it. That means not flying. No fancy calculations of risk with mask needed. Don't fly when you have COVID. Be a part of the solution
@MVGutierrezMD
@UHC
OMG, that is awful. this could be a
@DGlaucomflecken
skit. Along with the denial of wheels on a wheelchair that I had to do a peer-to-peer for.
@LadyInterlocks
Easy to rattle off the top 3 but this kid really knows here the rubber meets the road by asking for the 4th. And please don't tell the kids but sometimes my answers change so that we can share favorite colors.
I have already completed my 5K for
@UPMC_PMR
hosted by
@F4PMR
#PhysiatryDay
#AAPMR2021
but got out for a quick walk before the plenary and found myself matching the foliage. I love fall colors!
The "you do you" approach is not a public health approach. When you come from a place of health and economic privilege with access to the best health care has to offer, you aren't recognizing the real needs of many and thus don't advocate with their needs in mind.
Ppl in privileged positions are the ones who have large platforms to share their privileged takes.
Things would likely sound very different if the voices of ppl who can’t WFH, w/o health insurance, who don’t have sick leave, who are disabled, immunocompromised, were lifted up.
@copyrightmt
Just to make your blood boil more, I research salary inequities in my field. As with basically all fields, people who identified as women made statistically less than men. A reviewer thought the reason was because women were less capable of computing their salaries so misreported
@COlazagasti
I feel you. It isn't sustainable or acceptable. I often tell the tale of how I had to do a peer to "peer" for wheels for a wheelchair. I wish I was kidding. I think we need more stories in the media about this showing patient harm and more
@DGlaucomflecken
skits.
I'm tired of writing letters to the editor about flawed COVID risk logic. I don't want to even count the number of non-responses (rejections). It seems no one wants to hear (or at least not from me) that just because people have 'moved on' from pandemic doesn't mean it is over.
@RebeccaCokley
When Jennifer Arnold, MD was famous for her show, The Little Couple, people would think that I was her. I wasn't aware of the show for years and couldn't figure out who people thought I was. The fact that we are both pediatricians made folks extra sure that I was her. 🥸
@dysclinic
I literally just recommended not offering up any anxiety or mood issues to a friend who was seeking care for Long-COVID. Symptom attribution to a mental health cause is so much more pronounced for women patients.
@mattbc
@CDCDirector
To focus on the public's health instead relying on personal choice. Encourage her to stop falling victim to right-wing narratives. To let the science lead. To go back to her public health roots of primary prevention. Prioritize those who are vulnerable.
Reading that 19 officers were there & didn't try to help dying children while others begged for it is like a gut punch that takes your breath away. I cannot fathom what the children felt/feel, what their parents felt/feel. Their horror & grief is unknowable.
#BanAssaultWeaponsNow
@JAMA_current
We all have lots to learn. That podcast seemed willfully ignorant and a self-serving/ego driven attempt to claim that you aren't racist. To be anti-racist we need to understand our own roles in perpetuating racial inequities, our own implicit biases and our own racist behaviors.
@ChrisMukasaMD
It is unfortunate that two things being talked about in this thread are often true. That nurses often treat female doctors with less respect than male doctors AND that doctors often treat nurses poorly (and even more poorly if the nurse is a woman and a minority).
@DisabledEliza
Well, my favorite was when a particularly jerky pediatric orthopedic surgeon said to me, his colleague, "what do you have?" And I said, "you're a pediatric orthopedic surgeon, don't you think you should be able to figure it out." The nurse beside me said, "well played."
@POTUS
Also, we need policies that support people realistically taking time off work when ill. The pandemic is far from over. Our death counts are on the rise, our medications working less well, our tests showing false negatives. Your policies make it hard for people to stay safe.
@joshmcgoo
Little one kept rubbing Cheeto dust onto his Chiari incision. We put Cheetomeningitis on the differential and said we'd treat it with Cheetomycin.
@DocWithBowtie
They exist! I think we should be using them all the time when these things happen. 3 to consider: "Procedure not done because of administrative reasons" Z53.8, "Problem with health care specified" Z75.9, and "Inaccessibility of health care due to waiting period" Z75.2
@TheCanuckMD
&: "why don't you just check the blood for all of the diseases?" I am glad people advocate for themselves with doctors but the idea that we are withholding magic scanners & blood tests that could diagnose any/everything makes me incredibly sad. If it was that easy I would.
@ShikhaJainMD
@POTUS
@CDCgov
Agree 100%
@CDCDirector
. Many people seem indifferent to the likelihood that they will pass COVID to others. To address this indifference, a mandate would reduce spread.
For Day 16 (doing this a day early) of
#DisabilityPrideMonth
advocacy I am encouraging
@melanieruthrose
to host an episode of How to Build a Sex Room on
@netflix
for people with disabilities who would benefit from sexy adaptive equipment to optimize their intimate relationships.
Why is the term 'chairman' being used still, even sometimes when a woman is the chair? Just say 'chair' or if you like, 'chairperson'. For example, "I am delighted to introduce the new chair of pediatrics, Dr. So&so." Everyone knows I am referring to a person not an actual chair
@AshleyGWinter
This whole exchange... Doesn't want vaxx blood, gets told to get plasma [from blood] which is exactly what they're trying avoid and also somehow urine [a bodily fluid] is okay regardless of vaxx status?
For day 28 of
#DisabilityPrideMonth
advocacy, I attended an amazing grand rounds about how our health care system structures and reinforces inequities and subsequent poor outcomes. A stark reminder that we need to be anti-racist, anti-classist and anti-ableism in
#MedTwitter
Congratulations to HERL Medical Director Dr. Brad Dicianno on his promotion and elevated title of "Professor and Endowed Research Chair" in the Department of Physical Medicine & Rehabilitation at the University of Pittsburgh!
@mattbc
@PressSec
Ouch, she didn't handle that well at all. We need routine reliable testing for everyone that is easy to obtain and not dependent on someone's ability to pay for it.
My heart hurts for this loss. Judy was an incredible force. May we all honor her memory and legacy by continuing to fight for disability equity and justice.
#DisabilityTwitter
@acweyand
I hope his medical school is doing something about him that we are not privy to. Perhaps residency programs will quickly put him on their do not rank lists.
@paimadhu
Me all the time. And they won't/can't donate. Twice some of my identifying information has been in a security breech. Also, please create a new account for the CME portion and upload your talk to our special portal and despite you telling us not to disseminate it, we still will!
Working on my mentoring framework. This is a model of Ikigai I adapted.
@UPMC_PMR
#MedEd
Feedback appreciated as I am in a growth mindset for mentoring.
@JeromeAdamsMD
it seems that they have delayed the Moderna review for Pfizer to 'catch up.' It doesn't instill confidence. The littles have waited long enough.
@HoutrowMDPhDMPH
has been nominated for Secretary for the
#AAPMR
2021 Board of Governors! Learn more about Dr. Houtrow and the rest of the slate at .
Don't forget to cast your vote at the AAPM&R Business Meeting Nov 13 at 4 pm (CT)!
Baby Yoda encourages you to interact with to read about lessons learned from the pandemic to improve services for children with disabilities
@theNAMedicine
#BlueprintForChange
I am beyond excited to share our manuscript published in Pediatrics
@AmerAcadPeds
which highlights the need for policy action to reverse the rise in underinsurance among US children AND because I am so proud of the amazing work of my mentee Dr. Yu!
People seem to: drastically underestimate their risk of getting
#COVID
; overestimate their implementation of protective measures; choose to disregard the health of others if it inconveniences them; & have forgotten that the health care system is in crisis.
#MaskUp
@CDCgov
This is how ableism is normalized. This is social exclusion at work and everyone there just let it happen. This is how children who are inclusive by nature are taught to discriminate against people with disabilities.
@judithheumann
@USParalympics
Yup! The idea that one person could actually do the tasks of all of the athletes' personal care assistants is ridiculous and unsafe, to say the least. The denial of the accommodation she needs is unjust and unfair.
@CDCDirector
We should also be mourning the CDC's current pandemic policies. We would lose fewer lives if the CDC had maintained its role in promoting the public's health.
@POTUS
Children's hospitals are filled to the brim w/o the necessary staff & supplies they need to provide care to our nation's children. We have a shortage of nebulizer solutions, antibiotics, liquid fever reducers, specialty formulas, rehydration solutions... don't ignore the crisis!
For day 23
#DisabilityPrideMonth
advocacy, I contacted
@SenToomey
's office to support the Affordable Insulin Now Act. Disabled people often have high out of pocket expenses for medications, supplies and equipment contributing to the mutually reenforcing disability poverty cycle
In my virtual hill meeting with Alex, one of
@SpeakerPelosi
's staffers, I managed to keep it professional and not show off my Pelosi action figure as I was advocating for the needs of people with
#LongCovid
@AAPMR
. As a
#PRM
doc, playing with action figures is part of my job.
During her testimony in front of the U.S. Senate Special Committee on Aging,
@UPMC
's Dr. Amy Houtrow described her personal and professional
#COVID19
experience and why the structural problems that make certain members of our communities more vulnerable must be addressed.
It was an incredible honor to give the keynote address at the
@PittSHRS
graduate graduation ceremony. I closed with: "As you embark on your journeys, be bold, be kind, go forth with gratitude and grace. Raise your voice for justice and embrace our interconnectedness."
Our Graduate Ceremony keynote speaker, Amy J. Houtrow, MD, PhD, MPH, is the endowed chair for Pediatric Rehabilitation Medicine at the University of Pittsburgh School of Medicine.
#BoldMovesSHRS
@feministabulous
While doing residency interviews, I walked into the office of one of the interviewing physicians and she startled and said "your application makes you seem so much taller."
@acweyand
Interestingly, anti-vaxx snake oil salesmen are making bank off the same people who are claiming pediatricians vaccinate for the money. They don't want to be believe they've been conned.
Do you ever feel like it is more than just an inconvenience when your flight is canceled/delayed several hours? Why is that happening so much these days? In part b/c folks decided that masking was too much of an inconvenience. We reap what we sow folks.
#CovidIsNotOver
Dear Journals, we know it's difficult to find reviewers, but for sure I will decline if you make the request on Friday and send the automated reminder to accept/decline on Sunday. Managing editors need to fix this. Also, 2 weeks is too little time to review.
#AcademicTwitter